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Background. We investigated whether adults with attention-deficit/hyperactivity disorder (ADHD) show pseudoneglect—preferential allocation of attention to the left visual field (LVF) and a resulting slowing of mean reaction times (MRTs) in the right visual field (RVF), characteristic of neurotypical (NT) individuals —and whether lateralization of attention is modulated by presentation speed and incentives. Method. Fast Task, a four-choice reaction-time task where stimuli were presented in LVF or RVF, was used to investigate differences in MRT and reaction time variability (RTV) in adults with ADHD (n = 43) and NT adults (n = 46) between a slow/no-incentive and fast/incentive condition. In the lateralization analyses, pseudoneglect was assessed based on MRT, which was calculated separately for the LVF and RVF for each condition and each study participant. Results. Adults with ADHD had overall slower MRT and increased RTV relative to NT. MRT and RTV improved under the fast/incentive condition. Both groups showed RVF-slowing with no between-group or between-conditions differences in RVF-slowing. Conclusion. Adults with ADHD exhibited pseudoneglect, a NT pattern of lateralization of attention, which was not attenuated by presentation speed and incentives.

BackgroundRecent studies point to overlap between neuropsychiatric disorders in symptomatology and genetic aetiology.AimsTo systematically investigate genomics overlap between childhood and adult attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD).MethodAnalysis of whole-genome blood gene expression and genetic risk scores of 318 individuals. Participants included individuals affected with adult ADHD (n = 93), childhood ADHD (n = 17), MDD (n = 63), ASD (n = 51), childhood dual diagnosis of ADHD–ASD (n = 16) and healthy controls (n = 78).ResultsWeighted gene co-expression analysis results reveal disorder-specific signatures for childhood ADHD and MDD, and also highlight two immune-related gene co-expression modules correlating inversely with MDD and adult ADHD disease status. We find no significant relationship between polygenic risk scores and gene expression signatures.ConclusionsOur results reveal disorder overlap and specificity at the genetic and gene expression level. They suggest new pathways contributing to distinct pathophysiology in psychiatric disorders and shed light on potential shared genomic risk factors.

The definitive version is available at : http://www3.interscience.wiley.com/ Copyright Blackwell Publishing [Full text of this article is not available in the UHRA]

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder and symptoms often persist in adult life resulting in significant impairment. ADHD is increasingly recognized as occurring in children and adults with learning disability. ADHD symptoms were found to affect everyday life performance and to increase the impairment imposed by the learning disability, suggesting a double vulnerability and indicating the need for treatment. Although treatment of ADHD in this population has not been tested widely and randomized controlled trials are sparse, there is some evidence that pharmacological treatment can be effective. Thorough assessment of ADHD and comorbid conditions, and appropriate management is warranted.

People with intellectual disability (ID) are more susceptible to mental disorders including mental illness and developmental disorders, such as autism and attention-deficit hyperactivity disorder (ADHD). Identification of such comorbidities is important, as it has implications for diagnosis as well as treatment and prognosis. In this chapter the association between ADHD and ID is explored. The evidence for the validity of the diagnosis of ADHD in ID is reviewed. Subsequently, the assessment and diagnosis of ADHD in the context of ID is discussed. Finally, issues of treatment and management are highlighted.

An Autism Spectrum Disorder (ASD) diagnosis is often used to access services. We investigated whether ASD diagnostic outcome varied when DSM-5 was used compared to ICD-10R and DSM-IV-TR in a clinical sample of 150 intellectually able adults. Of those diagnosed with an ASD using ICD-10R, 56 % met DSM-5 ASD criteria. A further 19 % met DSM-5 (draft) criteria for Social Communication Disorder. Of those diagnosed with Autistic Disorder/Asperger Syndrome on DSM-IV-TR, 78 % met DSM-5 ASD criteria. Sensitivity of DSM-5 was significantly increased by reducing the number of criteria required for a DSM-5 diagnosis, or by rating ‘uncertain’ criteria as ‘present’, without sacrificing specificity. Reduced rates of ASD diagnosis may mean some ASD individuals will be unable to access clinical services.

BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is increasingly recognised as occurring in people with intellectual disability (ID), although treatment of ADHD in this population has not been tested widely. Amfetamine has been used to treat ADHD in people with and without ID, although the evidence for its efficacy in people with ID is unclear. OBJECTIVES To examine the effectiveness of amfetamine for the treatment of attention deficit hyperactivity disorder in people with intellectual disabilities. SEARCH STRATEGY MEDLINE, PsycINFO, EMBASE, AMED, ISI Web of Science and WorldCat Dissertations were searched using an extensive list of synonyms for ADHD and ID. CENTRAL, Current Controlled Trials meta-register (mRCT), CenterWatch, NHS National Research Register, clinicaltrials.gov were searched in August 2007. Pharmaceutical companies and experts in the field were contacted. Reference lists of review articles were examined and citation searches were performed in ISI Web of Knowledge. SELECTION CRITERIA All randomised controlled studies, both published and unpublished, in any language, in which children or adults with ADHD and ID were treated with amfetamine. DATA COLLECTION AND ANALYSIS Data were extracted independently by two reviewers using a standardised extraction sheet. Risk of bias was assessed by two authors using a standardised framework. Meta-analyses were planned but were not performed due to a lack of suitable studies. MAIN RESULTS Only one study was suitable for inclusion. This was a cross-over study in 15 children with ADHD, ID and Fragile X syndrome. Duration of treatment was only one week. No significant difference was reported between amfetamine and placebo for any of the ADHD measures, but significantly more side effects were reported while taking amfetamine, mainly mood lability and irritability. AUTHORS' CONCLUSIONS There is very little evidence for the effectiveness of amfetamine for ADHD in people with ID . Prescribing in this population is based on extrapolation of research in people without ID. More research into effectiveness and tolerability is urgently needed.

There is growing evidence that ADHD is more common inchildren and adults with Learning Disabilities (LD) andthat it can be successfully treated even if diagnosis can bedifficult because of ‘diagnostic overshadowing’. This studyprovides empirical data about the ADHD symptoms in LDand non-LD populations.

Background ADHD is a common childhood onset mental health disorder that persists into adulthood in two-thirds of cases. One of the most prevalent and impairing comorbidities of ADHD in adults are substance use disorders. We estimate rates of ADHD in patients with substance abuse disorders and delineate impairment in the co-morbid group. Method Screening for ADHD followed by a research diagnostic interview in people attending in-patient drug and alcohol detoxification units. Results We estimated prevalence of undiagnosed ADHD within substance use disorder in-patients in South London around 12%. Those individuals with substance use disorders and ADHD had significantly higher self-rated impairments across several domains of daily life; and higher rates of substance abuse and alcohol consumption, suicide attempts, and depression recorded in their case records. Conclusions This study demonstrates the high rates of untreated ADHD within substance use disorder populations and the association of ADHD in such patients with greater levels of impairment. These are likely to be a source of additional impairment to patients and represent an increased burden on clinical services.