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Symptomatological Variants and Related Clinical Features in Adult Attention Deficit Hyperactive Disorder

Author

Listed:
  • Alessandro Pallucchini

    (PISA-School of Experimental and Clinical Psychiatry, 56100 Pisa, Italy)

  • Marco Carli

    (Department of Clinical and Experimental Medicine, School of Clinical Pharmacology, University of Pisa, 56100 Pisa, Italy)

  • Marco Scarselli

    (Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56100 Pisa, Italy)

  • Icro Maremmani

    (Association for the Application of Neuroscientific Knowledge to Social Aims (AU-CNS), 55045 Pietrasanta, Lucca, Italy
    Vincent P. Dole Dual Disorder Unit, 2nd Psychiatric Unit, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy
    G. De Lisio Institute of Behavioral Sciences, 56100 Pisa, Italy
    Saint Camillus International University of Health and Medical Sciences—UniCamillus, 00131 Rome, Italy)

  • Giulio Perugi

    (2nd Psychiatric Unit, Department of Clinical and Experimental Medicine, Santa Chiara University Hospital, University of Pisa, 56100 Pisa, Italy)

Abstract

A large amount of the current literature has focused on the characteristic symptoms of attention deficit hyperactivity disorder (ADHD) in children and adolescents. In contrast, less attention has been devoted to ADHD clinical subtypes in adult patients. We evaluated 164 consecutive adult ADHD (A-ADHD) outpatients using DSM-5 criteria and many specific rating scales and questionnaires. A principal component factor analysis was performed on clinical and symptomatological variables to describe potential clinical variants. We sought to determine different A-ADHD variants focusing on demographic and clinical features. A four-factor solution was identified, and patients were clustered, according to their z-score, in 4 subgroups. The first was marked out by Emotional Dysregulation (ED), the second by Substance Use (SU), the third by Core-ADHD Symptoms (Co-ADHD) and the fourth by Positive Emotionality (PE). Predominantly ED patients showed worse overall function, early treatment with antidepressants and a greater presence of borderline personality disorder than predominantly Co-ADHD patients. Predominantly SU patients reported high rates of bipolar disorder and severe general psychopathology. The PE factor was related to hyperthymic temperament and hypomania and showed a higher level of functioning. Females with A-ADHD showed a lower risk of being included in SU, and A-ADHD patients with co-occurring delayed sleep phase had less risk of being included in the SU factor than the prevailing Co-ADHD group. Our empirically based description of four clinical A-ADHD variants shows several aspects beyond the definition given by the DSM-5 diagnostic criteria.

Suggested Citation

  • Alessandro Pallucchini & Marco Carli & Marco Scarselli & Icro Maremmani & Giulio Perugi, 2021. "Symptomatological Variants and Related Clinical Features in Adult Attention Deficit Hyperactive Disorder," IJERPH, MDPI, vol. 18(3), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:3:p:922-:d:484599
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    References listed on IDEAS

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    1. Vincenza Spera & Alessandro Pallucchini & Marco Maiello & Marco Carli & Angelo G. I. Maremmani & Giulio Perugi & Icro Maremmani, 2020. "Substance Use Disorder in Adult-Attention Deficit Hyperactive Disorder Patients: Patterns of Use and Related Clinical Features," IJERPH, MDPI, vol. 17(10), pages 1-11, May.
    2. Kirby, Kris N. & Marakovic, Nino N., 1995. "Modeling Myopic Decisions: Evidence for Hyperbolic Delay-Discounting within Subjects and Amounts," Organizational Behavior and Human Decision Processes, Elsevier, vol. 64(1), pages 22-30, October.
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    1. Jiaming Wang & Pin-Chao Liao, 2021. "Re-Thinking the Mediating Role of Emotional Valence and Arousal between Personal Factors and Occupational Safety Attention Levels," IJERPH, MDPI, vol. 18(11), pages 1-20, May.

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