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Fatigue in an adult attention deficit hyperactivity disorder population: A trans-diagnostic approach

hixxy

hixxy

Senior Member
Messages
1,229
Location
Australia
Br J Clin Psychol. 2016 Dec 5. doi: 10.1111/bjc.12119. [Epub ahead of print]

Fatigue in an adult attention deficit hyperactivity disorder population: A trans-diagnostic approach

Rogers DC, Dittner AJ, Rimes KA, Chalder T.

Abstract

OBJECTIVES:
Trans-diagnostic approaches suggest that key cognitive and behavioural processes maintain symptoms across a wide range of mental health disorders. Fatigue is a common clinical feature of attention deficit hyperactivity disorder (ADHD) in adulthood; however, empirical data supporting its prevalence are lacking. This study aimed to collate outcomes from outpatient services to (1) investigate the prevalence of fatigue in adults with ADHD, (2) examine symptoms of ADHD in adults with chronic fatigue syndrome (CFS), and (3) consider secondary clinical characteristics common to both disorder groups.

METHODS:
Measures of self-reported fatigue were compared across groups of adults with ADHD (N = 243), CFS (N = 86), and healthy controls (HC) (N = 211) using a between-subjects cross-sectional design. Groups were also compared on secondary clinical measures of functional impairment, mood, anxiety, sleep, self-efficacy, and their beliefs about the acceptability of expressing emotions.

RESULTS:
The ADHD group were significantly more fatigued than HC with 62% meeting criteria for fatigue caseness. ADHD symptoms were significantly greater in the CFS group than in HC. ADHD and CFS groups did not differ significantly on measures of functional impairment, mood, and self-efficacy. No significant differences were detected on measures of anxiety when items relating to physical restlessness were removed from the analysis.

CONCLUSIONS:
Adults with ADHD experience greater fatigue than HC. Adults with CFS and ADHD share many trans-diagnostic clinical characteristics, including difficulties with low mood, anxiety, and reduced self-efficacy, which impact upon their overall functioning. Further research is required to investigate extraneous factors mediating fatigue severity in these clinical groups.

PRACTITIONER POINTS:
Fatigue is a common clinical feature of attention deficit hyperactivity disorder (ADHD) in adulthood. Evidence-based interventions for chronic fatigue syndrome could be adapted to address fatigue in ADHD in adults.

© 2016 The British Psychological Society.

KEYWORDS:
attention deficit hyperactivity disorder; chronic fatigue; trans-diagnostic

PMID: 27918087
DOI: 10.1111/bjc.12119

https://www.ncbi.nlm.nih.gov/pubmed/27918087
 
M

me/cfs 27931

Guest
Messages
1,294
I was diagnosed with adult ADHD (Predominantly Inattentive Type) for nearly 10 years by 2 different doctors, after short symptom questionnaires. The same two doctors also missed that I had ME/CFS, and were bluntly dismissive of my complaints about worsened neuro/immune symtoms and other intolerable side effects from the prescribed stimulants.

Recent neurocognitive testing shows that I do not, in fact, have adult ADHD (no surprise there). But I do have the usual cognitive deficits associated with ME/CFS: problems with working memory and concentration, slowed processing speed, significant decrease in cognitive performance without frequent breaks, visual processing deficits, etc.

My case, of course, is anecdotal. But I wonder if there isn't a large group of patients with other conditions misdiagnosed with adult ADHD.

It's certainly possible there are more ME/CFS patients misdiagnosed with adult ADHD than actually diagnosed with ME/CFS. After all, roughly 8 out of 9 ME/CFS patients are currently undiagnosed (per IoM report).

I wonder how many in this study have had proper testing to rule out other causes of cognitive dysfunction? I wonder if this adult ADHD study might have a significantly heterogeneous patient cohort, similar to the useless "Oxford Definition" studies in CFS?

More questions than answers, I suppose.
 
mfairma

mfairma

Senior Member
Messages
205
That may be @Webdog. It's an interesting question, though I doubt this study can say anything useful on that subject.

It's amazing how driven they are to insert their tentacles into every little nook and cranny possible. CBT/GET, the universal cure.
 
mfairma

mfairma

Senior Member
Messages
205
drob31 said:
I don't understand ?
Click to expand...

I was being a bit literal. I had just taken out the trash and was thinking about all the waste we create, then logged on to see this. Guess my joke could have been a bit clearer.
 
S

soti

Senior Member
Messages
109
I also had an ADHD diagnosis before the ME/CFS (well, "CFS" :bang-head:) diagnosis. One thing that I think confounds the doctors is that the stimulant drugs tended to help, at least short-term. However, I did much better on things to promote quality of sleep, which confused the poor things. I think it's a good question to see what's happening with ADHD diagnosis in PWME. No confidence in Chalder's ability to figure it out though. It would be a nice avenue for Leonard Jason and his group to study.
 
wastwater

wastwater

Senior Member
Messages
1,271
Location
uk
I think there is an attention deficit in me/cfs I'm not sure if it is ADHD though as I struggle with stimulation from anti depressants and couldn't see myself tolerating stimulants
 
Jonathan Edwards

Jonathan Edwards

"Gibberish"
Messages
5,256
Lying in bed in an adult low back pain population: A trans-diagnostic approach
Rogues D, Ditties A, Rhymes K, Cardigan B.

Abstract

OBJECTIVES:
Trans-diagnostic approaches suggest that key cognitive and behavioural processes maintain symptoms across a wide range of mental health disorders. Lying in bed is a common clinical feature of low back pain disorder (LBPD) in adulthood; however, empirical data supporting its prevalence are lacking. This study aimed to collate outcomes from outpatient services to (1) investigate the prevalence of lying in bed in adults with LBPD, (2) examine symptoms of LBPD in adults with chronic fatigue syndrome (CFS), and (3) consider secondary clinical characteristics common to both disorder groups.

METHODS:
Ask the patients leading questions.

RESULTS:
What we wanted to find.

CONCLUSIONS:
Adults with LBPD experience greater lying in bed than HC. Adults with CFS and LBPD share many trans-diagnostic clinical characteristics, including difficulties with low mood, anxiety, and reduced self-efficacy, which impact upon their overall functioning. Further research is required to investigate extraneous factors mediating lying in bed severity in these clinical groups.

PRACTITIONER POINTS:
Lying in bed is a common clinical feature of low back pain disorder in adulthood. Evidence-based interventions for chronic fatigue syndrome could be adapted to address lying in bed in LBPD in adults.
 
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