1051
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Bonnet-Brilhault F, Broly F, Blanc R, Furet Y, Barthélémy C, Paintaud G. An ADHD 6-year-old child ultrarapid metabolizer for CYP2D6. J Clin Psychopharmacol 2006; 26:442-4. [PMID: 16855474 DOI: 10.1097/01.jcp.0000227352.52288.50] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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1052
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Gau SSF, Shen HY, Soong WT, Gau CS. An open-label, randomized, active-controlled equivalent trial of osmotic release oral system methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Child Adolesc Psychopharmacol 2006; 16:441-55. [PMID: 16958569 DOI: 10.1089/cap.2006.16.441] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study examined the efficacy and safety of osmotic release oral system methylphenidate (OROS MPH) as compared with immediate-release MPH (IR MPH) in children with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. Sixty-four children with Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) ADHD, ages 6-15 years, were randomized to OROS MPH once daily (n = 32) and IR MPH three times daily (n = 32) in an open, randomized, active-controlled equivalent 28-day trial. The main outcome measures included the Conner's Teacher Rating Scale -Revised: Short Form and Conner's Parent Rating Scale-Revised: Short Form, and other measures of social adjustment and side effects. Results showed significant reductions in the core ADHD symptoms, which did not differ between the two treatment groups. Compared to the IR MPH group, the OROS MPH group showed a significantly greater slope of reductions in ADHD symptoms and decline in the severity of problems at school, and with peers and parents over time. There was no difference in rates of side effect profile between the two groups. Our findings suggest that OROS MPH is superior over IR MPH in the greater magnitude of improvement over study period without increased side effects in the Chinese population.
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Affiliation(s)
- Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, National Taiwan University, Taipei, Taiwan
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1053
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Philip R, Turk J. Neurofibromatosis and Attentional Deficits: An Illustrative Example of the Common Association of Medical Causes with Behavioural Syndromes, Implications for General Child Mental Health Services. Child Adolesc Ment Health 2006; 11:89-93. [PMID: 32811091 DOI: 10.1111/j.1475-3588.2006.00398.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Neurofibromatosis type 1 (NF1) is a common autosomal dominant gene disorder. In addition to well described physical and cognitive features certain behavioural patterns have been reported. Clear association has been shown between NF1 and attention deficit hyperactivity disorder (ADHD), with up to half of children with NF1 fulfilling DSM-IV diagnostic criteria for ADHD. This article aims to increase awareness among child mental health workers of the common link between genetic conditions (like NF1) and ADHD, thus improving diagnosis and intervention.
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Affiliation(s)
- Rebecca Philip
- South Glasgow Adolescent and Family Service, Twomax Building, 5th Floor, 187 Old Rutherglen Road, Glasgow G5 0RE, UK. E-mail:
| | - Jeremy Turk
- Department of Clinical Developmental Sciences, St George's Hospital Medical School, University of London, Cranmer Terrace, London SW17 0RE, UK
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1054
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Pavuluri MN, Henry DB, Devineni B, Carbray JA, Birmaher B. Child mania rating scale: development, reliability, and validity. J Am Acad Child Adolesc Psychiatry 2006; 45:550-560. [PMID: 16601399 DOI: 10.1097/01.chi.0000205700.40700.50] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To develop a reliable and valid parent-report screening instrument for mania, based on DSM-IVsymptoms. METHOD A 21-item Child Mania Rating Scale-Parent version (CMRS-P) was completed by parents of 150 children (42.3% female) ages 10.3 +/- 2.9 years (healthy controls = 50; bipolar disorder = 50; attention-deficit/hyperactivity disorder [ADHD] = 50). The Washington University Schedule for Affective Disorders and Schizophrenia was used to determine DSM-IV diagnosis. The Young Mania Rating Scale, Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, Child Behavior Checklist, and Child Depression Inventory were completed to estimate the construct validity of the measure. RESULTS Exploratory and confirmatory factor analysis of the CMRS-P indicated that the scale was unidimensional. The internal consistency and retest reliability were both 0.96. Convergence of the CMRS-P with the Washington University Schedule for Affective Disorders and Schizophrenia mania module, the Schedule for Affective Disorders and Schizophrenia Mania Rating Scale, and the Young Mania Rating Scale was excellent (.78-.83). The scale did not correlate as strongly with the Conners parent-rated ADHD scale, the Child Behavior Checklist -Attention Problems and Aggressive Behavior subscales, or the child self-report Child Depression Inventory (.29-.51). Criterion validity was demonstrated in analysis of receiver operating characteristics curves, which showed excellent sensitivity and specificity in differentiating children with mania from either healthy controls or children with ADHD (areas under the curve of.91 to.96). CONCLUSION The CMRS-P is a promising parent-report scale that can be used in screening for pediatric mania.
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Affiliation(s)
- Mani N Pavuluri
- Drs. Pavuluri, Henry, Devineni, and Carbray are with the Department of Psychiatry, University of Illinois at Chicago; and Dr. Birmaher is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
| | - David B Henry
- Drs. Pavuluri, Henry, Devineni, and Carbray are with the Department of Psychiatry, University of Illinois at Chicago; and Dr. Birmaher is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Bhargavi Devineni
- Drs. Pavuluri, Henry, Devineni, and Carbray are with the Department of Psychiatry, University of Illinois at Chicago; and Dr. Birmaher is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Julie A Carbray
- Drs. Pavuluri, Henry, Devineni, and Carbray are with the Department of Psychiatry, University of Illinois at Chicago; and Dr. Birmaher is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Boris Birmaher
- Drs. Pavuluri, Henry, Devineni, and Carbray are with the Department of Psychiatry, University of Illinois at Chicago; and Dr. Birmaher is with the Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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1055
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Gau SSF, Soong WT, Chiu YN, Tsai WC. Psychometric properties of the Chinese version of the Conners' Parent and Teacher Rating Scales-Revised: Short Form. J Atten Disord 2006; 9:648-59. [PMID: 16648232 DOI: 10.1177/1087054705284241] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This article examines the psychometric properties of the Chinese version of the Conners' Parent and Teacher Rating Scales-Revised: Short Forms (CPRS-R:S-C and CTRS-R:S-C) in a representative sample of 2,584 first to ninth graders in Taipei and 479 clinical participants (274 with ADHD). METHOD The instruments include the CPRS-R:S-C, CTRS-R:S-C, and the Chinese version of the Swanson, Kotkin, Atkins, M-Flynn, and Pelham Scale. RESULTS Results show satisfactory factor structure, test-retest reliability, internal consistency, and convergent validity for all the subscales of the CTRS-R:S-C and CPRS-R:S-C. They clearly distinguish clinical participants with ADHD from those without. CONCLUSION Our findings suggest that the CPRS-R:S-C and CTRS-R:S-C are reliable and valid instruments for measuring inattention and hyperactivity in both clinical and community settings in the Chinese population in Taipei.
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1056
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Warner TD, Behnke M, Hou W, Garvan CW, Wobie K, Eyler FD. Predicting caregiver-reported behavior problems in cocaine-exposed children at 3 years. J Dev Behav Pediatr 2006; 27:83-92. [PMID: 16682870 PMCID: PMC3150578 DOI: 10.1097/00004703-200604000-00001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Predictors of caregiver-reported behavior problems for 3-year-olds with prenatal cocaine exposure (PCE) and matched controls were examined using structural equation modeling. We tested whether PCE had a direct effect on child behavior problems in a model that included other prenatal drug exposure, child sex, caregiver depression, and the quality of the child's home environment. The sample (N = 256) was drawn from a longitudinal, prospective study of children of (predominantly crack) cocaine-using women and controls matched on race, socioeconomic status, parity, and pregnancy risk. Child Behavior Problems was modeled as a latent variable composed of the 48-item Conners' Parent Report Scale Conduct Problem and Impulsive-Hyperactive scales and the Eyberg Child Behavior Inventory Intensity scale. Caregiver depression was the only significant predictor of Child Behavior Problems. Mean levels of caregiver self-reported depression and reported child behavior problems did not differ between groups. Mean depression scores were well above the recommended clinical cutoff while mean child behavior problems scores were within normal limits. The model explained 21% of the variance in caregiver-reported child behavior problems in our sample of rural African American, low SES youngsters. Non-maternal caregivers of cocaine-exposed children had significantly lower mean depression scores and mean child behavior problems ratings for 2 of 3 scales used in the study compared to biological mothers of children with PCE and controls. For all groups, much larger proportions of children were rated as having clinically significant behavior problems than would be expected based on the prevalence of behavior problems in the general population.
