{"title":"ADHD, substance use disorders and stimulant treatment: understanding the relationships.","authors":"Jeffrey H Newcorn","doi":"10.1002/wps.21348","DOIUrl":"https://doi.org/10.1002/wps.21348","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"45 1","pages":"377-378"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuele Cortese,Mark A Bellgrove,Isabell Brikell,Barbara Franke,David W Goodman,Catharina A Hartman,Henrik Larsson,Frances R Levin,Edoardo G Ostinelli,Valeria Parlatini,Josep A Ramos-Quiroga,Margaret H Sibley,Anneka Tomlinson,Timothy E Wilens,Ian C K Wong,Nina Hovén,Jeremy Didier,Christoph U Correll,Luis A Rohde,Stephen V Faraone
{"title":"Attention-deficit/hyperactivity disorder (ADHD) in adults: evidence base, uncertainties and controversies.","authors":"Samuele Cortese,Mark A Bellgrove,Isabell Brikell,Barbara Franke,David W Goodman,Catharina A Hartman,Henrik Larsson,Frances R Levin,Edoardo G Ostinelli,Valeria Parlatini,Josep A Ramos-Quiroga,Margaret H Sibley,Anneka Tomlinson,Timothy E Wilens,Ian C K Wong,Nina Hovén,Jeremy Didier,Christoph U Correll,Luis A Rohde,Stephen V Faraone","doi":"10.1002/wps.21374","DOIUrl":"https://doi.org/10.1002/wps.21374","url":null,"abstract":"Attention-deficit/hyperactivity disorder (ADHD) was once thought to be solely a childhood condition. Now it is well established that it can persist into adulthood, with an estimated worldwide prevalence of around 2.5%. Additionally, up to 70% of individuals with childhood-onset ADHD continue to experience impairing symptoms as adults, even if they no longer meet the criteria for a formal diagnosis. The validity of adult ADHD initially faced strong criticism. Today, empirical research supports its descriptive validity (identifying characteristic signs and symptoms), predictive validity (concerning specific outcomes, courses, and responses to treatment), and concurrent validity (evidence related to its underlying causes and biological mechanisms). Despite this progress, unresolved questions and ongoing debates about adult ADHD persist. This paper summarizes current empirical evidence, alongside uncertainties and controversies, regarding the definition, epidemiology, diagnosis, etiology, neurobiology, and management of ADHD in adults. Crucially, we also include perspectives from individuals with lived experience of this condition, highlighting their views on unmet needs and priorities for improving care. Key uncertainties and controversies on adult ADHD include: a) the possibility of late-onset ADHD; b) the significance of emotional dysregulation as a core symptom; c) the definition and characterization of functional impairment; d) the persistence of comorbid psychiatric and somatic conditions after accounting for confounders; e) the relevance of executive dysfunction in the definition of the condition; f) the use of objective diagnostic measures; g) the long-term effects of treatments; and h) the role of non-pharmacological interventions. Further research on adult ADHD is urgently needed. Funding for studies on this condition lags behind that for childhood ADHD and other mental disorders in adulthood. Hopefully, efforts by clinicians, researchers and other stakeholders will ultimately help ensure that adults with ADHD are better understood, supported, and empowered to thrive.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"72 1","pages":"347-371"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing mental health in university students: future directions in literacy and digital tools.","authors":"Anne Duffy,Quynh Pham","doi":"10.1002/wps.21357","DOIUrl":"https://doi.org/10.1002/wps.21357","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"9 1","pages":"439-440"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The efficacy of cognitive-behavioral therapy for adults with ADHD.","authors":"Mary V Solanto","doi":"10.1002/wps.21349","DOIUrl":"https://doi.org/10.1002/wps.21349","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"124 1","pages":"378-379"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oye Gureje,Maria Lourdes Rosanna De Guzman,Salma M Khaled,Michael Y Ni,Peter W Woodruff,Geoffrey M Reed,Corine S M Wong,Candi M C Leung,Marilyn Crisostomo,Shelby Borowski,Irving Hwang,Maria V Petukhova,Nancy Sampson,Ronald C Kessler
