Search Results (1,423)

Background: Alcohol use and attention-deficit/hyperactivity disorder (ADHD) are prevalent among college students. Individuals with ADHD are at increased risk for developing alcohol use disorder, but mechanisms contributing to this risk are unclear. Subjective alcohol response, or how one experiences the effects of alcohol use, is an important factor that contributes to alcohol consumption. Research suggests that individuals with ADHD, as compared to those without ADHD, may differentially experience the effects of alcohol. Consequently, the purpose of the present study was to examine the association between ADHD symptoms and subjective alcohol response (i.e., subjective effects of alcohol, perceived intoxication, and craving). Methods: Participants (N = 26; 38.5% male, 61.5% female) were college students who completed an in-person alcohol administration session where they received a 0.65 g/kg dose of alcohol. Breath alcohol concentrations and subjective effects of alcohol (feel, like, sedation, and stimulation), perceived intoxication (intoxication and willingness to drive), and craving were assessed at multiple time points throughout the session. ADHD symptoms were assessed at baseline. Results: Area under the curves (AUC) were generated for each participant and each subjective effect, perceived intoxication, and craving. Controlling for typical alcohol use, multiple regressions revealed that higher ADHD symptoms were associated with greater liking the drink, willingness to drive, and craving AUC scores. Conclusions: Individuals with higher ADHD symptoms may experience greater liking and craving during a drinking session. The present findings may also be useful to consider when tailoring intervention and prevention efforts to help reduce risk for college students who report elevated ADHD symptomology. Full article

Purpose: This study examined the relationships among attention-deficit/hyperactivity disorder (ADHD) symptoms, emotion dysregulation, and reflective functioning (RF) in adults. Specifically, it explored whether reflective functioning uncertainty—defined as difficulties in understanding one’s own and others’ mental states—was associated with the relationship between ADHD symptom severity and emotion dysregulation. Methods: In this case–control observational study, 40 adults with ADHD and 40 healthy controls completed the Adult ADHD Self-Report Scale (ASRS), the Difficulties in Emotion Regulation Scale (DERS), and the Reflective Functioning Questionnaire (RFQ). Analyses included group comparisons, correlation analyses, linear regression models, and adjusted mediation analysis. Results: Compared with controls, adults with ADHD showed significantly greater emotion dysregulation and higher reflective functioning uncertainty. ADHD symptom severity was positively associated with both emotion dysregulation and reflective functioning uncertainty. Mediation analysis supported a significant indirect effect, whereas the direct effect was not statistically significant, a pattern consistent with a possible indirect pathway. Conclusions: These findings suggest that difficulties in reflective functioning may be associated with the relationship between ADHD symptoms and emotion dysregulation in adults with ADHD. Assessing emotion dysregulation and reflective functioning may improve the clinical characterization of adult ADHD. Further studies with larger samples, longitudinal designs, and multimethod assessment are needed to clarify the directionality and clinical implications of these relationships. Full article

Background: Anorexia Nervosa (AN) is a severe eating disorder. Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two Neurodevelopmental Disorders (NDDs), frequently co-occurring with each other (ADHD+ASD). The present study aimed to clarify cognitive and behavioral profiles, with a specific focus on emotional regulation, executive functions and empathy, in three groups of female adolescents. Methods: A total of 102 female adolescents aged 12–18 years were recruited. Participants were divided into three groups (AN: n = 30, ADHD: n = 47, ADHD+ASD: n = 25). All participants underwent a psychometric and a multidimensional clinical assessment. Group differences were analyzed through ANOVA with Bonferroni corrections. Results: Adolescents with ADHD+ASD scored significantly higher than the ADHD group in verbal comprehension. The AN group performed significantly better than both the ADHD and ADHD+ASD groups in working memory, and significantly better than the ADHD+ASD group in processing speed. Both the AN and ADHD+ASD groups were characterized by significantly greater impairment in global functioning than the ADHD group. No significant differences were found among the three groups on the Attention Switching, Attention to Detail, and Imagination subscales of the Autism Spectrum Quotient. Behaviorally, AN participants exhibited higher internalizing symptoms (anxiety and depression), the ADHD group presented more prominent externalizing behaviors (aggressive, rule-breaking, and attention problems), and the comorbid ADHD+ASD group demonstrated significantly more pronounced social problems. Most measures used to assess emotional dysregulation did not reveal significant differences among the three groups. Both the ADHD and ADHD+ASD groups showed significantly greater impairment in executive functioning than the AN group. Regarding empathic abilities, mixed results emerged. Conclusions: Findings suggest the coexistence of condition-specific features and shared vulnerabilities in female adolescents with AN, ADHD, and ADHD+ASD. These data underscore the importance of investigating the female phenotype from a transdiagnostic perspective to facilitate early detection and tailored interventions. Full article