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Affiliation(s)
- Tamara Duckworth Warner
- Department of Pediatrics, Division of Neonatology, University of Florida College of Medicine, Gainesville, Florida, USA.
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1057
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Heatherley SV, Hancock KMF, Rogers PJ. Psychostimulant and other effects of caffeine in 9- to 11-year-old children. J Child Psychol Psychiatry 2006; 47:135-42. [PMID: 16423144 DOI: 10.1111/j.1469-7610.2005.01457.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recent research on adults suggests that "beneficial" psychostimulant effects of caffeine are found only in the context of caffeine deprivation; that is, caffeine improves psychomotor and cognitive performance in habitual caffeine consumers following caffeine withdrawal. Furthermore, no net benefit is gained because performance is merely restored to "baseline" levels. The effects of caffeine in children is an under-researched area, with only a handful of studies being carried out in the US where children's consumption of caffeine appears to be lower on average than in the UK. METHOD Twenty-six children aged between 9 and 11 years completed a double-blind, placebo-controlled study. Habitual caffeine consumers (mean daily caffeine intake = 109 mg) and non/low-consumers (12 mg) were tested on two separate days following overnight caffeine abstinence. On each day measures of cognitive performance (a number search task), and self-rated mood and physical symptoms, including alertness and headache, were taken before and after administration of 50 mg of caffeine, or placebo. RESULTS At baseline (before treatment), the habitual consumers showed poorer performance on the cognitive test than did the non/low-consumers, although no significant differences in mood or physical symptoms were found between the two groups. There were significant habit by treatment (caffeine vs. placebo) interactions for accuracy of performance and headache, and a significant main effect of treatment for alertness. Post hoc comparisons showed that caffeine administration improved the consumers' accuracy on the cognitive test (to near the level displayed by the non/low-consumers at baseline), but that it had no significant effect on the non/low-consumers' performance. In the consumers, caffeine prevented an increase in headache that occurred after placebo, and it increased alertness relative to placebo. Again, however, caffeine did not significantly affect levels of headache or alertness in the non/low-consumers. CONCLUSIONS These results suggest that, like adults, children probably derive little or no benefit from habitual caffeine intake, although negative symptoms associated with overnight caffeine withdrawal are avoided or rapidly reversed by subsequent caffeine consumption.
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Affiliation(s)
- Susan V Heatherley
- Department of Experimental Psychology, University of Bristol, 8 Woodland Road, Bristol BS8 1TN, UK
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1058
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Roemmich JN, Barkley JE, D'Andrea L, Nikova M, Rogol AD, Carskadon MA, Suratt PM. Increases in overweight after adenotonsillectomy in overweight children with obstructive sleep-disordered breathing are associated with decreases in motor activity and hyperactivity. Pediatrics 2006; 117:e200-8. [PMID: 16452329 DOI: 10.1542/peds.2005-1007] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the effect of adenotonsillectomy (T&A) in children with obstructive sleep-disordered breathing on growth, hyperactivity, and sleep and waking motor activity. METHODS We studied 54 children who were aged 6 to 12 years and had adenotonsillar hypertrophy and an obstructive apnea-hypopnea index of > or =1 before and 12 months after they all received adenotonsillectomy (T&A). We measured their height, weight, percentage overweight (patient BMI - BMI at 50th percentile)/BMI at 50th percentile x 100) and obtained a hyperactivity score from parent report on a standardized behavior questionnaire scale. A subset of 21 of these children were also studied for motor activity by wrist actigraphy for 7 consecutive days and nights before and 12 months after T&A. RESULTS After T&A, mean obstructive apnea-hypopnea index decreased from 7.6 to 0.6. Height percentile did not change, but weight percentile increased; as a consequence, percentage overweight increased from 32.0% to 36.3%. Hyperactivity scores and total daily motor activity were reduced after T&A. From linear regression, the reduction in hyperactivity scores predicted an increase in percentage overweight. Reduced motor activity was correlated with increased percentage overweight. CONCLUSIONS An increase in percentage overweight after T&A in children with obstructive sleep-disordered breathing is correlated to decreased child hyperactivity scores and to decreased measured motor activity in the subset studied. These associations suggest that the increase in overweight may be attributable to reductions in physical activity and fidgeting energy expenditure.
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Affiliation(s)
- James N Roemmich
- Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo, New York, USA.
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1059
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Allin M, Rooney M, Cuddy M, Wyatt J, Walshe M, Rifkin L, Murray R. Personality in young adults who are born preterm. Pediatrics 2006; 117:309-16. [PMID: 16452348 DOI: 10.1542/peds.2005-0539] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Very preterm birth (VPT; <33 weeks' gestation) is associated with later neuromotor and cognitive impairment, reduced school performance, and psychiatric morbidity. Several follow-up studies have demonstrated increased anxiety and social rejection and reduced self-esteem in preterm children and adolescents, but few studies have examined the effects of preterm birth on adult personality. METHODS We assessed 108 VPT individuals and 67 term-born controls at ages 18 to 19 years with the Eysenck Personality Questionnaire-Revised, short form (EPQ-RS). This questionnaire rates 3 dimensions of personality: extraversion (sociability, liveliness, sensation seeking); neuroticism (anxiety, low mood, low self-esteem); and psychoticism (coldness, aggression, predisposition to antisocial behavior). A fourth scale, "lie," which measures dissimulation, is also derived. RESULTS VPT individuals had significantly lower extraversion scores, higher neuroticism scores, and higher lie scores than term-born controls, after controlling for age at assessment and socioeconomic status. P scores were not significantly different between the 2 groups. There was a gender difference in that the increased neuroticism and decreased extraversion scores were accounted for mainly by VPT females. Associations between EPQ-RS scores and neonatal status, adolescent behavioral ratings, and body size at 18 to 19 years were assessed by using Kendall partial correlations, correcting for age at assessment and socioeconomic status. Gestational age, indices of neonatal hypoxia, and neonatal ultrasound ratings were not correlated with EPQ-RS scores. Birth weight was weakly associated with increased lie scores. Rutter Parents' Scale score, a measure of adolescent psychopathology, was associated with an increased neuroticism score. Poor social adjustment in adolescence was associated with an increased lie score. Height and weight at 18 to 19 years were not associated with EPQ-RS, but reduced occipitofrontal circumference was associated with both decreased extraversion and increased lie scores. CONCLUSIONS Young adults who are born VPT have different personality styles from their term-born peers. This may be associated with an increased risk of psychiatric difficulties.
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Affiliation(s)
- Matthew Allin
- Institute of Psychiatry, King's College, London, United Kingdom.
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1060
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Abstract
Although research has been conducted to support the psychometric properties of rating scales used to assess ADHD in adults, little work has been published examining semi-structured interviews to assess ADHD in adults. The present study examined the test-retest reliability and concurrent validity of the Conners Adult ADHD Diagnostic Interview for Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) in a sample (N = 30) of patients referred to an outpatient clinic. Kappa statistics for individual symptoms of inattention and hyperactivity-impulsivity were in the fair to good range for current report and retrospective childhood report. Kappa values for overall diagnosis, which included all DSM-IV symptoms, were fair for both current (adult) ADHD diagnosis (kappa = .67) and childhood report (kappa = .69). Concurrent validity was demonstrated for adult hyperactive-impulsive symptoms and child inattentive symptoms. The findings are discussed in the context of overall issues pertaining to adult ADHD assessment.
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Affiliation(s)
- Jeffery N Epstein
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, USA.
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1061
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Takiuchi H, Kawabe S, Goto M, Ota S, Kii T, Tanaka T, Nishitani H, Kuwakado S, Katsu KI. [Principles of managing chemotherapy-induced nausea and vomiting]. Gan To Kagaku Ryoho 2006; 33:19-23. [PMID: 16410692 DOI: 10.2217/14750708.3.1.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chemotherapy-induced nausea and vomiting (emesis) can significantly affect a patient's quality of life, leading to poor compliance with further chemotherapy treatment. For patients treated with emetogenic chemotherapy, it is very important to prevent nausea and vomiting completely. The incidence and severity of nausea and/or vomiting in patients receiving chemotherapy are affected by numerous factors, including: 1) the specific chemotherapeutic agents used; 2) their dosage; 3) the schedule and route of administration; and 4) individual patient variability. Approximately 70 to 80% of all cancer patients receiving chemotherapy experience emesis, whereas 10% to 44% experience anticipatory emesis. The following general principles are recommended. 1) A 5-HT3 receptor antagonist should be administered prior to each day's 1st dose of moderately or highly emetogenic chemotherapy. 2) Dexamethasone should be administered once daily either orally or intravenously for every day of moderately or highly-emetogenic chemotherapy and for 2-3 days after chemotherapy for regimens that are likely to cause significant delayed-emesis. 3) The most effective way to treat anticipatory nausea and/or vomiting is to prevent it by using optimal antiemetic therapy during every cycle of treatment.
