Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder

Gift, Thomas E.; Reimherr, Frederick W.; Marchant, Barrie K.; Steans, Tammy A.; Wender, Paul H.

doi:10.1097/nmd.0000000000000470

Cited by 9 publications

(2 citation statements)

References 39 publications

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“…Reports suggest that personality disorders are present in more than 50% of adults with ADHD, most commonly cluster B and C personality disorders, and 25% of individuals have two or more personality disorders [ 100 ]. Importantly, individuals with ADHD and personality disorders have more severe impairment [ 100 ], exhibit lower response rates to methylphenidate treatment compared to adults with ADHD alone [ 101 ], and have poorer persistence on ADHD therapy [ 102 ]. Adults with ADHD and predominant features of emotional dysregulation have a higher incidence of comorbid personality disorders (74%) than do adults with ADHD with predominantly inattentive features (32%) [ 103 ], lending further credence to the conceptualization of ADHD as a dimensional disorder that occurs along a spectrum of clinical presentations and severity.…”

Section: Main Textmentioning

confidence: 99%

Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

et al. 2017

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Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management.The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.

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Section: Main Textmentioning

confidence: 99%

Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

et al. 2017

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“…Personality disorders, mainly those of cluster B and C, are estimated to be present in more than 50% of adults with ADHD [22], leading to greater impairment and lower response to treatment [23].…”

Section: Introductionmentioning

confidence: 99%

The Characteristics of Mood Polarity, Temperament, and Suicide Risk in Adult ADHD

Giupponi

Innamorati

Rogante

et al. 2020

IJERPH

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The present study was designed to shed light on a topic rarely explored and to suggest possible ways to detect risk factors for the presence of suicidal ideation and behaviors in a sample of adult patients with Attention-Deficit Hyperactivity Disorder (ADHD). This study also explored the association between ADHD, affective temperaments, the presence of hypomania symptoms, and suicide risk. We hypothesized that (compared to healthy controls) (1) patients with adult ADHD would report more negative affective temperaments and more hypomania symptoms and (2) that they would have a higher suicide risk. The participants included 63 consecutive adult inpatients (18 women, 45 men) with ADHD and 69 healthy controls (42 women, 22 men). All participants were administered the Wender Utah Rating Scale (WURS), the Hypomania Check-List-32 (HCL-32), the Mood Disorder Questionnaire (MDQ), the Temperament Evaluation for Memphis, Pisa, Paris, and San Diego (TEMPS-A), and the Columbia-Suicide Severity Rating Scale (C-SSRS). Forty-six percent of the ADHD patients had an Axis 1 comorbid disorder. ADHD patients (compared to controls) more often reported suicidal ideation (46.0% vs. 5.9%, one-way Fisher exact test p < 0.001; phi = 0.46). ADHD patients and the controls also significantly differed in all the scales administered (with Cohen’s d between 0.92–4.70), except for the TEMPS-A Hyperthymia scale. A regression model indicated that ADHD was independently associated with higher scores of a negative temperaments/hypomania factor (Odd Ratio = 14.60) but not with suicidal ideation. A high incidence of suicidal ideation, comorbid psychiatric disorders, and negative affective temperaments was reported in adult ADHD patients, and clinicians should routinely assess risk factors for suicide among these patients.

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ADHD and Anxiety: Clinical Significance and Treatment Implications

Reimherr

Marchant

Gift

et al. 2017

Curr Psychiatry Rep

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In comparison to the DSM formulation of ADHD, we have proposed that ADHD in adults should be divided into Inattentive and Emotional Dysregulation Presentations. Under both systems, there is potential overlap with generalized anxiety disorder (GAD). We compared data from four distinct populations: ADHD clinical trials, GAD clinical trials, an ADHD clinic, and a forensic clinic. Approximately 25% of patients in each population had comorbid ADHD and anxiety. Comorbid subjects reported more childhood ADHD symptoms and higher scores on ADHD scales and were more likely to fit criteria for ADHD Emotional Dysregulation Presentation or DSM-IV combined type. Comorbid subjects did not drop out at a higher rate and showed significant drug-placebo differences on ADHD symptoms, including Emotional Dysregulation. Conversely, although symptoms of anxiety decreased, there was no drug-placebo difference in improvement.

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Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder

Cited by 9 publications

References 39 publications

Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

The Characteristics of Mood Polarity, Temperament, and Suicide Risk in Adult ADHD

ADHD and Anxiety: Clinical Significance and Treatment Implications

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