This study investigated whether alterations in error monitoring constitute shared risk factors for developmental dyslexia (DD) and attention deficit hyperactivity disorder (ADHD). A total of 148 children were recruited and categorized into four groups, including 37 children with DD only, 37 with ADHD only, 40 with comorbid DD + ADHD, and 34 typically developing (TD) controls. Participants completed a combined Flanker–No-Go task to assess error monitoring, utilizing post-error slowing (PES) and post-error accuracy (PEA) to index error detection and error regulation, respectively. Results of linear mixed-effects models showed a significant main effect of DD_status on PES, indicating that children with DD (including the DD-only and comorbid DD + ADHD groups) exhibited significantly shorter PES than their non-DD counterparts. Conversely, a significant main effect of ADHD_status was observed on PEA, where children with ADHD showed lower PEA relative to those without ADHD. Notably, there were no significant differences in error monitoring functions between children with single disorders and those with comorbidities. Furthermore, hierarchical regression analyses demonstrated that PES independently predicted character recognition, but not ADHD symptom severity. These findings suggest that while both DD and ADHD involve atypical error monitoring, the underlying patterns are dissociable. Specifically, the DD profile tended to align with altered error detection, whereas the ADHD profile was more closely associated with reduced error regulation. Crucially, the comorbid group exhibited a combination of the error monitoring problems observed in DD and ADHD. Full article

Objective: To characterize neurodevelopmental disorders in children and adolescents with Tuberous Sclerosis Complex (TSC) and explore associations with epilepsy onset and cortical tuber burden. Methods: This exploratory cross-sectional study included 18 children and adolescents with TSC followed at a tertiary pediatric neurology center in Brazil. Standardized neuropsychological, behavioral, and neuroimaging assessments were performed. Participants were stratified according to epilepsy onset and cortical tuber burden. Results: Epilepsy was present in 94.4% of participants, and pharmacoresistance in 52.9%. Neurodevelopmental disorders were highly prevalent, particularly autism spectrum disorder and attention-deficit/hyperactivity disorder, frequently occurring as comorbidities. Children with earlier epilepsy onset demonstrated exploratory trends toward poorer cognitive outcomes, whereas greater cortical tuber burden showed exploratory trends toward greater behavioral and emotional dysregulation, although these differences did not reach statistical significance. Conclusions: Neurodevelopmental disorders are highly prevalent in pediatric TSC. Exploratory findings suggest that epilepsy characteristics and lesion burden may be related to cognitive and behavioral outcomes. These exploratory findings support systematic multidisciplinary neurodevelopmental monitoring in children with TSC. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition commonly assessed through clinical interviews, behavioral observation, and rating scales. Although electroencephalography (EEG) has emerged as a promising complementary tool for ADHD assessment, robust, subject-independent classification remains challenging due to inter-subject variability, limited datasets, and the need for interpretable computational models. This work introduces EEG-TACT, a compact end-to-end deep learning architecture for identifying ADHD subjects from EEG epochs. The proposed model integrates an EEGNet-inspired convolutional embedding, a Transformer encoder operator, and an attention-based pooling mechanism. Together, these components capture local spatiotemporal EEG patterns, contextual temporal dependencies, and task-relevant latent representations. EEG-TACT was evaluated on a publicly available EEG dataset using strict, subject-independent stratified group partitions, ensuring no data leakage across subjects in the training, validation, and test subsets. Learned temporal filter responses, class-conditioned self-attention maps, and latent-space projections provide model interpretability. An ablation study quantifies the contribution of each architectural component. Performance analysis includes evaluation at the fold, subject, and epoch levels, together with statistical significance comparisons against representative state-of-the-art architectures. EEG-TACT achieved competitive performance among the contrasted models, reaching subject-level accuracy of 87.5%, recall of 96.0%, and precision of 82.8%, while requiring only a few thousand trainable parameters. By exhaustively repeating the initialization, the proposed model demonstrated improved labeling reliability and achieved the best average ranking among the evaluated architectures. The reported results therefore support evidence that EEG-TACT provides a compact, stable, and interpretable model for EEG-based ADHD identification under subject-independent evaluation settings. They also motivate further validation on larger, multi-site, and medication-controlled datasets. Full article

Using the Hierarchical Taxonomy of Psychopathology (HiTOP) as our framework, the current study examines how 13 common psychological disorders can be grouped into different spectra in two groups of adolescents: a community sample (N = 951), and a clinic-referred sample (N = 173). Scores for the disorders were obtained using the parent version of the Child and Adolescent PsychProfiler. Taken together, the findings across the two samples for factor structure, reliability, and discriminant and concurrent validity indicate the most support for a three-factor CFA oblique model with primary factors for neurodevelopment disorders (that include Specific Learning Disorder, Autism Spectrum Disorder, Language Disorder, and Speech Sound Disorder), internalizing disorder problems (that include Generalized Anxiety Disorder, Persistent Depressive Disorder, Separation Anxiety Disorder, Obsessive–Compulsive Disorder, Posttraumatic Stress Disorder, Anorexia Nervosa, and Bulimia Nervosa), and externalizing disorder problems [(that include Attention Deficit/Hyperactivity Disorder (ADHD), and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD)], with a covariance for the error variance for Anorexia Nervosa and Bulimia Nervosa. Additionally, the analysis for Sample 2 supports the concurrent validity of the factors in this model. A modification of this model, with ADHD cross-loading on the neurodevelopment disorders factor, did not produce an admissible solution. The findings indicate support for a neurodevelopmental spectrum in the HiTOP model, with ADHD and ODD/CD showing stronger statistical association with the externalizing factor than with the neurodevelopmental factor in the models tested. This finding pertains to dimensional structure and does not invalidate the neurodevelopmental classification of ADHD in DSM-5-TR. Full article

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