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1062
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Scime M, Norvilitis JM. Task performance and response to frustration in children with attention deficit hyperactivity disorder. PSYCHOLOGY IN THE SCHOOLS 2006. [DOI: 10.1002/pits.20151] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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1063
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Grizenko N, Kovacina B, Amor LB, Schwartz G, Ter-Stepanian M, Joober R. Relationship between response to methylphenidate treatment in children with ADHD and psychopathology in their families. J Am Acad Child Adolesc Psychiatry 2006; 45:47-53. [PMID: 16327580 DOI: 10.1097/01.chi.0000184932.64294.d9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the pattern of familial aggregation of psychopathology in children who are good responders (GR) to methylphenidate (MPH) versus those who are poor responders (PR). METHOD A total of 118 clinically referred children ages 6 to 12 years, diagnosed with ADHD participated in a double-blind, placebo-controlled, randomized 2-week crossover trial of MPH from 1999 to 2004. A low dose of 0.5 mg/kg of body weight of MPH divided in two equal doses was used. Family history was obtained by interviewing at least one key historian relative of each subject using Family Interview for Genetic Studies. Information was collected on 342 first-degree and 1,151 second-degree relatives of children with attention-deficit/hyperactivity disorder. RESULTS Forty-four subjects showed mild or no improvement (PR) and 74 showed moderate or very much improvement (GR) on MPH over placebo. First-degree relatives of GR subjects were at significantly higher risk of attention-deficit/hyperactivity disorder than the relatives of PR subjects (p<.05). Second-degree relatives of the GR were at significantly higher risk of antisocial personality disorder compared to the relatives of PR subjects (p<.05). CONCLUSIONS The significantly higher presence of attention-deficit/hyperactivity disorder in the first-degree relatives and of antisocial personality disorder in the second-degree relatives of GR children suggests that this group may, at least partially, be distinct from the PR group on the basis of genetic determinants.
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Affiliation(s)
- Natalie Grizenko
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada..
| | - Bojan Kovacina
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada
| | - Leila Ben Amor
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada
| | - George Schwartz
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada
| | - Marina Ter-Stepanian
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada
| | - Ridha Joober
- Dr. Grizenko, Dr. Joober, and Mr. Schwartz are with McGill University and Douglas Hospital; Mr. Kovacina is with McGill University; Dr. Ben Amor and Ms. Ter-Stepanian are with Douglas Hospital, Montreal, Québec, Canada
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1064
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1065
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Dreyer BP. The diagnosis and management of attention-deficit/hyperactivity disorder in preschool children: the state of our knowledge and practice. Curr Probl Pediatr Adolesc Health Care 2006; 36:6-30. [PMID: 16360075 DOI: 10.1016/j.cppeds.2005.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Benard P Dreyer
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
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1066
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Kratochvil CJ, Egger H, Greenhill LL, McGough JJ, Kratochvil CJ. Pharmacological management of preschool ADHD. J Am Acad Child Adolesc Psychiatry 2006; 45:115-118. [PMID: 16327589 DOI: 10.1097/01.chi.0000186451.49579.0a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Christopher J Kratochvil
- Dr. Kratochvil is with the Department of Psychiatry, University of Nebraska Medical Center, Omaha; Dr. Egger is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Dr. Greenhill is with the Department of Psychiatry, New York State Psychiatric Institute, New York; and Dr. McGough is with the Seml Institute for Neuroscience and Human Behavior at UCLA..
| | - Helen Egger
- Dr. Kratochvil is with the Department of Psychiatry, University of Nebraska Medical Center, Omaha; Dr. Egger is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Dr. Greenhill is with the Department of Psychiatry, New York State Psychiatric Institute, New York; and Dr. McGough is with the Seml Institute for Neuroscience and Human Behavior at UCLA
| | - Laurence L Greenhill
- Dr. Kratochvil is with the Department of Psychiatry, University of Nebraska Medical Center, Omaha; Dr. Egger is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Dr. Greenhill is with the Department of Psychiatry, New York State Psychiatric Institute, New York; and Dr. McGough is with the Seml Institute for Neuroscience and Human Behavior at UCLA
| | - James J McGough
- Dr. Kratochvil is with the Department of Psychiatry, University of Nebraska Medical Center, Omaha; Dr. Egger is with the Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Dr. Greenhill is with the Department of Psychiatry, New York State Psychiatric Institute, New York; and Dr. McGough is with the Seml Institute for Neuroscience and Human Behavior at UCLA
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1067
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Nass RD. Evaluation and assessment issues in the diagnosis of attention deficit hyperactivity disorder. Semin Pediatr Neurol 2005; 12:200-16. [PMID: 16780291 DOI: 10.1016/j.spen.2005.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article discusses the availability and appropriateness of various assessment techniques for diagnosing ADHD. In terms of the interview/history, the necessity and viability of using formal structured, semi structured, computerized and informal interviews for making an ADHD diagnosis are critiqued. The pros and cons of the various questionnaires frequently used to diagnose ADHD are addressed. The conundrum raised by multiple informants who often disagree is discussed, as are the effects of age and gender. The contributions of the medical and neurological examinations to the diagnosis of ADHD are considered. The utility of a neuropsychological assessment and of continuous performance testing to diagnosis is critiqued. Finally the lack of need for laboratory tests and the lack of necessity of neurological workup, specifically EEG and imaging, are argued.
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Affiliation(s)
- Ruth D Nass
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA.
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1068
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Kuntsi J, Andreou P, Ma J, Börger NA, van der Meere JJ. Testing assumptions for endophenotype studies in ADHD: reliability and validity of tasks in a general population sample. BMC Psychiatry 2005; 5:40. [PMID: 16262903 PMCID: PMC1291376 DOI: 10.1186/1471-244x-5-40] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2005] [Accepted: 11/01/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advances in both genetic and cognitive-experimental studies on attention deficit hyperactivity disorder (ADHD) have opened new opportunities for cognitive endophenotype research. In such genetic designs the focus is on individual differences in characteristics, associated with ADHD, that can be measured reliably over time. Genetic studies that take a 'quantitative trait loci' approach hypothesise that multiple susceptibility genes contribute to a continuous dimension of ADHD symptoms. As an important initial step, we aimed to investigate the underlying assumptions that (1) key cognitive-experimental tasks indicate adequate test-retest reliability and (2) ADHD symptom scores in a general population sample are associated with performance on these tasks. METHODS Forty-nine children were assessed on a go/no-go task and a reaction time task (the 'fast task') that included manipulations with event rate and incentives. The children were assessed twice, with a test-retest interval of two weeks. RESULTS The majority of the task variables demonstrated moderate-to-good test-retest reliability. The correlations between teacher ratings of ADHD symptoms and key task variables were .4-.6: ADHD symptoms were associated with poor performance (especially high reaction time variability) in a slow baseline condition, whereas there was low or no association in conditions with a faster event rate or incentives. In contrast, no clear pattern of findings emerged based on parent ratings of ADHD symptoms. CONCLUSION The data support the usefulness of the go/no-go and fast tasks for genetic studies, which require reliable and valid indices of individual differences. The overall pattern of associations between teacher ratings of ADHD symptoms and task variables is consistent with effects of event rate and incentives on performance, as predicted by the model of activation and arousal regulation. The lack of a clear pattern of findings with parent ratings of ADHD symptoms warrants further study.
