Search Results (1,143)

Mitochondrial dysfunction has been increasingly implicated in the pathobiology of neurodevelopmental conditions, particularly autism and attention-deficit/hyperactivity disorder (ADHD). Because the developing brain is critically dependent on sustained ATP production, impairments in oxidative phosphorylation, mitochondrial dynamics, and redox balance may disrupt neuronal maturation, synaptic development, and neural circuit refinement during sensitive developmental periods. This review examines evidence from postmortem neurochemistry, genomics, magnetic resonance spectroscopy, and biomarker research to characterize mitochondrial impairment across autism and ADHD. Studies in autism report an elevated burden of heteroplasmic mitochondrial DNA (mtDNA) variants, along with alterations in mtDNA copy number, respiratory chain capacity, fission–fusion dynamics, and antioxidant defenses. Postmortem data demonstrate reduced activity of electron transport chain Complexes I, III, and V in the frontal cortex, temporal lobe, and cerebellum. These bioenergetic abnormalities are accompanied by elevated oxidative stress markers alongside mitochondria-mediated immune activation. In vivo neuroimaging corroborates these findings through elevated cerebral lactate and reduced phosphocreatine-to-ATP ratios. Evidence in ADHD is limited, but similarly implicates mitochondrial dysfunction, consistent with the frequent co-occurrence of these conditions and their partially shared architecture. The available literature supports mitochondrial dysfunction as a transdiagnostic biological feature of neurodevelopmental conditions, with relevance to mechanistic biomarker identification and targeted therapeutic development. Full article

Introduction: The significant impact of attention deficit/hyperactivity disorder (ADHD) on health in adult life has been widely recognized. Among the comorbidities of this disorder in later life, dementia is one of the most relevant ones. We performed a systematic review and meta-analysis to explore the impact of previous ADHD diagnosis on dementia risk. Materials and methods: We systematically searched Pubmed, Embase and Scopus for the relevant literature. Cohort and case–control studies were included in our review. Retrieved records were selected by title and abstract and then by full text reading. For quality appraisal, the Newcastle–Ottawa scale was used. A meta-analysis of hazard ratios (HRs) was performed for each type of dementia. Results: Four cohort studies and one case–control study were included, for a total of 3,703,877 and 400 participants, respectively. For all-cause dementia, the pooled HR was 2.52 (95%CI 1.51–4.22, p < 0.001), pointing out a significantly higher hazard in subjects with ADHD. For Alzheimer’s disease, vascular dementia and Lewy body dementia, no meta-analysis was performed due to the low number of available studies. Discussion and conclusions: Our results support a significant association between ADHD and risk of dementia. The results regarding specific types of dementia are more challenging to interpret and could have been influenced by sample size issues. These findings show that ADHD deserves attention in future research on cognitive disorders of the elderly; in particular, more studies are needed to reveal if a true causal relationship links ADHD and dementia. Full article

This scoping review examined the current literature on routines and habits in individuals with attention deficit hyperactivity disorder (ADHD). To our knowledge, research in this area remains limited. Therefore, this review mapped which areas of daily routines are most affected in children and adults with ADHD and explored related assessments and interventions. A comprehensive search was conducted across four databases: PubMed, Scopus, CINAHL, and PsycINFO, using keywords including “attention deficit hyperactivity disorder,” “ADHD,” “routine,” “habit,” and “lifestyle.” The findings identified four main domains in which individuals with ADHD experience difficulties: sleep hygiene, feeding, physical activity, and sedentary behaviors, with sleep hygiene addressed in more than half of the included studies. Study habits were addressed in only one included study. Among the 31 included studies, six involved interventions. The review also found that no validated assessment was specifically designed to measure routines or habits in individuals with ADHD, and that broader measures of routines, habits, or lifestyle were often non-validated or developed for a single project. Overall, the existing studies were concentrated primarily in pediatric populations, with limited research involving adults. These findings highlight important gaps in the literature and underscore the need for more research on routines and habits in adults with ADHD. They also support the development of assessments and interventions that specifically address these areas. Full article

