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Cupertino RB, Soheili-Nezhad S, Grevet EH, Bandeira CE, Picon FA, Tavares MEDA, Naaijen J, van Rooij D, Akkermans S, Vitola ES, Zwiers MP, Rovaris DL, Hoekstra PJ, Breda V, Oosterlaan J, Hartman CA, Beckmann CF, Buitelaar JK, Franke B, Bau CHD, Sprooten E. Reduced fronto-striatal volume in attention-deficit/hyperactivity disorder in two cohorts across the lifespan. NEUROIMAGE-CLINICAL 2020; 28:102403. [PMID: 32949876 PMCID: PMC7502360 DOI: 10.1016/j.nicl.2020.102403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) has been associated with altered brain anatomy in neuroimaging studies. However, small and heterogeneous study samples, and the use of region-of-interest and tissue-specific analyses have limited the consistency and replicability of these effects. We used a data-driven multivariate approach to investigate neuroanatomical features associated with ADHD in two independent cohorts: the Dutch NeuroIMAGE cohort (n = 890, 17.2 years) and the Brazilian IMpACT cohort (n = 180, 44.2 years). Using independent component analysis of whole-brain morphometry images, 375 neuroanatomical components were assessed for association with ADHD. In both discovery (corrected-p = 0.0085) and replication (p = 0.032) cohorts, ADHD was associated with reduced volume in frontal lobes, striatum, and their interconnecting white-matter. Current results provide further evidence for the role of the fronto-striatal circuit in ADHD in children, and for the first time show its relevance to ADHD in adults. The fact that the cohorts are from different continents and comprise different age ranges highlights the robustness of the findings.
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Affiliation(s)
| | - Sourena Soheili-Nezhad
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eugenio Horacio Grevet
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Cibele Edom Bandeira
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Almeida Picon
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Maria Eduarda de Araujo Tavares
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daan van Rooij
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Akkermans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eduardo Schneider Vitola
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcel P Zwiers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Diego Luiz Rovaris
- Universidade de Sao Paulo Instituto de Ciencias Biomedicas Departamento de Fisiologia e Biofisica, São Paulo, Brazil
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Vitor Breda
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Amsterdam, The Netherlands; Vrije Universiteit, Clinical Neuropsychology Section, Van der Boechortstraat 7, 1081 BT Amsterdam, The Netherlands
| | - Catharina A Hartman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Emma Neuroscience Group, Department of Pediatrics, Amsterdam Reproduction & Development, Amsterdam, The Netherlands; Vrije Universiteit, Clinical Neuropsychology Section, Van der Boechortstraat 7, 1081 BT Amsterdam, The Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Claiton Henrique Dotto Bau
- Adulthood ADHD Outpatient Program (ProDAH), Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Developmental Psychiatry Program, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Radboud University Medical Center, Nijmegen, The Netherlands.
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Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry 2020; 20:404. [PMID: 32787804 PMCID: PMC7422602 DOI: 10.1186/s12888-020-02707-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO 1735, Croydon, London, CR9 7AE, UK.
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.
| | - Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Service for Complex Autism and Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, London, UK
| | | | | | | | | | | | - Quinton Deeley
- National Autism Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter Hill
- Independent Consultant in Child and Adolescent Psychiatry, Private Practice, London, UK
| | - Jack Hollingdale
- Michael Rutter Centre, South London and Maudsley Hospital, London, UK
| | | | | | - Peter Mason
- ADHD and Psychiatry Services Limited, Liverpool, UK
| | | | | | - Jane Sedgwick
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kevin Tierney
- Neuropsychiatry Team, National Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kobus van Rensburg
- Adult ADHD and AS Team & CYP ADHD and ASD Service in Northamptonshire, Northampton, UK
| | - Emma Woodhouse
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
- Compass, London, UK
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Silva D, Colvin L, Glauert R, Stanley F, Srinivas Jois R, Bower C. Literacy and Numeracy Underachievement in Boys and Girls With ADHD. J Atten Disord 2020; 24:1392-1402. [PMID: 26689936 DOI: 10.1177/1087054715613438] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drug Dependence Systems, Western Australian Literacy and Numeracy Assessment database, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: Twenty-three percent of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident in reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.
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Affiliation(s)
- Desiree Silva
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia.,School of Paediatrics and Child Health, University of Western Australia.,Joondalup Health Campus, Joondalup, Western Australia
| | - Lyn Colvin
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
| | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
| | - Fiona Stanley
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia.,School of Paediatrics and Child Health, University of Western Australia
| | | | - Carol Bower
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
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Elwin M, Elvin T, Larsson JO. Symptoms and level of functioning related to comorbidity in children and adolescents with ADHD: a cross-sectional registry study. Child Adolesc Psychiatry Ment Health 2020; 14:30. [PMID: 32760444 PMCID: PMC7392687 DOI: 10.1186/s13034-020-00336-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 07/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well known that a wide range of psychiatric disorders co-occur with attention deficit hyperactivity disorder. In this study we aimed to examine the associations of psychiatric comorbidity in ADHD with symptom severity and level of functioning. METHODS We used data from the Swedish National Quality Registry for ADHD Treatment Follow-up and identified comorbid diagnoses in a sample of 3246 Swedish children and adolescents with ADHD. We investigated the association of comorbidity with symptom severity and level of function by multiple linear regressions. RESULTS Autism spectrum disorder, anxiety and affective disorders, oppositional defiant disorder or conduct disorder, learning disorders, and multiple comorbid disorders associate to lower levels of functioning compared to ADHD only. Multiple comorbidity, autism spectrum disorder, oppositional defiant or conduct disorders and tic disorders relate to ADHD symptom severity. CONCLUSIONS Comorbidity subgroups with ADHD differ in functional impairment and ADHD symptoms severity. Information on comorbidity profiles could be used for treatment planning more adapted to the individual. Especially those who have autism spectrum disorders and multiple comorbid disorders are at risk of severe ADHD symptoms and low level of functioning.
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Affiliation(s)
- Marie Elwin
- University Health Care Research Center, Region Örebro County, Örebro, Sweden ,grid.15895.300000 0001 0738 8966Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Tove Elvin
- University Health Care Research Center, Region Örebro County, Örebro, Sweden
| | - Jan-Olov Larsson
- grid.4714.60000 0004 1937 0626Karolinska Institutet, Stockholm, Sweden
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Silva D, Colvin L, Glauert R, Stanley F, Srinivasjois R, Bower C. Literacy and Numeracy Underachievement in Boys and Girls With ADHD. J Atten Disord 2020; 24:1305-1316. [PMID: 26290485 DOI: 10.1177/1087054715596575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The aim was to determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drugs of Dependence System and Western Australian Literacy and Numeracy Assessment databases, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: A total of 23% of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident for reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.
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Affiliation(s)
- Desiree Silva
- Telethon Kids Institute, University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Joondalup Health Campus, University of Western Australia, Perth, Australia
| | - Lyn Colvin
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Fiona Stanley
- Telethon Kids Institute, University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | | | - Carol Bower
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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Zorlu A, Unlu G, Cakaloz B, Zencir M, Buber A, Isildar Y. The Prevalence and Comorbidity Rates of ADHD Among School-Age Children in Turkey. J Atten Disord 2020; 24:1237-1245. [PMID: 25846229 DOI: 10.1177/1087054715577991] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The aim of the present study was to explore the prevalence and comorbidity rates of ADHD in a community sample of school-age children. Method: Participants were 1,508 children aged 6 to 14 years. Parents and teachers of each child completed the Turgay Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S). Screen-positive cases were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Diagnoses were based on DSM-IV criteria. Results: The prevalence rate of ADHD was 8%. Children from extended families had extremely high rates (46.4%) of ADHD. Sixty percent of children with ADHD had one or more comorbid diagnoses. The most common comorbidities were learning disorders (35.7%) and oppositional defiant disorder (22.6%). Conclusion: The prevalence and comorbidity rates of ADHD in school-age children in Turkey are similar to those found in previous studies in other countries.
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Affiliation(s)
- Adil Zorlu
- Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | | | | | | | | | - Yetis Isildar
- Sami Ulus Training and Research Hospital, Ankara, Turkey
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Correlates of Loneliness in Children with Attention-Deficit/Hyperactivity Disorder: Comorbidities and Peer Problems. Child Psychiatry Hum Dev 2020; 51:478-489. [PMID: 31981083 DOI: 10.1007/s10578-020-00959-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are well-documented to experience social-emotional difficulties; however, little is known about their loneliness-an aspect of social-emotional functioning. Using a cross-sectional design, we examined how loneliness relates to comorbid internalizing disorders, externalizing disorders, and peer problems in a sample of 213 children with ADHD. Children (66 girls, Mage = 8.58, SDage = 1.55) reported their loneliness. Comorbid internalizing and externalizing disorders were assessed via a multi-informant procedure. Proportion of classmates who accepted, rejected, and ignored the child, friendship quantity, and friendship quality were peer problem indicators. Results suggested that children with comorbid internalizing disorders, fewer friendships, or potentially more negative friendship quality, reported more loneliness. Gender appeared to moderate the association between peer rejection and loneliness, such that boys with peer rejection reported more loneliness than girls. Clinical implications include targeting loneliness as a social-emotional problem to assess and treat in children with ADHD.
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Sobanski E, Brüggemann D, Alm B, Kern S, Philipsen A, Schmalzried H, Heßlinger B, Waschkowski H, Rietschel M. Subtype differences in adults with attention-deficit/hyperactivity disorder (ADHD) with regard to ADHD-symptoms, psychiatric comorbidity and psychosocial adjustment. Eur Psychiatry 2020; 23:142-9. [DOI: 10.1016/j.eurpsy.2007.09.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2007] [Revised: 09/26/2007] [Accepted: 09/27/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractBackgroundTo date, nearly all research of subtype differences in ADHD has been performed in children and only two studies, with conflicting results, have covered this subject in adults with ADHD.ObjectiveThis study examined subtype differences in the clinical presentation of ADHD-symptoms, related psychopathological features, psychosocial functioning and comorbid psychiatric disorders in adults with ADHD.MethodOne hundred and eighteen adults with ADHD, diagnosed according to DSM-IV criteria, and a population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic features. Comparisons were made between ADHD combined type (n = 64), predominantly inattentive type (n = 30) and predominantly inattentive type, anamnestically combined type (n = 24), relative to each other and to a community control group (n = 70).ResultsThe four groups did not differ in age and gender composition. All ADHD groups had significantly less education, were significantly more often unemployed and reported significantly more lifetime psychiatric comorbidity than controls. In comparison to each other, the three ADHD groups differed mainly in core symptoms and the pattern of comorbid psychiatric disorders, whereas no prominent differences in associated psychopathological features and most of the assessed psychosocial functions could be found. Patients with ADHD combined type and inattentive, anamnestically combined type both presented with significantly more hyperactive symptoms and also showed more impulsive symptoms than those with the predominantly inattentive type. With a similar overall lifetime psychiatric comorbidity in the three groups, patients with ADHD combined type and inattentive, anamnestically combined type suffered significantly more from lifetime substance use disorders than patients with predominantly inattentive type.ConclusionOur results clearly show impaired psychosocial adjustment and elevated risk for additional psychiatric disorders in adults with all subtypes of ADHD, compared to healthy controls. They provide preliminary evidence that in adult ADHD there might be a subgroup of patients, which is classified as predominantly inattentive subtype according to current diagnostic criteria, but which in its clinical presentation is in between ADHD combined and inattentive type. Further studies are needed to evaluate this finding and to gain a clear picture of its validity.
