Le mind-wandering est ce phénomène connu de tous, où l’attention décroche et « vagabonde » au gré de pensées sans lien avec la tâche en cours [1]. Dans une tâche de go/no-go, les épisodes de déconcentration entrainent une diminution des performances et une augmentation de la variabilité des temps de réponse, par rapport aux périodes où l’attention est soutenue [2]. Mais le déficit d’attention n’est pas spécifique du TDA/H (Trouble Déficit d’Attention avec ou sans Hyperactivité) car il est présent dans d’autres pathologies comme par exemple la dépression [3]. Dans cette étude nous recherchons une différence de profils attentionnels liés au « mind wandering », qui serait spécifique au TDA/H.

Au moyen d’un go/no-go interrompu par des rapports subjectifs du contenu de la pensée, nous avons mené la même expérience, à la fois dans des populations d’enfants et d’adultes, en comparant des groupes de sujets TDA/H, des groupes de sujets contrôles cliniques et sains.

Nous mettons en évidence une augmentation significative de pensées floues ou vides (mind-blanking[4]), chez les sujets TDA/H enfants et adultes.

Cette augmentation de pensées impossibles à rapporter, semble spécifique du TDA/H. Pour maintenir l’attention focalisée comme pour prolonger un épisode de rêverie éveillée, de bonnes fonctions exécutives semblent nécessaires [1]. Or le TDA/H se caractérise par un déficit de fonctions exécutives [5], ce qui impliquerait donc une alternance plus rapide entre cours externe et interne de pensées soit une durée moyenne des épisodes de focus attentionnel ou de rêverie, plus brève. Un stimulus qui ne dure pas suffisamment longtemps ne peut faire l’objet d’un rapport verbal car non accessible à la conscience [6]. Le mind-blanking pourrait être un marqueur indirect d’un fil de pensées trop labile pour être accessible à la conscience.

Results from clinical and molecular genetic studies suggest that autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) could have a shared pattern of heritability. Among a large number of clinical variables evaluated, obsessive compulsive/repetitive behaviors have been found to be highly correlated among autism probands and their relatives. Empirical evidence from neuropsychological studies suggest that an appropriate model for repetitive behaviours is a deficit of executive functions specifically flexibility. Given the lack of flexibility observed in ASD and OCD probands, we hypothesised that it could represent a shared endophenotype in both families.

Seven cognitive tests belonging to executive functions, central coherence and theory of mind were proposed to 58 unaffected first-degree relatives of probands with ASD and 61 unaffected first-degree relatives of OCD patients and compared with 34 healthy controls. A principal component analysis (PCA) was performed.

ASD relatives - specifically mothers - performed significantly worse on all the tests than OCD relatives and controls. Moreover, inside the OCD group, female individuals performed significantly worse than males. Finally, the PCA indicate that the cognitive profiles of the ASD relatives and the OCD relatives were similar but distinct from controls.

Lack of cognitive flexibility is observed in ASD and OCD families and might constitute a shared intermediate cognitive phenotype. Our study constitutes an effort to clarify the relationship between ASD and OCD having implications for our nosological understanding of both disorders.

Autism spectrum disorders (ASD) are characterized by deficits in social interaction and behavioral impairments. Several studies have reported differences in white matter generalized Fractional Anisotropy (gFA) in ASD.

We studied white matter microstructural integrity in individuals with ASD.

We conducted the first DWI-based whole brain tractography study to compare gFA in 22 deep white matter tracts in first-degree relatives of individuals with ASD to controls and individuals with ASD. Futhermore, we replicated our significants results in an independant sample.

Fifty-one first-degree relatives of individuals with ASD, 29 controls and 14 individuals with ASD participated.

We performed q-ball imaging whole-brain tractography based on 1.5 T diffusion weighted MRI over 32 non-colinear directions. Then, we computed mean gFA along 22 main deep white matter tracts. A linear mixed model using group, gender, age and IQ as fixed effects and family as a random effect was used and Bonferroni correction applied. We also recruited a replication sample comprising 23 individuals with ASD and 32 controls.

We demonstrated a significantly reduced mean gFA along the left IFOF in first-degree relatives of individuals with ASD and individuals with ASD compared with controls and replicated this finding in an independant sample of patients. A decrease in mean gFA was also observed in the left CST when we compared first-degree relatives of individuals with ASD to controls (no such decrease was present in patients).

Our work suggests that structural fronto-occipital disconnectivity may be an endophenotype of ASD.

Psychiatric comorbidities are shown to be very prevalent in patients diagnosed with Autism Spectrum Disorder (ASD), up high to 53% for mood, 50% anxiety and 43% for ADHD disorders in an European cohort of adults with HFA. Using a new approach, our study proposes to explore aspects of comorbidities in the largest French cohort of HFA adults (C0733/InfoR) by implying qualitative and quantitative clinical tools.

To explore: (1) the prevalence rates of psychiatric comorbidities; (2) the interplay between comorbidities and the ASD symptoms.

Diagnosis was made according to DSM 5 criteria. Dimensional evaluation used Social Responsiveness Scale (SRS), Systemizing Quotient (SQ) and Empathy Quotient (EQ). We used T-test, Mann–Whitney test and linear regression models.

We included 103 patients (mean age 29.3, sex ratio M/F: 3.4:1). Lifetime prevalence rates of 53.5% for depressive disorder 73.5% for anxiety disorders and 37.5% for ADHD were found. Subjects with psychotic co-morbid symptoms had a more severe social deficit (SRS score 66.2 vs 77.9 P < 0.05); patients with ADHD, lower cognition (mean IQ total 107.7 vs 99.0 P < 0.05). SQs (P < 0.05) were significantly higher in patients with co-morbid psychosis, dysthymia, suicide attempts, and depressive disorders and directly correlated with age (β = 0.35, P < 0.05). SQ and EQ were inversely correlated.

The results reproduce the high prevalence of comorbidities in other studies and explore its association with social functioning and cognition. Identification of associated psychiatric conditions in subjects with HFA is therefore a crucial clinical issue potentially guiding the treatment.

The authors have not supplied their declaration of competing interest.

Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.

Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.

Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?

Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.