Dora S Wynchank1, Denise Bijlenga2, Femke Lamers3, Tannetje I Bron4, Wim H Winthorst5, Suzan W Vogel6, Brenda W Penninx7, Aartjan T Beekman8, J Sandra Kooij9. 1. PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: d.wynchank@psyq.nl. 2. PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: D.Bijlenga@psyq.nl. 3. Department of Psychiatry and EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: f.lamers@ggzingeest.nl. 4. PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: Annet.Bron4@psyq.nl. 5. Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: w.h.winthorst@umcg.nl. 6. PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: S.Vogel@psyq.nl. 7. Department of Psychiatry and EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: B.Penninx@vumc.nl. 8. Department of Psychiatry and EMGO, Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: A.Beekman@ggzingeest.nl. 9. PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands. Electronic address: s.kooij@psyq.nl.
Abstract
OBJECTIVE: We evaluated whether the association between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Seasonal Affective Disorder (SAD) was mediated by the circadian rhythm. METHOD: Data of 2239 persons from the Netherlands Study of Depression and Anxiety (NESDA) were used. Two groups were compared: with clinically significant ADHD symptoms (N = 175) and with No ADHD symptoms (N = 2064). Sleep parameters were sleep-onset and offset times, mid sleep and sleep duration from the Munich Chronotype Questionnaire. We identified the prevalence of probable SAD and subsyndromal SAD using the Seasonal Pattern Assessment Questionnaire (SPAQ). Clinically significant ADHD symptoms were identified by using a T score>65 on the Conners Adult ADHD Rating Scale. RESULTS: The prevalence of probable SAD was estimated at 9.9% in the ADHD group (vs. 3.3% in the No ADHD group) and of probable s-SAD at 12.5% in the ADHD group (vs 4.6% in the No ADHD group). Regression analyses showed consistently significant associations between ADHD symptoms and probable SAD, even after adjustment for current depression and anxiety, age, sex, education, use of antidepressants and benzodiazepines (B = 1.81, p < 0.001). Late self-reported sleep onset was an important mediator in the significant relationship between ADHD symptoms and probable SAD, even after correction for confounders (total model effects: B = 0.14, p ≤ 0.001). CONCLUSION: Both seasonal and circadian rhythm disturbances are significantly associated with ADHD symptoms. Delayed sleep onset time in ADHD may explain the increase in SAD symptoms. Treating patients with SAD for possible ADHD and delayed sleep onset time may reduce symptom severity in these complex patients.
OBJECTIVE: We evaluated whether the association between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) and Seasonal Affective Disorder (SAD) was mediated by the circadian rhythm. METHOD: Data of 2239 persons from the Netherlands Study of Depression and Anxiety (NESDA) were used. Two groups were compared: with clinically significant ADHD symptoms (N = 175) and with No ADHD symptoms (N = 2064). Sleep parameters were sleep-onset and offset times, mid sleep and sleep duration from the Munich Chronotype Questionnaire. We identified the prevalence of probable SAD and subsyndromal SAD using the Seasonal Pattern Assessment Questionnaire (SPAQ). Clinically significant ADHD symptoms were identified by using a T score>65 on the Conners Adult ADHD Rating Scale. RESULTS: The prevalence of probable SAD was estimated at 9.9% in the ADHD group (vs. 3.3% in the No ADHD group) and of probable s-SAD at 12.5% in the ADHD group (vs 4.6% in the No ADHD group). Regression analyses showed consistently significant associations between ADHD symptoms and probable SAD, even after adjustment for current depression and anxiety, age, sex, education, use of antidepressants and benzodiazepines (B = 1.81, p < 0.001). Late self-reported sleep onset was an important mediator in the significant relationship between ADHD symptoms and probable SAD, even after correction for confounders (total model effects: B = 0.14, p ≤ 0.001). CONCLUSION: Both seasonal and circadian rhythm disturbances are significantly associated with ADHD symptoms. Delayed sleep onset time in ADHD may explain the increase in SAD symptoms. Treating patients with SAD for possible ADHD and delayed sleep onset time may reduce symptom severity in these complex patients.
Authors: Dora Wynchank; Margreet Ten Have; Denise Bijlenga; Brenda W Penninx; Aartjan T Beekman; Femke Lamers; Ron de Graaf; J J Sandra Kooij Journal: J Clin Sleep Med Date: 2018-03-15 Impact factor: 4.062
Authors: Jutta S Mayer; Katharina Hees; Juliane Medda; Oliver Grimm; Philip Asherson; Mariano Bellina; Michael Colla; Pol Ibáñez; Elena Koch; Antonio Martinez-Nicolas; Adrià Muntaner-Mas; Anna Rommel; Nanda Rommelse; Saskia de Ruiter; Ulrich W Ebner-Priemer; Meinhard Kieser; Francisco B Ortega; Johannes Thome; Jan K Buitelaar; Jonna Kuntsi; J Antoni Ramos-Quiroga; Andreas Reif; Christine M Freitag Journal: Trials Date: 2018-02-26 Impact factor: 2.279