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Affiliation(s)
- Jonna Kuntsi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Penny Andreou
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Jonathan Ma
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - Norbert A Börger
- Department of Developmental and Experimental Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Jaap J van der Meere
- Department of Developmental and Experimental Clinical Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
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1069
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Purper-Ouakil D, Fourneret P, Wohl M, Rénéric JP. [Atomoxetine: a new treatment for Attention Deficit/Hyperactivity Disorder (ADHD) in children and adolescents]. Encephale 2005; 31:337-48. [PMID: 16142049 DOI: 10.1016/s0013-7006(05)82399-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This paper provides a review of safety and efficacy data as well as of pharmacological characteristics of atomoxetine, a new drug treatment for the Attention Deficit/Hyperactivity Disorder (ADHD). To date, the only pharmacological treatment available in France for children and adolescents diagnosed with ADHD is methylphenidate, a psychostimulant drug. However, the clinical response to methylphenidate may be absent or insufficient in about 20-30% drug-treated children while the occurrence of adverse effects with methylphenidate (sleep disturbances, loss of appetite, tics increase...) may sometimes require a dose reduction or even the discontinuation of the treatment. Atomoxetine is an alternative candidate drug for the treatment of ADHD. The drug has been developed with respect to the actual standards of investigation of drugs intended to a -pediatric use. Atomoxetine has been recently licensed in the USA for the treatment of ADHD. Atomoxetine is a potent inhibitor of the norepinephrine transporter that shows only mini-mal affinity for other neurotransmitter systems. Although pharmacokinetics of atomoxetine is influenced by the polymorphism of the CYP2D6 metabolic pathway, safety and -tolerability data reported during clinical trials did not show any difference in poor versus extensive metabolizers. In addition, atomoxetine does not inhibit nor induce the CYP2D6 enzymatic function. The major metabolite of atomoxetine is 4-hydroxyatomoxetine, a pharmacologically active metabolic found in very low plasma concentrations in pediatric patients, suggesting that it plays only a minor role in the norepinephrine reuptake inhibition. Preliminary studies were aimed to assess the effective dose range of atomoxetine and to evaluate its safety and efficacy on the reduction of ADHD symptoms in adults and children diagnosed with ADHD. Main data on the child and adolescent population were obtained in four double-blind, randomized, placebo-controlled trials: two identical pivotal trials, a multiple dose study, a once-daily dose study. The first two pivotal trials were carried out in ADHD children aged 7-13 years, treated with atomoxetine vs placebo for a duration of 9 weeks. Patients presenting comorbidities (ie conduct disorder, -anxiety, depression) as well as a history of previous treatment with methylphenidate were also eligible to participate. The primary outcome was the reduction of the score on the ADHD rating scale, ADHD-RS ; secondary criteria included the responder's rate (patients with an ADHD-RS score reduction of 25% or above), the Clinical Global Impression Scale and the Conners Parent Rating Scale. With a mean dose of 1.5 mg/kg/day, atomoxetine showed a significant reduction of mean ADHD-RS scores at endpoint (ANOVA, p<0.001) (table II). Yet, the clinical significance of both studies is limited since efficacy was scored only in a social/familial setting and not in classroom conditions. In addition, intermediate results from baseline to endpoint were not presented in the publication. The multiple dose trial showed a significant reduction of the symptom score at the 1.2 and 1.8 mg/kg/day doses. The objective of the last study was to assess the efficacy of a single daily dose of atomoxetine versus placebo during a 6 week-treatment. Patients were evaluated by parents, investigators, as well as by teachers. The superiority of atomoxetine was demonstrated as compared to the placebo and the effect size of the daily dosing was similar to that reported with multiple doses. Preliminary data on ADHD patients presenting comorbidities showed that atomoxetine alone signi-ficantly reduced the symptom scores of anxiety and depression and similarly to atomoxetine associated with fluoxetine. In ADHD children with the oppositional defiant disorder, oppositional symptoms were reduced in the group receiving atomoxetine 1.8 mg/kg/day. Preliminary results in children with ADHD and chronic tics or Tourette syndrome showed a significant reduction of ADHD symptoms and a tendency to the decrease of tics. Tolerance and safety data pooled from the child and adolescent trials were acceptable. Study discontinuations due to adverse events in the four registration studies were only 2.8%. The most frequent adverse effects reported were gastrointestinal symptoms and decreased appetite. Weight loss reported early in clinical studies tended to stabilize during the open-label extension phases lasting up to 9 months. A retrospective comparison showed that the adverse event profile of poor metabolizers was similar to that of extensive metabolizers. In summary, data presented suggest that atomoxetine is a safe and effective drug for the treatment of ADHD in children and adolescents. Further studies are expected to accurately define the place of atomoxetine in the treatment strategy of ADHD, a chronic and invalidating disorder affecting 3 to 7% of school-aged children.
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Affiliation(s)
- D Purper-Ouakil
- Service de Psychopathologie de l'Enfant et de l'Adolescent, Hôpital Robert Debré, boulevard Sérurier, 75019 Paris
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1070
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Lauth GW, Kausch TWE, Schlottke PF. Effekte von eltern- und kindzentrierten Interventionen bei Hyperkinetischen Störungen. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2005. [DOI: 10.1026/1616-3443.34.4.248] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Kind- und elternzentrierte Behandlungsprogramme werden in der Therapie von Hyperkinetischen Störungen oft als unterschiedlich wirksam ausgewiesen. Allerdings fehlt es an systematischen Vergleichsuntersuchungen hierzu. Fragestellung: Die Wirksamkeit einer kind- und elternzentrierten Behandlung sowie deren Kombination werden miteinander verglichen. Methode: Insgesamt 60 Kinder (Altersbereich 7;3-12;2 Jahre) mit der Diagnose einer Hyperkinetischen Störung wurden aus einer größeren Grundgesamtheit ausgewählt. Jeweils 15 Kinder wurden einem kindzentrierten Training, einem Elterntraining, einer Kombinationsbehandlung (Kind- und Elterntraining) oder einer Wartekontrollgruppe ohne Behandlung zugewiesen. Die Effekte dieser Behandlungsmaßnahmen wurden jeweils aus der Perspektive der Eltern, der Lehrer und der Kinder in wiederholten Messungen überprüft (Symptomhäufigkeit, Symptomstärke). Ergebnisse: Im Urteil der Eltern und der Kinder führen alle drei Interventionsformen zu einer bedeutsamen und andauernden Reduktion der Hyperkinetischen Symptomatik. Nach Lehrerurteil ändert keine der Behandlungsbedingungen die Störungssymptomatik. Schlussfolgerung: Alle drei Behandlungsformen waren gleich wirkungsvoll.
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1071
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Pelham WE, Fabiano GA, Massetti GM. Evidence-Based Assessment of Attention Deficit Hyperactivity Disorder in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2005; 34:449-76. [PMID: 16026214 DOI: 10.1207/s15374424jccp3403_5] [Citation(s) in RCA: 504] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article examines evidence-based assessment practices for attention deficit hyperactivity disorder (ADHD). The nature, symptoms, associated features, and comorbidity of ADHD are briefly described, followed by a selective review of the literature on the reliability and validity of ADHD assessment methods. It is concluded that symptom rating scales based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994), empirically and rationally derived ADHD rating scales, structured interviews, global impairment measures, and behavioral observations are evidence-based ADHD assessment methods. The most efficient assessment method is obtaining information through parent and teacher rating scales; both parent and teacher ratings are needed for clinical purposes. Brief, non-DSM based rating scales are highly correlated with DSM scales but are much more efficient and just as effective at diagnosing ADHD. No incremental validity or utility is conferred by structured interviews when parent and teacher ratings are utilized. Observational procedures are empirically valid but not practical for clinical use. However, individualized assessments of specific target behaviors approximate observations and have both validity and treatment utility. Measures of impairment that report functioning in key domains (peer, family, school) as well as globally have more treatment utility than nonspecific global measures of impairment. DSM diagnosis per se has not been demonstrated to have treatment utility, so the diagnostic phase of assessment should be completed with minimal time and expense so that resources can be focused on other aspects of assessment, particularly treatment planning. We argue that the main focus of assessment should be on target behavior selection, contextual factors, functional analyses, treatment planning, and outcome monitoring.
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Affiliation(s)
- William E Pelham
- Department of Psychology, State University of New York at Buffalo, 14214, USA.
