1. Hsu JW, Lin WC, Chen LC, Bai YM, Tsai SJ, Chen MH. Effect of appetite hormone dysregulation on symptom trajectory in adolescents with attention deficit hyperactivity disorder: an exploratory prospective study. World J Biol Psychiatry;2026 (Mar 29):1-8.

BACKGROUND: Cross-sectional studies have reported an association between attention deficit hyperactivity disorder (ADHD) and appetite hormone dysregulation. However, the association of appetite hormones with symptom trajectory in adolescents with ADHD remains uncertain. METHODS: The present study included 32 adolescents with ADHD and 26 neurotypical adolescents. Appetite hormones (insulin, leptin, adiponectin, and ghrelin) were measured at baseline and at the third-year follow-up. RESULTS: Generalised linear models adjusted for demographic characteristics and ADHD medication use revealed that adiponectin levels significantly decreased over time in adolescents with ADHD compared with the levels in neurotypical adolescents (p = .003). However, changes in insulin, leptin, and ghrelin levels did not differ significantly between the two groups. In the ADHD group, changes in adiponectin level were negatively associated with changes in Swanson, Nolan, and Pelham, Version IV inattention scores (B = -1.72, p = .018) and Child Behaviour Checklist Dysregulation Profile scores (B = -3.00, p = .015) after adjustment for age, sex, body mass index, and ADHD medication use. CONCLUSION: This study suggests that a greater reduction in adiponectin level over time is associated with worse attentional and emotional dysregulation symptoms. Our findings may inform innovative adiponectin-focused strategies for patients with ADHD.

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2. Jacobsson P, Palage E, Hopwood CJ, Söderpalm B, Krueger RF, Tasselius V, Nilsson T. Personality Pathology and Functional Outcomes During Pharmacological Treatment of Adult ADHD. Personal Ment Health;2026 (May);20(2):e70071.

Adults with ADHD show substantial variability in response to pharmacological treatment, and comorbid personality pathology may help explain why symptom improvement often fails to translate into meaningful functional improvement. This naturalistic longitudinal study examined whether dimensional personality pathology predicts symptomatic and functional outcomes during routine stimulant treatment. A total of 246 adults with ADHD (66% women; mean age = 33.5) contributed repeated assessments over irregular follow-up intervals, with substantial attrition across waves. Linear mixed-effects models were used to accommodate unbalanced repeated measures. Linear mixed-effects models indicated that higher personality dysfunction was strongly associated with less improvement in functioning (β = 0.44, p < 0.001) and more persistent ADHD symptoms (β = 0.20, p < 0.001), independent of stimulant dose and time in treatment. Negative affectivity, detachment, psychoticism, and disinhibition were the maladaptive trait domains most consistently linked to poorer functional outcomes, whereas disinhibition showed the strongest association with residual ADHD symptom burden. Medication-related effects were modest in comparison. These findings identify personality pathology as a clinically relevant source of heterogeneity in adult ADHD treatment response and support routine assessment of personality functioning to inform clinical decision-making.

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3. Khan YS, Ahmed W, Stott J. Stability in attention-deficit hyperactivity disorder prevalence: wishful illusion or complex reality?. BJPsych Open;2026 (Mar 30);12(3):e96.

This editorial examines the current debate surrounding attention-deficit hyperactivity disorder prevalence, the perceived surge in diagnoses and the growing pressure on healthcare services. It discusses the wide methodological variation in recent studies, the limited pool of high-quality evidence and the challenges this creates when trying to understand true population rates. The article highlights the gap between stable epidemiological estimates and the marked rise in referrals, waiting lists, private assessments and prescribing. It explores how increased awareness, evolving diagnostic criteria and improved detection of previously unrecognised cases contribute to the overall picture, along with the role of social media and shifting societal attitudes. Implications for policy and clinical practice are outlined, emphasising the need for efficient clinical pathways, better-quality data and more comprehensive, multi-informant assessments.

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4. Reaume SV, Dubin JA, Perlman CM, Ferro MA. Health Functioning Moderates the Association Between Chronic Conditions and Mental Illness in Childhood. Child Care Health Dev;2026 (May);52(3):e70266.

OBJECTIVES: This study aimed to quantify associations between chronic conditions and mental illness; investigate potential moderating effects of child age, sex, health functioning, mental health service contact and household income on these associations; and explore the potential mediating effect of family functioning. METHODS: This study conducted secondary data analyses on a sample of 6242 children aged 4-17 years from the 2014 Ontario Child Health Study (OCHS). Chronic conditions were assessed using a standard list of conditions developed by the Statistics Canada. Mental illness was assessed with the Emotional Behavioural Scales (EBS). The Health Utility Index Mark III measured health functioning. Logistic regression models quantified associations between chronic conditions and mental illness. Moderating effects were tested with product-term interactions in logit models and interpreted using average marginal effects. Mediating effects were explored using the product of coefficients method. RESULTS: Having a chronic condition was associated with mood disorder (OR = 2.25 [95% CI: 1.36-3.74]). For children who have better health functioning, average marginal effects indicated that children with chronic conditions are 29% more likely to have any mental illness (p < 0.01), 21% more likely to have anxiety disorders (p < 0.05) and 21% more likely to have ADHD (p < 0.05) than children with no conditions. For children who have poorer health functioning, there was no association between chronic conditions and mental illnesses. Family functioning did not mediate any associations between chronic conditions and mental illness outcomes. CONCLUSION: The association between chronic conditions and mental illness in children is nuanced, with health functioning moderating this association for any mental illness, anxiety disorders and attention-deficit hyperactivity disorder specifically. Mental health screening programs should ensure children with chronic conditions who have better health functioning are routinely assessed and upstream interventions initiated early to reduce the incidence of physical-mental multimorbidity.

