Clinical Effects of ADHD Subtypes in Patients With Social Anxiety Disorder.

Objective: Our aim in this study is to evaluate the impacts of inattentive and combined types of childhood ADHD (ADHD-I, ADHD-C) in patients with social anxiety disorder (SAD). Methods: A total of 142 adult outpatients with a primary diagnosis of SAD were included. All patients were assessed by using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), ADHD module and a clinical and sociodemographic data form and scales were filled out. Results: Childhood ADHD comorbidity rates was found to be 88 (62%) in patients with SAD, and 63 of these patients had the diagnosis of ADHD-I. ADHD-I group had higher scores of social anxiety and avoidance and had earlier onset of SAD than the ADHD-C group. Conclusion: The inattentive subtype of ADHD may have a more specific relationship with SAD than ADHD-C.

Extended-release methylphenidate monotherapy in patients with comorbid social anxiety disorder and adult attention-deficit/hyperactivity disorder: retrospective case series.

BACKGROUND: The relationship between social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD) is a subject which has recently become a topic of interest for research. METHODS: In this study, 20 patients with comorbid SAD and adult ADHD who were treated with extended-release methylphenidate monotherapy were evaluated retrospectively. RESULTS: Clinical response for both ADHD and SAD symptoms was observed in 17 of 20 patients. Overall, one patient did not respond to treatment and two patients dropped out of treatment at the beginning due to adverse effects. CONCLUSION: Extended-release methylphenidate improved both SAD and ADHD symptoms and was generally well tolerated. Further studies are required to investigate the relationship between SAD and ADHD.

Beneficial Effects of Everolimus on Autism and Attention-Deficit/Hyperactivity Disorder Symptoms in a Group of Patients with Tuberous Sclerosis Complex.

OBJECTIVES: Such neuropsychiatric symptoms as autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), intellectual disability, aggression, and epilepsy are very common in patients with tuberous sclerosis complex (TSC). Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, is a recent and effective treatment for TSC patients with giant cell astrocytomas and renal angiomyolipoma, and it has been shown to have a potential to reduce tumor volume. However, there is a paucity of studies on the effects of everolimus on neuropsychiatric symptoms. The aim of the present study is to describe the effects of everolimus on emotional and behavioral symptoms and refractory epilepsy in a group of patients with TSC. METHODS: Four boys and two girls (median age 16.5; range 7.5-23 years) were included in the study. Information on the clinical and treatment characteristics of the patients was gathered from the medical records. RESULTS: Median everolimus dose was 10 mg/day (range 5-20 mg) and median time for follow-up was 17.5 (range 7-26) months. The drug was well tolerated with mild adverse effects, including stomatitis (three cases), increase in triglycerides and cholesterol (two cases), and constipation (one case). The adverse effects encountered during the course of treatment did not make it necessary to discontinue the drug or decrease its dose. All cases experienced very good to moderate response for controlling epileptic seizures. Besides, improvements in social contact, language, repetitive behavior, inattention, hyperactivity, and depression were observed in some patients. CONCLUSIONS: Everolimus was well tolerated without severe adverse effects. It was helpful in controlling seizures and additional improvements were noted in autistic, ADHD, and depressive symptoms.

Attention deficit and hyperactivity in social anxiety disorder: relationship with trauma history and impulsivity.

The aim of this study is to investigate the rate of childhood traumatic experiences and assess the relationship between childhood trauma and impulsivity in the presence of attention deficit-hyperactivity disorder (ADHD) in patients with social anxiety disorder (SAD). A total of 123 patients with a primary diagnosis of SAD were enrolled. All patients were assessed by using the clinical version of Structured Clinical Interview for DSM-IV (SCID-I/CV) and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime version (K-SADS-PL), ADHD module. A clinical and sociodemographic data form and rating scales were filled out. We found higher rates of emotional traumatic experiences and impulsivity along with more severe symptoms of depression, anxiety and social anxiety in the group of SAD patients with childhood ADHD than in SAD patients without ADHD in childhood. The presence of ADHD is associated with higher severity in several domains in patients with SAD. Patients with SAD should be assessed carefully whether they have ADHD, especially when their SAD symptoms are severe, when they have a history of traumatic experiences or problems with impulse control.

Immune system changes after sexual abuse in adolescents.

BACKGROUND: The immunological changes in diseases such as rheumatoid arthritis and multiple sclerosis have been found to be similar to the immunological changes in adults with post-traumatic stress disorder (PTSD). The biological consequences of and immunological disruptions associated with psychological trauma in sexually abused adolescents were investigated in this study. METHODS: Number of peripheral blood cells, intracellular cytokine level and cytotoxic activity of natural killer cells were measured on routine blood examination samples in adolescents aged 13-18 referred to the outpatient unit for forensic evaluation. Forty-three adolescents (patients with present/lifetime PTSD [PTSD-P/PTSD-L] associated with a history of childhood sexual abuse, n = 33; and 10 controls) were evaluated. RESULTS: Eosinophil percentage was high (P < 0.05), whereas stimulated intracellular interferon-γ was low (P < 0.05) in adolescents with PTSD-L compared with the control group. In PTSD-P patients exposed to repeated sexual abuse, CD3(+) HLA-DR(+) T-lymphocyte count was low (P < 0.05) compared with those with one-time sexual abuse. CONCLUSION: The increase in some immune system parameters and the decrease in several others, suggests a dysregulation of the immune system related to trauma in adolescents. Dysregulation of the immune system is known to cause autoimmune and chronic disease.