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J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):336-343. doi: 10.1016/j.jaac.2017.01.016. Epub 2017 Feb 4.

Psychotic Symptoms in Attention-Deficit/Hyperactivity Disorder: An Analysis of the MTA Database.

Author information

1
Division of Child and Adolescent Psychiatry, University of Turin, Turin, Italy. He was with the National Institute of Mental Health (NIMH), Bethesda, MD, when this research was conducted. Electronic address: bvitiell@unito.it.
2
Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
3
Ohio State University, Columbus.
4
Carleton University, Ottawa, ON, Canada.
5
University of California-Irvine.
6
University of Pittsburgh School of Medicine.

Abstract

OBJECTIVE:

To assess the prevalence of psychotic symptoms among youths (14-25 years of age) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type.

METHOD:

Participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed.

RESULTS:

Data were available from 509 MTA participants (88% of original MTA sample; mean age 25.1 years) and 276 LNCG participants (96% of original sample; mean age 24.6 years) at year 16. Twenty-six MTA participants (5%; 95% CI 3-7) and 11 LNCG participants (4%; 95% CI 2-6) screened positive for at least 1 psychotic symptom (p = .60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.1% (95% CI 0.2-2.1) in the MTA group and 0.7% (0-1.7) in the LNCG (p = .72). Greater cannabis use was reported by those who screened positive (p < .05) and were confirmed positive (p < .01).

CONCLUSION:

There was no evidence that ADHD increased the risk for psychotic symptoms. In the ADHD and normative comparison groups, more frequent cannabis use was associated with a greater likelihood of experiencing psychotic symptoms, thus supporting the recommendation that youth should not use cannabis.

KEYWORDS:

attention-deficit/hyperactivity disorder; cannabis; psychosis; screening

PMID:
28335878
PMCID:
PMC5367469
DOI:
10.1016/j.jaac.2017.01.016
[Indexed for MEDLINE]
Free PMC Article

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