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5. Soldati L, Deiber MP, Hasler R, Meuleman B, Desseilles M, Perroud N. Paraphilias and paraphilic disorders in Attention-Deficit/Hyperactivity Disorder: an observational study. J Psychiatr Res;2026 (Mar 26);198:182-187.

Individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) are more likely than the general population to exhibit increased sexual desire and to engage in risky sexual behaviors. Emerging evidence also links ADHD to a heightened risk of sexual offenses and recidivism. While certain paraphilias and paraphilic disorders are known risk factors for sexual offending, it remains unclear whether they are more prevalent in individuals with ADHD than in the general population. This preliminary study investigated the prevalence of paraphilias and paraphilic disorders among 50 adults with ADHD and 136 control subjects. Paraphilic disorders tended to be more prevalent among individuals with ADHD than among control subjects. Although several differences did not reach statistical significance, voyeurism, voyeuristic disorder, exhibitionism, sadism, and pedophilic disorder were more frequently observed in the ADHD group than in controls. The pattern of increased prevalence of paraphilic disorders suggests greater psychological distress related to paraphilic interests among individuals with ADHD. The increased occurrence of voyeurism, sadism, and exhibitionism-particularly among men-raises concerns about a potential risk of sexual offending. Clinically, it is essential to distinguish between individuals with ADHD and paraphilic interests who present no risk of sexual offending and those who may pose such a risk. For the former, clinicians should be trained to evaluate and discuss paraphilic interests sensitively to promote sexual health; when paraphilias cause psychological distress, psychotherapeutic support should be provided. For the latter, when a non-negligible risk is identified, targeted psychotherapeutic and/or psychopharmacological interventions should be implemented.

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6. Subasi Turgut F, Öztürk M, Bulut M, Gökcüoğlu Nakipoğlu S, Kızıl N, Mete N. Profile of Th1/Th2/Th17/Treg Signature Cytokines and Microglia Regulatory Cytokines in ADHD and Healthy Controls: A Neuroimmunological Approach. J Atten Disord;2026 (Mar 30):10870547261428864.

BACKGROUND: Emerging evidence suggests that dysregulated immune homeostasis may play a role in the pathophysiology of ADHD; however, comprehensive profiling of T-helper (Th) cell subsets and microglial regulatory cytokines remains limited. METHODS: This cross-sectional study included adolescents aged 12 to 18 years with ADHD (n = 45) and healthy controls (n = 41). Serum levels of Th1 (IL-12 and IFN-γ), Th2 (IL-4), Th17 (IL-17 and IL-23), Treg (IL-10 and TGF-β), and microglia regulatory cytokines (IL-34 and CSF-1) were measured by ELISA. ROC curve and logistic regression analyses were performed to determine the diagnostic and predictive value of the parameters in distinguishing ADHD. RESULTS: Significant increases in IL-12, IL-17, IL-23, IL-4, and IL-10 levels were observed in the ADHD group compared to the control group. IL-12 and IL-17 showed the highest diagnostic yield (AUC = 0.77). IL-12 remained a strong independent predictor in multivariate analysis (OR = 55.88, P = .015). IFN-γ and TGF-β did not differ significantly between the groups. CSF-1 levels did not differ between the groups, while IL-34 showed an increase that approached statistical significance in the ADHD group (P = .052; AUC = 0.622). CONCLUSIONS: Our results reveal a profile of Th1/Th17-dominated proinflammatory activation, partially compensatory Th2/Treg modulation, and potentially IL-34-mediated microglial divergence in ADHD. IL-12 and IL-17 showed the highest discriminatory performance; however, their AUC values (~0.77) remained at a moderate level. Our findings highlight the need for multidimensional immunophenotyping and point toward novel immune-targeted therapeutic strategies.

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7. Tobin KV, Pritchett A, Leeder JS, Gobburu J, Dunn A. Understanding Atomoxetine Exposure Variability in Children and Adolescents With ADHD Through Population Pharmacokinetics. J Clin Pharmacol;2026 (Apr);66(4):e70168.

Atomoxetine, a selective norepinephrine reuptake inhibitor, is a nonstimulant alternative to treat attention-deficit/hyperactivity disorder in children and adolescents. Atomoxetine exposure is highly variable due to cytochrome P450 polymorphism; however, the impact of these genetic variations has not been adequately characterized in the pediatric population. A population pharmacokinetic (PK) model was developed to evaluate steady-state atomoxetine exposures after oral administration in a large, heterogeneous population of children and adolescents with different metabolic phenotypes. Due to the highly variable and complex absorption between subjects and occasions, a two-stage approach was implemented, treating each participant/occasion as a separate individual. First, the individual atomoxetine parameters were estimated using a one-compartment distribution model with zero-order duration into a depot compartment followed by first-order absorption into the central compartment with linear elimination. Next, population-level parameters were obtained, and covariate analysis was performed. Using actual body weight, relative bioavailability based on CYP2D6 or CYP2C19 phenotype, and CYP2D6 clearance effects in the model reduced the variability from 81.6% to 64.5% and 92.4% to 75.5% for apparent volume and apparent clearance, respectively. The final model showed adequate precision in PK parameters and accuracy in exposure metrics. Following prospective validation, this model could be used to provide clinicians with individualized dosing targets when prescribing atomoxetine to children and adolescents based on their genetic disposition.

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