Similar changes in patients with ADHD and emotional instability

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A new study has found that in both Attention-deficit/hyperactivity disorder (ADHD) and emotional instability disorders, the brain exhibits similar changes in overlapping areas, and the two types of conditions should be seen as related and attention should be paid to both during diagnosis.

Clinical attention has shown that individuals with ADHD also demonstrate emotional problems, such as chaotic emotional responses, anxiety and depression. Yet the relationship between ADHD and impaired emotional regulation has not been identified, even though theories have been proposed that both conditions are rooted in a dysfunction in how the brain controls its information processing.

The researchers at the Karolinska Institute in Sweden substantiated the hypothesis by showing how both ADHD and a form of emotional instability trait (conduct disorder trait in children) exhibit similar, overlapping changes in the brain. The study included more than 1,000 adolescents.

"We can call them sibling conditions, since they both involve partly overlapping underlying brain mechanisms, and therefore attention should be paid to both dimensions during diagnosis," said Dr Predrag Petrovic.

It was with the help of structural brain imagery that the team was able to show how both ADHD and conduct disorder traits in adolescents manifested themselves in the form of reduced brain volume and surface area in parts of the frontal lobe and nearby regions. The affected parts of the brain were generally overlapping.

The researchers also found changes that were specifically related to ADHD symptoms or symptoms seen in conduct disorder. The study also included behavioural experiments that demonstrated both conditions.

"These results are important not least for the patients with emotional instability, since in many cases they are treated with scepticism and feel frustrated at not being taken seriously. We now show that this is related to changes in the brain that resemble those that have been observed in patients with ADHD, which can lead to a broader understanding and better diagnosis," added Dr Petrovic.

The study aims to provide a better understanding of how the brain and behaviour develop. The hope is that it will not only lead to better diagnoses but also to better treatments, where people with an ADHD diagnosis can receive special therapy to help them better handle their emotions.

The study appeared in the Journal of Molecular Psychiatry.