Background/Objectives. This study examined whether exposure to white noise improves reading and writing performance in children with Specific Learning Disorder (SLD), with and without comorbid Attention-Deficit/Hyperactivity Disorder (ADHD). Methods. Thirty children aged 8–13 years (mean age = 9.4) with SLD, 12 of whom also had ADHD, were recruited from the Centro di Riabilitazione San Raffaele Pisana (Rome). Each child completed two standardized reading and writing assessments, four weeks apart, under two auditory conditions (with vs. without white noise) in randomized order. The primary outcomes were reading speed and accuracy, while the secondary outcome was writing accuracy. Results. Among the 26 completers, white noise significantly improved nonword reading speed and accuracy, showed a trend toward improved passage-reading accuracy, and reduced accuracy in nonword writing. Benefits were different in children with SLD + ADHD compared to those with SLD only. Conclusions. These findings indicate task-specific effects of white noise and suggest potential applications for targeted educational interventions. Full article

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition. Growing evidence suggests that the gut–brain axis may contribute to its pathophysiology. However, findings regarding gut microbiota alterations in ADHD remain inconsistent. This systematic review aimed to synthesize the current evidence on the gut microbiota composition and microbial diversity in individuals with ADHD. A systematic search of PubMed, Scopus, and Web of Science was conducted up to 31 December 2025 following PRISMA guidelines, yielding 562 studies. Twenty-three studies published between 2015 and 2025 were included. Most studies reported no significant differences in alpha-diversity in ADHD and control groups. More consistently, beta-diversity analysis reported significant differences in microbial composition between ADHD and control groups. ADHD was often associated with a reduced abundance of Alistipes and butyrate producers such as Faecalibacterium and increased abundance of Roseburia and Agathobacter. Some longitudinal studies suggested that distinct early-life microbial patterns may precede the ADHD diagnosis. ADHD appears to be associated with alterations in the gut microbiota, particularly in taxa involved in short-chain fatty acid production and immune regulation. However, findings remain inconsistent due to methodological heterogeneity and potential confounding factors. Future research should prioritize longitudinal multi-omics approaches to clarify causal mechanisms and refine microbiota-targeted interventions. Full article

Background: Insomnia is common among people with mental health conditions and can exacerbate symptoms, impair functioning and negatively impact treatment outcomes. Community mental health services require practical data to quantify the burden of insomnia in routine care and to identify groups at a higher risk of experiencing clinically significant insomnia. Methods: We conducted a retrospective analysis of anonymized routinely collected clinical data from adult psychiatric outpatients attending the Community Mental Health Center in Bra (Department of Mental Health, Asl Cuneo 2, Italy). Consecutive patients were included over a three-month period (1 September to 30 November 2025). Insomnia severity was assessed using the Insomnia Severity Index (ISI). Diagnoses were established by psychiatrists using the Structured Clinical Interview for DSM-5 (SCID-5). Results: The sample included 506 patients (mean age: 45.1 ± 16.7 years; 265 women, 52.4%). The mean ISI total score was 12.18 ± 6.99. Clinically significant insomnia (ISI ≥ 15) was present in 205 out of 506 patients (40.5%), while severe insomnia (ISI ≥ 22) was present in 55 out of 506 patients (10.9%). The ISI score differed across diagnostic groups (ANOVA, F(8, 497) = 2.82, p = 0.0046, η² = 0.043). Post hoc comparisons revealed higher ISI scores in patients with depressive disorders than in those with anxiety disorders (Tukey, p = 0.0056). In a multivariable logistic regression model (outcome: ISI score of at least 15), adjusted for age, sex, education and the complexity of concurrent psychotropic medication (number of medication classes), depressive disorders were associated with clinically significant insomnia (OR: 1.99; 95% CI: 1.07–3.73). Attention deficit hyperactivity disorder (ADHD) also showed higher odds (OR: 3.64; 95% CI: 1.26–10.55). Medication complexity was also associated with an ISI score of at least 15 (OR: 1.43 per additional class; 95% CI: 1.16–1.77). In a sensitivity model additionally adjusting for benzodiazepine prescription (yes/no), benzodiazepine prescription was associated with ISI ≥ 15 (OR 1.82; 95% CI 1.13–2.95), while the estimate for medication complexity was attenuated using this association (OR 1.17; 95% CI 0.90–1.53). The eating disorders group was excluded from multivariable models due to the very small sample size (n = 4). Conclusions: Clinically significant insomnia was prevalent among this sample of psychiatric outpatients, with modest differences in insomnia severity across diagnostic groups. Sensitivity analyses suggested that the signal of medication complexity may be partly accounted for by benzodiazepine prescribing, supporting the cautious interpretation of medication-related correlates in routine cross-sectional data. These findings support routine insomnia screening in psychiatric outpatient care, while prospective studies are needed to clarify directionality and clinical implications. Full article

