The aim was to examine associations of age and gender with ADHD subtypes and subsequently to examine associations of age, gender, and subtypes with comorbid psychiatric disorders.
Odds ratios were calculated and logistic regression performed using information from a clinical sample of 155 ADHD adults referred to a Danish specialized ADHD unit from 2010 to 2011.
A majority of men (65%) was found in the sample. Most patients were subtyped ADHD combined (78%), followed by ADHD inattentive (18%), and ADHD hyperactive-impulsive (4%). No significant differences were found in gender and age across subtypes. Current comorbid disorders were found in 57% of the ADHD patients. Significantly more comorbidity was found in the ADHD combined type and in patients =25 years. Significantly more men had substance use disorders and significantly more women had personality disorders.
When assessing adult ADHD patients' age, gender, subtype, and related comorbid symptom profiles should be taken into account.
Knowledge on psychiatric emergencies in children and adolescents is limited. The Psychiatric Emergency Departments (PED) in Copenhagen enable the acute examination of children and adolescents 24 h a day, 7 days a week. However, very little is known about who presents to the PED, and the reason for their visit.
To describe the prevalence and characteristics of presentations in PED and treatment provided.
A retrospective population based study comprising data of more than 4000 visitors presenting to PED from 2001-2010. In 2003 and 2006, two randomly chosen years, a more thorough analysis was performed, based on the individual emergency charts. Inter-rater reliability was high.
Visits increased nearly threefold during the period. Symptom score for 2003 and 2006 revealed that more than one third of the visitors had suicidal ideation. Depressive and anxiety symptoms together with suicidal ideation rose significantly (P
The study examines the validity and reliability of the Danish version of the Children's Depression Inventory (CDI) in a child psychiatric population. Participants were 149 child psychiatric patients aged 8-13 and their parents. After diagnostic interview with the Kiddie-Schedule for Affective Disorders and Schizophrenia, the children completed the CDI. A subgroup of 44 children repeated the CDI after 2 weeks. The psychometric properties of the Danish CDI were similar to those reported for the English version. CDI is moderately correlated with other measures for depressive disorder, but the instrument is not sufficiently reliable or valid to be used as a single diagnostic or screening measure in a child psychiatric population.
Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive-compulsive disorder that were non-responders to cognitive-behavior therapy: a randomized controlled trial.
Expert guidelines recommend cognitive-behavior therapy (CBT) as a first-line treatment in pediatric obsessive-compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors when CBT is not effective. However, the recommendations for CBT non-responders are not supported by empirical data. Our objective was to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Randomized controlled trial conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7-17 years, with DSM-IV primary OCD were randomized to SRT or continued CBT for 16 weeks. These participants had been classified as non-responders to CBT following 14 weekly sessions. Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS
Cites: J Am Acad Child Adolesc Psychiatry. 2001 Jul;40(7):773-911437015
Cites: J Am Acad Child Adolesc Psychiatry. 2001 Oct;40(10):1175-8111589530
Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. firstname.lastname@example.org.
Anxiety and depression are often co-occurring disorders, reflecting both homotypic and heterotypic continuity as possible developmental pathways. The present study aimed to examine homotypic and heterotypic continuities of anxiety and depression across 3 years in adolescence and young adulthood. Participants included patients presenting to psychiatric care with diagnoses of anxiety and/or depressive disorders aged 13-18 at T1 (N = 717, 44% initial participation rate) and aged 16-21 at T2 (N = 549, 80% follow-up participation rate). McNemar's mid-p test and ordinal proportional odds logistic regression analyses were used to assess changes in prevalence within and across diagnostic categories, respectively. More adolescents had an anxiety disorder (+ 11%), whereas fewer had a depressive disorder (- 11%), at T2 compared to T1. Of adolescents with anxiety and/or depression at T1, only 25% recovered or were non-symptomatic 3 years after referral to a psychiatric clinic. Homotypic continuity was observed for anxiety disorders in general (OR = 2.33), for phobic anxiety disorders (OR = 7.45), and for depressive disorders (OR = 2.15). For heterotypic continuity, depression predicted later anxiety (OR = 1.92), more specifically social anxiety (OR = 2.14) and phobic anxiety disorders (OR = 1.83). In addition, social anxiety predicted later generalized anxiety disorder (OR = 3.11). Heterotypic continuity was thus more common than homotypic continuity. For adolescents presenting with anxiety or depression, treatment should, therefore, target broad internalizing symptom clusters, rather than individual diagnoses. This may contribute to prevent future mental illness, particularly anxiety, in clinical samples.
OBJECTIVE: DSM-IV is the most widely used diagnostic classification system in research, whereas ICD-10 is more widely used clinically. Knowledge of differences is essential when research findings are implemented in daily clinical practice. We examined differences between the two diagnostic systems regarding three major child psychiatric diagnostic categories. METHODS: A total of 199 consecutively referred, child psychiatric patients were interviewed with a semistructured diagnostic interview (K-SADS-PL) including questions covering specific ICD-10-DCR criteria, and diagnosed according to both diagnostic systems. RESULTS: Differences were found regarding the diagnoses major depressive disorder/depressive episode and attention deficit hyperactivity disorder/disturbance of activity and attention. In both cases, more children met DSM-IV-TR criteria than ICD-10-DCR criteria. The diagnosis, oppositional defiant disorder, proved interchangeable between the two diagnostic systems. CONCLUSION: Differences between diagnostic systems must be taken into account when research findings using one diagnostic system are implemented with children diagnosed by another diagnostic system.
No Danish studies examining functional impairments in a naturalistic sample of clinically referred adults with attention-deficit/hyperactivity disorder (ADHD) are available. Our study aimed to examine educational and occupational outcomes and risk-taking behaviour in a Danish clinical sample of adults with ADHD.
Naturalistic, cross-sectional study of 155 ADHD adults consecutively referred to a Danish ADHD clinic from 2010 to 2011.
A total of 51% had primary/lower secondary school only as their highest education, and 65% were not self-supporting at the time of their assessment. Criminal behaviour was found in more than 50%, suspension of driving licence in 16% and risk-taking sexual behaviour in 37-51%. Co-morbidity did not significantly increase the odds for a low educational level or of risk-taking behaviours. Having a personality disorder (PD) increased occupational vulnerability. Male gender and ADHD-C (combined type) were significantly associated with criminality and suspension of driving licence. Patients with substance use disorders and PD had non-significantly increased odds for risk-taking behaviours.
Functional impairments were evident in this Danish sample of adults with ADHD. Most of our findings could not be accounted for by co-morbidity, underlining the importance of targeting treatment at ADHD itself.
This research was funded by The Psychiatric Research Foundation of the Central Denmark Region.