Clinical and functional implications of a history of childhood ADHD in first-episode psychosis.
There is mounting evidence indicating that a childhood history of attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk for psychotic disorders, including schizophrenia. However, the implications of such a history on the symptomatic and functional outcomes of patients with psychotic disorders are still not well documented. This study examined the prevalence of childhood ADHD in patients with first episode psychosis (FEP) consecutively admitted to a specialized early intervention clinic covering a well-defined catchment area, and compared patients with and without a history of childhood ADHD on socio-demographic, clinical, and functional outcomes over a six to twelve months period. Out of 179 patients with FEP, 27 (15%) were treated for ADHD during childhood, consistent with previous literature indicating an association between childhood ADHD and psychosis. FEP patients with childhood history of ADHD had lower academic achievement, earlier onset of psychosis, and higher rates of childhood conduct and learning disorder. While the two groups had similar scores on psychopathology and functioning at baseline, patients with childhood ADHD showed significantly less improvement in positive and negative symptoms, as well as social and occupational functioning. These results strongly indicate that a history of childhood ADHD in FEP is more frequent than that reported in the general population and predictive of poorer clinical response to treatment. This emphasizes the need for actively screening for a history of ADHD in FEP patients and for treatments that are tailored for these patients.
Douglas Mental Health University Institute, Research Institute, Boulevard LaSalle, H4H 1R3 Montreal, QC, Canada. Electronic address: aldanie.rho@douglas.mcgill.ca.
Aldanie
A
Rho
Douglas Mental Health University Institute, Research Institute, Boulevard LaSalle, H4H 1R3 Montreal, QC, Canada; McGill University, Faculty of Medicine, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. Electronic address: alexandru.traicu@mail.mcgill.ca.
Alexandru
A
Traicu
McGill University, Faculty of Medicine, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. Electronic address: martin.lepage@douglas.mcgill.ca.
Martin
M
Lepage
Douglas Mental Health University Institute, Research Institute, Boulevard LaSalle, H4H 1R3 Montreal, QC, Canada; McGill University, Faculty of Medicine, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. Electronic address: srividya.iyer@douglas.mcgill.ca.
Srividya N
SN
Iyer
Douglas Mental Health University Institute, Research Institute, Boulevard LaSalle, H4H 1R3 Montreal, QC, Canada; McGill University, Faculty of Medicine, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. Electronic address: Ashok.malla@douglas.mcgill.ca.
Ashok
A
Malla
Douglas Mental Health University Institute, Research Institute, Boulevard LaSalle, H4H 1R3 Montreal, QC, Canada; McGill University, Faculty of Medicine, Department of Psychiatry, Ludmer Research & Training Building, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada. Electronic address: Ridha.joober@douglas.mcgill.ca.
Ridha
R
Joober
D000328:Adult; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
Attention-deficit hyperactivity disorder (ADHD); First-episode psychosis (FEP); Long-term outcomes; Premorbid functioning; Schizophrenia spectrum disorder (SSD)