Background/Objectives: Children’s mental health and positive development are shaped by family, environmental, and individual factors. Although neurodevelopmental disabilities (NDDs) are well-established correlates of poorer mental health outcomes, few national-scale studies have simultaneously modeled positive (flourishing) and negative (anxiety, depression) outcomes within a unified ecological framework. This study examined how parent mental health, peer victimization, neighborhood and school context, and four NDD diagnoses (autism spectrum disorder [ASD], attention-deficit/hyperactivity disorder [ADHD], developmental delay, and learning disability) are associated with flourishing, current anxiety, and current depression in a national sample of U.S. children aged 6–17 years. Methods: Cross-sectional data from the 2023–2024 National Survey of Children’s Health (NSCH; N = 71,172) restricted to ages 6–17 with complete data (unweighted n = 64,263; weighted population estimate ≈ 44.6 million children) were analyzed using Complex Sample logistic regression (SPSS 30), accounting for stratified design (state × stratum), household clustering, and sampling weights. Three hierarchical models were estimated for each outcome. NDD-stratified subgroup analyses (n = 13,971; weighted ≈ 8.6 million) triangulated moderation findings. Multiple imputation (m = 5) sensitivity analyses confirmed robustness. Results: Weighted prevalence was 60.7% for flourishing, 13.2% for current anxiety, and 5.1% for current depression. In Block 2 models, poorer parent mental health and more frequent bullying victimization were robustly associated with all outcomes (flourishing OR = 0.62 and 0.65; anxiety OR = 1.64 and 1.63; depression OR = 1.95 and 1.75; all p < 0.001). Supportive neighborhood (flourishing OR = 1.40, depression OR = 0.80) and safe school (flourishing OR = 1.20, anxiety OR = 0.87) were protective. ADHD was the strongest disability-specific correlate (flourishing OR = 0.29; anxiety OR = 4.69; depression OR = 4.27). Three of the twelve interaction terms were significant, all involving ADHD. Relative to children without any NDD, subgroup analyses suggested attenuated associations of parent mental health and bullying with anxiety and depression among children with any NDD (e.g., bullying on anxiety: no-NDD aOR = 1.73 vs. Any-NDD 1.52); however, formal interaction tests identified ADHD as the only significant moderator of these associations. On the absolute-risk scale, however, the increase in internalizing problems with more frequent bullying was larger in children with ADHD. Conclusions: Family mental health support and bullying prevention are universally relevant levers for improving children’s mental health and flourishing. Although attenuation of the odds-ratio associations was observed primarily in ADHD-related analyses, specifically for the internalizing outcomes (anxiety and depression), universal anti-bullying and parent mental health interventions remain relevant for children with NDDs, supporting integration into pediatric clinical and public-health programs alongside disability-specific support pathways. Full article

