Many studies have focused on the strong link between impulsivity and addictive behaviors, such as alcohol use disorders.

Our study aimed to investigate the links between alcohol use and impulsivity in a sample of Tunisian pupils.

This was a cross-sectional study conducted in May and June 2016. It enrolled 317 pupils from four colleges and schools in Sfax (Tunisia). The participants were asked to answer a self-administered questionnaire, after their consent. Alcohol use disorders identification test (AUDIT) was used to evaluate alcohol dependence. The Barratt Impulsiveness Scale (BIS), in its 11th version, was used to assess impulsivity trait. Its three second-order factors were attentional impulsiveness, motor impulsiveness, and non-planning impulsiveness.

The mean age was 16 years with a sex-ratio of 1.07. The school children reported having drunk alcohol at least once in 18.9% of cases and 41.66% of them still consume. According to AUDIT, 1.6% of alcohol users presented an alcohol misuse and 21.6% presented dependence. According to BIS, impulsivity prevalence (IP) in the whole sample was 27.8% while it was 40% among the alcoholic participants versus 24.9% in non-alcoholic participants. The average BIS score was more important in the alcoholic participants (69.25 versus 65.53; P = 0.011). Alcohol consumption was correlated to attentional impulsiveness (P = 0.01) and motor impulsiveness (P = 0.008). Alcohol dependence was correlated to motor impulsiveness (P = 0.018).

These results show the importance of clinically evaluating and intervening on impulsive personality traits to better prevent addictive behavior such as alcoholism among adolescents.

The authors have not supplied their declaration of competing interest.

It is widely recognized that parents and peers play a critical role in the adolescent's introduction to alcohol.

The aim of the study was to examine the relationship of parental and peers drinking to adolescent drinking behavior.

A cross-sectional study was carried out in four colleges and schools in Sfax in Tunisia, in May and June 2016. The sample consisted of 317 pupils, and was determined through a simple randomized sampling. These adolescents were asked to answer a self-administered questionnaire, after their consent. Alcohol use disorders identification test (AUDIT) was used to evaluate alcohol dependence.

The mean age was 16 years, with a sex-ratio of 1.07. The participants reported having drunk alcohol at least once in 18.9% of cases and 41.66% of them still consume. According to AUDIT, 1.6% of alcohol users presented an alcohol misuse and 21.6% presented dependence. They reported that parents’ attitude toward their alcohol use was favorable in 27.11% of cases. Among dependent adolescents, the prevalence of fathers’ alcohol consumption was 20% while that of friends was 70%. Adolescent drinking was significantly correlated to fathers, mothers and peers drinking (P < 0.001, P = 0.004, P < 0.001 respectively), mothers and peers smoking (P = 0.05, P < 0.001 respectively), fathers and peer's cannabis use (P < 0.001, P < 0.001 respectively).

Findings suggest that negative family and peers influence increased risk of alcohol consumption in adolescents. Understanding the influences on parents’ beliefs about their children's drinking and the functions of social networks in preventing alcohol consumption may be necessary to address adolescent risky drinking.

The authors have not supplied their declaration of competing interest.

The associations between genetic variants of drug metabolizing enzyme and transporter (DMET) genes and steady-state plasma concentrations of risperidone, 9-hydroxyrisperidone, total active-moiety, and metabolic ratio remain unclear.

The objective of the present study was to present the results of the association between genetic variants of DMET gene and steady-state plasma concentration risperidone and its metabolite using Affymetrix DMET Plus genotyping microarray.

Subjects eligible for this study included male and female adolescents with ASD diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and being treated with risperidone for at least 4 weeks prior to the blood sample collection. Blood samples were drawn prior to the next dose of risperidone intake to determine the steady-state plasma trough concentrations of risperidone and 9-hydroxyrisperidone. Genotyping profile was obtained using the microarray. Steady-state plasma risperidone and 9-hydroxyrisperidone were measured using liquid chromatography/tandem mass spectrometry (LC-MS/MS) assay.

