for professionals: recent publications

April 20, 2024The diagnostic criteria for ADHD are largely based on studies of young white boys. The symptoms spelled out in the DSM-5 — i.e., Is often “on the go” acting as if “driven by a motor” — do not reflect the lived experiences of many adults with the condition.

March 27, 2024ADHD symptoms in children are associated with unusual interactions between the frontal cortex and deep centers of the brain where information is processed, according to a recent report in the American Journal of Psychiatry.1 These findings may help inform additional research into the ADHD brain that leads to more effective treatments and interventions.A research team from the National Institute of Mental Health (NIMH) and National Human Genome Research found children with ADHD demonstrated heightened connectivity between brain structures involved in learning, movement, and reward, and frontal areas of the brain that regulate emotion, attention, and behavior.“The present findings suggest that these brain alterations are specifically associated with ADHD and are not indicative of general features of childhood psychopathology or influenced by comorbid symptoms,” the study’s authors wrote.Researchers have long suspected that ADHD symptoms result from atypical interactions between the frontal cortex and these deep information-processing brain structures. However, the study’s authors noted that prior studies testing this model returned mixed results, possibly due to the small size of the studies they suggested.The present study examined more than 10,000 functional brain images of 1,696 youth with ADHD and 6,737 without ADHD aged 6 to 18.

February 21, 2024 To what degree are ongoing nationwide ADHD drug shortages worsened by the role of pharmaceutical middlemen? This is the subject of a public inquiry recently launched by the Federal Trade Commission (FTC) and U.S. Department of Health and Human Services (HHS), which issued a joint Request for Information (RFI) on February 14.The public has until April 15 to publicly submit comments at Regulations.gov.The RFI asks patients to submit comments, documents, and data regarding how the practices of two types of pharmaceutical drug intermediaries — group purchasing organizations (GPOs) and drug wholesalers — may contribute to generic drug shortages, including how both entities may influence the pricing and availability of pharmaceutical drugs.“When you’re prescribed an important medication by your doctor, and you learn the drug is out of stock, your heart sinks,” HHS Secretary Xavier Becerra said in a press release.

January 24, 2024ADHD symptoms in children and adolescents are routinely overlooked by general practitioners (GPs), who see these patients more often than they do their neurotypical peers in the two years preceding a diagnosis, according to the journal Archives of Disease in Childhood. With better training in ADHD, GPs could recognize these frequent visits — for everything from asthma and eczema to behavioral disorders — as possible indicators of ADHD and opportunities for early evaluation, say the researchers behind the study.

By Russell Barkley, Ph.D.DSM-5 ADHD criteria are flawed for several reasons. “The DSM-5 does not capture ADHD accurately because its criteria do not conceptualize ADHD as a disorder of executive functioning and self-regulation,” says Russell Barkley, Ph.D.

December 6, 2023Long-term use of ADHD medications may increase the risk of cardiovascular disease (CVD) in children and adults, according to a new study published in JAMA Psychiatry.1 However, ADHD experts caution against changing ADHD treatment based on these findings.“The substantial improvement in ADHD impairments significantly outweighs the study’s risk, which is easily monitored and addressed by the prescribing clinician,” David W. Goodman, M.D., LFAPA, assistant professor in psychiatry and behavioral sciences at the Johns Hopkins School of Medicine, told ADDitude.

November 6, 2023Pediatrics Research has retracted a paper on the effectiveness of using homeopathy to treat ADHD, citing “substantial concerns regarding the validity of the results presented in this article.” 1The original article “Is Homeopathy Effective for Attention Deficit and Hyperactivity Disorder? A Meta-Analysis” reported that “individualized homeopathy showed a clinically relevant and statistically robust effect in the treatment of ADHD.”1 This retraction directly challenges those results and addresses the concerns of critics, who argue that science does not support the use of homeopathy for addressing ADHD symptoms.The journal’s editor-in-chief issued the retraction after a review found four “deficiencies,” including the following:The paper’s retraction comes more than a year after critics first questioned the validity of the studies included in the meta-analysis. Shortly after the paper’s June 2022 publication, Edzard Ernst, M.D., Ph.D., MAE, FMedSci, FRSB, FRCP, FRCPEd, asked the editors of Pediatrics Research to add a caution notice or withdraw the paper.“We conclude that the positive result obtained by the authors is due to a combination of the inclusion of biased trials unsuitable to build evidence together with some major misreporting of study outcomes,” he wrote.In a follow-up letter sent in June 2023, Ernst wrote, “In our comment, we point out that the authors made a lot of errors — to say it mildly.

