Always Screen for Co-Existing ADHD and Insomnia

What’s happening – A study exploring comorbid ADHD and insomnia revealed important advice for clinicians: When treating people with ADHD, you should also screen them for insomnia, and insomnia patients should, likewise, be screened for ADHD. Why? Each of these diagnoses has been independently linked to lower quality of life (QoL) scores and when they show up in combination, they can significantly increase the impact on QoL. In fact, findings indicate that people who have co-existing ADHD and insomnia are more likely to have poorer mental functioning, as well as lower productivity than their counterparts dealing with only one of these conditions. Data were based on a survey of 4,500 participants as part of The Netherlands Mental Health Survey and Incidence Study.

The details – Read the full report.
(Van Andei E, Combined impact of ADHD and insomnia symptoms on quality of life, productivity, and health care use in the general population, Psychological Medicine, June 2020)

Worth noting – Researchers discovered that physical functioning and healthcare utilization were not impacted by the co-occurrence of ADHD and insomnia.

The perspectives –

  • The Community for Sleep Care Professions suggested a possible link between ADHD and a circadian disorder
  • An interview on MedicalNewsToday noted that sleep disorders in people with ADHD may lead to other health problems as well.
  • An earlier study published in Acta Psychiatrica Scandinavica found that in adults with ADHD, taking stimulants didn’t increase insomnia symptoms. In fact, they may even help address insomnia symptoms.

The conversation – 

  • @OruenCNS (Oruen) culled out: “These results underscore the importance of screening for sleep problems when ADHD symptoms are present.”
  • According to @DrSeanOMara, using a weighted blanket is one way to address insomnia, ADHD, and related conditions.

In practice – see our report on the cultural factors that may impact an ADHD diagnosis and how to track student progress during the COVID pandemic.

Test your ADHD & insomnia knowledge with this week’s Psy-Q.

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Pandemic Triggers Those with Eating Disorders

What’s happening – The isolation and social distancing requirements imposed during COVID has been a trigger for people with existing eating disorders, according to a study conducted by researchers at UNC’s Center of Excellence for Eating Disorders (CEED) in collaboration with the National Center of Excellence for Eating Disorders (NCEED). After surveying approximately 1,000 people living in the US and The Netherlands, researchers discovered that concerns around food supply and shortages, as well as overall anxiety related to the pandemic, increased existing eating patterns in many respondents consistent with their diagnoses.  

The details – Read the full findings
(Termorshuizen JD, Early Impact of COVID-19 on Individuals with Eating Disorders: A survey of ~1000 Individuals in the United States and The Netherlands, medRxiv preprint, June 2020)

Worth noting – Survey respondents also revealed limitations around teletherapy appointments.

 The perspectives  – 

  • The APA said that in the midst of COVID-19 stressors on eating disorders also comes opportunities for psychologists to find creative ways to better support patients.
  • Medscape dug deeper with an NEDA spokesperson on why the pandemic has reinforced unhealthy eating habits.
  • Scientific American shares one woman’s experience with eating disorder regression.

The conversation – 

  • @GenPsychPC (GenPsych) called out the pandemic’s disrupted routines, public behavior triggers, and inaccessible health services.
  • @EDCoalition (Eating Disorder Coalition) shared: “The @nceedus recently collaborated on a study examining the early impacts of #COVID-19 on those with eating disorders. 79% of those surveyed in the US fear that their eating disorder would worsen in connection to the coronavirus.”
  • @sczerwas (S. Zerwas) tweeted another paper revealing how the pandemic is “affecting people w. #eatingdisorders. We’re seeing increased restriction, binge eating & that pxs struggle w. telehealth.”
  • @DrHowardLiu (Howard Liu, MD, MBA) commented: “What an important and timely study suggesting over half of US individuals with eating disorder symptoms are concerned about worsening illness due to lack of structure in COVID. And telehealth may not be ideal for ED patients.”

In practice – which mHealth apps to recommend for patients with eating disorders and how to guide patients through heightened anxiety during COVID.


PTSD: Look Deeply into your Patient’s Eyes (Really)

What’s happening – An episode of Netflix’s “Unbreakable Kimmy Schmidt” introduced an unusual fact in one of its storylines: that experiencing post-traumatic stress disorder (PTSD) can leave its mark on a person’s eyes.  This phenomenon was described in scientific detail in a study by Aimee McKinnon at Cardiff University (she’s now at Oxford) published in Biological Psychology. Her findings support that the eyes of patients who have experienced trauma and who have related PTSD have an exaggerated response to stimuli. Specifically, people with PTSD experience changes to the pupil size when viewing images that evoke an autonomic nervous system response.

The details – Read the complete findings.
(McKinnon AI, Enhanced emotional response to both negative and positive images in post-traumatic stress disorder: Evidence from pupillometry, Biological Psychology, July 2020).

Worth noting – Study participants experienced enhanced physiological arousal to both negative and positive images.

The perspectives

 The conversation – 

  • @CombatStress shared: “Dr Murphy, our Head of Research, said ‘We welcome this research as it may help to diagnose PTSD sooner and allow veterans to get the treatment they need quicker.’”
  • David Jackson @Voiceofaveteran said the study was: “interesting but once again the psychosocial implications and consequences are ignored/not taken into account.”
  • @Fae8edSaga pointed out that this research could pave the way “to use positive pictures in therapy, rather than relying upon negative images, and make therapy more bearable.”

In practice – How medical marijuana and psychedelic-assisted treatment may help those with PTSD. Plus, when PTSD overlaps with schizophrenia.


This week’s Psy-Q: Test your ADHD and Sleep knowledge 

This week’s Practice Essential: Why I Take Breaks

Last Updated: Jun 16, 2021