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1072
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Cornish KM, Manly T, Savage R, Swanson J, Morisano D, Butler N, Grant C, Cross G, Bentley L, Hollis CP. Association of the dopamine transporter (DAT1) 10/10-repeat genotype with ADHD symptoms and response inhibition in a general population sample. Mol Psychiatry 2005; 10:686-98. [PMID: 15809660 DOI: 10.1038/sj.mp.4001641] [Citation(s) in RCA: 169] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Association between attention-deficit hyperactivity disorder (ADHD) and the 10-repeat allele of the dopamine transporter gene (DAT1) has been reported in independent clinical samples using a categorical clinical definition of ADHD. The present study adopts a quantitative trait loci (QTL) approach to examine the association between DAT1 and a continuous measure of ADHD behaviours in a general-population sample, as well as to explore whether there is an independent association between DAT1 and performance on neuropsychological tests of attention, response inhibition, and working memory. From an epidemiological sample of 872 boys aged 6-11 years, we recruited 58 boys scoring above the 90th percentile for teacher reported ADHD symptoms (SWAN ADHD scale) and 68 boys scoring below 10th percentile for genotyping and neuropsychological testing. A significant association was found between the DAT1 homozygous 10/10-repeat genotype and high-scoring boys (chi(2)square=4.6, P<0.03; odds ratio=2.4, 95% CI 1.1-5.0). Using hierarchical linear regression, a significant independent association was found between the DAT1 10/10-repeat genotype and measures of selective attention and response inhibition after adjusting for age, IQ, and ADHD symptoms. There was no association between DAT1 and any component of working memory. Furthermore, performance on tasks of selective attention although associated with DAT1 was not associated with SWAN ADHD high scores after controlling for age and IQ. In contrast, impairment on tasks that tapped sustained attention and the central executive component of working memory were found in high-scoring boys after adjusting for age and IQ. The results suggest that DAT1 is a QTL for continuously distributed ADHD behaviours in the general population and the cognitive endophenotype of response inhibition.
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Affiliation(s)
- K M Cornish
- Neuroscience Laboratory for Research and Education in Developmental Disorders, McGill University, Montreal, Canada.
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1073
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Mulvaney SA, Goodwin JL, Morgan WJ, Rosen GR, Quan SF, Kaemingk KL. Behavior problems associated with sleep disordered breathing in school-aged children--the Tucson children's assessment of sleep apnea study. J Pediatr Psychol 2005; 31:322-30. [PMID: 15888642 DOI: 10.1093/jpepsy/jsj035] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of the current study was to examine prevalence of and relations between a commonly used measure of nighttime breathing problems, the Respiratory Disturbance Index (RDI), and a range of problem behaviors in community children. METHODS Participants were 403 unreferred children aged 6-12 years. Recruitment was completed through public elementary schools. Overnight unattended in-home polysomnography was used to assess sleep and breathing. The RDI was used as the indicator of respiratory events during sleep. The Child Behavior Checklist and the Conners' Parent Rating Scales-Revised were used to assess behavior. RESULTS Prevalence rates for Attention, Cognitive Problems, Aggression, Oppositional behavior, and Social Problems were greatest for subjects with high RDIs. Prevalence for Internalizing behaviors was not greater for those subjects with high RDIs. Hyperactivity was not strongly related to higher RDIs. CONCLUSIONS Behavioral problems may exist in the presence of nocturnal breathing events in unreferred children. Specific patterns of behavioral morbidity have still not been established. Some behaviors, such as hyperactivity, may show differing sensitivity and specificity in relation to the RDI.
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Affiliation(s)
- Shelagh A Mulvaney
- Center for Evaluation and Program Improvement, Vanderbilt University, Peabody 151, 230 Appleton Place, Nashville, Tennessee 37203, USA.
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1074
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Abikoff H, McGough J, Vitiello B, McCracken J, Davies M, Walkup J, Riddle M, Oatis M, Greenhill L, Skrobala A, March J, Gammon P, Robinson J, Lazell R, McMahon DJ, Ritz L. Sequential pharmacotherapy for children with comorbid attention-deficit/hyperactivity and anxiety disorders. J Am Acad Child Adolesc Psychiatry 2005; 44:418-27. [PMID: 15843763 DOI: 10.1097/01.chi.0000155320.52322.37] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by clinically significant anxiety, but few empirical data guide treatment of children meeting full DSM-IV criteria for ADHD and anxiety disorders (ADHD/ANX). This study examined the efficacy of sequential pharmacotherapy for ADHD/ANX children. METHOD Children, age 6 to 17 years, with ADHD/ANX were titrated to optimal methylphenidate dose and assessed along with children who entered the study on a previously optimized stimulant. Children with improved ADHD who remained anxious were randomly assigned to 8 weeks of double-blind stimulant + fluvoxamine (STIM/FLV) or stimulant + placebo (STIM/PL). Primary efficacy measures were the Swanson, Nolan, Atkins, and Pelham IV Parent and Teacher Rating Scale ADHD score and the Pediatric Anxiety Rating Scale total score. ADHD, ANX, and overall Clinical Global Impressions-Improvement scores were also obtained. RESULTS Of the 32 medication-naive children openly treated with methylphenidate, 26 (81%) improved as to ADHD. Twenty-five children entered the randomized trial. Intent-to-treat analysis indicated no differences between the STIM/FLV (n = 15) and STIM/PL groups on the Pediatric Anxiety Rating Scale or Clinical Global Impressions-Improvement-defined responder rate. Medications in both arms were well tolerated. CONCLUSIONS Children with ADHD/ANX have a response rate to stimulants for ADHD that is comparable with that of children with general ADHD. The benefit of adding FLV to stimulants for ANX remains unproven.
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Affiliation(s)
- Howard Abikoff
- New York University Child Study Center, New York, NY 10016, USA.
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1075
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Bjornstad G, Montgomery P. Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents. Cochrane Database Syst Rev 2005:CD005042. [PMID: 15846741 DOI: 10.1002/14651858.cd005042.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is diagnosed in between 3% and 7% of school-age children and consists of the core symptoms of inattention, impulsivity and hyperactivity. Children are often treated with medication, usually stimulant medication such as methylphenidate. Stimulant medication has been found to be effective for alleviating ADHD symptoms, at least in the short term. ADHD is also treated with a variety of psychosocial and psychoeducational interventions for parents, children, and with multicomponent interventions combined with medication management. However, many patients (10 to 13% of patients) cannot or prefer not to take medication. Family therapy without medication may help to develop structure in the family, help to manage children's behaviour, and may help families cope with distress from the presence of the disorder. OBJECTIVES This review seeks to address the question of whether family therapy without medication can reduce the core symptoms of ADHD as compared to no treatment or standard treatment. SEARCH STRATEGY The following electronic databases were searched using a specific search strategy: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2004), MEDLINE (1966 to April 2004), PsycINFO (1872 to April 2004), CINAHL (1982 to April 2004), Biosis (Biological Abstracts) (1985 to March 2004), Dissertation Abstracts (1980 to April 2004), and Sociological Abstracts (Sociofile) (1963 to April 2004). Hand searches of relevant journals and bibliographies were also conducted and experts in the field were contacted for further information. SELECTION CRITERIA Included studies were randomised controlled trials investigating the efficacy of behavioural family therapy, cognitive behavioural family therapy, or functional family therapy for children with ADHD or ADD (Attention Deficit Disorder). DATA COLLECTION AND ANALYSIS Studies were evaluated for methodological quality and to determine whether they met the inclusion criteria. MAIN RESULTS This assessment yielded two studies. Data were extracted for both studies. The findings from Jensen 1999 (N=579) indicate that no difference can be detected between the efficacy of behavioural family therapy and treatment as usual in the community. The finding from the available data from Horn 1991 slightly favours treatment over medication placebo. AUTHORS' CONCLUSIONS Further research examining the effectiveness of family therapy versus a no-treatment control condition is needed to determine whether family therapy is an effective intervention for children with ADHD. There were no results available from studies investigating forms of family therapy other than behavioural family therapy.
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Affiliation(s)
- G Bjornstad
- Social Policy and Social Work, University of Oxford, Wolfson College, Linton Road, Oxford, Oxon, UK, OX2 6UD.
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1076
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Mahone EM, Pillion JP, Hoffman J, Hiemenz JR, Denckla MB. Construct validity of the auditory continuous performance test for preschoolers. Dev Neuropsychol 2005; 27:11-33. [PMID: 15737941 DOI: 10.1207/s15326942dn2701_2] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Development of diagnostic instruments directed toward neuropsychological assessment of preschoolers lags significantly behind those available for school-age children (DeWolfe, Byrne, & Bawden, 2000). This is particularly true for measures of executive function (EF). The Auditory Continuous Performance Test for Preschoolers (ACPT-P; Mahone, Pillion, & Hiemenz, 2001) is a computerized, Go-No-go test developed to measure selected EF skills in preschoolers. First, to determine whether performance on the ACPT-P is associated with hearing impairment, we compared performance of children with mild hearing loss (MHL) to controls on the ACPT-P, and measures of spatial working memory (SWM) and motor persistence (MP). There were no differences between performance of the MHL group and controls on any of these measures. Second, to examine the construct validity of the ACPT-P, we compared performance of 40 preschoolers with ADHD to 40 age- and sex-matched controls, using the ACPT-P to measure response preparation, sustained attention, and inhibitory control. We also compared these groups on measures of SWM and MP. The group with attention deficit hyperactivity disorder (ADHD) performed significantly worse than controls on the ACPT-P (omissions, mean response time, variability) and MP. The ACPT-P was correlated with the MP, but not with the SWM measure. Both the ACPT-P and the MP measures showed low to moderate correlations with parent ratings of behavior associated with ADHD. These findings support the use of performance-based assessment of executive control skills in preschoolers suspected of having ADHD. In this age group, the ACPT-P may be particularly useful in assessing sustained attention and response preparation and may complement behavior rating scales.
