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Tesi etd-02212019-130439

Thesis type
Tesi di laurea magistrale LM6
ADHD nell'adulto: alterazioni della regolazione emotiva e temperamenti affettivi
Corso di studi
relatore Prof. Perugi, Giulio
Parole chiave
  • Attention Deficit Hyperactivity Disorder
  • mood disorders
  • affective temperaments
  • neurodevelopmental disorders
  • borderline personality disorder
  • emotional dysregulation
  • ADHD
  • cyclothymia
Data inizio appello
Data di rilascio
Riassunto analitico
INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopment disorder defined by a persistent and age-inappropriate pattern of inattention, hyperactivity-impulsivity or both. ADHD persist into adulthood in a substantial proportion of cases (65%) and is often comorbid with other psychiatric conditions (80%), such as mood and anxiety disorders, substance use disorder, and personality disorders. About 30-70% of adults with ADHD present emotional dysregulation (ED), regardless of the possible comorbidities, and in most of them it is the major symptom. ED has been defined as a deficiency in executive and/or in cognitive management of emotions, particularly the negative ones. In adult ADHD patients, ED leads to major impairment and worsening of prognosis.

AIMS: with the present study, we aimed to assess the possible relationships between ED, affective temperaments and psychiatric comorbidities in adults with ADHD.

METHODS: A total of 61 adult patients with ADHD were identified using the DIVA 2.0 diagnostic interview. Thus, BriefTEMPS-M, CAARS, BIS-11, DERS and RIPoSt rating scales were used to evaluate ED and affective temperaments.

RESULTS: More than a third of our patients reported familiarity with ADHD. As concern psychiatric comorbidities, we found SUD (49.2%), THC (26.2%), cocaine (19.7%) and alcohol (21.3%) abuse. About 2/3 presented mood disorders and 25.4% borderline personality disorder. Thus, we found a significative positive correlation between irritable temperament and CAARS hyperactive/impulsive domain (p=0,000756). Cyclothymic temperament significantly correlated with the BIS motor subdomain (p = 0.00022), while irritable temperament correlated with BIS attentional (p = 0.000028) and BIS cognitive instability (p = 0.001). Irritable affective temperament was positively associated with the DERS impulse subdomain (p = 0.0000037). The RIPoSt scale showed a direct correlation between cyclothymic temperament and ED (p = 0.000000046), negative emotionality (p = 0.0000048) and affective instability (p = 0.00000000026); Irritable temperament correlated with ED (p = 0.00004), emotional impulsivity (p = 0.00000000003) and affective instability (p = 0.00024). Finally, there was a statistically significant positive correlation between the RIPoSt ED’ scores (p = 0.0084) and RIPoSt affective instability (p = 0.022) with the presence of Borderline Personality Disorder. On the other hand, the presence of mood disorders, panic disorder and alcohol use disorder, had a direct correlation with RIPoSt affective instability (respectively p = 0.0467, p = 0.0073, p = 0.0291).

CONCLUSIONS: Our results show a big overlap between ED, Cyclothymia, mood and personality disorders. It is likely that many of the mechanisms underlying neurodevelopmental disorders, affective temperaments and personality disorders are the same. Finally, from our results it is not possible to establish whether ED is a core component of ADHD or only an associated dimension that only appears in some patients. Emotional dysregulation still seems to characterize a large proportion of patients who continue to have ADHD in adulthood and it is unclear whether this depends on the fact that these forms are different, or are simply more severe, allowing to less chances of recovery and adaptation ending up with ADHD persisting throughout the entire lifetime.