Pubmed (TDAH) du 14/03/26
1. Adak İ, Varan E, Eyüpoğlu N, Alpman A, Durmuş Z, Karakuş OB, Gamlı İ S, Ekinci Ö. Neurocognitive Correlates of Diagnostic Heterogeneity in Children with ADHD: The Differential Contributions of Cognitive Disengagement Syndrome, Symptom Severity, and Anxiety. Diagnostics (Basel). 2026; 16(5).
Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) shows substantial cognitive heterogeneity, complicating individualized clinical formulation. This study examined whether Cognitive Disengagement Syndrome (CDS), anxiety, and ADHD symptom severity are associated with memory functions and visuospatial skills in children with ADHD. Methods: The sample included 120 children aged 6-12 years with ADHD (ADHD + CDS: n = 40; ADHD-only: n = 80). Memory was assessed with the Oktem Verbal Memory Processes Test (OVMPT) and Wechsler Memory Scale-Visual Reproduction (WMS-VR), and visuospatial skills with WISC-IV Block Design and Judgment of Line Orientation (JLO). ADHD symptoms were rated using combined parent-teacher Turgay-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Disruptive Behavior Disorders Scale (T-DSM-IV-S) scores; CDS symptoms with the Barkley Child Attention Scale; and anxiety with the SCARED-Child Form. Group comparisons, correlation analyses, and multivariable linear regression models were conducted. Results: The ADHD + CDS group performed worse on WISC-IV Block Design than the ADHD-only group (p = 0.005). In the ADHD + CDS group, inattention severity showed a strong negative association with WMS-VR short-term memory (r = -0.560, p < 0.001). In the ADHD-only group, inattention severity was negatively associated with OVMPT Spontaneous Recall (ρ = -0.319, p = 0.004) and JLO total score (ρ = -0.348, p = 0.002). Anxiety severity in the ADHD-only group was positively associated with OVMPT Total Learning (ρ = 0.350, p = 0.001), Highest Learning (ρ = 0.370, p = 0.001), and WMS-VR short-term memory (ρ = 0.304, p = 0.006). In regression analyses, the presence of CDS independently and negatively predicted WMS-VR short-term memory (β = -0.187, p = 0.018) and Block Design performances (β = -0.226, p = 0.016). Inattention symptom severity was also independently and negatively associated with Block Design performance (β = -0.243, p = 0.013). Conclusions: CDS status and symptom dimensions contribute to cognitive variability in pediatric ADHD, with CDS showing independent associations with timed visuospatial construction and short-term visual memory. Inattention severity emerged as a robust dimensional predictor of cognitive inefficiency across domains, supporting the clinical utility of symptom-based cognitive profiling in ADHD diagnostic evaluations. In addition, mild anxiety symptoms demonstrated meaningful associations with some learning and memory performances within the ADHD-only group, indicating that affective factors may modulate cognitive outcomes in ADHD. Taken together, these findings support considering CDS status and symptom dimensions jointly when characterizing cognitive variability in ADHD.
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2. Uzoaru F, Preston MA, Loux T, Ross L. Medicaid Expansion and Medication Use Among U.S. Children with ASD or ADHD: A Repeated Cross-Sectional Analysis Comparing Before and During the COVID-19 Periods. Healthcare (Basel). 2026; 14(5).
BACKGROUND/OBJECTIVES: Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) frequently rely on pharmacological treatment to manage core symptoms. This study examined how Medicaid expansion and the COVID-19 pandemic influenced medication use among children with ASD or ADHD, including those with comorbid diagnoses. METHODS: We analyzed 2016-2023 data from the National Survey of Children’s Health (NSCH) for children aged 3-17 years with caregiver-reported diagnoses. Logistic regression models assessed the association between Medicaid expansion, the pandemic period, and current medication use, including an interaction between expansion and pandemic period. Analyses were conducted for the full sample (N = 35,198) and a subgroup with comorbid ASD and ADHD (N = 4298). RESULTS: Current Medicaid expansion was associated with significantly lower odds of medication use in the full sample (aOR = 0.68, p < 0.001) but not the comorbid group (aOR = 0.98, p = 0.9). Medication use showed no significant change during the COVID-19 period in either the full sample (aOR = 0.99; p > 0.90) or the comorbid subgroup (aOR = 1.22; p = 0.4). A significant interaction indicating increased odds of medication use during the pandemic in expansion states was observed only in the full sample, although a similar but non-significant pattern appeared in the comorbid group. Age, race, and insurance-related differences were significant across groups, with coverage consistency playing a larger role in the full sample. Sensitivity analyses, excluding the 2020 survey year and modeling pre/post pandemic periods, supported the robustness of findings. CONCLUSIONS: Medicaid expansion was associated with patterns consistent with buffering pandemic-related disruptions in medication use among children with ASD or ADHD overall, but those with co-occurring conditions remain especially vulnerable.