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Affiliation(s)
- E Mark Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD 21231, USA.
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1077
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Curran S, Purcell S, Craig I, Asherson P, Sham P. The serotonin transporter gene as a QTL for ADHD. Am J Med Genet B Neuropsychiatr Genet 2005; 134B:42-7. [PMID: 15719397 DOI: 10.1002/ajmg.b.30118] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Molecular studies of attention deficit hyperactivity disorder (ADHD) have identified susceptibility genes for the categorically diagnosed disorder using operational diagnostic criteria. Here, we take a QTL approach to mapping genes for ADHD using a composite continuous index of ADHD behavior in a large epidemiological sample. Previous studies of clinical ADHD suggest that two functional polymorphisms in the serotonin transporter gene (SLC6A4), one in the 5'-regulatory region of the gene (5-HTTLPR) and the other a VNTR (5-HTTVNTR) in the second intron, as well as a single nucleotide polymorphism in the 3'-untranslated region (3'-UTR SNP), may be associated with the disorder. Here, we investigate these polymorphisms as well as an additional ten SNPs spread across the gene. We found significant association with the long (L) allele of the 5-HTTLPR; P = 0.019, but neither the 5-HTTVNTR nor the 3'-UTR SNP were significantly associated. Significant associations (P < 0.05) were found for a further 5 the 10 other markers tested. We found evidence for two haplotype blocks spanning the region. We found strong evidence for association with the first haplotype block (comprised of four markers), with the significance of a combined primary and secondary test of association reaching an empirical P value = 0.0054 for the global test and an empirical P value = 0.00081 for the largest local test. Thus, we show here that SLC6A4, which has a major influence on brain serotonin availability, may be a QTL for ADHD.
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Affiliation(s)
- Sarah Curran
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, De Crespigny Park, London, United Kingdom.
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1078
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Kuntsi J, Rijsdijk F, Ronald A, Asherson P, Plomin R. Genetic influences on the stability of attention-deficit/hyperactivity disorder symptoms from early to middle childhood. Biol Psychiatry 2005; 57:647-54. [PMID: 15780852 DOI: 10.1016/j.biopsych.2004.12.032] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2004] [Revised: 12/13/2004] [Accepted: 12/23/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high heritability of the core symptoms of attention-deficit/hyperactivity disorder (ADHD) has been repeatedly demonstrated, but few studies to date have investigated the extent to which the same genetic influences operate across development or new genes emerge at different developmental periods. METHODS We report data from a large, population-based study of approximately 4,000 twin pairs, who have been followed up from early to middle childhood. RESULTS Parents' ratings of ADHD symptoms showed moderate stability across the ages, which was mainly due to shared genetic influences. There was also evidence of additional genetic influences, which were not shared with those acting earlier on, emerging at later age periods. The contribution of environmental influences to the stability of the ADHD symptoms over time was small. Parents' ratings on the Conners' DSM-IV ADHD subscale at the last assessment point, at an average age of 8 years, did not show the rater contrast effects that were observed in the parents' ratings at earlier ages with briefer measures. Similar estimates of genetic and environmental influences were obtained for girls and boys. CONCLUSIONS We discuss the implications of the findings for molecular genetic studies on ADHD symptomatology.
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Affiliation(s)
- Jonna Kuntsi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.
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1079
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Korkman M, Jaakkola M, Ahlroth A, Pesonen AE, Turunen MM. Screening of developmental disorders in five-year-olds using the FTF (Five to Fifteen) questionnaire: a validation study. Eur Child Adolesc Psychiatry 2005; 13 Suppl 3:31-8. [PMID: 15692878 DOI: 10.1007/s00787-004-3005-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The study examined the validity of the Five to Fifteen (FTF) questionnaire in detecting developmental disorders in five-year-old children. A pilot study (N=70) was first undertaken to try out a translation of the FTF into Finnish. Subsequently, FTF questionnaires were mailed to parents of all five-year-old children from specified health-care districts in Vantaa, Finland. A total of 769 questionnaires (60%) were completed and returned. Children scoring above a cut-off value in any domain were considered at risk for having developmental disorders (the Risk Group; N=90). A Control Group was formed by randomly selecting 30 children who did not score above the threshold value in any domain. The children from the Risk Group and the Control Group were called to individual neuropsychological assessments. All invited children attended the assessments. The parts of the FTF that assess fine motor skills, executive functions (including attention and impulsivity), perception, memory, and language were used for this study. The external criterion measure was the NEPSY, a neuropsychological assessment instrument. Results demonstrated that the five FTF Domain Scores used in this study correlated significantly with the corresponding NEPSY Domain Scores. Second, the Risk Group obtained significantly poorer scores on the NEPSY than the Control Group. Third, on a cross-tabulation a very high rate of positive hits (93 %) was obtained as well as a very low rate of misses (7 %), indicating a very good sensitivity. However, there were a large percentage of false positives (63 %), indicating that specificity was not so good. Evidently, parents may report concerns related to the young child's development even when neuropsychological assessments do not indicate significant disorders. On the whole, the findings supported the validity of the FTF as a developmental screening instrument.
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Affiliation(s)
- Marit Korkman
- Institution of Psychology, Abo Akademi University, 20500 Turku, Finland
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1080
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Helton SC, Corwyn RF, Bonner MJ, Brown RT, Mulhern RK. Factor Analysis and Validity of the Conners Parent and Teacher Rating Scales in Childhood Cancer Survivors. J Pediatr Psychol 2005; 31:200-8. [PMID: 16467320 DOI: 10.1093/jpepsy/jsj010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine the factor structure of the Conners Parent Rating Scale-Revised: Short Form (CPRS-R:S) and the Conners Teacher Rating Scale-Revised: Short Form (CTRS-R:S) in children who are long-term survivors of acute lymphocytic leukemia (ALL) or brain tumors (BT)and who have received central nervous system directed treatment. METHOD Parents and teachers of 150 long-term survivors completed the CPRS-R:S or CTRS-R:S as part of a screening battery. The data were submitted to a maximum likelihood confirmatory factor analysis to test the construct validity of the scales and the forms were compared. The CPRS-R:S was also compared to selected subscales of the Achenbach Child Behavior Checklist (CBCL) for further validation. RESULTS The analyses demonstrated an adequate fit of the original three-factor structure of the CTRS-R:S [oppositional, cognitive problems/inattention, hyperactivity]. The analyses of the CPRS-R:S suggested a less adequate fit of the original three-factor structure but principal components factor analysis yielded a three-factor solution with factors similar to those of Conners' original factor structure. Significant correlations were found between the CPRS-R:S and the selected subscales of the CBCL. CONCLUSIONS These findings support the similar construct validity of the original CTRS-R:S and CPRS-R:S. Although significantly correlated, the CPRS-R:S and CTRS-R:S are not interchangeable in the assessment of survivors of childhood cancer.
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Affiliation(s)
- Susan C Helton
- Division of Behavioral Medicine, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, Tennessee 38105-2794, USA.
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1081
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Abstract
The management of attention deficit/hyperactivity disorder (ADHD) requires a multimodal approach. Although shared-care protocols are suggested, uptake by general practice has been tentative. Behavioural management, both on its own and in combination with pharmacotherapy, reduces core symptoms and associated behaviours, such as oppositional defiant disorder (ODD). Links with education and social support are also important for helping children and their families. Psychostimulants have shown to be effective in the treatment of ADHD, however, their short duration of action highlights potential limitations. Other drugs used in the management of ADHD and comorbid disorders include antidepressants, clonidine and its analogues, newer atypical neuroleptics, and atomoxetine, a novel, non-stimulant therapy that has potential to fulfil some unmet treatment needs. Further research is needed in preschool children, girls, those with epilepsy, young adults, and in those with associated sleep disturbance. Selected rating scales and careful history taking, allied to close links with schools, are vital for the initial and ongoing assessment of ADHD and its comorbidities.
