Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study.

OBJECTIVE: We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS: We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS: We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS: Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.

Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study

Objective: We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). Methods: We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. Results: We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. Conclusions: Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.

Objetivo: Nuestro objetivo es determinar la prevalencia de trastornos mentales en hermanos de casos con TDAH y cómo los factores de adversidad psicosocial se relacionan con esta psicopatología en un país de ingresos bajos-medios (Colombia). Métodos: Se evaluó a sujetos con TDAH diagnosticado según los criterios del DSM-5, uno de sus padres y uno de sus hermanos (edades, 8-19 anos). Mediante la escala de calificación del TDAH y un conjunto de otros instrumentos se evaluó la presencia de trastornos mentales y adversidad psicosocial. Resultados: Se evaluó a 74 tríos formados por el caso índice con TDAH, un hermano y uno de los padres. Se halló que un 24,3% de los hermanos participantes también cumplían los criterios de TDAH y otro 24,3%, otros trastornos psiquiátricos. El riesgo de que estos hermanos tuvieran TDAH aumentó aún más cuando uno de los padres informó antecedentes de TDAH. También, que el 28,3% de las familias se enfrentaron a altos niveles de adversidad psicosocial según sus puntuaciones en el Índice de Adversidad de Rutter. Conclusiones: Los hermanos de sujetos con TDAH mostraron un significativo riesgo de TDAH y otros trastornos mentales. Ese riesgo aumenta si uno de los padres reporta antecedentes de TDAH y también cuando se presentan 2 o más factores de adversidad psicosocial. Este estudio respalda la importancia de la detección temprana con el fin de disminuir el riesgo para otros hermanos.

Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study.

OBJECTIVE: We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS: We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS: We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS: Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.

Riesgo de trastorno por déficit de atención e hiperactividad y otros trastornos psiquiátricos de los hermanos de pacientes con TDAH / Risk of Attention Deficit/Hyperactivity Disorder (ADHD) and Other Psychiatric Disorders in Siblings of ADHD Probands

RESUMEN Introducción: El trastorno por déficit de atención con hiperactividad (TDAH) ocurre con mayor frecuencia en familiares de primer grado. Se cree que el riesgo no solo es específico de este trastorno, sino también de otras psicopatologías. Estudiar a los hermanos de pacientes con TDAH es un campo interesante porque comparten factores ambientales comunes. Métodos: Revisión narrativa de la literatura. Se realizó una búsqueda bibliográfica en las bases de datos PubMed y PsychNet, y se seleccionaron los artículos relacionados con el tema sin límites de fecha de publicación o diseño. Resultados: Los hermanos de pacientes con TDAH tienen mayor posibilidad de sufrir el mismo trastorno en comparación con controles, con odds ratio que varían entre 11,4 y 13,5. En estos hermanos la prevalencia de TDAH oscila entre el 26 y el 45,2%. Los hermanos con TDAH y aquellos sin TDAH están en mayor riesgo de sufrir otros trastornos, de los que el más frecuente es el trastorno de oposición desafiante (TOD). Conclusiones: Los hermanos de personas con TDAH tienen mayor riesgo de padecer el mismo trastorno. El riesgo de otro trastorno psiquiátrico aumenta marcadamente cuando el hermano también tiene TDAH; esto es aplicable especialmente al TOD, el trastorno por uso de sustancias y el trastorno bipolar.

ABSTRACT Introduction: Attention deficit and hyperactivity disorder (ADHD) occurs more frequently in first-degree relatives. It is believed that this risk is not specific to this disorder but also occurs with other psychopathologies. The study of siblings of ADHD probands is an interesting field since they share common environmental factors. Methods: This is a narrative literature review. A bibliographic search was performed on PubMed and PsychNet databases and topic-related publications were included without date of publication or study design limits. Results: Siblings of patients with ADHD have a higher likelihood of having this disorder when compared to controls, with odds ratios (OR) ranging between 11.4 and 13.5. Among these siblings, ADHD prevalence ranges between 26 and 45.2%. Siblings with ADHD and those without ADHD have an increased risk of having other disorders, the most frequent being oppositional defiant disorder (ODD). Conclusions: Siblings of people with ADHD have an increased risk of having the same disorder. The risk of having another psychiatric disorder markedly increases when the sibling also presents ADHD; this is especially true for ODD, substance use disorder and bipolar disorder.

Risk of Attention Deficit/Hyperactivity Disorder (ADHD) and Other Psychiatric Disorders in Siblings of ADHD Probands. / Riesgo de trastorno por déficit de atención e hiperactividad y otros trastornos psiquiátricos de los hermanos de pacientes con TDAH.