October 24, 2023Older drivers with ADHD face an elevated risk for receiving traffic tickets, slamming on the breaks, and having car crashes, according to new research published in Jama Network Open. 1Car crashes were 74% more likely, traffic tickets were 102% more likely, and hard-breaking events were 7% more likely among adults aged 65 to 79 with ADHD than they were among neurodivergent drivers of the same age, according to a cohort study lead by researchers at Columbia University Mailman School of Public Health.

September 8, 2023A bi-directional link between attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD) means that 35% to 50% of all adults with ADHD will experience one or more depressive episodes in their lives, according to a new study published in the journal BMJ Mental Health.1 The research, which demonstrates “a familial association and shared genetic risk between ADHD and depression,” also found that patients with ADHD are at elevated risk for post-traumatic stress syndrome (PTSD), anorexia nervosa (AN), and suicide attempts.Observational studies have shown past associations between ADHD and mood and anxiety disorders; however, ADHD’s connections to other mental health conditions have remained somewhat less clear. Using the Mendelian randomization (MR) method, researchers in this study gathered genetic evidence to determine potential links between ADHD and MDD, bipolar disorder, anxiety disorder, schizophrenia, PTSD, AN, and suicide attempts.The MR data and subsequent meta-analyses revealed the following relationships, among others:Other findings showed that ADHD increased the chances of developing PTSD by 18%.

July 22, 2023The ADHD community lost one of its fiercest advocates when Chris A. Ziegler Dendy, M.S., died unexpectedly on July 8, 2023.

January 27, 2023ADHD prescriptions and medication use among 12th grade patients hit an all-time high last year, according to a new study that found 15% of high school seniors reported stimulant or non-stimulant ADHD medication use in 2022 compared to 11% in 2021. The annual Monitoring the Future (MTF) survey published by the National Institute on Drug Abuse (NIDA) attributed this 36% increase in ADHD medication use to “more stress” or attention issues made “more salient to their parents” during the pandemic’s lockdowns and remote learning.1The legal, or medically supervised, use of ADHD medication was “one of the few substances with increasing prevalence during the pandemic,” according to the report, which found that lifetime use had increased for 8th, 10th, and 12th graders in 2022.

January 19, 2023Virtual reality (VR) games may be used to accurately and objectively diagnose ADHD symptoms in children, according to a team of Finland-based researchers. Their newly developed VR game, Executive Performance in Everyday LIving (EPELI), performed better than standard behavioral tests in distinguishing children with ADHD from those without ADHD in a small study of 76 subjects.

January 10, 2023Psychiatrist, ADHD expert, and ADDitude contributor Joseph Biederman, M.D., passed away late last week, just days before he was scheduled to receive a Lifetime Achievement Award from the American Professional Society of ADHD and Related Disorders (APSARD), which he co-founded, honoring his decades of groundbreaking ADHD research and advocacy.Biederman, age 75, served as Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital (MGH), Director of the Alan and Lorraine Bressler Clinical and Research Program for Autism Spectrum Disorders at MGH, and Professor of Psychiatry at Harvard Medical School.Considered the father of pediatric psychopharmacology, Biederman dedicated his career to examining the causes, diagnosis, and ADHD treatment across the lifespan.“He was truly a giant in our field with a brilliant mind and compelling personality,” wrote APSARD president Ann Childress, M.D., on the organization’s website. “As one of the most highly cited child and adolescent psychiatrists in the world, he changed the course of pediatric psychopharmacology.

December 3, 2022Over the years, persistent concerns by clinicians about the safety of ADHD medications have hampered treatment, particularly in middle-aged and older adults. The notion that ADHD stimulants were intrinsically toxic to the cardiovascular system, despite reliable evidence to the contrary, has now been debunked.A new meta-analysis of studies from the last 15 years, involving more than 3.9 million participants, concluded that “ADHD medication use was not statistically significantly associated with the risk of any CVD (cardiovascular disease) among children and adolescents, young and middle-aged adults, older adults, or overall.” The analysis, published in JAMA Network Open, was the most comprehensive to date on the association between ADHD medication and CVD risk.1The study found:[Download: ADHD Medications – Comparison Chart of Stimulants & Nonstimulants]Moreover, there was no increased risk of cardiovascular disease, regardless of the type of CVD the patient had when starting the ADHD stimulant, or that developed while they were taking ADHD medications.