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Affiliation(s)
- C R Steer
- Victoria Hospital, Paediatric Unit, Hayfield Road, Kirkcaldy, Fife KY3 0TL, UK.
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1082
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Barton J. Atomoxetine: a new pharmacotherapeutic approach in the management of attention deficit/hyperactivity disorder. Arch Dis Child 2005; 90 Suppl 1:i26-9. [PMID: 15665154 PMCID: PMC1765270 DOI: 10.1136/adc.2004.059386] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Atomoxetine is a novel, non-stimulant, highly selective noradrenaline reuptake inhibitor that has been studied for use in the treatment of attention deficit/hyperactivity disorder (ADHD). Data from clinical trials show it to be well tolerated and effective in the treatment of ADHD in children, adolescents, and adults. Improvements were seen not only in core symptoms of ADHD, but also in broader social and family functioning and self esteem. Once-daily dosing of atomoxetine has been shown to be effective in providing continuous symptom relief. Atomoxetine does not appear to have abuse potential and is associated with a benign side effect profile. The development of atomoxetine thus represents an important advance in the pharmacological management of ADHD.
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Affiliation(s)
- J Barton
- North Staffordshire Combined Health Care NHS Trust, Moorlands Team, Abbey Hulton Clinic, Leek Road, Stoke-On-Trent, Staffordshire ST2 8BP, UK.
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1083
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1084
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Schwartz G, Amor LB, Grizenko N, Lageix P, Baron C, Boivin DB, Joober R. Actigraphic monitoring during sleep of children with ADHD on methylphenidate and placebo. J Am Acad Child Adolesc Psychiatry 2004; 43:1276-82. [PMID: 15381895 DOI: 10.1097/01.chi.0000135802.94090.93] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Sleep disturbances appear as a comorbid condition in children with attention-deficit/hyperactivity disorder. The aim of this study was to investigate the relationship of activity levels during sleep and therapeutic response to methylphenidate (MPH). METHOD Nightly sleep actigraphic recordings during a double-blind, placebo-controlled, crossover clinical study (1-week of 0.5 mg/kg MPH; 1-week of placebo) were obtained on 44 children, 6 to 12 years old, diagnosed with attention-deficit/hyperactivity disorder (DSM-IV). RESULTS Significant (p <.005) differences between the conditions were found in several software-computed parameters: sleep onset latency (MPH, 39.3 minutes; placebo, 28.2 minutes), sleep efficiency (MPH, 78.0%; placebo, 80.4%), total sleep time (MPH, 7 hours; 57 minutes; placebo, 8 hours, 16 minutes). No significant differences on any of these measures were found among the 26 subjects who showed a moderate or large global improvement on MPH over placebo compared with 18 subjects who showed mild or no clinical improvement. CONCLUSIONS MPH, given twice daily, induces a slight but significant sleep disturbance. Motor activity levels during sleep did not differentiate children who responded to MPH from those who did not respond. This suggests that responders to MPH treatment do not experience greater sleep disturbances than nonresponders, at least at the dose studied.
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Affiliation(s)
- George Schwartz
- Douglas Hospital Research Centre and the Department of Psychiatry, McGill University, Montreal, Canada
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1085
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Lampert TL, Polanczyk G, Tramontina S, Mardini V, Rohde LA. Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD. J Atten Disord 2004; 8:63-71. [PMID: 15801336 DOI: 10.1177/108705470400800204] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the diagnostic performance of the Attention Problem Scale of the Child Behavior Checklist (CBCL-APS) for the screening of Attention-Deficit/Hyperactivity Disorder (ADHD) in a sample of Brazilian children and adolescents. METHODS The CBCL-APS was given to 763 children and adolescents. Child psychiatrists using DSM-IV criteria confirmed the clinical diagnoses. Diagnostic performance was evaluated through Receiver-Operating Characteristic (ROC) curves. RESULTS Only moderate areas under the curve (AUC) were found for the general sample (AUC = 0.79; 95% CI = 0.76-0.82), and for the subsample of referred patients (AUC = 0.78; 95% CI = 0.74-0.82). The subsample of patients with ADHD of the combined type presented the largest AUC (AUC = 0.85; 95% CI = 0.82-0.88). CONCLUSION Our findings concur with previous studies of different cultures demonstrating adequate diagnostic performance of the CBCL-APS for the screening of ADHD, especially of the combined type.
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Affiliation(s)
- T L Lampert
- ADHD outpatient program at Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande du Sul, Brazil
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1086
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Gottlieb DJ, Chase C, Vezina RM, Heeren TC, Corwin MJ, Auerbach SH, Weese-Mayer DE, Lesko SM. Sleep-disordered breathing symptoms are associated with poorer cognitive function in 5-year-old children. J Pediatr 2004; 145:458-64. [PMID: 15480367 DOI: 10.1016/j.jpeds.2004.05.039] [Citation(s) in RCA: 167] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the relation of sleep-disordered breathing (SDB) symptoms in children to neurocognitive function. STUDY DESIGN A cross-sectional, population-based study of 205 5-year-old children. A parent-completed questionnaire was used to ascertain SDB symptoms, defined as frequent snoring, loud or noisy breathing during sleep, or witnessed sleep apnea. Polysomnography (PSG) data were available in 85% of children. Standardized neurocognitive tests were administered by a trained psychometrist unaware of the children's SDB status. Children with (n=61) and without SDB symptoms were compared using analysis of variance to adjust for demographic and respiratory health variables. RESULTS Children with SDB symptoms scored significantly lower than those without SDB symptoms on tests of executive function (95.5 vs 99.9 on NEPSY Attention/Executive Core Domain, P=.02; 10.4 vs 11.2 on Wechsler Preschool and Primary Scale of Intelligence, Revised [WPPSI-R] Animal Pegs test, P=.03), memory (96.8 vs 103.0 on NEPSY Memory Domain, P=.02), and general intellectual ability (105.9 vs 111.7 on WPPSI-R Full Scale IQ, P=.02). There were no significant differences on a computerized continuous performance task. These findings persisted when children with PSG evidence of obstructive sleep apnea (OSA) were excluded from analysis. CONCLUSION Even in the absence of OSA, SDB symptoms are associated with poorer executive function and memory skills and lower general intelligence in 5-year-old children.
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Affiliation(s)
- Daniel J Gottlieb
- Department of Medicine, Slone Epidemiology Center, Boston University School of Medicine, Boston, Massachusetts 02118-2394, USA.
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1087
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Snyder SM, Drozd JF, Xenakis SN. Validation of ADHD rating scales. J Am Acad Child Adolesc Psychiatry 2004; 43:1189-90; discussion 1190-1; author reply 1191. [PMID: 15381880 DOI: 10.1097/01.chi.0000135631.10911.fd] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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1088
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Lahey BB, Applegate B, Waldman ID, Loft JD, Hankin BL, Rick J. The structure of child and adolescent psychopathology: generating new hypotheses. JOURNAL OF ABNORMAL PSYCHOLOGY 2004; 113:358-85. [PMID: 15311983 DOI: 10.1037/0021-843x.113.3.358] [Citation(s) in RCA: 174] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To begin to resolve conflicts among current competing taxonomies of child and adolescent psychopathology, the authors developed an interview covering the symptoms of anxiety, depression, inattention, and disruptive behavior used in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), the International Statistical Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1992), and several implicit taxonomies. This interview will be used in the future to compare the internal and external validity of alternative taxonomies. To provide an informative framework for future hypothesis-testing studies, the authors used principal factor analysis to induce new testable hypotheses regarding the structure of this item pool in a representative sample of 1,358 children and adolescents ranging in age from 4 to 17 years. The resulting hypotheses differed from the DSM-IV, particularly in suggesting that some anxiety symptoms are part of the same syndrome as depression, whereas separation anxiety, fears, and compulsions constitute a separate anxiety dimension.
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Affiliation(s)
- Benjamin B Lahey
- Department of Psychiatry, University of Chicago, Chicago, IL 60637, USA.
