High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD.

OBJECTIVE: To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks. METHOD: We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according to their IQ level (IQ ≥ 110-ADHD group with more elevated IQ, and IQ < 110-ADHD group with standard IQ). RESULTS: The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 ( p = .000) and 3 ( p = .000), Trail Making Test (TMT) B ( p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors ( p = .022) and failures to maintain set ( p = .020), Continuous Performance Test (CPT)-omission errors ( p = .005) and commission errors ( p = .000), and Frontal Assessment Battery (FAB)-conceptualization ( p = .016). The ADHD group with more elevated IQ presented only impairments in the CPT-commission errors ( p = .019) when compared with the control group. CONCLUSION: Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a precise clinical diagnosis.

Neurofibromatosis type 1 and attention deficit hyperactivity disorder: a case study and literature review.

BACKGROUND: The cognitive profile of children with neurofibromatosis type 1 (NF1) and attention deficit hyperactivity disorder (ADHD) has been well characterized, but few studies have evaluated the cognitive abilities of adults with NF1 and ADHD. OBJECTIVES: We investigated 1) the cognitive profile of an adult patient with NF1 and inattention problems, 2) changes in his cognition after 14 months of follow-up, and 3) whether the patient exhibited comorbid NF1 and ADHD or secondary ADHD-like symptoms. METHODS: We administered neuropsychological tests of executive function, attention, verbal and visual memory, visuospatial function, and language during two evaluations separated by 14 months. RESULTS: We found no changes in sustained attention, language, or verbal memory. Visual memory, verbal learning, selective attention inhibitory control, and problem solving declined over time, whereas visual search, psychomotor speed, visuospatial function, and mental flexibility improved. CONCLUSION: Our patient exhibited a cognitive profile characteristic of both NF1 and ADHD, leading to the hypothesis that the patient had comorbid ADHD instead of secondary ADHD-like symptoms. More studies are necessary to characterize the cognition of patients with NF1 and ADHD.

Estudo comparativo do desempenho cognitivo de portadores adultos do Transtorno de Déficit de Atenção Hiperatividade (TDAH) associado a Transtorno por Uso de Substâncias Psicoativas (TUSP) e portadores adultos de TDAH sem a presença de TUSP / Comparative study of the cognitive performance in adults with Attention-Deficit Hyperactivity Disorder (ADHD) with Substance Use Disorder (SUD) and a group of adults with ADHD without SUD

Objetivo: O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) e o Transtorno por uso de substancias psicoativas (TUSP) são frequentemente comórbidos. Apesar disso, observa-se que poucos dados foram publicados a respeito do desempenho cognitivo e de impulsividade de adultos TDAH com e sem dependência de cocaína e/ou crack. Este estudo procurou verificar a presença de diferenças cognitivas em funções executivas, memória verbal e em impulsividade em grupos de adultos com TDAH com e sem dependência de cocaína e/ou crack, e se a presença de outras comorbidades psiquiátricas influencia estas diferenças. Desenho: Uma amostra de adultos com TDAH com dependência de cocaína e/ou crack (grupo experimental) e uma amostra de adultos TDAH sem dependência de qualquer substância psicoativa (grupo controle). Métodos: A amostra foi formada por pacientes de ambos os sexos, com idade entre 18 e 60 anos, diagnosticados de acordo com os critérios do DSM-IV. Formaram o grupo experimental adultos com TDAH e dependência de cocaína e/ou crack (TDAH+COC) internados na Associação Promocional Oração e Trabalho (APOT), e nas enfermarias do Hospital Geral de Taipas, e do Programa do Grupo Interdisciplinar de Estudo de Álcool e Drogas (GREA) do Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (IPq- HCFMUSP). O grupo controle foi formado por adultos com TDAH sem dependência de qualquer substância psicoativa atendidos no ambulatório do Programa de Transtorno de Déficit de Atenção e Hiperatividade (PRODATH) do IPq-HCFMUSP. Instrumentos: O desempenho cognitivo foi verificado por: Vocabulário (WASI); Raciocínio Matricial (WASI); Rey Auditory Verbal Learning Test (RAVLT); Torre de Hanói; Memória Lógica (WMS III); FAS; Digit Span (WAIS III); Sequência de Números e Letras (WAIS III); Reading Mind in the Eyes Task; Stroop, Trail Making (partes A e B); Wisconsin Card Sorting Test (WCST), Conner's Continuous Performance Test...

Background: Comorbidity is frequent between attention-deficit/hyperactivity disorder (ADHD) and cocaine dependence. Despite this fact, scarce data have been published with regard to the neuropsychological profile and impulsiveness traits of adult ADHD individuals with and without comorbid cocaine and/or crack dependence. The aim of the present study was to fill this gap in the literature by assessing cognitive differences in executive functions, verbal memory, and impulsiveness in groups of adult ADHD patients with and without cocaine and/or crack dependence, and determining whether the presence of other psychiatric comorbidities influences these differences. Study design: One group of adults with ADHD and comorbid cocaine and/or crack dependence (experimental) and one group of adults with ADHD and no psychoactive substance abuse or dependence (control). Methods: Male and female patients aged 18 and 60 years with a diagnosis of ADHD with or without comorbid cocaine and/or crack dependence by the DSM-IV criteria were recruited for the study. The experimental group (ADHD+COC) consisted of adults with ADHD and comorbid cocaine and/or crack dependence admitted to Associação Promocional Oração e Trabalho (APOT), in the Hospital Geral de Taipas wards, or a ward of the Programa do Grupo Interdisciplinar de Estudo de Álcool e Drogas (GREA) do Instituto de Psiquiatria do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (IPq-HCFMUSP). The control group (ADHD) comprised adults with ADHD without any psychoactive substance dependence; these patients received care at the outpatient clinic of the IPq- HCFMUSP Attention-Deficit/Hyperactivity Disorder Program. Instruments: The patients's neuropsychological performance was assessed using the following measures: Vocabulary and Matrix Reasoning (WASI); Rey Auditory Verbal Learning Test (RAVLT); Tower of Hanoi; Logical Memory (WMS III); FAS; Digit Span (WAIS III); Letter-Number Sequencing...