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LETTER TO EDITOR
Year : 2019  |  Volume : 39  |  Issue : 3  |  Page : 155-156

Adults with attention-deficit/hyperactivity disorder might relate with poor resilience and psychological well-being in military personnel


Department of Psychiatry, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan

Date of Submission14-Nov-2018
Date of Decision14-Jan-2019
Date of Acceptance18-Feb-2019
Date of Web Publication27-May-2019

Correspondence Address:
Prof. Chin-Bin Yeh
No. 325, Sec. 2, Cheng-Kung Road, Nei-Hu Area, Taipei 114
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmedsci.jmedsci_181_18

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How to cite this article:
Huang YC, Yeh CB. Adults with attention-deficit/hyperactivity disorder might relate with poor resilience and psychological well-being in military personnel. J Med Sci 2019;39:155-6

How to cite this URL:
Huang YC, Yeh CB. Adults with attention-deficit/hyperactivity disorder might relate with poor resilience and psychological well-being in military personnel. J Med Sci [serial online] 2019 [cited 2019 Jun 26];39:155-6. Available from: http://www.jmedscindmc.com/text.asp?2019/39/3/155/253800



Dear Editor,

A research assessing relations between coping strategies, resilience, psychological well-being (PWB), and perceived health in soldiers were published in Volume 38 Issue 2 in Journal of Medical Science. The authors concluded that approach-oriented coping results in significant positive effects on resilience and PWB and avoidant coping has opposite effects. Furthermore, they thought positive coping strategies are important.

In the clinical setting, some soldiers visit psychiatrists due to emotional dysregulation, tense interpersonal relationship, low perseverance, or impulsivity, with poor coping strategies, and functional impairment. These situations might relate with mental disorders, such as depressive disorder, bipolar disorder, personality disorder, or attention-deficit/hyperactivity disorder (ADHD). Among these mental disorders, we should raise awareness about the diagnosis of ADHD in soldiers. Individuals with ADHD are not exempt from compulsory service in the current Taiwanese military law, and they might face struggles in the army. They may have more argumentative or defiant behaviors and have difficulty adjusting to military life for the hierarchical relationships in the troop. Their decline in executive function and decreased inhibition might lead to poor time management and occupational performance.[1] The inattention or hyperactivity and impulsivity symptoms in their childhood might be subtle or undetected. With retrospective reports of ADHD traits, they might be diagnosed with child-onset ADHD, late-onset ADHD (with onset age after 12), or adults with ADHD.[2]

ADHD is a chronic neurodevelopmental disorder and may persist into adulthood. The prevalence rate of ADHD in general population in adults is 2.5%.[3] There is greater prevalence in males than females in ADHD. There are also gender differences in ADHD, women with ADHD tend to have more inattentive symptoms, and they are more often undiagnosed. In DSM-5, the age of onset extends from 7 to 12 years and the symptom threshold is lowered to five in individuals who are 17 years or older,[4] decreasing the rate of false-negative diagnosis of adult ADHD. With the change of diagnostic criteria and evidence from previous research, there is more emphasis on late-onset and adult ADHD. Patients might have decline of executive function, poor academic or occupational achievement, and more psychiatric comorbidities.[5] The later, the patients with ADHD are diagnosed and treated, the greater risk for low self-esteem will develop. The comorbid mental disorders included mood disorders or substance use disorders, and the comorbidities might be the reason they visit a psychiatrist for the first time.

Medication alone or combining with psychosocial treatment improves ADHD symptoms. Medication included stimulants, nonstimulants, or treating comorbid depressive or bipolar disorders by antidepressants or antipsychotics.

With high comorbidities and disabling condition in adults, burden of ADHD increases, warrants focused attention and management. We suggest early detection. Screening soldiers with avoidant coping strategies or poor resilience for ADHD might be of great benefit and will help them adapt and increase their quality of life.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Berryessa CM. Attention, reward, and inhibition: Symptomatic features of ADHD and issues for offenders in the criminal justice system. Atten Defic Hyperact Disord 2017;9:5-10.  Back to cited text no. 1
    
2.
Caye A, Sibley MH, Swanson JM, Rohde LA. Late-onset ADHD: Understanding the evidence and building theoretical frameworks. Curr Psychiatry Rep 2017;19:106.  Back to cited text no. 2
    
3.
Simon V, Czobor P, Bálint S, Mészáros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: Meta-analysis. Br J Psychiatry 2009;194:204-11.  Back to cited text no. 3
    
4.
American Psychiatric Association. Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013. p. 59.  Back to cited text no. 4
    
5.
Magnin E, Maurs C. Attention-deficit/hyperactivity disorder during adulthood. Rev Neurol (Paris) 2017;173:506-15.  Back to cited text no. 5
    




 

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