Mood Stabilizers for Treating Emotional Dysregulation in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) with or Without Comorbid Bipolar Spectrum Disorders

被引:0
|
作者
Brancati, Giulio Emilio [1 ]
De Rosa, Ugo [1 ]
Magnesa, Anna [1 ]
De Dominicis, Francesco [2 ,3 ]
Petrucci, Alessandra [2 ,4 ]
Schiavi, Elisa [5 ]
Medda, Pierpaolo [5 ]
Barbuti, Margherita [1 ]
Perugi, Giulio [1 ,5 ]
机构
[1] Univ Hosp Pisa, Dept Clin & Expt Med, Psychiat Unit 2, Via Roma 67, I-56126 Pisa, Italy
[2] Univ Hosp Pisa, Dept Clin & Expt Med, I-56100 Pisa, Italy
[3] Local Hlth Unit 2, Mental Hlth Ctr, Via San Carlo 2, I-06049 Spoleto, Italy
[4] Local Hlth Unit 2, Mental Hlth Ctr, Viale Trieste 68, I-05100 Terni, Italy
[5] Azienda Osped Univ Pisana, Psychiat Unit 2, Via Roma 67, I-56126 Pisa, Italy
关键词
attention-deficit/hyperactivity disorder; emotional dysregulation; affective instability; bipolar disorder; mood stabilizer; lithium; valproate; lamotrigine; methylphenidate; atomoxetine; DEFICIT-HYPERACTIVITY DISORDER; DOUBLE-BLIND; SELF-REGULATION; ATOMOXETINE; CHILDREN; METHYLPHENIDATE; ADOLESCENTS; IMPAIRMENT; PHARMACOTHERAPY; METAANALYSIS;
D O I
10.3390/brainsci15020182
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Objectives: The treatment of emotional dysregulation (ED) poses a major challenge for clinicians managing adult attention-deficit/hyperactivity disorder (ADHD). This naturalistic longitudinal study aimed to evaluate the effects of combining mood stabilizers (MS) with standard pharmacotherapy in this population. Methods: Fifty-six adult patients with ADHD, with or without bipolar spectrum disorders, who were followed-up for at least 4 months at Pisa University Hospital were included and grouped based on the prescription of ADHD treatment with prior MS, with conomitant MS and without MS. Changes in self-reported ED, self-reported and informant-reported ADHD severity were assessed using RIPoSt-40, ASRS-v1.1, and CAARS-O:SV. Longitudinal analyses were conducted separately for each group using a pairwise one-sample paired Student's t-test. Results: A significant reduction in ED severity was observed in those treated with methylphenidate (MPH) and concomitant MS and in those with atomoxetine (ATX) without MS. Negative emotionality and emotional impulsivity significantly decreased in both these groups, while affective instability only improved in those with MPH and concomitant MS. Self-reported ADHD improvements were significant in all groups receiving MPH, whether with concomitant, prior, or without MS. Significant changes in informant-reported ADHD severity were found in those receiving MPH with concomitant or prior MS. Conclusions: The findings highlight the benefits of concomitant MS and MPH treatment on ED, suggest a preferential effect of ATX on negative emotionality, and confirm the effectiveness of MPH for adult ADHD symptoms, regardless of additional treatment with MS. Further studies are needed to explore whether and how MS and MPH may complement each other in reducing ED.
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页数:14
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