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Athanasiadou A, Buitelaar JK, Brovedani P, Chorna O, Fulceri F, Guzzetta A, Scattoni ML. Early motor signs of attention-deficit hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2020; 29:903-916. [PMID: 30798414 PMCID: PMC7321902 DOI: 10.1007/s00787-019-01298-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/18/2019] [Indexed: 11/24/2022]
Abstract
ADHD is a common neurodevelopmental disorder with onset of symptoms typically in early childhood. First signs of the disorder, including language delay, motor delay and temperament characteristics, may be evident as early as infancy. The present review describes published evidence about early motor signs of either children with later symptoms of ADHD or a later diagnosis of the disorder. Nine published cohort studies were included after a systematic search of related terms in PubMed and PsycInfo databases. Study eligibility criteria included: (1) report on early motor function or any motor-related signs; (2) the presence of a participants' assessment by/at 12 months of age; (3) report of a later presence of ADHD symptoms. The limited number of reports included suggests an association between mild early neurological markers and later developmental coordination disorder and motor overflow movements. Unfortunately, due to their small sample sizes and focus on group reports rather than individuals, they have limited power to find strong associations. Early motor indicators of ADHD, if present, appear to be non-specific, and therefore not yet useful in clinical screening. Spontaneous motility seems to be a promising measure for early ADHD detection, although further studies with large cohorts are recommended to determine its clinical role in children at risk for ADHD.
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Affiliation(s)
- A. Athanasiadou
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - J. K. Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - P. Brovedani
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa Italy
| | - O. Chorna
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa Italy
| | - F. Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - A. Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris, Calambrone, Pisa Italy
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Wu Y, Feng G, Xu Z, Li X, Zheng L, Ge W, Ni X. Identification of different clinical faces of obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol 2019; 127:109621. [PMID: 31521054 DOI: 10.1016/j.ijporl.2019.109621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to identify the heterogeneity of obstructive sleep apnea syndrome clinical presentation in children. PARTICIPANTS Children who were 3-14 years old and with obstructive sleep apnea syndrome after polysomnography monitoring (apnea and hypopnea index>5 or obstructive apnea index>1) in the sleep center of Beijing Children's Hospital were included. METHODS A sleep disorder questionnaire including different combinations of symptoms and co-morbidities of obstructive sleep apnea syndrome in children was used. A cluster analysis was used to classify the data. RESULTS The apnea hypopnea index alone is not adequate to predict clinical phenotypes. Based on symptoms and co-morbidities of obstructive sleep apnea syndrome, three distinct clusters were identified. They were "nocturnal snoring and daytime sleepiness group" (cluster 1), "hyperactivity group" (cluster 2), and "minimally symptomatic group" (cluster 3). A prediction model was built according to eight variables which showed statistical significance by pairwise comparison among clusters. Overall accuracy of the prediction model could reach 86%. Both the sensitivity and specificity of cluster 2 and 3 prediction were around 90%. CONCLUSION Children with obstructive sleep apnea syndrome have different patterns of clinical presentation and the identification of the different clinical profiles of obstructive sleep apnea syndrome can provide clues for more personalised diagnoses and therapies.
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Affiliation(s)
- Yunxiao Wu
- Beijing Key Laboratory of Pediatric Otolaryngology, Head & Neck Surgery, Beijing Pediatric Research Institute, China
| | | | | | - Xiaodan Li
- Otolaryngology, Head and Neck Surgery Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Li Zheng
- Otolaryngology, Head and Neck Surgery Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wentong Ge
- Otolaryngology, Head and Neck Surgery Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Ni
- Otolaryngology, Head and Neck Surgery Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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Bergwerff CE, Luman M, Weeda WD, Oosterlaan J. Neurocognitive Profiles in Children With ADHD and Their Predictive Value for Functional Outcomes. J Atten Disord 2019; 23:1567-1577. [PMID: 28135892 DOI: 10.1177/1087054716688533] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We examined whether neurocognitive profiles could be distinguished in children with ADHD and typically developing (TD) children, and whether neurocognitive profiles predicted externalizing, social, and academic problems in children with ADHD. METHOD Neurocognitive data of 81 children with ADHD and 71 TD children were subjected to confirmatory factor analysis. The resulting factors were used for community detection in the ADHD and TD group. RESULTS Four subgroups were detected in the ADHD group, characterized by (a) poor emotion recognition, (b) poor interference control, (c) slow processing speed, or (d) increased attentional lapses and fast processing speed. In the TD group, three subgroups were detected, closely resembling Subgroups (a) to (c). Neurocognitive subgroups in the ADHD sample did not differ in externalizing, social, and academic problems. CONCLUSION We found a neurocognitive profile unique to ADHD. The clinical validity of neurocognitive profiling is questioned, given the lack of associations with functional outcomes.
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Affiliation(s)
| | | | - Wouter D Weeda
- 1 Vrije Universiteit Amsterdam, The Netherlands.,2 Leiden University, The Netherlands
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Abstract
OBJECTIVE No systematic reviews could be identified in the literature that address ADHD research in Arab countries. In an attempt to help fill this gap, this systematic review was undertaken. METHOD An electronic literature search of ADHD studies carried out in Arab countries was done by using Google Scholar, PsycINFO, PubMed, Education Resources Information Center (ERIC), and Arabpsynet. RESULTS The search yielded 58 studies (10 studies on psychoeducational and social aspects of ADHD, 26 prevalence studies and two reviews of epidemiology of ADHD, and 22 studies on risk factors and comorbidities in ADHD). CONCLUSION Although there has been an increase in ADHD research in Arab countries in recent years, this research remains relatively sparse and used methods and procedures that limit the generalizability of the findings.
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Theule J, Hurl KE, Cheung K, Ward M, Henrikson B. Exploring the Relationships Between Problem Gambling and ADHD: A Meta-Analysis. J Atten Disord 2019; 23:1427-1437. [PMID: 26832122 DOI: 10.1177/1087054715626512] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: At present, there are inconsistencies in the literature pertaining to the association between ADHD and problem gambling. This study utilized meta-analytic techniques to clarify the association between symptoms of problem gambling and symptoms of ADHD. Method: Several meta-analyses were conducted using a random effects model. PsycINFO, PubMed, ProQuest Dissertations & Theses, and Google Scholar were searched for relevant studies. Results: The weighted mean correlation between ADHD symptomology and gambling severity was r = .17, 95% confidence interval (CI) = [0.12, 0.22], p < .001. Mean age of the sample was the only moderator to approach significance, with greater age being linked to a stronger relationship between symptoms of ADHD and gambling severity. Conclusion: Clinicians needs to be cognizant of the greater risk of ADHD symptoms when working with problem gamblers and vice versa.
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Velõ S, Keresztény Á, Ferenczi-Dallos G, Balázs J. Long-Term Effects of Multimodal Treatment on Psychopathology and Health-Related Quality of Life of Children With Attention Deficit Hyperactivity Disorder. Front Psychol 2019; 10:2037. [PMID: 31607973 PMCID: PMC6769122 DOI: 10.3389/fpsyg.2019.02037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/20/2019] [Indexed: 11/13/2022] Open
Abstract
AIM The current study aimed to examine the association between long-term (36 months) multimodal (pharmacological and psychological) treatment and psychopathology and health-related quality of life (HRQoL) in children with attention deficit/hyperactivity disorder (ADHD) from the perspectives of both the children and parents. METHODS The sample consisted of 23 children with ADHD (21 boys, 2 girls, mean age = 13.46 years, SD = 2.36) and 23 healthy control children (11 boys, 12 girls, mean age = 12.49 years, SD = 1.75). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was applied to measure psychopathology and both parent and self-rated versions of the Inventory for the Measure of the Quality of Life in Children and Adolescents were used to assess HRQoL at baseline and at the 36-month follow-up visit. The ADHD group took part in multimodal (medical and behavioral) therapy. The healthy control group did not get any intervention. RESULTS At the baseline, the ADHD group was characterized with higher scores in nine MINI Kid scales and showed lower HRQoL than the control group according to both children and their parents. At the 36-month follow-up visit six scale scores (ADHD, social phobia, oppositional defiance and conduct disorder, major depressive episode, dysthymic disorder) showed statistically significant decreases in the ADHD group, while these scores were constant in the control group. Parent-rated HRQoL was significantly lower in the clinical group at baseline than at the end of the study, but there were no significant changes in the control group. Self-reported changes in HRQoL matched parent-reported changes. INTERPRETATION Multimodal therapy is associated with decreased psychopathology and improved HRQoL over the long term.
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Affiliation(s)
- Szabina Velõ
- Doctoral School of Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Ágnes Keresztény
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Gyöngyvér Ferenczi-Dallos
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Vadaskert Foundation, Child Psychiatry Hospital and Outpatient Clinic, Budapest, Hungary
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Bjørknes University College, Oslo, Norway
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Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019; 7:2420-2426. [PMID: 31559278 PMCID: PMC6745333 DOI: 10.12998/wjcc.v7.i17.2420] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/10/2019] [Accepted: 07/27/2019] [Indexed: 02/05/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset in early childhood. It is a clinically heterogenous condition with comorbidity posing a distinct challenge to diagnosing and managing these children and adolescents. This review aims to provide an overview of comorbidity with ADHD including other neurodevelopmental disorders, learning disorders, externalising and internalising disorders. Challenges in screening for, diagnosing and managing comorbidity with ADHD are summarised. Also, methodological challenges and future directions in research in this interesting field are highlighted.
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Affiliation(s)
- Sundar Gnanavel
- Child Mental Health Services, Tees, Esk and Wear Valleys NHS Foundation Trust, Durham DH1 4LW, United Kingdom
| | - Pawan Sharma
- Department of Psychiatry, Patan Academy of Health Sciences, Patan 44700, Nepal
| | - Pulkit Kaushal
- Northumberland, Tyne and Wear NHS foundation Trust, Newcastle NE3 3XT, United Kingdom
| | - Sharafat Hussain
- Northumberland, Tyne and Wear NHS foundation Trust, Newcastle NE3 3XT, United Kingdom
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66
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Papadopoulos N, Stavropoulos V, McGinley J, Bellgrove M, Tonge B, Murphy A, Cornish K, Rinehart N. Moderating Effect of Motor Proficiency on the Relationship Between ADHD Symptoms and Sleep Problems in Children With Attention Deficit Hyperactivity Disorder-Combined Type. Behav Sleep Med 2019. [PMID: 29528702 DOI: 10.1080/15402002.2018.1443455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES/BACKGROUND A high proportion of children with Attention Deficit Hyperactivity Disorder- Combined type (ADHD-CT) experience sleep and motor problems. This study investigated (a) whether motor proficiency moderated the relationship between ADHD symptoms and sleep problems in children with and without ADHD-CT and (b) whether this moderation differed as a function of ADHD diagnosis. PARTICIPANTS A sample of 70 primary school male children between 8-15 years were recruited; children with ADHD-CT (n = 38; mean age 10 years, 2 months [SD = 1 year, 6 months]) and a typically developing (TD) (n = 32; mean age 9 years, 6 months [SD = 1 year, 5 months]) group. METHODS Motor proficiency was measured using the Movement Assessment Battery for Children-2nd Edition (MABC-2), ADHD symptoms were measured using the Conners' Parent Rating Scale (CPRS) and parent reported sleep problems were measured using the Children's Sleep Habits Questionnaire (CSHQ). RESULTS Children who reported higher ADHD symptoms and lower motor proficiency scores reported more sleep problems. The moderation effect only held in children with a diagnosis of ADHD-CT and not in the typically developing group. CONCLUSIONS These findings indicate that children who experience greater severity of ADHD symptoms who also have lower motor proficiency may be at increased risk of experiencing sleep problems. These findings also illustrate the importance of considering motor proficiency when exploring risk factors for sleep problems in children with ADHD-CT as well as sleep interventions.
