Attention Deficit/Hyperactivity Disorder in Youth at Clinical Risk for Psychosis: Childhood Functioning, Familial Mental Illness, and Current Symptoms Público
Goines, Katrina (Spring 2018)
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed childhood disorders in those who go on to develop psychosis. Familial risk studies also consistently report high prevalence of ADHD among the family members of individuals with a psychotic disorder. Despite multiple theories attempting to account for the comorbidity between ADHD and psychosis, the meaning of the ADHD-psychosis association remains unclear. The present study investigated potential clinical correlates of ADHD in a sample of youth at clinical high risk (CHR) for psychosis. A CHR group with a previous ADHD diagnosis was compared to a matched CHR group without an ADHD diagnosis in terms of severity of prodromal symptoms, impairments in childhood functioning, and the presence of a family history of mental illness. Due to recent studies indicating that sex may moderate the relation between ADHD and psychosis, exploratory analyses aimed at identifying differential effects of sex were also conducted. All data were gathered during a baseline clinical interview. Results revealed that ADHD was associated with significantly more severe disorganized prodromal symptoms and a trend towards more severe positive symptoms when compared with the non-ADHD group. Additionally, ADHD was associated with significantly more impaired academic functioning that began early in childhood and remained consistently impaired throughout adolescence. ADHD was not associated with more impaired social functioning compared to the CHR non-ADHD group. Finally, ADHD was also associated with a greater family history of mental illness, and exploratory analyses revealed that this effect differed by sex of the participant. Specifically, relatives with psychosis were found to be 6.7 times more common in ADHD females compared to non-ADHD females, and relatives with depression were found to be twice as common in males with ADHD when compared to males without ADHD. Overall, findings provide support for theories of a specific subtype of psychosis characterized by both early symptoms of ADHD and a familial liability for psychosis. Findings also highlight the need for additional investigations into the role of biological sex in ADHD-psychosis relations.
Table of Contents
Introduction…………………………………………………………………………………..1
Defining Risk for Psychosis…………………………………...…………………….....2
ADHD and Risk for Psychosis…………………………......…………………………….3
Models of ADHD/Psychosis Relations...…………………………………....................5
Present Study & Hypotheses……...……………………………………………….….10
Method……………………………………………………………………………………...11
Participants…………………………………...………………………………..….....11
Measures……………………………………………………………………………..12
Procedures...…………………………………………………………………...…….13
Analytic Strategy………………………………………………………………...…..14
Results…………………………………………………………………………………....16
Analysis 1…………………………………………………………………………………..17
Analysis 2……………………………………………………………………………….…..18
Analysis 3…………………………………………………………………………………...20
Discussion……………………………………………………………………...................21
References…………………………………………………………………….......................36
Appendix……………………………………………………….............................................44
Tables ……………..………………………………………….…………...................44
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