ADHD prevalence in adult outpatients with nonpsychotic psychiatric illnesses.

OBJECTIVE: The prevalence of ADHD in the general adult population has been estimated to be about 4.4%. However, few studies exist in which the prevalence of ADHD in psychiatric adult outpatient samples has been estimated. These studies suggest that the prevalence is higher than in the general population. The objective of this study is to estimate the prevalence of ADHD in a psychiatric nonpsychotic adult outpatient sample and to compare this data with the prevalence of a group of nonclinical participants. METHOD: The structured clinical interview Mini International Neuropsychiatric Interview (M.I.N.I.-Plus) was applied to 161 consecutive nonpsychotic psychiatric adult outpatients and to 149 healthy participants from the community. In addition, clinical rating scales were applied to measure the severity of general psychopathology such as mania, anxiety, depression, ADHD, and alcohol consumption in both groups. RESULTS: The prevalence of ADHD in psychiatric nonpsychotic adult outpatients was 16.80% and 5.37% in nonclinical participants. In male psychiatric outpatients the prevalence of ADHD was 8.5% and for females was 21.6%. CONCLUSION: This study concludes that a higher prevalence of ADHD exists in psychiatric nonpsychotic adult outpatients compared with nonclinical participants. In the psychiatric adult outpatients, females showed a higher prevalence of ADHD than males. Implications and limitations are discussed.

Persistent decrease in alpha current density in fully remitted subjects with major depressive disorder treated with fluoxetine: A prospective electric tomography study.

Major depressive disorder (MDD) is recurrent, and its pathophysiology is not fully understood. Studies using electric tomography (ET) have identified abnormalities in the current density (CD) of MDD subjects in regions associated with the neurobiology of MDD, such as the anterior cingulate cortex (ACC) and medial orbitofrontal cortex (mOFC). However, little is known regarding the long-term CD changes in MDD subjects who respond to antidepressants. The aim of this study was to compare CD between healthy and MDD subjects who received 1-year open-label treatment with fluoxetine. Thirty-two-channel electroencephalograms (EEGs) were collected from 70 healthy controls and 74 MDD subjects at baseline (pre-treatment), 1 and 2weeks and 1, 2, 6, 9 and 12months. Variable-resolution ET (VARETA) was used to assess the CD between subject groups at each time point. The MDD group exhibited decreased alpha CD (αCD) in the occipital and parietal cortices, ACC, mOFC, thalamus and caudate nucleus at each time point. The αCD abnormalities persisted in the MDD subjects despite their achieving full remission. The low sub-alpha band was different between the healthy and MDD subjects. Differences in the amount of αCD between sexes and treatment outcomes were observed. Lack of a placebo arm and the loss of depressed patients to follow-up were significant limitations. The persistence of the decrease in αCD might suggest that the underlying pathophysiologic mechanisms of MDD are not corrected despite the asymptomatic state of MDD subjects, which could be significant in understanding the highly recurrent nature of MDD.