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Affiliation(s)
- Nicole Papadopoulos
- a Deakin University, Geelong, Australia, Deakin Child Study Centre, School of Psychology, Faculty of Health , Geelong , Australia
| | | | - Jennifer McGinley
- c Department of Physiotherapy, The University of Melbourne , Melbourne , Australia
| | - Mark Bellgrove
- d Monash Institute of Cognitive and Clinical Neuroscience & School of Psychological Sciences, Monash University , Melbourne , Australia
| | - Bruce Tonge
- e Centre for Developmental Psychiatry and Psychology, Monash University , Melbourne , Australia
| | - Anna Murphy
- f Clinical Research Centre for Movement Disorders & Gait, Monash Health, Melbourne, Australia
| | - Kim Cornish
- d Monash Institute of Cognitive and Clinical Neuroscience & School of Psychological Sciences, Monash University , Melbourne , Australia
| | - Nicole Rinehart
- a Deakin University, Geelong, Australia, Deakin Child Study Centre, School of Psychology, Faculty of Health , Geelong , Australia
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67
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Peskin M, Rotem A, Golubchik P, Weizman A, Manor I. Demographic and Clinical Predictors of Hospitalization in Preschoolers With ADHD. J Atten Disord 2019; 23:1284-1290. [PMID: 29749278 DOI: 10.1177/1087054718772145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This chart review study characterized demographic and clinical indicators of the need for hospitalization in preschoolers with ADHD. Method: Medical records of preschoolers with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) ADHD during 2009-2012 were systematically reviewed. The cohort included 111 children (aged 5.13 ± 0.55 years, 77.47% boys). The demographic and clinical variables of hospitalized at a day-care unit (n = 30) and nonhospitalized (n = 81) preschoolers were compared. Results: Hospitalized preschoolers were younger (p < .0001), had higher rates of unmarried mothers (p < .001), and a higher number of comorbidities. The number of inattentive/hyperactivity-impulsivity symptoms was similar in both groups. Neurodevelopmental comorbidity (p < .0001), but not externalized (p = .82) or internalized (p = .20) psychopathology, was significantly higher in the hospitalized group. Conclusion: ADHD severity in preschoolers tends to be associated with younger age, specific parenthood constellations, and a high rate of neurodevelopmental, but not other, comorbidities. These findings emphasize the importance of the neurodevelopmental context in planning ADHD interventions at preschool age.
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Affiliation(s)
- Miriam Peskin
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Ann Rotem
- 1 Geha Mental Health Center, Petah Tikva, Israel
| | - Pavel Golubchik
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Abraham Weizman
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
| | - Iris Manor
- 1 Geha Mental Health Center, Petah Tikva, Israel.,2 Tel Aviv University, Israel
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68
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Salum GA, Sato JR, Manfro AG, Pan PM, Gadelha A, do Rosário MC, Polanczyk GV, Castellanos FX, Sonuga-Barke E, Rohde LA. Reaction time variability and attention-deficit/hyperactivity disorder: is increased reaction time variability specific to attention-deficit/hyperactivity disorder? Testing predictions from the default-mode interference hypothesis. ACTA ACUST UNITED AC 2019; 11:47-58. [PMID: 30927230 DOI: 10.1007/s12402-018-0257-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 06/08/2018] [Indexed: 12/15/2022]
Abstract
Increased reaction time variability (RTV) is one of the most replicable behavioral correlates of attention-deficit/hyperactivity disorder (ADHD). However, this may not be specific to ADHD but a more general marker of psychopathology. Here we compare RT variability in individuals with ADHD and those with other childhood internalizing and externalizing conditions both in terms of standard (i.e., the standard deviation of reaction time) and alternative indices that capture low-frequency oscillatory patterns in RT variations over time thought to mark periodic lapses of attention in ADHD. A total of 667 participants (6-12 years old) were classified into non-overlapping diagnostic groups consisting of children with fear disorders (n = 91), distress disorders (n = 56), ADHD (n = 103), oppositional defiant or conduct disorder (ODD/CD; n = 40) and typically developing controls (TDC; n = 377). We used a simple two-choice reaction time task to measure reaction time. The strength of oscillations in RTs across the session was extracted using spectral analyses. Higher RTV was present in ADHD compared to all other disorder groups, effects that were equally strong across all frequency bands. Interestingly, we found that lower RTV to characterize ODD/CD relative to TDC, a finding that was more pronounced at lower frequencies. In general, our data support RTV as a specific marker of ADHD. RT variation across time in ADHD did not show periodicity in a specific frequency band, not supporting that ADHD RTV is the product of spontaneous periodic lapses of attention. Low-frequency oscillations may be particularly useful to differentiate ODD/CD from TDC.
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Affiliation(s)
- Giovanni A Salum
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, Clinical Research Center, 6th Floor, Porto Alegre, 90035-903, Brazil
| | - João R Sato
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,Universidade Federal do ABC, São Paulo, Brazil
| | - Arthur G Manfro
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil. .,ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, Clinical Research Center, 6th Floor, Porto Alegre, 90035-903, Brazil.
| | - Pedro M Pan
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria C do Rosário
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,Universidade Federal de São Paulo, São Paulo, Brazil
| | - Guilherme V Polanczyk
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,Universidade de São Paulo, São Paulo, Brazil
| | - Francisco X Castellanos
- New York University Langone Medical Center, New York, NY, USA.,Nathan Kline Institute, Orangeburg, NY, USA
| | | | - Luis A Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents - CNPq, São Paulo, Brazil.,ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, Clinical Research Center, 6th Floor, Porto Alegre, 90035-903, Brazil.,Universidade de São Paulo, São Paulo, Brazil
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69
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Kang NR, Kwack YS. Temperament and Character Profiles Associated with Internalizing and Externalizing Problems in Children with Attention Deficit Hyperactivity Disorder. Psychiatry Investig 2019; 16:206-212. [PMID: 30934188 PMCID: PMC6444095 DOI: 10.30773/pi.2019.01.10.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 01/10/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE This study aimed to identify temperament and character profiles associated with internalizing and externalizing problems in children with attention deficit hyperactivity disorder (ADHD). METHODS Children with ADHD (n=114, 8.51±1.87 years) were selected from the Department of Child and Adolescent Psychiatry at Jeju National University Hospital. They were diagnosed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version and evaluated using the Advanced Test of Attention and Korean Wechsler Intelligence Scale for Children-Fourth Edition. Their parents completed the ADHD Rating Scale, Korean-Child Behavioral Checklist, and Junior Temperament and Character Inventory. RESULTS The participants with both internalizing and externalizing problem had more severe ADHD symptoms and significantly higher novelty seeking, harm avoidance, and self-transcendence, as well as lower self-directedness and cooperativeness than those who had not comorbid problems. Harm avoidance was correlated with their level of internalizing problems regardless of severity of ADHD symptoms. In addition, novelty seeking and sex (male) were being associated with the level of externalizing problems. CONCLUSION Differences were observed in the temperament and character profiles of children with ADHD according to their comorbid psychopathology. Results suggested that temperament and character profiles may affect the comorbid psychopathology in children with ADHD regardless of ADHD symptom severity.
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Affiliation(s)
- Na Ri Kang
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Young Sook Kwack
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Republic of Korea
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Moore DA, Richardson M, Gwernan-Jones R, Thompson-Coon J, Stein K, Rogers M, Garside R, Logan S, Ford TJ. Non-Pharmacological Interventions for ADHD in School Settings: An Overarching Synthesis of Systematic Reviews. J Atten Disord 2019; 23:220-233. [PMID: 25755258 DOI: 10.1177/1087054715573994] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This overarching synthesis brings together the findings of four systematic reviews including 138 studies focused on non-pharmacological interventions for ADHD used in school settings. These reviews considered the effectiveness of school-based interventions for ADHD, attitudes toward and experience of school-based interventions for ADHD, and the experience of ADHD in school settings. METHOD We developed novel methods to compare the findings across these reviews inductively and deductively. RESULTS Key contextual issues that may influence the effectiveness and implementation of interventions include the relationships that pupils with ADHD have with their teachers and peers, the attributions individuals make about the etiology of ADHD, and stigma related to ADHD or intervention attendance. CONCLUSION Although we found some positive effects for some outcomes and intervention categories, heterogeneity in effect size estimates and research evidence suggests a range of diverse contextual factors potentially moderate the implementation and effectiveness of school-based interventions for ADHD.
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71
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Mokobane M, Pillay BJ, Meyer A. Fine motor deficits and attention deficit hyperactivity disorder in primary school children. S Afr J Psychiatr 2019; 25:1232. [PMID: 30899581 PMCID: PMC6424539 DOI: 10.4102/sajpsychiatry.v25i0.1232] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/06/2018] [Indexed: 12/31/2022] Open
Abstract
Background Many children with attention deficit hyperactivity disorder (ADHD) display motor deficiencies during their daily routine, which may have impact on their developmental course. Children with ADHD who experience motor deficiencies often display deficits in tasks requiring movements, such as handwriting. Aim This study investigated deficiencies in fine motor skills in primary school children with ADHD. The study further sought to establish whether ADHD subtypes differ in deficiencies of fine motor performance, recorded for both the dominant and non-dominant hands. Methods The Disruptive Behavior Disorders Rating Scale, completed by educators and parents, was used to screen for ADHD symptoms. Researchers confirmed the diagnosis of ADHD. Motor functioning was assessed using the Grooved Pegboard and Maze Coordination. The children diagnosed with ADHD were matched for age and gender with controls without ADHD. The sample consisted of an ADHD group (160) and control group (160) of primary school children from the Moletjie area. Results Children with ADHD (predominantly inattentive subtype) and ADHD (combined subtype) performed significantly more poorly than the control group on the Grooved Pegboard (p < 0.05) with both the dominant and non-dominant hand. No significant difference between the hyperactivity and impulsiveness subtype and the controls were found. There was no difference on the Maze Coordination Task (p > 0.05) between the ADHD subtypes and the controls. Conclusion Difficulties in fine motor skills are prevalent in children with ADHD, particularly in the ADHD-PI and ADHD-C. Problems are encountered in distal, complex, speeded tasks. The effect may lead to poor handwriting and academic performance.
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Affiliation(s)
- Maria Mokobane
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
| | - Basil J Pillay
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
| | - Anneke Meyer
- Department of Behavioural Medicine, University of KwaZulu-Natal, South Africa
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72
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Müller O, Rothenberger A, Brüni GL, Wang B, Becker A. Questioning the long-term stability of the additive model in comorbid CTD+ADHD - The transition from childhood to adulthood. PLoS One 2018; 13:e0207522. [PMID: 30458012 PMCID: PMC6245783 DOI: 10.1371/journal.pone.0207522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 11/01/2018] [Indexed: 11/25/2022] Open
Abstract
Background A previous study (Roessner et al. 2007) found psychopathological evidence of an additive model of the comorbid group with Chronic Tic Disorders and Attention Deficit Hyperactivity Disorder (CTD+ADHD), which demanded clinical interventions aimed primarily at the factor ADHD. This 14-year follow-up study tested whether this childhood additive model can also be found in young adulthood and whether ADHD remains the most impairing factor. Methods 92 patients (22.8% girls) from Roessner et al. (2007) were re-investigated as young adults at the age of 24 years, broken down into four groups: CTD-only (n = 22), CTD+ADHD (n = 23), ADHD-only (n = 24), and controls (n = 23). The Adult Behavior Checklist (ABCL) was used as an equivalent parent-report instrument to the Child Behavior Checklist (CBCL) applied 14 years ago. Statistically, 2x2 factorial design was completed. Results From the point of view of parents, the factors CTD and ADHD in young adults contributed almost equally to psychopathological problems and showed many interactions, i.e. an interactive model was supported. In addition, the ADHD factor was no longer the leading problem for psychosocial impairment in the adult CTD+ADHD group. Conclusion The additive model of CTD+ADHD seems to exist no longer in young adults, nor may the childhood predominance of the factor ADHD in comorbid CTD+ADHD. Thus, treatment priority should be decided by clinicians on a case-by-case basis depending on the most impairing disorder of each patient.