INTRODUCTION: Attention deficit and hyperactivity disorder (ADHD) occurs more frequently in first-degree relatives. It is believed that this risk is not specific to this disorder but also occurs with other psychopathologies. The study of siblings of ADHD probands is an interesting field since they share common environmental factors. METHODS: This is a narrative literature review. A bibliographic search was performed on PubMed and PsychNet databases and topic-related publications were included without date of publication or study design limits. RESULTS: Siblings of patients with ADHD have a higher likelihood of having this disorder when compared to controls, with odds ratios (OR) ranging between 11.4 and 13.5. Among these siblings, ADHD prevalence ranges between 26 and 45.2%. Siblings with ADHD and those without ADHD have an increased risk of having other disorders, the most frequent being oppositional defiant disorder (ODD). CONCLUSIONS: Siblings of people with ADHD have an increased risk of having the same disorder. The risk of having another psychiatric disorder markedly increases when the sibling also presents ADHD; this is especially true for ODD, substance use disorder and bipolar disorder.

Tratamiento farmacológico de la apatía en la enfermedad de Parkinson: revisión sistemática de la literatura / Pharmacological Treatment of Apathy in Parkinson's Disease: a Systematic Review of the Literature

Resumen Introducción y objetivos: La apatía, entendida como un déficit para el inicio y el mantenimiento de la acción, es un síntoma que afecta a los pacientes con diversas enfermedades psiquiátricas y neuropsiquiátricas, como demencias, secuelas de traumatismo craneal, esquizofrenia y depresión y enfermedad de Parkinson (EP). La apatía afecta negativamente a la funcionalidad y la calidad de vida de los pacientes con EP y es fuente importante de estrés del cuidador. El tratamiento farmacológico de la apatía en la EP es el foco de esta revisión sistemática. Métodos: Se realizó una búsqueda con selección sistemática de artículos originales sobre el tratamiento de la apatía en la EP en diferentes bases de datos, se consolidaron los resultados, se realizó lectura crítica de los artículos y se discutieron los hallazgos. Resultados: Se incluyeron 11 estudios. Aunque algunos mostraron eficacia, todos presentaban limitaciones metodológicas importantes, que no permitían considerar que se pueda tomar en cuenta los resultados de dichos ensayos clínicos como evidencia para guiar las decisiones clínicas. Conclusiones: Hasta el momento no se puede ofrecer recomendaciones basadas en la evidencia para el tratamiento farmacológico de la apatía en la EP. Hacen falta estudios con mejor calidad metodológica. Es un área de investigación potencialmente fructífera y muy necesaria para los pacientes con EP y sus familiares.

Abstract Introduction and objectives: Apathy, defined as a deficit for initiating and maintaining action, is a symptom affecting patients with diverse psychiatric and neuropsychiatric diseases, including dementia, sequelae of traumatic brain injury, schizophrenia, depression, and Parkinson's disease (PD). Apathy negatively affects function and quality of life of PD patients, and it is an important cause of caregiver's distress. The pharmacological treatment of apathy in PD is the focus of this systematic review. Methods: A comprehensive search and systematic selection was performed in different databases of original research papers on the treatment of apathy in PD. The results were then consolidated, and a critical analysis was made of the research papers. The results are then discussed according to the methodological standards for systematic reviews of the literature. Results: A total of 11 studies were included. Although some studies showed efficacy, all of them had important methodological limitations that hampered the interpretation of results. The results of the examined studies cannot be considered as evidence for guiding clinical decisions. Conclusions: So far, no evidence-based recommendations can be offered for the treatment of apathy in PD. More studies with better methodological quality are needed. It is a potentially fruitful area for research and one badly needed by both PD patients and their caregivers.

[Pharmacological Treatment of Apathy in Parkinson's Disease: a Systematic Review of the Literature]. / Tratamiento farmacológico de la apatía en la enfermedad de Parkinson: revisión sistemática de la literatura.

INTRODUCTION AND OBJECTIVES: Apathy, defined as a deficit for initiating and maintaining action, is a symptom affecting patients with diverse psychiatric and neuropsychiatric diseases, including dementia, sequelae of traumatic brain injury, schizophrenia, depression, and Parkinson's disease (PD). Apathy negatively affects function and quality of life of PD patients, and it is an important cause of caregiver's distress. The pharmacological treatment of apathy in PD is the focus of this systematic review. METHODS: A comprehensive search and systematic selection was performed in different databases of original research papers on the treatment of apathy in PD. The results were then consolidated, and a critical analysis was made of the research papers. The results are then discussed according to the methodological standards for systematic reviews of the literature. RESULTS: A total of 11 studies were included. Although some studies showed efficacy, all of them had important methodological limitations that hampered the interpretation of results. The results of the examined studies cannot be considered as evidence for guiding clinical decisions. CONCLUSIONS: So far, no evidence-based recommendations can be offered for the treatment of apathy in PD. More studies with better methodological quality are needed. It is a potentially fruitful area for research and one badly needed by both PD patients and their caregivers.