Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults

Tia Sternat,1,2 Kathryn Fotinos,1 Alexa Fine,1 Irvin Epstein,1 Martin A Katzman1–4 1START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; 2Department of Psychology, Adler Graduate Professional School, Toronto, ON, Canada; 3Division of Clinical Sciences, The Northern Ontario Sc...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sternat T, Fotinos K, Fine A, Epstein I, Katzman MA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	anhedonia catecholamine suicide dopamine attention drug response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/c9c0ded7207c469c8fe612e9d0ec8533
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c9c0ded7207c469c8fe612e9d0ec8533
record_format	dspace
spelling	oai:doaj.org-article:c9c0ded7207c469c8fe612e9d0ec85332021-12-02T08:34:56ZLow hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults1178-2021https://doaj.org/article/c9c0ded7207c469c8fe612e9d0ec85332018-09-01T00:00:00Zhttps://www.dovepress.com/low-hedonic-tone-and-attention-deficit-hyperactivity-disorder-risk-fac-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Tia Sternat,1,2 Kathryn Fotinos,1 Alexa Fine,1 Irvin Epstein,1 Martin A Katzman1–4 1START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; 2Department of Psychology, Adler Graduate Professional School, Toronto, ON, Canada; 3Division of Clinical Sciences, The Northern Ontario School of Medicine, Thunder Bay, ON, Canada; 4Department of Psychology, Lakehead University, Thunder Bay, ON, Canada Background: The burdens imposed by treatment-resistant depression (TRD) necessitate the identification of predictive factors that may improve patient treatment and outcomes. Because depression and attention-deficit hyperactivity disorder (ADHD) are frequently comorbid and share a complex relationship, we hypothesized that ADHD may be a predictive factor for the diagnosis of TRD. This exploratory study aimed to determine the percentage of undetected ADHD in those with TRD and evaluate factors associated with treatment resistance and undetected ADHD in depressed patients. Subjects and methods: Adults referred (n=160) for psychiatric consultation completed a structured interview (MINI Plus, Mini International Neuropsychiatric Interview Plus) to assess the presence of psychiatric disorders. Results: TRD was significantly associated with the number of diagnoses (P<0.001), past (P<0.001) and present medications (P<0.001), chronic anhedonia (P=0.013), and suicide ideation (P=0.008). Undetected ADHD was present in 34% of TRD patients. The number of referral diagnoses (P<0.001), failed medications (P=0.002), and past selective serotonin reuptake inhibitor failures (P=0.035) were predictive of undetected ADHD in TRD. Conclusion: Undetected ADHD may be more prevalent among TRD patients than previously thought. In addition, TRD patients are more likely to present with psychiatric comorbidity than non-TRD patients. Screening patients with depression for the presence of ADHD and chronic anhedonia/low hedonic tone may help identify patients with TRD and undetected ADHD and improve treatment outcomes. Keywords: anhedonia, catecholamine, suicide, dopamine, attention, drug responseSternat TFotinos KFine AEpstein IKatzman MADove Medical Pressarticleanhedoniacatecholaminesuicidedopamineattentiondrug responseNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 2379-2387 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	anhedonia catecholamine suicide dopamine attention drug response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	anhedonia catecholamine suicide dopamine attention drug response Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Sternat T Fotinos K Fine A Epstein I Katzman MA Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
description	Tia Sternat,1,2 Kathryn Fotinos,1 Alexa Fine,1 Irvin Epstein,1 Martin A Katzman1–4 1START Clinic for Mood and Anxiety Disorders, Toronto, ON, Canada; 2Department of Psychology, Adler Graduate Professional School, Toronto, ON, Canada; 3Division of Clinical Sciences, The Northern Ontario School of Medicine, Thunder Bay, ON, Canada; 4Department of Psychology, Lakehead University, Thunder Bay, ON, Canada Background: The burdens imposed by treatment-resistant depression (TRD) necessitate the identification of predictive factors that may improve patient treatment and outcomes. Because depression and attention-deficit hyperactivity disorder (ADHD) are frequently comorbid and share a complex relationship, we hypothesized that ADHD may be a predictive factor for the diagnosis of TRD. This exploratory study aimed to determine the percentage of undetected ADHD in those with TRD and evaluate factors associated with treatment resistance and undetected ADHD in depressed patients. Subjects and methods: Adults referred (n=160) for psychiatric consultation completed a structured interview (MINI Plus, Mini International Neuropsychiatric Interview Plus) to assess the presence of psychiatric disorders. Results: TRD was significantly associated with the number of diagnoses (P<0.001), past (P<0.001) and present medications (P<0.001), chronic anhedonia (P=0.013), and suicide ideation (P=0.008). Undetected ADHD was present in 34% of TRD patients. The number of referral diagnoses (P<0.001), failed medications (P=0.002), and past selective serotonin reuptake inhibitor failures (P=0.035) were predictive of undetected ADHD in TRD. Conclusion: Undetected ADHD may be more prevalent among TRD patients than previously thought. In addition, TRD patients are more likely to present with psychiatric comorbidity than non-TRD patients. Screening patients with depression for the presence of ADHD and chronic anhedonia/low hedonic tone may help identify patients with TRD and undetected ADHD and improve treatment outcomes. Keywords: anhedonia, catecholamine, suicide, dopamine, attention, drug response
format	article
author	Sternat T Fotinos K Fine A Epstein I Katzman MA
author_facet	Sternat T Fotinos K Fine A Epstein I Katzman MA
author_sort	Sternat T
title	Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
title_short	Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
title_full	Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
title_fullStr	Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
title_full_unstemmed	Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
title_sort	low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/c9c0ded7207c469c8fe612e9d0ec8533
work_keys_str_mv	AT sternatt lowhedonictoneandattentiondeficithyperactivitydisorderriskfactorsfortreatmentresistanceindepressedadults AT fotinosk lowhedonictoneandattentiondeficithyperactivitydisorderriskfactorsfortreatmentresistanceindepressedadults AT finea lowhedonictoneandattentiondeficithyperactivitydisorderriskfactorsfortreatmentresistanceindepressedadults AT epsteini lowhedonictoneandattentiondeficithyperactivitydisorderriskfactorsfortreatmentresistanceindepressedadults AT katzmanma lowhedonictoneandattentiondeficithyperactivitydisorderriskfactorsfortreatmentresistanceindepressedadults
_version_	1718398458811908096

Low hedonic tone and attention-deficit hyperactivity disorder: risk factors for treatment resistance in depressed adults

Ejemplares similares