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Affiliation(s)
- Olga Müller
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
| | - Geza L. Brüni
- Service for Child and Adolescent Psychiatry Thurgau, Romanshorn, Switzerland
| | - Biyao Wang
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
- * E-mail:
| | - Andreas Becker
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany
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Factors associated with problematic internet use among children and adolescents with Attention Deficit Hyperactivity Disorder. North Clin Istanb 2018; 5:302-313. [PMID: 30859160 PMCID: PMC6371990 DOI: 10.14744/nci.2017.92668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/08/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE: The aim of this study was to determine the association of problematic internet use with attention deficit hyperactivity disorder (ADHD), personal risk factors, and familial factors and compare with a healthy control group and investigate the risk factors. METHODS: The study sample consisted of 34 children aged 12–16 years and their families who applied to Ankara University Faculty of Medicine Department of Child and Adolescent Psychiatry with the diagnosis of ADHD. The control group consisted of 36 junior high and high school children aged 12–16 years and their families. The control group was matched with the ADHD group for age and sex. The Kiddie Schedule for Affective Disorders and Schizophrenia Present and LifetimeVersion (K-SADS-PL) version was used according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria for patients with ADHD and the control group. Internet/Computer Use Assessment Questionnaire for Children/Adolescents, the Strengths and Difficulties Questionnaire adolescent form (SDQ), and Online Cognition Scale (OCS) were applied to children. Internet/Computer Use Assessment Questionnaire for Parents and SDQ-parent form and Family Assessment (FAS) were applied to the parents. RESULTS: Weekly internet usage was higher in the ADHD group than the control group. The OCS total scores and subscale scores were significantly higher in the ADHD group. The subscales of SDQ hyperactivity, conduct problems, and peer problems were significantly higher in the ADHD group. FAS-general functions, communication, roles and behavior control subscale scores were higher in the ADHD group. There was no significant difference between groups regarding the internet usage in the daily life, with the availability of a computer and internet at home. In the ADHD group, there was a significant correlation between the OCS scores, weekly internet usage, and psychiatric comorbidities Oppositional Defiant Disorder and Conduct Disorder. Also, affective responsiveness subscale scores of FAS were significantly correlated with OCS scores in the ADHD group. CONCLUSION: In this study, it was noted that problematic internet use was more frequent in ADHD. During ADHD treatment, problematic internet use may interfere in the treatment goals. Interventions to problematic internet use should consider familial emotional expression studies.
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74
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Rantanen K, Vierikko E, Nieminen P. Effects of the EXAT neuropsychological multilevel intervention on behavior problems in children with executive function deficits. Scand J Psychol 2018; 59:483-495. [PMID: 30001471 DOI: 10.1111/sjop.12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Abstract
This is a clinical intervention study of children with executive function (EF) deficits. A neuropsychological multimodal group intervention called EXAT (rehabilitation of EXecutive function and ATtention) was developed at the Psychology Clinic of the University of Tampere. Based on the principles of neuropsychological rehabilitation and behavioral modification, EXAT combines child group training, parent training, and teacher consultations. The aims of this study were to investigate behavior problems before and after the intervention in children attending EXAT and in controls, and to compare intervention effects in hyperactive, inattentive, and EF subgroups based on the primary deficit described in the referral. The participants were 86 children (6-12 years) with a mean IQ of 91.4 attending EXAT and 45 controls. The participants' parents and teachers completed the Conners' Rating Scales-Revised. In addition, the Strengths and Difficulties Questionnaire was completed by the parents attending EXAT. The parents reported statistically significant decreases with medium effect sizes for the CPRS-R subscales for impulsivity, hyperactivity, and oppositional behavior. In the controls within the same time interval, there was increase in restless and impulsive behavior, and a decrease in total problems. The teachers reported positive changes after the intervention in ADHD symptoms and anxiousness/shyness, but the effects sizes were small. The intervention effects were larger in the hyperactive subgroup. Positive intervention effects were related to a younger age, lower IQ, and simultaneous learning support. In conclusion, EXAT - a structured multilevel group intervention - has positive effects on children's behavior regulation skills by decreasing impulsivity and restless behavior.
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Affiliation(s)
- Kati Rantanen
- University of Tampere, Faculty of Social Sciences, Psychology Clinic, Finland.,Tampere University Hospital, Department of Paediatrics, Finland
| | - Elina Vierikko
- University of Tampere, Faculty of Social Sciences, Psychology Clinic, Finland
| | - Pirkko Nieminen
- University of Tampere, Faculty of Social Sciences, Psychology Clinic, Finland
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75
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Menghini D, Armando M, Calcagni M, Napolitano C, Pasqualetti P, Sergeant JA, Pani P, Vicari S. The influence of Generalized Anxiety Disorder on Executive Functions in children with ADHD. Eur Arch Psychiatry Clin Neurosci 2018; 268:349-357. [PMID: 28766128 DOI: 10.1007/s00406-017-0831-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 07/24/2017] [Indexed: 12/30/2022]
Abstract
The present study was aimed at verifying whether the presence of generalized anxiety disorder (GAD) affects executive functions in children with attention-deficit hyperactivity disorder (ADHD). Two groups of children with ADHD were selected for the study according to the presence or absence of GAD. The first group of 28 children with ADHD with GAD (mean age: 9 ± 1.2; males/females: 24/4) was matched for gender, age, IQ, psychiatric comorbidity with a second group of 29 children with ADHD without GAD (mean age: 8.8 ± 0.7; males/females: 26/3). The two groups with ADHD were compared to 28 typically developing children (mean age: 8.3 ± 1.3; males/females: 23/5) on different measures involving processes especially important in inhibitory control such as rule maintenance, stimulus detection, action selection and action execution. Our results indicated that, differently from children with ADHD with GAD, only the group with ADHD without GAD showed a deficit in inhibitory control. Comorbid subgroups should be differentiated, especially, to develop specific and efficient therapeutic interventions in ADHD.
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Affiliation(s)
- D Menghini
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - M Armando
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.,Office Médico-Pédagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - M Calcagni
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - C Napolitano
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - P Pasqualetti
- Service of Medical Statistics and Information Technology (SeSMIT), Fatebenefratelli Hospital, Rome, Italy.,Language and Communication Across Modalities Laboratory (LACAM), Institute of Cognitive Sciences and Technologies (ISTC-CNR), Rome, Italy
| | - J A Sergeant
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - P Pani
- Department of Physiology and Pharmacology, Sapienza University, Rome, Italy
| | - S Vicari
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
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76
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Hansen BH, Oerbeck B, Skirbekk B, Petrovski BÉ, Kristensen H. Neurodevelopmental disorders: prevalence and comorbidity in children referred to mental health services. Nord J Psychiatry 2018; 72:285-291. [PMID: 29488416 DOI: 10.1080/08039488.2018.1444087] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Accurate prevalence rates of the neurodevelopmental disorders (ND) and comorbid conditions in child and adolescent mental health services (CAMHS) are essential for treatment planning and organization of health care. However, valid and reliable prevalence estimates from Nordic CAMHS populations are scarce, and the published findings vary. AIMS To report prevalence rates of ND (attention-deficit hyperactivity disorder: ADHD, tic disorder: TD or autism spectrum disorder: ASD) and comorbid disorders by a validated diagnostic instrument in children referred to CAMHS outpatient clinics. METHODS Parents of 407 consecutively referred children aged 7-13 years were interviewed with the semistructured interview schedule for affective disorders and schizophrenia, present and lifetime version (Kiddie-SADS-PL) at time of admittance. RESULTS One or more ND was diagnosed in 226 children (55.5%; 69.9% boys): ADHD (44.5%; 68.5% boys); TD (17.7%; 77.8% boys) and ASD (6.1%; 76% boys). Among children with ND 70 (31.0%) had only one ND with no comorbid disorder, 49 (21.7%) had more than one ND (homotypic comorbidity) and 131 (58%) had a non-ND psychiatric disorder (heterotypic comorbidity). Anxiety disorders were the most frequently occurring heterotypic comorbidity in all three ND. Comorbid depressive disorder was associated with older age, and comorbid anxiety disorder with female gender. CONCLUSION In children referred to CAMHS, ND constitute the most frequently occurring group of disorders, with high rates of both homotypic and heterotypic comorbidity. This needs to be taken into consideration in health service planning and treatment delivery.
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Affiliation(s)
- Berit Hjelde Hansen
- a BUP Nedre Romerike, Division of Mental Health , Akershus University Hospital , Lørenskog , Norway.,b Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom) , Oslo University Hospital , Oslo , Norway.,c Institute of Clinical Medicine, University of Oslo , Oslo , Norway
| | - Beate Oerbeck
- d Department of Mental Health and Addiction , Oslo University Hospital , Oslo , Norway
| | | | - Beáta Éva Petrovski
- f Health Services Research Center (HØKH) , Akershus University Hospital , Lørenskog , Norway
| | - Hanne Kristensen
- g Center for Child and Adolescent Mental Health , Eastern and Southern Norway , Oslo , Norway
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77
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Veenman B, Luman M, Oosterlaan J. Moderators Influencing the Effectiveness of a Behavioral Teacher Program. Front Psychol 2018; 9:298. [PMID: 29593604 PMCID: PMC5859326 DOI: 10.3389/fpsyg.2018.00298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/22/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: This study assessed which moderators influenced the effectiveness of a low-intensive behavioral teacher program for children with symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). Methods: Primary school children (N = 114) with ADHD symptoms in the classroom were randomly assigned to the intervention program (n = 58; 91% male) or control group (n = 56; 77% male). Multilevel regression analyses assessed differential treatment gains of the intervention program in terms of ADHD symptoms and social skills. Moderators included demographic characteristics (gender, age, parental educational level), severity and comorbidity of problem behavior (ADHD symptoms, conduct and internalizing problems), social functioning, and classroom variables (teaching experience, class size). Results: Results revealed larger program effects for older children and children from highly educated families and smaller beneficial effects for children with comorbid conduct or anxiety problems. Conclusion: The intervention program seems more beneficial for highly educated families and children without comorbid problem behavior, but more intensive treatments appear necessary for children facing additional challenges. ClinicalTrials.gov registration number: NCT02518711
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Affiliation(s)
- Betty Veenman
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marjolein Luman
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jaap Oosterlaan
- Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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78
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Andersson H, Sonnesen L. Sleepiness, occlusion, dental arch and palatal dimensions in children attention deficit hyperactivity disorder (ADHD). Eur Arch Paediatr Dent 2018. [DOI: 10.1007/s40368-018-0330-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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79
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Fibert P, Relton C, Peasgood T, Daley D. Protocol for the STAR (Sheffield Treatments for ADHD) project: an internal pilot study assessing the feasibility of the Trials within Cohorts (TwiCs) design to test the effectiveness of interventions for children with ADHD. Pilot Feasibility Stud 2018; 4:61. [PMID: 29511570 PMCID: PMC5834871 DOI: 10.1186/s40814-018-0250-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/02/2018] [Indexed: 12/20/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is a common and growing problem and a leading cause of child referrals to Child and Adult Mental Health Services (CAMHS). It is a drain on resources across nationally funded support agencies and associated with negative outcomes such as early criminality, school disruption and antisocial behaviour. Mainstream interventions (pharmacological and behavioural) demonstrate effectiveness whilst implemented, but are costly, often have unwanted side effects and do not appear to be affecting long-term outcomes.Development of a robust evidence base for the effectiveness of current and novel interventions and their impact over the long term is required. The aim of the Sheffield Treatments for ADHD Research (STAR) project is to facilitate a rigorous evidence base in order to provide information about the comparative (cost) effectiveness and acceptability of multiple interventions to key stakeholders. Methods The Trials within Cohorts (TwiCs) design was used to build a cohort of children with a diagnosis of ADHD and conduct a three-armed pilot trial of the clinical and cost effectiveness of two novel interventions: (a) treatment by nutritional therapists and (b) treatment by homoeopaths, compared to (c) treatment as usual.Participants are recruited to the STAR long-term observational cohort, and their outcomes of interest (ADHD symptoms, health-related quality of life, school disruption, resource use and criminality) are measured every 6 months by carers and (blinded) teachers. Two promising interventions were identified for the first randomised controlled trial embedded in the cohort. A random selection of eligible participants is offered treatments (a) and (b). The outcomes of those offered treatment are compared to those not offered treatment using intention to treat (ITT) analysis.The feasibility of recruiting to the cohort and the trial, delivering the interventions, the effectiveness of the interventions and the appropriateness, sensitivity and collectability of outcomes is trialled. Discussion The results of this trial will provide information on the feasibility of the TwiCs design to facilitate multiple trials of potential interventions for children with ADHD, and the acceptability, clinical and cost effectiveness of two potential interventions for ADHD to ADHD stakeholders including service providers. Future stages of the STAR project will test other treatments informed by the results in stage 1. Trial registration ISRCTN number 17723526. 10.1186/ISRCTN17723526. Date assigned 27/4/15.