The polymorphisms of UGT2B4, CYP2D6 were highly associated with metabolic ratio. Of all the DMET analysis, ABCB11 (3084A > G, 420A > G, 368G > A, and 236G > A) and ADH7 (690G > A and –5360G > A) were found to be associated with plasma concentrations of risperidone (P < 0.01). In addition, 6 genetic variations among the SLC transporter family were associated with the plasma concentration of 9-hydroxyrisperidone.

This study provides a pharmacogenomic approach to investigate further among the DMET genetic variants which influence plasma concentration of risperidone. The treatment of ASD should be based on genetic factors making the challenge of psychopharmacological treatment more efficacious with lesser adverse events.

The author has not supplied his/her declaration of competing interest.

Autism spectrum disorders (ASD) are neurodevelopmental disorders characterized by abnormalities in 3 domains; social interaction, communication/language, and restricted and repetitive behavior. The study of ASD prevalence in Thailand showed that it is approximately 9.9 children per 10,000 population for children 1–5 years old. ASD has a strong genetic basis, although the genetics of autism are complex and it is unclear. The objective of this study was to identify the genetic markers of Thai ASD.

Exome sequencing was performed with twelve unrelated ASD affected individuals from twelve families. Each sample was sequenced on SOLiD 5500xl genetic analyzer, and the resulting data was processed and analyzed on LifeScope Genomic Analysis software. Exome sequencing with two additional samples was performed Ion Proton System and the data was processed on Ion Reporter server. Tertiary data analysis with all fourteen exome sequencing data were performed by using Golden Helix software. In filtering process, data were annotated to various databases including UCSC KnownGenes for non-coding and synonymous variants filter, 1000 Genomes Project for high frequency variants filter, and dbNSFP for functional prediction.

The genetic markers were identified for Thai ASD associated variants (c.2014G > A in EIF2AK3, c.2951G > A in FGD6, and c.6119A > G in CHD8).

these genetic markers were the most possible of causing variants Thai. We also demonstrated a potential of exome sequencing and bioinformatics pipeline to identify the possible causative variants of ASD, which could by applied in the case that unable to identified variants by other technique.

The author has not supplied his/her declaration of competing interest.

Atypical anti-psychotics have been found to be associated with hyperuricemia. The aims of this study were to determine the prevalence of hyperuricemia and metabolic adverse events in children and adolescents with ASD treated with risperidone.

In this cross-sectional study, we recruited 127 Thai ASD children and adolescents aged 3–20 years receiving risperidone for more than 4 weeks. The clinical data and laboratory data were obtained and analyzed. Hyperuricemia was defined as serum uric acid > 5.5 mg/dL.

Hyperuricemia was present in 57.48% of total ASD patients treated with risperidone. Uric acid levels were significantly higher in adolescents as compared to children. Uric acid levels correlated with risperidone dose (P = 0.01), duration of treatment (P < 0.0001), BMI (P < 0.0001), waist circumference (P = 0.003), triglyceride (TG; P < 0.0001), triglycerides/high-density lipoprotein cholesterol ratio (TG/HDL-C; P < 0.0001), insulin (P = 0.04), homeostatic model assessment index (HOMA-IR; P = 0.03), high-sensitivity CRP (hs-CRP; P < 0.0001), and leptin levels (P < 0.0001). HDL-C and adiponectin levels were negatively correlated with uric acid levels (P < 0.0001). In multiple regressions analysis, age, BMI, TG/HDL-C, and adiponectin level remained significantly associated with uric acid levels (P < 0.0001).

Hyperuricemia may play a role in metabolic adverse effects in children and adolescents with ASD receiving high dose and/or long-term treatment with risperidone.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Anxiety-phobic disorders are caused both by environmental and hereditary factors. The study was designed to determine the level of chromosomal aberrations in the peripheral blood lymphocytes (PBL) of children and adolescents of both sexes with phobic-anxiety disorders (PAD).

Cytogenetic analysis was performed in 27 children and adolescents of both sexes with PAD, aged 9–15 years; the control group consisted of 50 healthy peers of both genders. Statistical analysis-Excel and SPSS statistics 17.0.

Cytogenetic analysis of patients with PAD and in healthy age-matched individuals has established normal female (46,XX) and male (46,XY) karyotypes. The frequency of the chromosomal aberrations (CA) spontaneous level in the PBL is 4.6 times higher than the CA frequency in healthy persons. In children and adolescents with the disease, the spontaneous frequency of aberrations of chromatid and chromosome types is also significantly higher than the same in healthy children and adolescents. Single acentric fragments and exchanges prevail among the chromatid–type aberrations; pair acentric fragments prevail among the chromosome–type aberrations. An increase in the frequency of the chromosome-type aberrations has been revealed in boys with PAD (1.72 vs.0.55 per100 cells in healthy boys, P < 0.001 by pair acentric fragments), in comparison with healthy boys; and the chromatid–type aberrations have been observed in girls with PAD (3.22 vs.0.94 per 100 cells in healthy girls, P < 0.001 by single acentric fragments), in comparison with healthy girls. A pronounced individual variability of CA frequency, which ranges in our patients from 2.0 to18.0 per 100 metaphase plates, has been found along with an increase in the CA level in patients with PAD.

Children and adolescents with PAD require a careful cytogenetic analysis and the consequent therapeutic measures for genome stabilization.

The authors have not supplied their declaration of competing interest.

To date, limited data has been available regarding the impact of adenotonsillectomy (AT) on the psychosocial well-being of chronic adenotonsillar hypertrophy (CAH) subjects.

In the present study, we examined the impacts of AT on attention-deficit/hyperactivity disorder symptoms (ADHD) and sleep disturbance symptoms and quality of life of children with chronic adenotonsillar hypertrophy.

Parents of children with CAH filled in Conners Parent Rating Scale-Revised Short (CPRS-RS), children's sleep habits questionnaire (CSHQ), and the pediatric quality of life inventory, parent versions (PedsQL-P) before and six months after AT.

A total of 64 children were included the study (mean age: 6.8 ± 2.4 years; 50% boys). Mean ADHD Index (11.98 ± 6.94 versus 10.35 ± 6.44) (before AT versus after AT) and oppositional scores (6.73 ± 3.72 versus 5.87 ± 3.52) improved statistically significantly after AT (P < 0.05). All of the CSHQ subdomain scores, except sleep duration, significantly reduced after AT (P < 0.05). Regarding to quality of life, both PedsQL-P physical health (64.20 ± 19.81 versus 69.84 ± 18.63) and psychosocial health subdomain scores (67.83 ± 12.89 versus 75.57 ± 13.16), and PedsQL-P total score (66.57 ± 12.94 versus 73.58 ± 12.46) of the patients were significantly higher six months after AT (P < 0.001).

It is necessary for child and adolescent psychiatrists to query the symptoms of CAH to identify children with chronic adenotonsillar hypertrophy who suffer from ADHD symptoms, oppositionality, and sleep disturbance. To carry out AT seems to be beneficial for coexisting ADHD and sleep disorder symptoms and quality of life in these children.

The authors have not supplied their declaration of competing interest.

Cerebral palsy (CP) is described as a primary disorder of posture and movement; however, intellectual impairment is prevalent in children with CP.

The aim of the present study was to examine the association with intellectual level and gross motor function, hand function, type of CP, and the presence of co-morbid disorders in these children.

A total of 107 children with CP were included in the study. Intellectual functions of the children were determined by clinical assessment, adaptive function of daily life, and individualized standardized intelligence testing. Gross motor function and hand function of the patients were classified using the gross motor function classification system and the bimanual fine motor function measurements.

The mean age of the patients were 8.10 ± 3.43 years (age: 2–16 years). During clinical typing, we observed that 80.4% of the patients were spastic, 11.2% were mixed, 4.7% were dyskinetic, and 3.7% were ataxic. No significant relationship was determined between the type of CP and intellectual functioning (P > 0.05). Intellectual functioning was found to be significantly correlated negatively with both gross motor function and hand functions level (P < 0.001). The factors related to intellectual functioning were neonatal convulsion (x2 = 12.97, P = 0.002), epilepsy (x2 = 29.221, P < 0.001), and speech disorders (x2 = 23.29, P < 0.001).

There is an association between intellectual functioning in children with CP and the degree of motor impairment, neonatal convulsion, epilepsy, and speech disorders. Intelligence assessment should be an essential part of CP evaluation.

The authors have not supplied their declaration of competing interest.

Adolescents’ well being is affected by their parenting situation and can influence their well being over time. We present an exploratory study with an Illumina 450 k array, comparing methylation in adolescents, based on perceived parenting at T0, and how methylation can interact with parenting in explaining depressive symptoms two years later (T2).

Identify differentially methylated regions (DMRs) associated with perceived parenting at T0 and investigate their association with depressive symptoms two years later.

An exploratory analysis evaluating the association between methylation and depressive symptoms longitudinally.

From two extreme parenting clusters: perceived supportive, and punishing neglecting, we randomly selected 44 adolescents (MAge = 14 at T0; 48%boys). The CES-D scale (Center for Epidemiologic Studies Depression Scale) assessed depressive symptoms. DMRs were identified based on the parenting clusters (DMRcate and comb-p) using llumina Infinium HumanMethylation 450 BeadChip data. Associations between the most significant CpG for each DMR and the depression score at T2, were calculated using linear regression analysis.

We identified 17 DMRs, but only cg13306335 in PEX10 was associated with depressive symptoms at T2 (P = 0.0014, Bonferroni (17 tests): P < 0.0029). Additionally, an interaction between parenting at T0 and PEX10 methylation (T0) in explaining depressive symptoms (T2) can be suggested (P = 0.014).

We show that methylation at PEX10's most significant CpG is correlated with depressive symptoms at T2, these exploratory results also suggest a possible interaction between parenting and PEX10 methylation at T0 in association with depressive symptoms at T2. Validation in a larger sample is needed to support the role of methylation and its interactions in depression over time.

The authors have not supplied their declaration of competing interest.

Receiving an autism spectrum disorder (ASD) diagnosis often is daunting for individuals and families because of the life-long difficulties with functioning, health and quality of life [1]. “Casa del Giardiniere” is the reference facility for ASD at the Local health authority. The multidisciplinary team is composed by child psychiatrist, psychiatrist, psychologist, behavior analyst, educator, speech therapists, neuropsychomotor therapist, and social worker. Following the international guidelines for the neurodevelopmental disorders, patients’ age changed from 0–18-year-old to lifespan.

This work aims to illustrate our model, resulting from the integration of family, social and health services, and school.

Data on demographic, family, and clinical factors were gathered among subjects admitted to our ASD unit along 2015. All participants underwent to the following process: diagnostic assessment, Functional assessment of speech, communication, cognitive and adjustment skills, treatment, and parent training.

Data showed a general improvement of skills. The best results were achieved when a full sharing of methods and strategies in all areas of life were possible. Results will be discussed in details.

This model allows to realize efficient individualized treatment programs and to benefit of specific training both on intervention programs and approach with families. Furthermore, parents learn to “see” their child not only within its limits.

The authors have not supplied their declaration of competing interest.

Despite fragmented evidence on individual interventions, good practice and child welfare programmes in low and middle-income countries (LMIC), there is no comprehensive model for early interventions, particularly for children who experience complex trauma.

The objective of the World Awareness for Children in Trauma (WACIT: www.wacit.org) is to develop an evidence-based psychosocial model for vulnerable children in low and middle-income countries with limited or no access to specialist resources.

The aim of the preliminary evaluation was to establish stakeholders’ views on the extent of need, socio-cultural context, service gaps, and recommendations for improvement and creation of working partnerships. This consisted of four studies:

– 1. Participatory workshops in six countries (Turkey, Pakistan, Indonesia, Kenya, Rwanda, Brazil) with a total 250 strategic and operational stakeholders;

– 2. Quantitative evaluation in two of these countries (Turkey, 32 participants; and Brazil, 80 participants);

– 3. Interviews with 17 stakeholders from the six countries;

– 4. Focus groups with 7 children, 7 parents, 9 teachers and 11 other professionals in one country (Kenya).

Findings indicated that lack of resources (funding, facilities, training and personnel), poor collaboration (between church, families, government, schools and community), impaired parenting, socio-economic challenges and limited knowledge on child mental health as key factors that impede interventions.

The findings have informed the next phase of the WACIT programme in developing sustainable networks, training, and culturally appropriate interventions in the participating LMIC.

The author has not supplied his/her declaration of competing interest.

Schizophrenia is associated with cannabis use and deficits in selective attention.

This study investigated these relationships using habituation of the startle reflex in schizophrenia patients relative to cannabis users during selective attentional tasks.

Participants included 12 healthy controls (CON), 16 healthy cannabis users in the last 12 months (THC), and eight schizophrenia patients (SCZ). Auditory startle reflex was recorded from orbicularis oculi muscle while participants were attending to (Attend Task) or ignoring (Ignore Task) 100 dB startling pulses. Startle habituation was measured as the absolute reduction in startle magnitude on block 2 (last nine trials) vs. block 1 (first nine trials) on each attentional task and in each group.

All three groups were matched on demographics, alcohol, and caffeine consumption. ANCOVA with two within-subject factors (attention and habituation with 2 levels each), one between-subject factor (group with 3 levels), and one covariate (nicotine use which was higher in SCZ vs. CON or THC) showed a significant startle habituation with moderate to large effect sizes in all three groups on the Ignore Task (Cohen's d = 0.67 in CON, d = 0.59 in THC, d = 0.90 in SCZ) but not on the Attend Task. Attentional modulation of the startle reflex occurred only in CON (d = 1.33) and THC (d = 1.17), but not in SCZ.

Auditory startle habituation depends on selective attention but is not affected by schizophrenia or cannabis use. Deficient attentional modulation of the startle reflex suggests that a more severe deficit in selective attention occurs in schizophrenia relative to cannabis use.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

The objective of this family-based whole exome sequencing (WES) is to examine genetic variants of autism spectrum disorder (ASD) in Korean population.

The probands with ASD and their biological parents were recruited in this study. We ascertained diagnosis based on DSM-5™ criteria, using Autism Diagnostic Observation Schedule and Autism Diagnostic Interview–Revised. We selected probands with typical phenotypes of ASD both in social interaction/communication and repetitive behaviour/limited interest domains, with intellectual disability (IQ < 70), for attaining homogeneity of the phenotypes. First, we performed WES minimum 50× for 13 probands and high-coverage pooled sequencing for their parents. We performed additional WES for 38 trio families, at least 100× depth. De novo mutations were confirmed by Sanger sequencing. All the sequence reads were mapped onto the human reference genome (hg19 without Y chromosome). Bioinformatics analyses were performed by BWA-MEM, Picard, GATK, and snpEff for variant annotation. We selected de novo mutation candidates from probands, which are neither detected in two pooled samples nor both parents.

Fifty-one subjects with ASD (5 females, 40∼175 months, mean IQ 42) and their families were included in this study. We discovered 109 de novo variants from 46 families. Twenty-nine variants are expected to be amino acid changing, potentially causing deleterious effects. We assume CELSR3, MYH1, ATXN1, IDUA, NFKB1, and C4A/C4B may have adverse effect on central nerve system.

We observed novel de novo variants which are assumed to contribute to development of ASD with typical phenotypes and low intelligence in WES study.

This work has been supported by Healthcare Technology R&D project (No: A120029) by Ministry of Health and Welfare, Republic of Korea.

The work was developed with the people hospitalized in the period of 1 year in a psychiatric clinic in Rio de Janeiro city, Brazil. 175 patients who presented dual diagnosis were evaluated.

The research aims to know the distribution of the most frequent psychiatric diagnosis associated with the disorders for the use of psychoactive substances. The work also has as objective to assess the treatment of patients carrying these disorders so that there is a better efficiency of the individual treatment plan.

The work consisted of the evaluation of all patients who were admitted to the clinic in the period of 1 year, using the ICD-10 for the diagnosis of dual pathologies. All the patients were assessed by the multiprofessional team, composed by general practicioner, psychiatrist, psychologist, pharmaceutic, therapist in chemical dependence, family therapist and physiotherapist. The patients were treated with the use of psychopharms, cognitive behavioral psychotherapy, 12-step program, art therapy and moderate physical activity. Family members of all patients were also interviewed.

In the evaluation conducted by the team, it was found the following distribution of the most frequent diagnosis associated to disorder for the use of psychoactive substances: depression (26.3%), personality disorder (22.9%), bipolar disorder (22.3%), non-schizophrenic psychosis (12.6%), schizophrenia (9.1%), and other diagnosis (6.8%).

The formulation of the dual diagnosis provided a better approach of the patients on the part of the team, promoting the strengthening of the therapeutic bond and causing positive impact on the evolution of these disorders.

The authors have not supplied their declaration of competing interest.

Previous studies have reported depressive symptoms in patients with persistent delusional disorder (PDD). Patients with PDD and depression may need antidepressants for treatment.

The aim of the study was to compare the sociodemographic profile, clinical presentation and treatment response in patients with PDD with and without comorbid depressive symptoms.

We conducted a retrospective chart review of patients diagnosed with PDD (ICD-10) from 2000 to 2014 (n = 455). We divided the patients into PDD + depression (n = 187) and PDD only (n = 268) for analysis.

Of the 187 patients with PDD + D, only eighteen (3.9%) were diagnosed with syndromal depression. There were no significant differences in sociodemographic profile including sex, marital and socioeconomic status (all P > 0.05). PDD + D group had a significantly younger age at onset ([PDD + D: 30.6 9.2 years vs. PDD: 33.5 11.1 years]; t = 2.9, P < 0.05). There was no significant difference between the clinical presentation including mode of onset, the main theme of their delusion and secondary delusions (all P > 0.3). However, comorbid substance dependence was significantly higher in patients with PDD only. (χ2 = 5.3, P = 0.02). In terms of treatment, response to antipsychotics was also comparable ([> 75% response: PDD + D = 77/142 vs. PDD = 106/179); χ2 = 1.9, P = 0.3). There was a significant difference between the two groups in terms of antidepressant treatment ([PDD + D = 32/187; 17% vs PDD: 17/268; 6%), χ2 = 12.9, P = 0.001).

Patients with PDD + D had significantly earlier onset of illness. These patients may require antidepressants for treatment.

The authors have not supplied their declaration of competing interest.

Internet addiction has become a harmful behavioral problem found to be highly prevalent in high school and college students. Many studies demonstrated significantly association between Internet addiction and depression.

To study the prevalence of Internet addiction and the association between internet addiction and depression in medical students, faculty of medicine, Ramathibodi hospital.

A cross-sectional study was conducted. Participants were the first to fifth-year medical students who agreed to participate in this study. Demographic characteristics were derived from self-rated questionnaire and were analyzed by descriptive statistics. Thai version of Young's Internet Addiction Diagnostic Questionnaire and Thai version of Patient Health Questionnaire (PHQ-9) were used to assess internet addiction and depression, then Chi2 test and logistic regression were used to analyze the associations between internet addiction, depression and associated factors.

From 705 participants, 24.5% had internet addiction and 29.0% had depression. There was statistically significant association between Internet addiction and depression (odd ratio: 1.92; 95% confidence interval [CI]: 1.34–2.77, P-value < 0.000). Logistic regression analysis illustrated that the Internet addiction group had risk of depression 1.58 times higher than the group without Internet addiction (95% CI: 1.04-2.38; P-value < 0.031). Academic problem was found to be a significant predictor of both Internet addiction and depression. Furthermore, Internet addiction, relationship problems with friend and lover, and health problem were also significant predictors of depression.

Internet addiction was common psychiatric problem which associated with depression among medical students. We suggest that surveillance of Internet addiction should be considered in medical schools.

The authors have not supplied their declaration of competing interest.

The first phase following the diagnosis of a first psychotic episode (FEP), is crucial to determine clinical and functional long-term outcome. Cannabis exerts a mediating action on the debut of the disease and determines a poor prognosis.

The description of a specific population profile of increased vulnerability to maintain cannabis use after a FEP could help to identify this high risk subtype of patients and speed up the implementation of specific interventions.

One hundred and seventy-eight patients were recruited from PAFIP (early intervention program on FEP), obtaining detailed socio-demographic assessment. They were followed-up for a year during which cannabis consumption was assessed by Drake scale every three months. We divided the sample into two groups:

– those patients who neither smoked cannabis before the FEP nor during follow-up period (nn);

– consumers group: cannabis users before the FEP who kept on smoking during the follow-up period (ss) and those who smoked before the FEP and gave up consumption during follow-up (sn).

Statistically significant differences between groups were observed. The consumers group (ss + sn) had an earlier age of onset, most were male, unemployed, single, prone to loneliness and they were concomitant users of alcohol and tobacco.

The use of cannabis has a detrimental effect on the outcome of schizophrenia. A specific and early intervention could contribute to prognostic improvements. Identifying cannabis consumption subtypes could be useful for this purpose.

The authors have not supplied their declaration of competing interest.

ADHD is associated with psychopathic traits, both in the general population and in perpetrators, due to the impulsivity, but not the affective component of psychopathy.

To analyze this relationship among a sample of inmates from a high-security male prison, using an instrument that further divides the callous-unemotional factor of psychopathy into boldness and cruelty, and see if they relate to ADHD independently from the impulsivity/disinhibition.

One hundred and one subjects aged 18–65, with at least 4 years of formal education, were interviewed for socio-demographic data and completed the ASRS-v1.1 (Adult ADHD Self-Report Scale) and the TriPM (Triarchic Psychopathy Measure). Subjects were divided into ADHD positive or negative according to their score in the ASRS-v1.1, and then compared regarding TriPM score (total, disinhibition, boldness and cruelty) using Student's t-test. Linear regression was used to assess independency between the subscales of TriPM.

Seventeen subjects scored positive for ADHD. They significantly differed from the non-ADHD group regarding all psychopathy scores (total, t = −5.03, P < 0.0001; disinhibition, t = −3.53, P = 0.0006; and cruelty, t = −4.96, P < 0.0001), except for boldness (t = 1.97, P = 0.005). The cruelty score is independent from boldness (R2 = 0.03) but not from the disinhibition score (R2 = 0.24). Disinhibition and boldness are also unrelated (R2 = 0.01).

In line with previous work, our study shows a strong association between ADHD and psychopathy, with both conditions sharing the disinhibition/impulsivity factor. Although ADHD subjects score higher for cruelty, this isn’t independent from disinhibition, and may be a result of them being more prone to admit to cruel behaviours, due to deficient response inhibition.

The authors have not supplied their declaration of competing interest.