Introduction: Medical care for transgender minors is understudied, largely because these forms of care are relatively recent. The primary objective of this work was to describe the cohort of transgender adolescents who initiated follow-up at the Strasbourg University Hospital before the age of 18, whether or not they began hormone therapy prior to reaching adulthood. Method: This was an observational, retrospective, single-center, descriptive study conducted among adolescents who had attended at least one consultation in our center before the age of 18 between January 2017 and March 2024. Results: Our population consisted of 115 patients predominantly made up of transmasculine (AFAB) adolescents (68%). Compared with the general population, we observed significantly higher rates of psychiatric co-occurrences, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). Only 46.1% initiated gender-affirming hormone therapy (GAHT) in our cohort, and just 34.8% before age 18. A total of 6% of adolescents received puberty blockers as monotherapy. The mean age at GAHT initiation was 16.99 years. Transition pathways appear to differ according to the adolescent’s type of schooling. The rate of retransition/treatment interruption in our sample ranged from 0% to 6.1%, depending on the criteria applied. We did not identify any adolescent who retransitioned to their sex assigned at birth after starting GAHT by the end of the data collection. Discussion: The high prevalence of psychiatric co-occurrences raises important questions regarding how to improve care for these adolescents. The predominance of AFAB adolescents similarly prompts reflection on the barriers that transfeminine adolescents may face when seeking to transition before adulthood. In addition, the substantial number of adolescents presenting with ASD or ADHD underscores the need for particular vigilance regarding their specific needs and overall well-being. Finally, the variability in retransition rates depending on the criteria applied highlights the absence of a consensual definition, which limits the comparability and validity of existing studies. Conclusions: Long-term prospective studies are needed to objectively demonstrate the effectiveness of current transition pathways. Academic research in this field should be strengthened, along with the development of larger prospective datasets, to improve the overall health of this population. Full article

Attention deficit hyperactivity disorder (ADHD), a prevalent neurodevelopmental disorder characterized by inattention, impulsivity, and hyperactivity, is associated with monoaminergic dysfunction, neuronal damage, and gut microbiota disorders. Low molecular weight fucoidan (LMWF) is a sulfated polysaccharide extracted from Saccharina japonica (Phaeophyta), processes antioxidant, anti-inflammatory, and neuroprotective properties, suggesting its potential relevance for ADHD-related pathophysiology. This study investigated the therapeutic effects of LMWF on ADHD-like symptoms in spontaneously hypertensive rats (SHR). Behavioral tests revealed that LMWF reduced hyperactivity and anxiety-related behavior in the open field test, and improved spatial memory in the Morris water maze test. LMWF treatment significantly increased dopamine (DA), norepinephrine (NE), and 5-hydroxyindoleacetic acid (5-HIAA) levels in the prefrontal cortex (PFC). The transcript levels of tyrosine hydroxylase (Th) and synaptosome-associated protein-25 (Snap25) were upregulated, while dopamine transport (Dat) was downregulated in the PFC. TH protein expression was elevated in the striatum (STR), and neuronal integrity was preserved in the STR and cerebellum. LMWF also reshaped gut microbiota composition and enhanced microbial diversity, contributing to improved gut-brain axis homeostasis. These findings suggest that LMWF may serve as a promising dietary intervention for ADHD through neurochemical restoration and microbiota modulation. Full article

Background/Objectives: Executive function (EF) impairments are common in neurodevelopmental disorders but are often examined using group-level approaches that may overlook clinically meaningful cognitive heterogeneity. This study explored EF heterogeneity in children with attention deficit hyperactivity disorder (ADHD), developmental dyslexia, and comorbid presentations using a clinically grounded mixed-method approach. Methods: Standardized neuropsychological data from the NEPSY-II, WISC-IV, and Woodcock–Johnson IV batteries were integrated with a case-based thematic synthesis of 11 clinical evaluations. Semi-inductive analysis was informed by preliminary patterns observed in a larger clinical sample. Results: Three executive function profiles were identified: (1) globally reduced executive functioning, characterized by widespread deficits in inhibition, attention, and working memory; (2) verbal–mnestic executive vulnerability, marked by weaknesses in verbal memory and attention regulation despite relative cognitive strengths; and (3) selective executive control deficit, reflecting impairments in inhibitory control and self-regulation. These profiles revealed clinically meaningful patterns that were not fully captured by categorical diagnostic classifications. Conclusions: The findings support the value of integrated, profile-based approaches for understanding executive function heterogeneity in neurodevelopmental conditions. Such approaches may enhance ecological validity in assessment and contribute to individualized intervention planning. Given the exploratory and case-based nature of the study, the findings should be considered preliminary and hypothesis-generating. Full article