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Affiliation(s)
- Philippa Fibert
- 1School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Clare Relton
- 1School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Tessa Peasgood
- 1School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - David Daley
- 2Institute of Mental Health, Jubilee Campus, University of Nottingham, Wollaton Road, Nottingham, NG8 1BB UK
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80
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Nobusako S, Sakai A, Tsujimoto T, Shuto T, Nishi Y, Asano D, Furukawa E, Zama T, Osumi M, Shimada S, Morioka S, Nakai A. Deficits in Visuo-Motor Temporal Integration Impacts Manual Dexterity in Probable Developmental Coordination Disorder. Front Neurol 2018; 9:114. [PMID: 29556211 PMCID: PMC5844924 DOI: 10.3389/fneur.2018.00114] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/14/2018] [Indexed: 11/13/2022] Open
Abstract
The neurological basis of developmental coordination disorder (DCD) is thought to be deficits in the internal model and mirror-neuron system (MNS) in the parietal lobe and cerebellum. However, it is not clear if the visuo-motor temporal integration in the internal model and automatic-imitation function in the MNS differs between children with DCD and those with typical development (TD). The current study aimed to investigate these differences. Using the manual dexterity test of the Movement Assessment Battery for Children (second edition), the participants were either assigned to the probable DCD (pDCD) group or TD group. The former was comprised of 29 children with clumsy manual dexterity, while the latter consisted of 42 children with normal manual dexterity. Visuo-motor temporal integration ability and automatic-imitation function were measured using the delayed visual feedback detection task and motor interference task, respectively. Further, the current study investigated whether autism-spectrum disorder (ASD) traits, attention-deficit hyperactivity disorder (ADHD) traits, and depressive symptoms differed among the two groups, since these symptoms are frequent comorbidities of DCD. In addition, correlation and multiple regression analyses were performed to extract factors affecting clumsy manual dexterity. In the results, the delay-detection threshold (DDT) and steepness of the delay-detection probability curve, which indicated visuo-motor temporal integration ability, were significantly prolonged and decreased, respectively, in children with pDCD. The interference effect, which indicated automatic-imitation function, was also significantly reduced in this group. These results highlighted that children with clumsy manual dexterity have deficits in visuo-motor temporal integration and automatic-imitation function. There was a significant correlation between manual dexterity, and measures of visuo-motor temporal integration, and ASD traits and ADHD traits and ASD. Multiple regression analysis revealed that the DDT, which indicated visuo-motor temporal integration, was the greatest predictor of poor manual dexterity. The current results supported and provided further evidence for the internal model deficit hypothesis. Further, they suggested a neurorehabilitation technique that improved visuo-motor temporal integration could be therapeutically effective for children with DCD.
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Affiliation(s)
- Satoshi Nobusako
- Neurorehabilitation Research Center, Kio University, Nara, Japan.,Graduate School of Health Science, Kio University, Nara, Japan
| | - Ayami Sakai
- Department of Rehabilitation, Higashi Osaka Yamaji Hospital, Osaka, Japan
| | - Taeko Tsujimoto
- Department of Rehabilitation, Nanso-no-Sato, Nursing Care Insurance Facilities, Osaka, Japan
| | - Takashi Shuto
- Department of Rehabilitation, Nogami Hospital, Osaka, Japan
| | - Yuki Nishi
- Department of Home-Visit Rehabilitation, Ishida Clinic, Osaka, Japan
| | - Daiki Asano
- Department of Rehabilitation, Japan Baptist Hospital, Kyoto, Japan
| | - Emi Furukawa
- Faculty of Education, Kio University, Nara, Japan
| | - Takuro Zama
- Department of Electrical Engineering, Graduate School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Michihiro Osumi
- Neurorehabilitation Research Center, Kio University, Nara, Japan.,Graduate School of Health Science, Kio University, Nara, Japan
| | - Sotaro Shimada
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kanagawa, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara, Japan.,Graduate School of Health Science, Kio University, Nara, Japan
| | - Akio Nakai
- Hyogo Children's Sleep and Development Medical Research Center, Kobe, Japan
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Courtabessis E, Pupier F, Surig L, Picot MC, Nogué E, Macioce V, Stein E, Purper-Ouakil D. Clinical factors associated with decision to recommend methylphenidate treatment for children with ADHD in France. Eur Child Adolesc Psychiatry 2018; 27:367-376. [PMID: 28983797 DOI: 10.1007/s00787-017-1061-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022]
Abstract
European guidelines advise on best practices for the diagnosis and non-pharmacological and pharmacological treatment of attention-deficit hyperactivity disorder (ADHD). This study aimed to (1) assess whether clinician's decisions to initiate methylphenidate treatment in children diagnosed with ADHD are in accordance with European guidelines and (2) identify clinical factors associated with the decision to recommend methylphenidate prescription. 5 to 13-year-old patients with an ADHD diagnosis were consecutively evaluated in an outpatient child and adolescent psychiatry clinic in France. Patients underwent a multidisciplinary evaluation including a diagnostic interview, symptom severity assessments with parent questionnaires, and IQ testing. We compared children with (n = 105) and without (n = 55) recommended methylphenidate treatment using Student's t test or Wilcoxon Mann-Whitney test and Chi-square or Fisher's test. Multivariate logistic regression was implemented to determine the respective influence of each variable on treatment recommendation. Recommendation to initiate methylphenidate treatment was associated with (1) ADHD combined presentation, (2) co-occurring Oppositional Defiant Disorder/Conduct Disorder (ODD/CD), Developmental Coordination Disorder (DCD) and Learning Disorder (LD), (3) clinical severity and impairment indicated on parent questionnaires, and (4) reduced perceptual reasoning. Using a multivariate regression model, ADHD combined presentation [combined versus predominantly hyperactive/impulsive and unspecified OR 4.52 (1.23-16.55), p = 0.023], age [OR 1.46 (1.14-1.88), p = 0.003], ODD/CD [OR 5.53 (2.19-14.01), p < 0.001], DCD [OR 4.22 (1.70-10.48), p = 0.002], PRI [OR 0.97 (0.94-0.99), p = 0.01] were significantly associated with recommendation of methylphenidate treatment. Our results indicate that clinicians' treatment decision-making complies with European guidelines and is furthermore associated with the type and severity of ADHD symptoms but also with co-occurring disorders.
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Affiliation(s)
- Elodie Courtabessis
- Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier-Hopital Saint Eloi, Montpellier Cedex 5, France.
| | - Florence Pupier
- Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier-Hopital Saint Eloi, Montpellier Cedex 5, France
| | - Laurie Surig
- Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier-Hopital Saint Eloi, Montpellier Cedex 5, France
| | - Marie-Christine Picot
- Unité de Recherche Clinique et Epidémiologie, Département Information Médicale, CHU Montpellier, 34295, Montpellier Cedex 5, France.,INSERM, Centre d'Investigation Clinique 1411, Montpellier, France
| | - Erika Nogué
- Unité de Recherche Clinique et Epidémiologie, Département Information Médicale, CHU Montpellier, 34295, Montpellier Cedex 5, France
| | - Valérie Macioce
- Unité de Recherche Clinique et Epidémiologie, Département Information Médicale, CHU Montpellier, 34295, Montpellier Cedex 5, France
| | - Elizabeth Stein
- Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier-Hopital Saint Eloi, Montpellier Cedex 5, France
| | - Diane Purper-Ouakil
- Médecine Psychologique de l'Enfant et de l'Adolescent, CHRU Montpellier-Hopital Saint Eloi, Montpellier Cedex 5, France
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82
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Mulraney M, Schilpzand EJ, Anderson V, Nicholson JM, Efron D, Hazell P, Sciberras E. Correlates of Anxiety in 6- to 8-Year-Old Children With ADHD: A Community-Based Study. J Atten Disord 2018; 22:425-434. [PMID: 27020802 DOI: 10.1177/1087054716638510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to identify the child and parent/family correlates of anxiety in a community-based sample of children with ADHD. METHOD Children (6-8 years) with ADHD ( n = 179) and controls ( n = 212) were assessed for ADHD and anxiety using the Diagnostic Interview Schedule for Children IV. Potential child and parent/family correlates were measured through direct assessments, and parent- and teacher-reported questionnaires. Associations were examined using univariate and multivariate logistic regression analyses. RESULTS One in four children with ADHD ( n = 44) met criteria for an anxiety disorder, compared with one in 20 controls ( n = 10). Anxiety was common in both boys and girls with ADHD. The strongest correlates of anxiety in multivariate analyses were ADHD subtype, primary caregiver psychosocial distress, and neighborhood socioeconomic disadvantage. CONCLUSION Anxiety is common in children with ADHD. This study provides insight into the potential parent/family stressors that may increase risk for anxiety in children with ADHD.
