title: Cortisol responses in children and adults with attention deficit hyperactivity disorder (ADHD): a possible marker of inhibition deficits.
abstract: Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disease whose neurobiological background is not completely understood. It has been proposed that deficits of the inhibitory function with an underactive behavioral inhibition system (BIS) may be in the core of ADHD. In this regard, this review summarizes all studies that examine the involvement of cortisol in ADHD. Differences in cortisol responses from different ADHD subtypes, hyperactive/impulsive, inattentive, and combined, are analyzed. In addition, we examine the role of comorbidities as confounding factors in the study of cortisol in ADHD, including comorbid disruptive behavioral disorder (DBD), as well as anxiety and depressive disorders. Because ADHD is a neurodevelopmental condition and approximately half of the children enter adulthood with the disorder, we review cortisol studies in adults and children separately. Two diverse patterns of cortisol have been reported both in children and adults with ADHD. Blunted cortisol responses to stress are associated with comorbid DBD, whereas high cortisol responses are associated to comorbid anxiety disorders. Nevertheless, the inhibitory deficits in ADHD do not appear to be related directly to cortisol deficits in either children or adults. This review increases our understanding of the heterogeneity of ADHD and could help in determining new strategies for the treatment of these patients. Future studies including gender and a more systematic methodology to study the cortisol response are needed.
authors.affiliation: Department of Psychiatry, Hospital Universitari Vall d'Hebron (UAB), Escola d'Infermeria building 5th floor, Pg. Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain. mcoromin@vhebron.net
authors.forename: M
authors.initials: M
authors.lastname: Corominas
authors.forename: J A
authors.initials: JA
authors.lastname: Ramos-Quiroga
authors.forename: M
authors.initials: M
authors.lastname: Ferrer
authors.forename: N
authors.initials: N
authors.lastname: Sáez-Francàs
authors.forename: G
authors.initials: G
authors.lastname: Palomar
authors.forename: R
authors.initials: R
authors.lastname: Bosch
authors.forename: M
authors.initials: M
authors.lastname: Casas
mesh_terms: D000367:Age Factors; D001008:Anxiety Disorders / Q000150:complications / Q000378:metabolism; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000378:metabolism*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D003866:Depressive Disorder / Q000150:complications / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007266:Inhibition, Psychological; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone