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Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

[journal article]

West, Dirk; Claes, Stephan; Deboutte, Dirk

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Please use the following Persistent Identifier (PID) to cite this document:http://nbn-resolving.de/urn:nbn:de:0168-ssoar-202684

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Abstract Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/ hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress. The results indicate that a low-cortisol responsivity to stress may be a neurobiological marker for children with ADHD-C, but not for those with ADHD-I. Directions for future research and clinical implications are discussed.
Keywords psychophysical stress
Classification Psychological Disorders, Mental Health Treatment and Prevention
Free Keywords ADHD; Children; Cortisol; HPA axis
Document language English
Publication Year 2009
Page/Pages p. 543-553
Journal European Child & Adolescent Psychiatry, 18 (2009) 9
DOI http://dx.doi.org/10.1007/s00787-009-0011-1
Status Postprint; peer reviewed
Licence PEER Licence Agreement (applicable only to documents from PEER project)