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Adult ADHD: Genetic factors, evaluation and pharmacological treatment

Adult ADHD: Genetic factors, assessment and drug treatment. [PhD THESIS] College: UAB. Department / Institute: Department of Psychiatry and Legal Medicine. Direction of thesis: Homes Brugué, Miguel; Cormand Rifà, Bru. Defense Date: 07/03/2009

. Summary:

This thesis focuses on the study of attention deficit disorder (ADHD) in adults. We present a total of four papers published in journals with impact factor. The first two genetic factors, the third on the validation of the questionnaire in English ASRS 1.1 of the WHO screening of ADHD in adults and útlimo on pharmacological treatment of ADHD in this population.

The main conclusions are:

1. The results of association studies of case-control population made a total of 19 genes related to the serotonin neurotransmitter system provide evidence for the contribution of genes DDC (aromatic amino acid decarboxylase) and 5HT2A (receiver Serotonin 2A) with ADHD in both adults and children. Furthermore, the effect is specific 5HT2A gene combined clinical subtype. It has also identified association between the gene MAOB (monoamine oxidase B) and ADHD only in adults, suggesting a role in the persistence of the disorder throughout life. 2. Association studies of case-control studies of 10 genes encoding neurotrophins or their receptors allow us to relate the gene CNTFR (ciliary neurotrophic factor receptor) with ADHD in both adults and children. In addition, the results provide evidence for a specific association between childhood ADHD and genes NTF3 (neurotrophin 3) and NTRK2 (neurotrophic tyrosine kinase receptor type 2), suggesting its potential influence changes in ADHD symptoms throughout life.

3. The questionnaire ASRS v1.1 approved by WHO for use in English presents a psychometric properties, justifying its utility as a tool to detect cases of adult ADHD patients in the outpatient clinical setting. The guest ASRS v1.1 optimizes performance to be scored in a range between 0 and 24 and considering a total cutoff of 12 units. (See blog entry explaining how to do http://tdahenadultos.blogspot.com/2011/04/un-test-para-ver-si-podriamos-tener-un.html )

4. Methylphenidate on both LI and OROS formulations is an effective and safe treatment. LI metilenidato change OROS methylphenidate is safe and effective in adults with ADHD. OROS Methylphenidate treatment was associated with improved compliance and effectiveness. Most patients prefer to OROS methylphenidate treatment. For more information see theses Network: http://www.tdr.cesca.es/