Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
J Affect Disord. 2024 Nov 15;365:417-426. doi: 10.1016/j.jad.2024.08.083. Epub 2024 Aug 16.
Attention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies.
A total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M).
64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI "positive attitude" subscale (B = -0.438, p = 0.024) (R = 0.496, R = 0.246, F(2,66) = 10.747, p < 0.001).
While considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed.
Affective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.
成年人注意力缺陷多动障碍(ADHD)可能由于同时存在精神疾病而经常被漏诊,包括抑郁症状,这可能会导致不适当的治疗。我们的研究旨在对伴有或不伴有抑郁症状的成年 ADHD 患者进行临床特征描述,以确定与特定的情感气质特征和应对策略的关系。
我们回顾性地筛选了自 2019 年 9 月以来连续到我们成人 ADHD 门诊就诊的 225 名门诊患者,以确定其是否符合条件,并对他们进行贝克抑郁量表第二版(BDI-II)、应对方式问卷(COPE-NV)和孟菲斯、比萨、巴黎和圣地亚哥评估的情感气质问卷(TEMPS-M)测试。
64.7%的患者表现出明显的共患抑郁症状。根据多元线性回归模型,抑郁水平与 TEMPS-M 环性亚量表呈正相关(B=0.567,p=0.004),与 COPE-NVI“积极态度”亚量表呈负相关(B=-0.438,p=0.024)(R=0.496,R=0.246,F(2,66)=10.747,p<0.001)。
在考虑结果时,应该注意以下几点:评估仅在基线时进行,我们的样本仅由成年 ADHD 患者组成,且大多数患者没有 ADHD 的先前诊断,ADHD 亚型的发生率存在差异,没有健康对照组以及情绪调节未直接评估。
情感气质特征和应对策略有助于对伴有抑郁症状的成年 ADHD 患者进行临床特征描述和个性化治疗。需要进一步研究来探索在这个 ADHD 亚组中针对特定的心理治疗和药物干预的疗效。