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Affiliation(s)
- Melissa Mulraney
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,3 The University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth J Schilpzand
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,3 The University of Melbourne, Parkville, Victoria, Australia
| | - Vicki Anderson
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,2 The Royal Children's Hospital, Parkville, Victoria, Australia.,3 The University of Melbourne, Parkville, Victoria, Australia
| | - Jan M Nicholson
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,4 La Trobe University, Melbourne, Victoria, Australia
| | - Daryl Efron
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,2 The Royal Children's Hospital, Parkville, Victoria, Australia.,3 The University of Melbourne, Parkville, Victoria, Australia
| | | | - Emma Sciberras
- 1 Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,2 The Royal Children's Hospital, Parkville, Victoria, Australia.,3 The University of Melbourne, Parkville, Victoria, Australia.,6 Deakin University, Melbourne, Victoria, Australia
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83
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KHAZAIE H, EGHBALI F, AMIRIAN H, MORADI MR, GHADAMI MR. Risk Factors of Nocturnal Enuresis in Children with Attention Deficit Hyperactivity Disorder. SHANGHAI ARCHIVES OF PSYCHIATRY 2018; 30:20-26. [PMID: 29719355 PMCID: PMC5925595 DOI: 10.11919/j.issn.1002-0829.216088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Presence of attention deficit hyperactivity disorder (ADHD) has a negative effect on the resolution of incontinence; however, there are few studies which investigated the risk factors of nocturnal enuresis (NE) in patients with ADHD. AIMS This study was conducted to investigate the prevalence of NE and its risk factors in children with ADHD. METHODS 331 children, aged 6 to 10 years, diagnosed as having ADHD were enrolled in this study. The diagnosis of ADHD was confirmed by an experienced child and adolescent psychiatrist according to DSM-IV-TR. NE was defined as nighttime wetting with or without daytime incontinence, at least twice a week over a period of 3 months or longer in children 5 years old and older without anatomical abnormalities. Details on demographic data, perinatal history, medical history and developmental history were collected from parents or medical records. RESULTS Most of the ADHD patients with inattentional subtype (77.5%) had NE, compared to 31.7% in the hyperactive/Impulsive subtype and 22.5% in the combined subtype (p<0.001, t=42.71). Among children with enuresis, there were significantly higher rates of history of familial enuresis (26% vs. 18 %, p<0.001, t=16.9), cesarean delivery (47% vs. 33%, p=0.019, t=5.84) and history of neonatal sepsis (16% vs. 7%, p=0.018, t=5.62) than non-NE children. Moreover, patients with NE had lower birth weight than non-NE patients (2.93(0.65) vs. 3.09 (0.46), p=0.026, t=2.51). Also, low parental education was associated with increase in the rate of NE. CONCLUSION Children with ADHD have a high prevalence of NE. Male sex, low education level of parents, history of neonatal sepsis, positive family history of NE, low birth weight and caesarian delivery may be risk factors for NE in ADHD children. Most ADHD patients with inattentional subtype had NE.
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Affiliation(s)
| | | | | | | | - Mohammad Rasoul GHADAMI
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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84
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Comorbidity prevalence and treatment outcome in children and adolescents with ADHD. Eur Child Adolesc Psychiatry 2017; 26:1443-1457. [PMID: 28527021 DOI: 10.1007/s00787-017-1005-z] [Citation(s) in RCA: 197] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/14/2017] [Indexed: 12/14/2022]
Abstract
Although ADHD comorbidity has been widely studied, some issues remain unsolved. This multicenter observational study aims to examine comorbid psychiatric disorders in a clinical sample of newly diagnosed, treatment naïve children and adolescents with and without ADHD and, to compare treatment efficacy based on the type of comorbidity. We performed an analysis of the medical records of patients identified from the Regional ADHD Registry database, enrolled in 18 ADHD centers in the 2011-2016 period. 1919 of 2861 subjects evaluated (67%) met the diagnostic criteria for ADHD: 650 (34%) had only ADHD, while 1269 (66%) had at least one comorbid psychiatric disorder (learning disorders, 56%; sleep disorders, 23%; oppositional defiant disorder, 20%; anxiety disorders, 12%). Patients with ADHD of combined type and with severe impairment (CGI-S ≥5) were more likely to present comorbidity. 382 of 724 (53%) followed up patients improved after 1 year of treatment. ADHD with comorbidity showed greater improvement when treated with combined interventions or methylphenidate alone. Specifically, combined treatment showed significant superiority for ADHD with learning disorders (ES 0.66) and ODD (ES 0.98), lower for ADHD with sleep or anxiety disorders. Training intervention alone showed only medium efficacy (ES 0.50) for ADHD and learning disorders. This study was the first describing comorbidity patterns of ADHD in Italy, confirming, in a multicenter clinical setting, that ADHD is more often a complex disorder. Findings highlight important diagnostic, therapeutic, and service organization aspects that should be broadly extended to ensure an appropriate and homogenous ADHD management.
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85
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Bielefeld M, Drews M, Putzig I, Bottel L, Steinbüchel T, Dieris-Hirche J, Szycik GR, Müller A, Roy M, Ohlmeier M, Theodor te Wildt B. Comorbidity of Internet use disorder and attention deficit hyperactivity disorder: Two adult case-control studies. J Behav Addict 2017; 6:490-504. [PMID: 29280392 PMCID: PMC6034949 DOI: 10.1556/2006.6.2017.073] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives There is good scientific evidence that attention deficit hyperactivity disorder (ADHD) is both a predictor and a comorbidity of addictive disorders in adulthood. These associations not only focus on substance-related addictions but also on behavioral addictions like gambling disorder and Internet use disorder (IUD). For IUD, systematic reviews have identified ADHD as one of the most prevalent comorbidities besides depressive and anxiety disorders. Yet, there is a need to further understand the connections between both disorders to derive implications for specific treatment and prevention. This is especially the case in adult clinical populations where little is known about these relations so far. This study was meant to further investigate this issue in more detail based on the general hypothesis that there is a decisive intersection of psychopathology and etiology between IUD and ADHD. Methods Two case-control samples were examined at a university hospital. Adult ADHD and IUD patients ran through a comprehensive clinical and psychometrical workup. Results We found support for the hypothesis that ADHD and IUD share psychopathological features. Among patients of each group, we found substantial prevalence rates of a comorbid ADHD in IUD and vice versa. Furthermore, ADHD symptoms were positively associated with media use times and symptoms of Internet addiction in both samples. Discussion Clinical practitioners should be aware of the close relationships between the two disorders both diagnostically and therapeutically. When it comes to regain control over one's Internet use throughout treatment and rehabilitation, a potential shift of addiction must be kept in mind on side of practitioners and patients.
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Affiliation(s)
- Martin Bielefeld
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | | | - Inken Putzig
- Clinic for Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Oldenburg, Germany
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Toni Steinbüchel
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Gregor R. Szycik
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Astrid Müller
- Clinic for Psychosomatic and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mandy Roy
- Asklepios Clinic North Psychiatry Ochsenzoll, Hamburg, Germany
| | - Martin Ohlmeier
- Department of Psychiatry and Psychotherapy, Ludwig Noll Krankenhaus, Kassel, Germany
| | - Bert Theodor te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Bochum, Germany,Corresponding author: Bert Theodor te Wildt; Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL University Hospital, Alexandrinenstr 1-3, 44791, Bochum, Germany; Phone: +49 234 5077 3120/3333; Fax: +49 234 5077 3111; Emails: ,
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Stewman CG, Liebman C, Fink L, Sandella B. Attention Deficit Hyperactivity Disorder: Unique Considerations in Athletes. Sports Health 2017; 10:40-46. [PMID: 29144831 PMCID: PMC5753970 DOI: 10.1177/1941738117742906] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Attention deficit hyperactivity disorder (ADHD) is a common psychiatric condition in the general population, with evidence suggesting that it may be more common among athletes. Evidence Acquisition: Literature searches were performed on PubMed, MEDLINE, and Cochrane databases for the years 2000 to 2016 utilizing the following key search terms: ADHD, ADD, guidelines, diagnosis, athlete, sports, treatment, pharmacotherapy, stimulants, risk, cardiovascular effects, concussion, and traumatic brain injury (TBI). Study Design: Clinical review. Level of Evidence: Level 4. Results: ADHD exists among athletes at all levels of play, and symptomatology overlaps significantly with that of concussion. Treatment with stimulants has cardiovascular effects and may not be permitted by the athlete’s governing body. An athlete’s level of competition and individual cardiovascular risk factors may therefore affect medication choices. Conclusion: ADHD diagnosis and treatment are paramount to optimal quality of life and functioning in affected individuals. Pharmacologic treatment options should not specifically be avoided in athletes; however, stimulant use is an independent risk factor for heat illness. Concussion, a common athletic injury, may have an altered course in those affected by ADHD, specifically with regard to neurocognitive testing and recovery.
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Affiliation(s)
- Chaney G Stewman
- Christiana Care Health System, University of Delaware, Newark, Delaware
| | - Catherine Liebman
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura Fink
- Department of Family Medicine, Saint Alphonsus Medical Group, Boise, Idaho
| | - Brad Sandella
- Associate Lead Musculoskeletal Service Line, Christiana Care Health System, Newark, Delaware
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87
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Grünwald J, Schlarb AA. Relationship between subtypes and symptoms of ADHD, insomnia, and nightmares in connection with quality of life in children. Neuropsychiatr Dis Treat 2017; 13:2341-2350. [PMID: 28919767 PMCID: PMC5592957 DOI: 10.2147/ndt.s118076] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study examined the links between sleep disorders and subtypes of attention deficit-hyperactivity disorder (ADHD-inattention, ADHD-combined, ADHD-hyperactive/impulsive) in childhood. We set up a hypothetical model linking different symptoms of both disorders to construct the underlying and shared pathways. By examining a sample of children with ADHD we firstly tested parts of the model. METHODS A total of 72 children with symptoms of ADHD (aged 6-13 years; 79.2% boys) were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and the International Classification of Sleep Disorders, third edition in regards to ADHD and sleep disorders via standardized parent-rated questionnaires. Additionally, quality of life (QoL) was assessed. Overall, 46 children fulfilled the criteria of ADHD and were medication-naive. RESULTS On average, the whole sample had clinically elevated total scores of the Children's Sleep Habits Questionnaire in the validated German version (CSHQ-DE), indicating an increased prevalence of sleep disorders in children with ADHD. In accordance to our hypothetical model, children with primarily hyperactive-impulsive ADHD showed the highest CSHQ-DE scores. Moreover, we found a high impact for insomnia in this subgroup and a high comorbid load for the mutual occurrence of insomnia and nightmares. Furthermore, QoL was reduced in our whole sample, and again intensified in children with comorbid insomnia and nightmares. CONCLUSION We verified an elevated occurrence of sleep disorders in children with ADHD and were able to link them to specific subtypes of ADHD. These results were in line with our hypothetical model. Moreover, we found a clinically reduced QoL in mean for the whole sample, indicating the strong impact of ADHD in the lives of affected children, even intensified if children exhibited comorbid insomnia and nightmares. These results should be kept in mind regarding the treatment and therapy of this subgroup of children. Specific treatment strategies should be considered for these children.
