title: Emotional dysregulation in adult ADHD and response to atomoxetine.
abstract: BACKGROUND
  Before 1980, attention-deficit/hyperactivity disorder (ADHD) was called minimal brain dysfunction and included emotional symptoms now listed as "associated features" in DSM-IV. Data from two multicenter, placebo-controlled studies with 536 patients were reexamined to assess: 1) the pervasiveness of these symptoms in samples of adults with ADHD; 2) the response of these symptoms to atomoxetine; and 3) their association with depressive/anxiety symptoms.
  
  
  METHODS
  The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) was used to assess temper, affective lability, and emotional overreactivity, thus identifying patients exhibiting "emotional dysregulation." Other DSM-IV Axis I diagnoses were exclusionary. Outcome measures were the Conners' Adult ADHD Rating Scale (CAARS) and the WRAADDS.
  
  
  RESULTS
  Thirty-two percent of the sample met post hoc criteria for emotional dysregulation and had higher baseline scores on ADHD measures, a lower response to placebo, and greater response to atomoxetine (p = .048). Symptoms of emotional dysregulation had a treatment effect (p < .001) at least as large as the CAARS (p = .002) and the total WRAADDS (p = .001). Emotional dysregulation was present in the absence of anxiety or depressive diagnosis.
  
  
  CONCLUSIONS
  Symptoms of emotional dysregulation were present in many patients with ADHD and showed a treatment response similar to other ADHD symptoms.
authors.affiliation: Mood Disorders Clinic, Department of Psychiatry, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA. fred.reimherr@hsc.utah.edu
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Reimherr
authors.forename: Barrie K
authors.initials: BK
authors.lastname: Marchant
authors.forename: Robert E
authors.initials: RE
authors.lastname: Strong
authors.forename: Dawson W
authors.initials: DW
authors.lastname: Hedges
authors.forename: Lenard
authors.initials: L
authors.lastname: Adler
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
authors.forename: Scott A
authors.initials: SA
authors.lastname: West
authors.forename: Poonam
authors.initials: P
authors.lastname: Soni
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D009638:Norepinephrine / Q000378:metabolism; D011437:Propylamines / Q000627:therapeutic use*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride; D009638:Norepinephrine