Co-occurring symptoms of attention deficit hyperactivity disorder and depression. Sex, aetiology, help-seeking and assessment

Publicerad:2014-04-25

Uppdaterad:2014-08-29

Förmodligen borde fler flickor ha en adhd-diagnos. Det är nämligen vanligt att tjejer som är deprimerade samtidigt har symptom på adhd, men att man missar det. Det visar Karin Sonnbys avhandling.
– Risken att drabbas av depression ökar om man har adhd, och det är särskilt vanligt bland flickor, säger Karin Sonnby.

Författare

Karin Sonnby

Handledare

Kent W Nilsson, professor, Centrum för klinisk forskning, Västerås. Mia Ramklint, docent, Uppsala universitet

Opponent

Hans Ågren, professor emeritus, Göteborgs universitet

Disputerat vid

Uppsala universitet

Disputationsdag

2014-04-11

Titel (eng)

Co-occurring symptoms of attention deficit hyperactivity disorder and depression. Sex, aetiology, help-seeking and assessment

Institution

Institutionen för neurovetenskap, Barn- och ungdomspsykiatri

Abstrakt

Flickor som har ADHD upptäcks i betydligt lägre omfattning jämfört med pojkar som har ADHD. Samtidigt är depression är ett vanligt tillstånd, speciellt bland tonåriga flickor. Både ADHD och depression uppvisar hög samsjuklighet, d.v.s. de förekommer ofta samtidigt med andra psykiatriska tillstånd.

Hypotesen som ligger till grund för avhandlingen är att det bland tonåriga flickor med symtom på depression, finns många som har samtidiga symtom på ADHD. Därför är syftet med avhandlingen att öka kunskapen om samtidiga symtom på ADHD och depression hos ungdomar samt att belysa eventuella könsskillnader, vilket är fokus i de första tre delarbetena.

Co-occurring symptoms of attention deficit hyperactivity disorder and depression. Sex, aetiology, help-seeking and assessment

The general aim of the thesis was to contribute to the knowledge about co-occurring symptoms of ADHD and depression in adolescence, focusing on sex differences, as well as aetiology, help-seeking and assessment.

Studies I–III used epidemiological samples of self-reports from all students in Västmanland aged 15–16 and 17–18 years. Study I investigated the prevalence of co-occurring symptoms of ADHD and depression, as well as associations between co-occurring symptoms of ADHD and depression and one environmental stress factor; experience of sexual abuse. Study II examined associations between one biological factor—a polymorphism in TFAP-2β—and co-occurring symptoms of ADHD with andco-occurringsymptoms of depression. Study III investigated the association between the parent–adolescent relationship and seeking help from specialized mental health services in relation to symptoms of ADHD and/or depression. Study IV was a clinical study among adolescent psychiatric patients that compared self-reported ADHD symptoms via the Adult ADHD Self-Report Scale–Adolescent version (ASRS-A) and the Adult ADHD Self-Report Scale–Adolescent–Screening version (ASRS-A-S) with an ADHD diagnosis determined by the gold-standard method; the Kiddie Schedule of Affective Disorders and Schizophrenia diagnostic interview.

Studies I–III showed that the phenotype of co-occurring symptoms of ADHD and depression is frequent, with a distinct preponderance among girls. Approximately 50% of both boys and girls with co-occurring symptoms of ADHD and depression had also experienced sexual abuse, indicating that this is a group with multiple risk factors for long-term impaired mental health.

Results also support biological sex differences because girls with symptoms of ADHD and a common polymorphism of TFAP-2β (absence of a 9 repeat) reported more symptoms of depression, but boys did not.

Further, only 5% of the adolescents with symptoms of ADHD and/or depression sought help from specialized mental health services. The co-occurrence of symptoms of ADHD and depression was a stronger predictor of help-seeking than all other psychosocial factors investigated, including secure attachment cognitions styles to parents. Among help-seeking girls, co-occurring symptoms of ADHD and depression were more common than symptoms of ADHD without co-occurring symptoms of depression.

The ASRS-A/ASRS-A-S showed promising psychometric properties for further validation in adolescentsresults as a screening tool for use in adolescents.