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Affiliation(s)
- Julia Grünwald
- Department of Psychology, Faculty of Science, University of Tübingen, Tübingen
| | - Angelika Anita Schlarb
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology and Sports Science, University of Bielefeld, Bielefeld, Germany
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88
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Kim D, Lee D, Lee J, Namkoong K, Jung YC. Association between childhood and adult attention deficit hyperactivity disorder symptoms in Korean young adults with Internet addiction. J Behav Addict 2017; 6:345-353. [PMID: 28786707 PMCID: PMC5700719 DOI: 10.1556/2006.6.2017.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background and aims Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric comorbidities of Internet addiction (IA); however, the possible mechanisms that contribute to this high comorbidity are still under debate. This study aims to analyze these possible mechanisms by comparing the effect of IA severity and childhood ADHD on inattention, hyperactivity, and impulsivity in young adults with IA. We hypothesized that IA might have associations with ADHD-like cognitive and behavior symptoms aside from childhood ADHD. Methods Study participants consisted of 61 young male adults. Participants were administered a structured interview. The severity of IA, childhood and current ADHD symptoms, and psychiatry comorbid symptoms were assessed through self-rating scales. The associations between the severity of IA and ADHD symptoms were examined through hierarchical regression analyses. Results Hierarchical regression analyses showed that the severity of IA significantly predicted most dimensions of ADHD symptoms. By contrast, childhood ADHD predicted only one dimension. Discussion The high comorbidity of inattention and hyperactivity symptoms in IA should not solely be accounted by an independent ADHD disorder but should consider the possibility of cognitive symptoms related to IA. Functional and structural brain abnormalities associated with excessive and pathologic Internet usage might be related to these ADHD-like symptoms. Conclusion Inattention and hyperactivity in young adults with IA are more significantly associated with the severity of IA than that of childhood ADHD.
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Affiliation(s)
- DongIll Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Deokjong Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Junghan Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kee Namkoong
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Young-Chul Jung
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea,Corresponding author: Young-Chul Jung, MD, PhD; Department of Psychiatry, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, South Korea; Phone/Fax: +82 2 2228 1620; E-mail:
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89
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Uebel-von Sandersleben H, Albrecht B, Rothenberger A, Fillmer-Heise A, Roessner V, Sergeant J, Tannock R, Banaschewski T. Revisiting the co-existence of Attention-Deficit/Hyperactivity Disorder and Chronic Tic Disorder in childhood-The case of colour discrimination, sustained attention and interference control. PLoS One 2017; 12:e0178866. [PMID: 28594866 PMCID: PMC5464598 DOI: 10.1371/journal.pone.0178866] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/19/2017] [Indexed: 01/28/2023] Open
Abstract
Objective Attention Deficit / Hyperactivity Disorder (ADHD) and Chronic Tic Disorder (CTD) are two common and frequently co-existing disorders, probably following an additive model. But this is not yet clear for the basic sensory function of colour processing sensitive to dopaminergic functioning in the retina and higher cognitive functions like attention and interference control. The latter two reflect important aspects for psychoeducation and behavioural treatment approaches. Methods Colour discrimination using the Farnsworth-Munsell 100-hue Test, sustained attention during the Frankfurt Attention Inventory (FAIR), and interference liability during Colour- and Counting-Stroop-Tests were assessed to further clarify the cognitive profile of the co-existence of ADHD and CTD. Altogether 69 children were classified into four groups: ADHD (N = 14), CTD (N = 20), ADHD+CTD (N = 20) and healthy Controls (N = 15) and compared in cognitive functioning in a 2×2-factorial statistical model. Results Difficulties with colour discrimination were associated with both ADHD and CTD factors following an additive model, but in ADHD these difficulties tended to be more pronounced on the blue-yellow axis. Attention problems were characteristic for ADHD but not CTD. Interference load was significant in both Colour- and Counting-Stroop-Tests and unrelated to colour discrimination. Compared to Controls, interference load in the Colour-Stroop was higher in pure ADHD and in pure CTD, but not in ADHD+CTD, following a sub-additive model. In contrast, interference load in the Counting-Stroop did not reveal ADHD or CTD effects. Conclusion The co-existence of ADHD and CTD is characterized by additive as well as sub-additive performance impairments, suggesting that their co-existence may show simple additive characteristics of both disorders or a more complex interaction, depending on demand. The equivocal findings on interference control may indicate limited validity of the Stroop-Paradigm for clinical assessments.
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Affiliation(s)
| | - Björn Albrecht
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Aribert Rothenberger
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Anke Fillmer-Heise
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Joseph Sergeant
- Department of Clinical Neuropsychology, Faculteit der Psychologie, Vrije University, Amsterdam, The Netherlands
| | | | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
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90
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Weissenberger S, Ptacek R, Klicperova-Baker M, Erman A, Schonova K, Raboch J, Goetz M. ADHD, Lifestyles and Comorbidities: A Call for an Holistic Perspective - from Medical to Societal Intervening Factors. Front Psychol 2017; 8:454. [PMID: 28428763 PMCID: PMC5382165 DOI: 10.3389/fpsyg.2017.00454] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 03/10/2017] [Indexed: 01/19/2023] Open
Abstract
The review examines Attention Deficit Hyperactivity Disorder (ADHD in its Child and Adult form) and its various presentations (Hyperactive Impulsive, Inattentive, and Combined) with a particular focus on environmental (incl. social factors), lifestyles and comorbidities. It is argued that ADHD is best understood in a holistic and interactive context and a vast empirical literature is presented to illustrate the point: Environmental factors include stress in general as well as exposure to toxins (phthalates, bisphenol A). Social factors are illustrated by effects of social deprivation and seduction to unhealthy lifestyles. Maternal lifestyle during pregnancy is pointed out (particularly her exposure to nicotine, alcohol, caffeine, and drugs, even seemingly benign medications like acetaminophen), which all tend to be related to ADHD. Family environment is discussed with respect to protective effect of (mainly authoritative and autocratic) parenting styles. Societal factors include mainly economic and political issues: income inequality and poverty (low SES is an ADHD risk factor) and a growing moral dilemma between a humanistic effort to globally spread the knowledge of ADHD and the medicalization and commercialization of the disorder. The second part of the review is devoted to ADHD related lifestyles and resulting comorbidities (e.g., food addiction and obesity, substance abuse, electronic media dependencies and conduct and personality disorders). Although ADHD is a neurodevelopmental disorder, its assessment and treatment are also linked to environmental, behavioral and social factors and their interactions.
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Affiliation(s)
| | - Radek Ptacek
- First Medical Faculty, Charles UniversityPrague, Czechia
| | | | - Andreja Erman
- Faculty of Theology, University of LjubljanaLjubljana, Slovenia
| | | | - Jiri Raboch
- First Medical Faculty, Charles UniversityPrague, Czechia
| | - Michal Goetz
- Department of Child Psychiatry, Second Faculty of Medicine, Motol University Hospital, Charles UniversityPrague, Czechia
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91
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Miyazaki C, Koyama M, Ota E, Swa T, Mlunde LB, Amiya RM, Tachibana Y, Yamamoto-Hanada K, Mori R. Allergic diseases in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis. BMC Psychiatry 2017; 17:120. [PMID: 28359274 PMCID: PMC5374627 DOI: 10.1186/s12888-017-1281-7] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 03/23/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Reports of frequent manifestation of allergic diseases in children with attention deficit hyperactivity disorder (ADHD) have been the subject of mounting clinical interest. However, evidence supporting the association between ADHD and allergies is inconsistent and has yet to be systematically reviewed. The objective of this study was to compile and assess available studies on the association between ADHD and allergic diseases in children. METHODS A comprehensive search using MEDLINE, EMBASE, the Cochrane library, and CINAHL databases was completed in 23 November 2015. The inclusion criteria for studies were that the research assessed allergic diseases in children, 18 years of age and younger, with a diagnosis of ADHD and that a distinct comparison group was incorporated. Any comparative studies, encompassing both randomized controlled trials and observational studies, were considered for inclusion. Two review authors independently assessed the quality of the selected studies by the use of validated assessment tools, performed data extraction and conducted meta-analysis according to Cochrane Collaboration guidelines. RESULTS Five eligible studies were included in this systematic review. Of these studies, three were case-control and two were cross sectional studies. A majority of information from the five studies was classified as having low or unclear risk of bias. The meta-analysis showed an association between children with ADHD and asthma compared with the control groups (OR: 1.80, 95% CI: 1.57 - 2.07; five studies, low quality of evidence), but did not indicate an association between food allergy and ADHD (OR: 1.13, 95% CI: 0.88 - 1.47; three studies very low quality of evidence). The odds of experiencing allergic rhinitis, atopic dermatitis, and allergic conjunctivitis were slightly higher in children with ADHD compared with control groups, though a substantial statistical heterogeneity was notable in the overall effect estimates. CONCLUSIONS The findings from this review and meta-analysis show that children with ADHD are more likely to have asthma, allergic rhinitis, atopic dermatitis, and allergic conjunctivitis than their counterparts. Interventions including strategies for managing allergies in children with ADHD would be beneficial.
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Affiliation(s)
- Celine Miyazaki
- Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Momoko Koyama
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654 Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
- Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashicho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Toshiyuki Swa
- Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
- Graduate School of Human Sciences, Osaka University, 1-1 Yamadaoka Suita, Osaka Prefecture, 565-0871 Japan
| | - Linda B. Mlunde
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654 Japan
| | - Rachel M. Amiya
- Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8654 Japan
| | - Yoshiyuki Tachibana
- Department of Psychosocial Medicine, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Kiwako Yamamoto-Hanada
- Department of Medical Specialties, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, 10-1-2 Okura, Setagaya-ku, Tokyo, 157-8535 Japan
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Neely KA, Wang P, Chennavasin AP, Samimy S, Tucker J, Merida A, Perez-Edgar K, Huang-Pollock C. Deficits in inhibitory force control in young adults with ADHD. Neuropsychologia 2017; 99:172-178. [PMID: 28284985 DOI: 10.1016/j.neuropsychologia.2017.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 02/06/2023]
Abstract
Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD.
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Affiliation(s)
- Kristina A Neely
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA.
| | - Peiyuan Wang
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA
| | - Amanda P Chennavasin
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Shaadee Samimy
- Department of Kinesiology, The Pennsylvania State University, PA 16802, USA
| | - Jacqueline Tucker
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Andrea Merida
- Department of Biomedical Engineering, The Pennsylvania State University, PA 16802, USA
| | - Koraly Perez-Edgar
- Department of Psychology, The Pennsylvania State University, PA 16802, USA
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Cupertino RB, Schuch JB, Bandeira CE, da Silva BS, Rovaris DL, Kappel DB, Contini V, Salatino-Oliveira A, Vitola ES, Karam RG, Hutz MH, Rohde LA, Grevet EH, Bau CHD, Mota NR. Replicated association of Synaptotagmin (SYT1) with ADHD and its broader influence in externalizing behaviors. Eur Neuropsychopharmacol 2017; 27:239-247. [PMID: 28130000 DOI: 10.1016/j.euroneuro.2017.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/30/2016] [Accepted: 01/05/2017] [Indexed: 12/20/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common psychiatric disorder, affecting both children and adults. The Soluble N-ethylmaleimide sensitive factor Attachment REceptors (SNARE) complex has been implicated in ADHD pathophysiology since it is a key component of neurotransmitter release events and neurodevelopment processes, and SNPs in this complex have been associated with ADHD. Here we aim to analyze the effects of SNARE complex variants on ADHD susceptibility and its clinical heterogeneity in affected adults. We tested the association between ADHD and polymorphisms on the SNARE genes STX1A (rs2228607), SYT1 (rs1880867 and rs2251214), VAMP2 (26bp Ins/Del) and SNAP25 (rs6108461 and rs8636) on a sample comprised of 548 adults with ADHD and 644 non-affected controls. Regarding clinical heterogeneity, we further investigated the effects of associated SNPs on age at onset of impairment due to ADHD and on relevant externalizing behaviors (i.e. school suspensions/expulsions and problems with law/authority) and comorbidities (i.e. Substance Use Disorder, Oppositional Defiant Disorder, Conduct Disorder and Antisocial Personality Disorder). We replicated a previously reported association between SYT1-rs2251214 and ADHD in adulthood. This SNP was also associated with age at onset of impairment due to ADHD symptoms and with a range of externalizing phenotypes. These findings involving SYT1 suggest that variation in neurotransmitter exocytosis mechanisms may represent an underlying genetic factor shared by a spectrum of externalizing behaviors and disorders, including - but not restricted to - ADHD.