{"title":"The epidemiology of ICD-11 bodily distress disorder and DSM-5 somatic symptom disorder in new large-scale population surveys within the World Mental Health Survey Initiative.","authors":"Oye Gureje,Maria Lourdes Rosanna De Guzman,Salma M Khaled,Michael Y Ni,Peter W Woodruff,Geoffrey M Reed,Corine S M Wong,Candi M C Leung,Marilyn Crisostomo,Shelby Borowski,Irving Hwang,Maria V Petukhova,Nancy Sampson,Ronald C Kessler","doi":"10.1002/wps.21353","DOIUrl":"https://doi.org/10.1002/wps.21353","url":null,"abstract":"Distressing somatic symptoms are common and disabling, but a lack of reliable classification of the underlying disorders has limited our understanding of the extent of their population burden. The new categories of bodily distress disorder (BDD) in the ICD-11 and somatic symptom disorder (SSD) in the DSM-5 were designed to address the fundamental weaknesses of previous conceptualizations, but have important differences in their criteria specifications. Three new large-scale population surveys within the World Mental Health (WMH) Survey Initiative, conducted in socially and culturally diverse settings, provide the opportunity to address questions regarding population prevalence, mental and physical health correlates, and associations with role impairment of BDD and SSD. WMH surveys were carried out in representative household samples of adults in Hong Kong, the Philippines, and Qatar (combined N=18,105 respondents). Multivariable regression analysis examined associations of BDD and SSD with socio-demographic variables, comorbid DSM-5 mental disorders, and chronic physical conditions. Role impairment was assessed by examining the mean number of health-related days out of role (DOR) in the 30 days before the interview, adjusting for socio-demographic variables and comorbidities. The point prevalence across the three settings was 2.0% for BDD, 3.5% for SSD, and 4.1% for either diagnosis. The point prevalence of BDD and especially of SSD was highest in Hong Kong, suggesting a role of cultural and social factors. Females were twice as likely as males to meet the criteria for either disorder. Prevalence increased with age. BDD and SSD were significantly associated with generalized anxiety, panic, post-traumatic stress, major depressive, and bipolar spectrum disorders, and associations were consistently stronger for BDD than SSD. More modest comorbidities were found with common chronic physical conditions (arthritis, asthma, diabetes mellitus, hypertension, and stomach or intestinal ulcer). BDD and SSD were both significantly associated with increased mean DOR after adjusting for comorbid mental disorders and chronic physical conditions, but the adjusted mean DOR was significantly higher in the BDD-only than in the SSD-only subsample (4.7 vs. 3.1, p<0.001). These findings attest to the high public health importance of BDD and SSD. Even though both are not highly prevalent in the community, their co-occurrence with common physical and mental disorders, and the fact that they are associated significantly with role impairment, provide strong reason for clinical attention.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"70 1","pages":"395-403"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cut from the same cloth: neurobiological continuity between childhood and adult ADHD.","authors":"Philip Shaw","doi":"10.1002/wps.21350","DOIUrl":"https://doi.org/10.1002/wps.21350","url":null,"abstract":"","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"76 1","pages":"380-381"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carla Sharp,Lee Anna Clark,Kennedy M Balzen,Tom Widiger,Stephanie Stepp,Mark Zimmerman,Robert F Krueger
{"title":"The validity, reliability and clinical utility of the Alternative DSM-5 Model for Personality Disorders (AMPD) according to DSM-5 revision criteria.","authors":"Carla Sharp,Lee Anna Clark,Kennedy M Balzen,Tom Widiger,Stephanie Stepp,Mark Zimmerman,Robert F Krueger","doi":"10.1002/wps.21339","DOIUrl":"https://doi.org/10.1002/wps.21339","url":null,"abstract":"A substantial body of empirical evidence has accumulated over the last 12 years since the publication of the Alternative Model for Personality Disorders (AMPD) in the DSM-5. As yet, this evidence has not been organized and reported using the criteria required by the American Psychiatric Association (APA) for proposals submitted to revise the DSM-5. These criteria are based on the Kendler-Kupfer update and expansion of the classic Robins-Guze criteria for establishing psychiatric diagnostic validity. We have been invited by the APA to undertake a review of the last decade of research on the AMPD and to propose a revised, simplified version of the model informed by this evidence. Here we present the findings of the review and our recommendations for the