The first-episode psychosis (FEP-ADHD+) reported fewer years of education than the FEP-ADHD− and were more likely to use tobacco and cannabis and to require higher doses of antipsychotics to achieve a clinical response.
The relationship between childhood attention-deficit/hyperactivity disorder (c-ADHD) and psychosis has been understudied. Cognitive dysfunction is a core feature of both disorders, but no previous study has investigated whether first-episode psychosis (FEP) with c-ADHD (FEP-ADHD+) presents a different cognitive profile than FEP without c-ADHD (FEP-ADHD−). One hundred and thirty-three FEP outpatients were screened for c-ADHD through a diagnostic interview and underwent a comprehensive clinical and cognitive assessment with the MATRICS Consensus Cognitive Battery (MCCB). Cognitive differences among FEP groups, and a group of 65 healthy controls (HCs) were analysed by multivariate analysis of covariance. Nearly 25% of FEP fulfilled criteria for c-ADHD. Both FEP groups performed worse than HCs in speed processing, executive function and social cognition, but only the FEP-ADHD+group was significantly more impaired than the HC group in attention (F = 4.35; p = 0.04). Only the Trail Making Test A (TMT-A) (F = 6.99; p = 0.01) within the domain of processing speed and the Neuropsychological Assessment Battery (NAB) (F = 6.46; p = 0.01) within the domain of executive function reliably differentiated the two clinical groups. The FEP groups did not differ in the severity of psychopathology, but the FEP-ADHD+reported fewer years of education than the FEP-ADHD− and were more likely to use tobacco and cannabis and to require higher doses of antipsychotics to achieve a clinical response. In conclusion, we found a gradient of severity in cognitive performance between groups, with FEP-ADHD+ having the greatest cognitive impairment. Our results suggest that FEP-ADHD+ represents a subgroup with a worse prognosis than FEP-ADHD−.
https://www.sciencedirect.com/science/article/abs/pii/S0924977X2030184X?via%3Dihub
El TDAH acentúa los déficits cognitivos si hay un primer episodio psicótico
Un estudio realizado por investigadores del Hospital Universitario (HU) Institut Pere Mata sobre el efecto del trastorno por Déficit de atención e hiperactividad (TDAH) en los síntomas clínicos y cognitivos en sujetos con un primer episodio psicótico (PEP) demuestra que el TDAH “comporta más déficits cognitivos” en los primeros episodios psicóticos.
Según un comunicado de este martes, el 25 por ciento de la muestra con primer episodio psicótico tenía criterios de TDAH de inicio en la infancia; además, presentaba peor rendimiento cognitivo, menor nivel educativo, consumía con más frecuencia cannabis y requería dosis de antipsicóticos más elevadas que los que tenían un primer episodio psicótico sin TDAH.
Para los investigadores, estos resultados “ponen en evidencia que habría un sub-grupo con un peor pronóstico”, lo que abre la puerta a futuros estudios para encontrar intervenciones terapéuticas más individualizadas.
