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      Prevalence of attention deficit hyperactivity disorder symptoms in patients with schizophrenia

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          Abstract

          Objective

          To investigate the frequency of childhood and adult attention deficit hyperactivity disorder ( ADHD) symptoms in a cohort of patients with schizophrenia ( SCZ).

          Methods

          A systematic review was conducted to evaluate existing evidence. Two self‐report questionnaires were used to investigate adult ADHD and childhood ADHD symptoms in 126 patients with ICD‐10 diagnoses of SCZ.

          Results

          Five studies were included in the systematic review, with the prevalence of childhood and adult ADHD in SCZ subjects ranging between 17–57% and 10–47% respectively. Within our cohort, 47% of patients reported positive screening for ADHD symptoms either in childhood or adulthood. 23% reported symptomatology consistent with both childhood and adult ADHD.

          Conclusions

          We demonstrate a greater presence of ADHD symptomatology in SCZ compared to that reported for ADHD in the general population. Our findings highlight the importance of improved clinical assessment and treatment considerations in a subgroup of patients with SCZ.

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          Most cited references 51

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          The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration

          Systematic reviews and meta-analyses are essential to summarise evidence relating to efficacy and safety of healthcare interventions accurately and reliably. The clarity and transparency of these reports, however, are not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (quality of reporting of meta-analysis) statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realising these issues, an international group that included experienced authors and methodologists developed PRISMA (preferred reporting items for systematic reviews and meta-analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this explanation and elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA statement, this document, and the associated website (www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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            The worldwide prevalence of ADHD: a systematic review and metaregression analysis.

            The worldwide prevalence estimates of attention deficit hyperactivity disorder (ADHD)/hyperkinetic disorder (HD) are highly heterogeneous. Presently, the reasons for this discrepancy remain poorly understood. The purpose of this study was to determine the possible causes of the varied worldwide estimates of the disorder and to compute its worldwide-pooled prevalence. The authors searched MEDLINE and PsycINFO databases from January 1978 to December 2005 and reviewed textbooks and reference lists of the studies selected. Authors of relevant articles from North America, South America, Europe, Africa, Asia, Oceania, and the Middle East and ADHD/HD experts were contacted. Surveys were included if they reported point prevalence of ADHD/HD for subjects 18 years of age or younger from the general population or schools according to DSM or ICD criteria. The literature search generated 9,105 records, and 303 full-text articles were reviewed. One hundred and two studies comprising 171,756 subjects from all world regions were included. The ADHD/HD worldwide-pooled prevalence was 5.29%. This estimate was associated with significant variability. In the multivariate metaregression model, diagnostic criteria, source of information, requirement of impairment for diagnosis, and geographic origin of the studies were significantly associated with ADHD/HD prevalence rates. Geographic location was associated with significant variability only between estimates from North America and both Africa and the Middle East. No significant differences were found between Europe and North America. Our findings suggest that geographic location plays a limited role in the reasons for the large variability of ADHD/HD prevalence estimates worldwide. Instead, this variability seems to be explained primarily by the methodological characteristics of studies.
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              What are the functional consequences of neurocognitive deficits in schizophrenia?

              It has been well established that schizophrenic patients have neurocognitive deficits, but it is not known how these deficits influence the daily lives of patients. The goal of this review was to determine which, if any, neurocognitive deficits restrict the functioning of schizophrenic patients in the outside world. The author reviewed studies that have evaluated neurocognitive measures as predictors and correlates of functional outcome for schizophrenic patients. The review included 1) studies that have prospectively evaluated specific aspects of neurocognition and community (e.g., social and vocational) functioning (six studies), 2) all known studies of neurocognitive correlates of social problem solving (five studies), and 3) all known studies of neurocognitive correlates and predictors of psychosocial skill acquisition (six studies). Despite wide variation among studies in the selection of neurocognitive measures, some consistencies emerged. The most consistent finding was that verbal memory was associated with all types of functional outcome. Vigilance was related to social problem solving and skill acquisition. Card sorting predicted community functioning but not social problem solving. Negative symptoms were associated with social problem solving but not skill acquisition. Notably, psychotic symptoms were not significantly associated with outcome measures in any of the studies reviewed. Verbal memory and vigilance appear to be necessary for adequate functional outcome. Deficiencies in these areas may prevent patients from attaining optimal adaptation and hence act as "neurocognitive rate-limiting factors." On the basis of this review of the literature, a series of hypotheses are offered for follow-up studies.
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                Author and article information

                Contributors
                izemnur.arican.14@ucl.ac.uk
                Journal
                Acta Psychiatr Scand
                Acta Psychiatr Scand
                10.1111/(ISSN)1600-0447
                ACPS
                Acta Psychiatrica Scandinavica
                John Wiley and Sons Inc. (Hoboken )
                0001-690X
                1600-0447
                13 August 2018
                January 2019
                : 139
                : 1 ( doiID: 10.1111/acps.2019.139.issue-1 )
                : 89-96
                Affiliations
                [ 1 ] Molecular Psychiatry Laboratory Division of Psychiatry University College London London UK
                [ 2 ] Greater Manchester Mental Health NHS Foundation Trust Bolton UK
                Author notes
                [* ] Izemnur Arican, Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, Gower Street, London, WC1E 6BT, UK.

                E‐mail: izemnur.arican.14@ 123456ucl.ac.uk

                Article
                ACPS12948
                10.1111/acps.12948
                6412852
                30105761
                © 2018 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                Counts
                Figures: 0, Tables: 4, Pages: 8, Words: 5822
                Product
                Funding
                Funded by: UCLH
                Funded by: NIHR
                Funded by: BRC
                Funded by: Medical Research Council PhD studentship
                Award ID: MR/K501268‐1
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                acps12948
                January 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.1 mode:remove_FC converted:12.03.2019

                Clinical Psychology & Psychiatry

                cognitive impairment, comorbidity, psychoses, diagnosis, adhd

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