Essential trace elements such as zinc (Zn), iron (Fe), and copper (Cu) play a critical role in neurodevelopment, influencing key processes like neurotransmitter regulation and neuronal signaling. To synthesize the existing evidence, we conducted a systematic review and meta-analysis of case–control studies investigating the associations between these trace elements and Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. A comprehensive literature search was performed up to March 2026 across multiple databases, including Web of Science, PubMed, and the Chinese National Knowledge Infrastructure. A total of 46 studies involving 5515 ADHD cases and 8166 controls were included. The results showed that Zn (SMD = −1.01, 95% CI: −1.51 to −0.52), Fe (SMD = −0.82, 95% CI: −1.52 to −0.11) and Ferritin (SMD = −0.54, 95% CI: −1.00 to −0.27) levels were significantly lower in children with ADHD than in controls, while no significant difference was observed for Cu levels (SMD = −0.55, 95% CI: −1.12 to 0.02). When the research subjects are limited to children ≤12 years old, the differences in Zn are more pronounced. Moreover, the differences in the levels of Zn, Fe, and Cu were more pronounced among children and adolescents from developing countries. These findings suggest that imbalances in Zn and Fe may be involved in the pathogenesis of ADHD. Further research is needed to validate early biomarkers of ADHD risk and to explore their potential application in clinical diagnosis and management, especially considering the high heterogeneity of the studies included in this study. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized as a neurodevelopmental condition shaped by early-life biological and environmental factors. Emerging evidence highlights the role of nutrition in modulating key brain processes involved in ADHD, from gestational development through childhood. This review aims to examine how dietary interventions influence neuroimaging outcomes in individuals with ADHD, assessing whether nutritional approaches can modulate brain structure, function, or connectivity. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted to identify studies examining the effects of dietary interventions on neuroimaging outcomes in individuals with ADHD. Study quality was assessed using Cochrane RoB 2.0, ROBINS-I, the Newcastle–Ottawa Scale, and the JBI Critical Appraisal Checklist, according to study design. Results: A total of 1059 records were identified, and 4 studies met the final inclusion criteria. The included studies suggest that prenatal vitamin D exposure, omega-3 fatty acids, and micronutrients such as zinc may be associated with structural, functional, and neurometabolic brain characteristics relevant to ADHD. Reported findings included associations with brain volume, glutamatergic regulation, white matter organization, resting-state network integrity, and inattentive symptom. Conclusions: Current evidence supports the hypothesis that nutrition may influence neurodevelopmental processes involved in ADHD, including brain maturation and neural network organization. Although findings remain heterogeneous and limited in number, nutrition appears to represent a biologically plausible and potentially modifiable factor within the developmental framework of ADHD. Further longitudinal and multimodal neuroimaging studies are needed to clarify the mechanisms linking nutrition, brain development, and ADHD. Full article