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Affiliation(s)
- Renata Basso Cupertino
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaqueline Bohrer Schuch
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cibele Edom Bandeira
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruna Santos da Silva
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Diego Luiz Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Djenifer B Kappel
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Verônica Contini
- PPGBIOTEC - Postgraduate Program in Biotechnology, Centro Universitário Univates, Lajeado, Brazil
| | - Angélica Salatino-Oliveira
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Schneider Vitola
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Gomes Karam
- ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Mara Helena Hutz
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
| | - Eugenio Horacio Grevet
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Claiton Henrique Dotto Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Nina Roth Mota
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Oerbeck B, Overgaard KR, Aspenes ST, Pripp AH, Mordre M, Aase H, Reichborn-Kjennerud T, Zeiner P. ADHD, comorbid disorders and psychosocial functioning: How representative is a child cohort study? Findings from a national patient registry. BMC Psychiatry 2017; 17:23. [PMID: 28095819 PMCID: PMC5240379 DOI: 10.1186/s12888-017-1204-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 01/10/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cohort studies often report findings on children with Attention Deficit Hyperactivity Disorder (ADHD) but may be biased by self-selection. The representativeness of cohort studies needs to be investigated to determine whether their findings can be generalised to the general child population. The aim of the present study was to examine the representativeness of child ADHD in the Norwegian Mother and Child Cohort Study (MoBa). METHODS The study population was children born between January 1, 2000 and December 31, 2008 registered with hyperkinetic disorders (hereafter ADHD) in the Norwegian Patient Registry during the years 2008-2013, and two groups of children with ADHD were identified in: 1. MoBa and 2. The general child population. We used the multiaxial International Classification of Diseases (ICD-10) and compared the proportions of comorbid disorders (axes I-III), abnormal psychosocial situations (axis V) and child global functioning (axis VI) between these two groups. We also compared the relative differences in the multiaxial classifications for boys and girls and for children with/without axis I comorbidity, respectively in these two groups of children with ADHD. RESULTS A total of 11 119 children were registered with ADHD, with significantly fewer in MoBa (1.45%) than the general child population (2.11%), p < 0.0001. The proportions of comorbid axis I, II, and III disorders were low, with no significant group differences. Compared with the general child population with ADHD, children with ADHD in MoBa were registered with fewer abnormal psychosocial situations (axis V: t = 7.63, p < .0001; d = -.18) and better child global functioning (axis VI: t = 7.93, p < 0.0001; d = .17). When analysing relative differences in the two groups, essentially the same patterns were found for boys and girls and for children with/without axis I comorbidity. CONCLUSIONS Self-selection was found to affect the proportions of ADHD, psychosocial adversity and child global functioning in the cohort. However, the differences from the general population were small. This indicates that studies on ADHD and multiaxial classifications in MoBa, as well as other cohort studies with similar self-selection biases, may have reasonable generalisability to the general child population.
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Affiliation(s)
- Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424, Oslo, Norway.
| | - Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway
| | | | - Are Hugo Pripp
- Oslo University Hospital, Oslo Centre of Biostatistics and Epidemiology, Oslo, Norway
| | - Marianne Mordre
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway
| | - Heidi Aase
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway ,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pal Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Pb. 4959 Nydalen, 0424 Oslo, Norway
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Chutko LS, Surushkina SY, Anisimova TI. A dyad approach to the treatment of attention deficit hyperactivity disorder. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:81-84. [DOI: 10.17116/jnevro20171172181-84] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Clemow DB, Bushe C, Mancini M, Ossipov MH, Upadhyaya H. A review of the efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in children and adult patients with common comorbidities. Neuropsychiatr Dis Treat 2017; 13:357-371. [PMID: 28223809 PMCID: PMC5304987 DOI: 10.2147/ndt.s115707] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder that is often diagnosed during childhood, but has also increasingly been recognized to occur in adults. Importantly, up to 52% of children (including adolescents) and 87% of adults with ADHD also have a comorbid psychiatric disorder. The presence of a comorbid disorder has the potential to impact diagnosis and could affect treatment outcomes. Atomoxetine is a nonstimulant treatment for ADHD. Despite numerous published studies regarding efficacy of atomoxetine in the treatment of ADHD in patients with comorbid disorders, there is limited information about the impact of individual common comorbid disorders on the efficacy of atomoxetine for ADHD, especially with regard to adults. Moreover, a cumulative review and assessment of these studies has not been conducted. For this reason, we performed a literature review to find, identify, and cumulatively review clinical studies that examined the efficacy of atomoxetine in the treatment of patients with ADHD and comorbid psychiatric disorders. We found a total of 50 clinical studies (37 in children; 13 in adults) that examined the efficacy of atomoxetine in patients with ADHD and a comorbid disorder. The comorbidities that were studied in children or in adults included anxiety, depression, and substance use disorder. Overall, the presence of comorbidity did not adversely impact the efficacy of atomoxetine in treatment of ADHD symptoms in both patient populations. In the studies identified and assessed in this review, atomoxetine did not appear to exacerbate any of the comorbid conditions and could, therefore, be an important therapy choice for the treatment of ADHD in the presence of comorbid disorders.
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Satoh M, Obara T, Nishigori H, Ooba N, Morikawa Y, Ishikuro M, Metoki H, Kikuya M, Mano N. Prescription trends in children with pervasive developmental disorders: a claims data-based study in Japan. World J Pediatr 2016; 12:443-449. [PMID: 27286689 DOI: 10.1007/s12519-016-0036-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 03/19/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND The only drug approved for pervasive developmental disorders (PDD) in Japan is pimozide. Several psychotropic drugs are also prescribed for offlabel use in Japan, but details regarding their prescription and use are largely unknown. The purpose of this study was to clarify the use of drug treatment in Japanese children with PDD. METHODS Data were extracted from claims data from the Japan Medical Data Center for children younger than 18 years of age who were newly diagnosed with PDD (International Classification of Diseases version 10 codes: F84) from 2005 to 2010 (total of 3276 patients as of 2010). The prescription rates were presented as the percentage of PDD patients who were prescribed each drug. RESULTS Prior to 2010, the prescription rates for atypical antipsychotics, other antipsychotics, psychostimulants, all other central nervous system drugs, anticovnvulsants, non-barbiturates, and Parkinson's disease/syndrome drugs significantly increased among the Anatomical Therapeutic Chemical classifications defined as the "nervous system" (trend P≤0.02). The prescription rate for risperidone consistently increased, reaching 6.9% in 2010 (trend P<0.0001), the highest rate of the surveyed drugs among the antipsychotics. The prescription rate for aripiprazole also increased (trend P<0.0001), reaching 1.9% in 2010. The prescription rate for pimozide showed no annual changes, with a low rate of 0.4% in 2010. CONCLUSION Compared with pimozide, the prescription rates for risperidone, aripiprazole and other psychotropic drugs have increased. Because safety data for these drugs in Japanese children are sparse, there is a need for future safety evaluations of these drugs in Japanese children.
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Affiliation(s)
- Michihiro Satoh
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan
| | - Taku Obara
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan. .,Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan. .,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Hidekazu Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Yoshihiko Morikawa
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Mami Ishikuro
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hirohito Metoki
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Japan.,Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, 980-8575, Japan
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98
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Sollie H, Larsson B. Parent-reported symptoms, impairment, helpfulness of treatment, and unmet service needs in a follow-up of outpatient children with attention-deficit/hyperactivity disorder. Nord J Psychiatry 2016; 70:582-90. [PMID: 27269883 DOI: 10.1080/08039488.2016.1187204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Limited information exists regarding the associations between impairment, symptoms, helpfulness of treatments, and service needs after initial treatment of children with attention-deficit/hyperactivity disorder (ADHD). AIMS The aims of this study were to examine persistence rates and associations between parent-reported symptoms, impairment, helpfulness of treatments, and service needs in a retrospective follow-up study of children with ADHD. METHODS Parents of 214 children with a mean age of 12.6 years (SD = 2.1) who were diagnosed with ADHD at five child and adolescent mental health clinics (CAMHS) completed questionnaires 1-10 years (mean = 3.7 years, SD = 2.2) after baseline assessment. The response rate was 43.4%. A community comparison group (n = 110) was recruited from the same area. RESULTS Approximately two-thirds (60.3%) of the sample fulfilled the DSM-IV symptom criteria of ADHD at follow-up, 84.3% were functionally impaired, and most children (84.7%) were on medication. Inattentive and emotional symptoms were the strongest predictors of impairment across impairment areas. Perceived helpfulness of different treatments varied from 71.8-88.7%, and no significant difference was found between the ADHD sub-groups regarding reported helpfulness. 'Adjustment of the school situation' was the most frequent service need, and approximately half of the parents reported needs for care co-ordination. Children fulfilling the symptom criteria of the ADHD Combined sub-group were most impaired and had most service needs. CONCLUSIONS At follow-up, children were highly symptomatic and impaired, despite a high rate of persistent medication treatment. The findings underline the need for more tailored treatment and co-ordinated care over time.
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Affiliation(s)
- Henrik Sollie
- a Department of Child and Adolescent Mental Health , Kristiansund Hospital, Møre and Romsdal Health Trust , Norway ;,b Faculty of Medicine , Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Bo Larsson
- b Faculty of Medicine , Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
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Bekker J, Bruck D, Sciberras E. Congruent Validity of the Strengths and Difficulties Questionnaire to Screen for Comorbidities in Children With ADHD. J Atten Disord 2016; 20:879-88. [PMID: 23881559 DOI: 10.1177/1087054713496462] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to determine whether the Strengths and Difficulties Questionnaire (SDQ) is an effective screening tool for identifying comorbid mental health difficulties in children with ADHD. METHOD Parents of children with ADHD (5-13 years) completed the SDQ and the Anxiety Disorders Interview Schedule for DSM-IV-Parent Version (ADIS-C/P-IV). Data from both the measures were compared to determine congruent validity. RESULTS Analyses revealed that significant relationships exist between the SDQ total score and the total number of comorbidities on the ADIS-C/P-IV. The SDQ emotional problem and conduct problem scales were significantly related to internalizing and externalizing comorbidities on the ADIS-C/P-IV, respectively. CONCLUSION While significant relationships were found between the SDQ and ADIS-C/P-IV across various domains, this relationship was stronger for externalizing comorbidities. Additional screening questions are required to effectively screen for less common internalizing comorbidities in children with ADHD, for example, major depression and panic disorder.
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Affiliation(s)
- Joshua Bekker
- Victoria University, Melbourne, Australia Murdoch Childrens Research Institute, Melbourne, Australia
| | | | - Emma Sciberras
- Murdoch Childrens Research Institute, Melbourne, Australia The Royal Children's Hospital, Melbourne, Australia
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Waxegård G, Thulesius H. Integrating care for neurodevelopmental disorders by unpacking control: A grounded theory study. Int J Qual Stud Health Well-being 2016; 11:31987. [PMID: 27609793 PMCID: PMC5016529 DOI: 10.3402/qhw.v11.31987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. METHODS Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed. RESULTS The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients' status and needs. Unpacking control is key to the professionals' strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways. CONCLUSIONS The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development.
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Affiliation(s)
- Gustaf Waxegård
- Department of Psychology, Linnaeus University, Växjö, Sweden;
| | - Hans Thulesius
- Research Unit, Region of Kronoberg, Department of Clinical Sciences, Family Medicine, Lund University, Lund, Sweden
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