revision of the model. We begin with a brief reiteration of the background and rationale for the AMPD, followed by a description of the revision criteria required by the APA. We then summarize the evidence in support of the AMPD using the required framework. Our review indicates that AMPD-defined personality disorder (PD) shows similar patterns of associations as have been demonstrated for categorical PD diagnoses in terms of antecedent, concurrent and predictive validators. Head-to-head comparisons between AMPD-defined PD and categorical diagnoses suggest a more precise characterization of personality pathology by the AMPD. In addition, AMPD-defined PD appears to show higher reliability estimates than categorical PDs, and strong clinical utility, often outperforming categorical PD diagnoses. We conclude that the AMPD is ready for inclusion in the main section of the DSM. Recommendations are made for: a) further streamlining the AMPD in light of the last decade of accumulated evidence, and b) future research directions in areas where evidence is lacking or more limited.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"29 1","pages":"319-340"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A pragmatic randomized controlled trial of cognitive therapy for post-traumatic stress disorder in children and adolescents exposed to multiple traumatic stressors: the DECRYPT trial.","authors":"Richard Meiser-Stedman,Leila Allen,Polly-Anna Ashford,Ella Beeson,Sarah Byford,Andrea Danese,Annie Farr,Jack Finn,Ben Goodall,Lauren Grainger,Matthew Hammond,Rebecca Harmston,Ayla Humphrey,Dorothy King,Katie Lofthouse,Gerwyn Mahoney-Davies,Sarah Miles,Jessica Moore,Nicola Morant,Sarah Robertson,Lee Shepstone,Erika Sims,Paul Stallard,Annie Swanepoel,David Trickey,Katie Trigg,Ramesh Vishwakarma,Jon Wilson,Tim Dalgleish,Patrick Smith","doi":"10.1002/wps.21355","DOIUrl":"https://doi.org/10.1002/wps.21355","url":null,"abstract":"Trauma-focused cognitive-behavioral therapies (TF-CBTs) are efficacious in children and adolescents with post-traumatic stress disorder (PTSD). However, there is limited evidence in youth exposed to multiple traumas, especially in real-world settings. This paper reports on a pragmatic randomized controlled trial (RCT) evaluating whether one form of TF-CBT, cognitive therapy for PTSD (CT-PTSD), was effective for PTSD following multiple trauma exposure in 8-17 year-olds attending UK mental health services, relative to treatment-as-usual (TAU). Youth with PTSD (N=120) following multiple traumas were randomly allocated to receive CT-PTSD or TAU. At baseline, complex PTSD diagnosis was common (55.0% of cases), and a large proportion of youth had comorbid mental disorders. The primary outcome was the score on the Child Revised Impact of Event Scale, 8-item version (CRIES-8) at post-treatment. Secondary outcomes included the CRIES-8 score at 11 months post-randomization, and several measures of PTSD, anxiety, depression, suicidal ideation, affect regulation, irritability, and general functioning at post-treatment and 11 months post-randomization. CT-PTSD was not found to be significantly superior to TAU on the CRIES-8 at post-treatment (adjusted difference: -3.80, 95% CI: -7.56 to -0.06, p=0.095; Hedges' g=-0.37, 95% CI: -0.78 to 0.03), but it was superior to TAU when patients who had received TF-CBT were excluded from that arm (adjusted difference: -4.60, 95% CI: -8.36 to -0.81, p=0.047; g=-0.46, 95% CI: -0.89 to -0.04). CT-PTSD was also superior to TAU on the CRIES-8 at 11 months (adjusted difference: -5.38, 95% CI: -8.88 to -1.87, p=0.003; g=-0.46, 95% CI: -0.90 to -0.02), and in a mixed-effect model incorporating all time points (p=0.007). Evidence of superiority for CT-PTSD was observed on parent-reported emotional difficulties at post-treatment and 11 months; and on child-reported total anxiety and depression, total anxiety, panic and separation anxiety, and parent-reported affect dysregulation and irritability at 11 months. Treatment withdrawal rate was low. Despite high baseline levels of comorbidity and impairment not seen in previous trials, CT-PTSD was not associated with significant deterioration or adverse events. This pragmatic trial is likely to contribute to the optimization of psychological intervention in youth with PTSD following multiple traumas, accompanied by severe comorbid mental disorders, in routine settings.","PeriodicalId":23858,"journal":{"name":"World Psychiatry","volume":"34 1","pages":"422-434"},"PeriodicalIF":73.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}