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Original article
DOI: 10.1016/j.rpsmen.2014.08.001
Prevalence of attention deficit/hyperactivity disorder symptoms in outpatient adolescents and young adults with other psychiatric disorders refractory to previous treatments
Prevalencia de síntomas de trastorno por déficit de atención con hiperactividad en adolescentes y adultos jóvenes con otros trastornos psiquiátricos refractarios a tratamientos previos
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Raquel Vidala,b,, Víctor Barraua,, Miguel Casasa,b, María Caballero-Correac, Pedro Martínez-Jiménezc, Josep Antoni Ramos-Quirogaa,b,
Corresponding author
jaramos@vhebron.net

Corresponding author.
a Servicio de Psiquiatría, Hospital Universitari Vall d’Hebron, CIBERSAM, Barcelona, Spain
b Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, Spain
c Departamento Médico, Janssen-Cilag, S.A., Madrid, Spain
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Tables (3)
Table 1. Psychiatric diagnoses in the study population.
Table 2. Drug use in patients with substance use disorders according to the presence or absence of ADHD symptoms.
Table 3. Distribution of patients with total score≥24 in the ADHD rating scale and 6 or more inattention or hyperactivity/impulsivity symptoms according to the primary psychiatric diagnosis.
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Abstract
Introduction

The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments.

Materials and methods

A total of 795 outpatients aged 15–24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18-item DuPaul ADHD Rating Scale.

Results

ADHD (DSM-IV criteria) was present in 48 patients (6%), none of them had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (p=0.007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio=1.543, p=0.01) and borderline personality disorders (odds ratio=2.173, p=0.0001).

Conclusion

Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders.

Keywords:
Attention deficit/hyperactivity disorder
Adolescents
Adults
Comorbidity
Refractory
Resumen
Introducción

El objetivo de este estudio fue evaluar la prevalencia de síntomas de trastorno por déficit de atención con hiperactividad (TDAH) en adolescentes y adultos jóvenes diagnosticados de otros trastornos psiquiátricos primarios que no habían respondido a tratamientos previos.

Material y métodos

Se incluyeron 795 pacientes ambulatorios de 15-24 años. Se estudió la presencia de un TDAH según los criterios DSM-IV y la frecuencia de los síntomas utilizando la escala de valoración del TDAH de DuPaul de 18 ítems.

Resultados

Se objetivó la presencia de un TDAH (criterios DSM-IV) en 48 pacientes (6%), ninguno de los cuales previamente había recibido este diagnóstico. Un total de 260 pacientes (32,7%) presentaron síntomas moderados de TDAH y en ellos la gravedad del trastorno psiquiátrico de base era mayor según la ICG-S (p=0,007). Los factores de riesgo para tener síntomas moderados de TDAH fueron la presencia de trastornos por uso de sustancias (TUS) (odds ratio=1,543; p=0,01) y de trastorno límite de la personalidad (odds ratio =2,173; p=0,0001).

Conclusiones

El TDAH no diagnosticado previamente estaba presente en el 6% de los pacientes, observándose asimismo una elevada frecuencia de síntomas moderados del trastorno (32,7%) en la muestra. Por estos motivos sería recomendable hacer un minucioso estudio del TDAH en los jóvenes refractarios al tratamiento del trastorno primario, principalmente en aquellos con trastornos por uso de sustancias, trastornos de conducta y de personalidad, debido a la elevada comorbilidad entre el TDAH y estos trastornos.

Palabras clave:
Trastorno por déficit de atención con hiperactividad
Adolescentes
Adultos
Comorbilidad
Refractario

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