Background: Emotional dysregulation (ED) is increasingly recognized as a clinically relevant dimension of adult attention-deficit/hyperactivity disorder (ADHD), yet its multidimensional structure and independent contribution beyond impulsivity and psychiatric comorbidity remain incompletely understood. This study aimed to characterize the profile of ED and its clinical correlates in a large, well-characterized clinical sample of adults with ADHD. Methods: In this cross-sectional observational study, 231 adults with a DSM-5 diagnosis of ADHD, confirmed through structured interview (DIVA 5), completed the Difficulties in Emotion Regulation Scale (DERS). Associations between ED and ADHD presentation, psychiatric comorbidity, current substance use disorder (SUD), impulsivity (BIS-11), problematic internet use (IAT), camouflaging behaviors (CAT-Q), and clinical functioning were examined using independent-samples t-tests, Pearson correlation analyses, and multiple linear regression models. Results: Participants showed elevated emotional dysregulation relative to reference data. When DERS subscales were interpreted against Italian reference values, the largest elevation was observed for Clarity, followed by Goals, Nonacceptance, and Impulse, whereas Strategies showed a more modest elevation and Awareness was only slightly higher than the reference value. The combined ADHD presentation was associated with significantly greater dysregulation compared to the predominantly inattentive presentation. Higher DERS total scores were observed among participants with combined ADHD presentation, psychiatric comorbidity, and current SUD. DERS total score was positively correlated with current ADHD symptoms, retrospective childhood ADHD symptoms, depressive symptoms, state and trait anxiety, impulsivity, problematic internet use, and camouflaging behaviors, and negatively correlated with ADHD-related quality of life. In multiple regression models, current SUD, current ADHD symptoms, retrospective childhood ADHD symptoms, trait anxiety, and ADHD-related quality of life were independently associated with DERS total score. Conclusions: Emotional dysregulation in adult ADHD represents a clinically relevant affective dimension that is only partially accounted for by impulsivity and is closely associated with psychosocial impairment and maladaptive coping behaviors. These findings support an integrated affective–executive framework for the assessment and treatment of adult ADHD, with implications for targeted, skills-based interventions addressing emotional regulation across clinical subgroups. Full article

Objective: To identify FDA-authorized prescription or clinician-directed digital mental health products, including applications and software-enabled devices, for psychiatric treatment or diagnostic support. Methods: FDA Medical Device Databases were searched for records associated with nine product codes relevant to digital mental health. Eligible records were consolidated into distinct product families. Peer-reviewed literature and FDA documentation were reviewed to characterize indications, authorization pathways, and the quality of supporting evidence. Results: Sixteen digital mental health products and software-enabled devices authorized by the FDA met the inclusion criteria. Twelve products supported treatment for substance use disorders, insomnia, attention-deficit/hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD)-related conditions, major depressive disorder, generalized anxiety disorder, and postpartum depression. Four products provided diagnostic support for ADHD or autism spectrum disorder. Authorization was granted through either 510(k) clearance or De Novo classification, with considerable variation in the quantity, independence, and clinical relevance of supporting evidence. Conclusions: FDA marketing authorization does not uniformly indicate clinical effectiveness. Because 510(k) clearance, De Novo classification, and premarket approval (PMA) reflect distinct regulatory standards, clinicians should interpret digital mental health products in the context of the specific authorization pathway, product indication, and supporting evidence base. Full article

Background: Children with ADHD exhibit deficits not only with attentional control but also with emotional dysregulation and experiential avoidance. Acceptance and Commitment Therapy (ACT) directly targets these processes by enhancing psychological flexibility and reducing maladaptive responses to internal experiences. Functional Near-Infrared Spectroscopy (fNIRS) offers a feasible and reliable method for assessing cortical hemodynamics in the ADHD population due to its portability and robustness to motion. This study aimed to investigate the immediate effects of a single-session ACT intervention on resting-state prefrontal hemodynamic activity in children with ADHD. Methods: Twenty children with ADHD underwent a single session of emotion regulation-focused ACT intervention. Resting-state fNIRS data were acquired immediately before and after the intervention. Changes in oxygenated (HbO) and deoxygenated hemoglobin (HbR) concentrations were statistically compared using paired t-tests. Results: All participants completed the protocol, and fNIRS acquisition was well tolerated. Post-intervention analyses revealed significant hemodynamic alterations after the session, marked by increased HbO at 0–240 s in the right lateral prefrontal cortex. HbO levels after the intervention were associated with SNAP hyperactivity scores. Conclusions: These findings provide preliminary evidence that single-session ACT intervention may be associated with short-term changes in resting hemodynamic activity in children with ADHD. fNIRS may demonstrate utility as a sensitive modality for detecting short-term intervention-related changes in neural activity. Given the exploratory nature of the study, future research with larger, controlled, and longitudinal designs is needed to evaluate the reproducibility of these findings and the clinical relevance of the observed hemodynamic changes. Full article