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1089
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Neurofeedback as a Treatment for ADHD: A Methodological Review with Implications for Future Research. ACTA ACUST UNITED AC 2004. [DOI: 10.1300/j184v08n02_04] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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1090
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Riggs PD, Hall SK, Mikulich-Gilbertson SK, Lohman M, Kayser A. A randomized controlled trial of pemoline for attention-deficit/hyperactivity disorder in substance-abusing adolescents. J Am Acad Child Adolesc Psychiatry 2004; 43:420-9. [PMID: 15187802 DOI: 10.1097/00004583-200404000-00008] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In adolescents with substance use disorder (SUD), comorbid attention-deficit/hyperactivity disorder (ADHD) is associated with greater severity of substance abuse, conduct problems, and worse treatment outcomes. Although many controlled trials have established the efficacy of psychostimulants, including pemoline, for ADHD in children and adolescents, none have been conducted in adolescents with SUD. This randomized, placebo-controlled trial, conducted between 1996 and 2000, evaluated the safety and efficacy of pemoline on substance abuse and conduct problems. METHOD Sixty-nine adolescents (aged 13-19) with conduct disorder (CD), SUD, and ADHD were recruited from the community and randomly assigned to a 12-week clinical trial of pemoline (n = 35) or placebo (n = 34), titrated over 4 weeks to a single morning dose of 75 to 112.5 mg as tolerated. RESULTS Pemoline had greater efficacy than placebo for ADHD as determined by significantly more Clinician's Global Impression-Improvement (CGI-I) ratings of 1 (very much improved) or 2 (much improved) at the study endpoint (n = 69; p <.05). There was also greater reduction in ADHD severity on the parent-rated Conners Hyperactivity-Impulsivity scale in pemoline-treated study completers compared to placebo-treated completers (pemoline, n = 17; placebo, n = 16; p <.01), but no difference between groups in the intent-to-treat analysis (n = 68; p <.13). Substance use did not decline in either group, and there was no difference between groups in baseline to study endpoint change in substance use or CD symptoms. Overall, pemoline was well tolerated, demonstrating a good safety profile and no elevation in liver enzyme levels. CONCLUSIONS Pemoline was efficacious for ADHD but did not have an impact on CD or substance abuse in the absence of specific treatment for SUD.
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Affiliation(s)
- Paula D Riggs
- Department of Psychiatry, University of Colorado School of Medicine, Denver 80262, USA.
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1091
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Meyer A, Eilertsen DE, Sundet JM, Tshifularo J, Sagvolden T. Cross-cultural Similarities in ADHD-Like Behaviour Amongst South African Primary School Children. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2004. [DOI: 10.1177/008124630403400108] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigates whether the Disruptive Behaviour Disorders (DBDs) rating scale measures the same constructs in South African as in Western cultures, and explores the differences in scale scores as a function of language, gender and age. Teacher ratings between 1997 and 1999 of the 18 DSM-IV symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) in 6 094 primary school children of six language groups in the Limpopo Province of South Africa were collected and analysed. For all language groups, the results were consistent with a two-factor model of ADHD with correlated factors. There were gender and age effects on both scales. The prevalence rates for ADHD sub-types were in line with rates in the United States of America (US) and Europe. Similarities across language groups, as well as to results reported in the US and Europe, were striking. Despite the limitations discussed, teacher ratings of ADHD symptoms on the DBD scale can be used as a screening instrument in South Africa. Separate norms for different language groups are not indicated.
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Affiliation(s)
- Anneke Meyer
- School of Social Sciences, University of the North, Private Bag X1106, Sovenga, 0727, South Africa
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1092
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Abstract
This article reviews measures of child and adolescent psychopathology used in Asian cultures. Sixteen imported measures from the West are identified and their psychometric equivalence across cultures is reviewed; 2 new measures are briefly introduced. Although initial evidence is generally promising, more studies are needed to support their use in Asia. One recently developed Singapore measure cannot be considered genuinely indigenous. Culture-specific items proposed for imported measures could be grouped into existing diagnostic constructs. There is, as yet, no strong theoretical support for culture-bound diagnostic constructs in Asian cultures.
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Affiliation(s)
- Patrick W Leung
- Department of Psychology, Chinese University of Hong Kong, Shatin, Hong Kong.
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1093
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Gottlieb DJ, Vezina RM, Chase C, Lesko SM, Heeren TC, Weese-Mayer DE, Auerbach SH, Corwin MJ. Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics 2003; 112:870-7. [PMID: 14523179 DOI: 10.1542/peds.112.4.870] [Citation(s) in RCA: 155] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Sleep-disordered breathing (SDB) in children is reportedly associated with problem behaviors suggestive of attention-deficit/hyperactivity disorder; however, there are few data on the relation of SDB to problem behaviors in the general pediatric population. The goal of this study was to assess the prevalence of SDB symptoms in 5-year-old children and their relation to sleepiness and problem behaviors. METHODS A population-based, cross-sectional survey was conducted of a birth cohort of children who were born in eastern Massachusetts. Subjects were 3019 5-year-old children (1551 boys, 1468 girls) who were enrolled in the Infant Care Practices Study and whose mothers were contacted within 3 months of their child's fifth birthday. A parent-completed questionnaire was used to ascertain the presence and intensity of snoring and other SDB symptoms and the presence of daytime sleepiness and problem behaviors. Parent-reported hyperactivity, inattention, and aggressiveness were each assessed by a single question that was validated against the Conners' Parent Rating Scale. SDB was defined as frequent or loud snoring; trouble breathing or loud, noisy breathing during sleep; or witnessed sleep apnea. RESULTS Parent-reported hyperactivity (19%) and inattention (18%) were common, with aggressiveness (12%) and daytime sleepiness (10%) reported somewhat less often. SDB symptoms were present in 744 (25%) children. Compared with children without snoring or other symptoms of SDB, children with SDB symptoms were significantly more likely to have parent-reported daytime sleepiness (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.7-2.8) and problem behaviors, including hyperactivity (OR: 2.5; CI: 2.0-3.0), inattention (OR: 2.1; 95% CI: 1.7-2.6), and aggressiveness (OR: 2.1; 95% CI: 1.6-2.6). These associations remained significant after adjustment for sex, race/ethnicity, maternal education level, maternal marital status, household income, and respiratory health history. CONCLUSIONS SDB symptoms are common in 5-year-old children and are associated with an increased risk of daytime sleepiness and with problem behaviors suggestive of attention-deficit/hyperactivity disorder.
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Affiliation(s)
- Daniel J Gottlieb
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118-2394, USA.
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1094
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Alessi NE. Quantitative Documentation of the Therapeutic Efficacy of Adolescent Telepsychiatry. Telemed J E Health 2003; 9:283-9. [PMID: 14611696 DOI: 10.1089/153056203322502678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The following is a case report of a 15-year-old adolescent who was evaluated and treated via telepsychiatry as part of an ongoing project at the University of Michigan Health System and the Hiawatha Community Mental Health Center in Michigan. In addition to clinical information, prospective quantitative data was collected at baseline, 6 weeks, and 3 months. Measures included the Youth Self Report (YSR), Child Behavior Checklist (CBCL), Suicide Probability Scale (SPS), Reynold's Adolescent Depression Scale (RADS), Connor's Global Index-Parent Version (CGI-P), and the Children's Global Assessment Scale (CGAS). Prior to the telepsychiatry intervention, the patient was diagnosed as having bipolar disorder with psychosis. During the telepsychiatry intervention, the diagnosis was altered to a posttraumatic stress disorder; medications were discontinued and the patient improved. All scales showed reductions in severity of symptoms after the telepsychiatry interventions. This case represents the first application of adolescent telepsychiatry for the diagnosis, treatment, and tracking of clinical symptoms.
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Affiliation(s)
- Norman E Alessi
- Psychiatric Informatics Program, Department of Psychiatry, University of Michigan, Ann Arbor 48109, USA.
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1095
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Collett BR, Ohan JL, Myers KM. Ten-year review of rating scales. V: scales assessing attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2003; 42:1015-37. [PMID: 12960702 DOI: 10.1097/01.chi.0000070245.24125.b6] [Citation(s) in RCA: 207] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHOD The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here. RESULTS Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad. CONCLUSIONS Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.
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Affiliation(s)
- Brent R Collett
- University of Washington School of Medicine at Children's Hospital and Regional Medical Center, Seattle, USA
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1096
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Abstract
In the this study, both fine and gross motor ability of males with attention-deficit-hyperactivity disorder (ADHD) were compared with a group of control children. Three groups of males with the following ADHD subtypes: predominantly inattentive (ADHD-PI; n = 50), hyperactive/impulsive (ADHD-HI; n = 16), or combined (ADHD-C; n = 38) were compared with 39 control males. Mean ages for the control group were 10 years 4 months (SD 1 year 4 months, range 7 years 8 months to 12 years 11 months); for the ADHD-PI group, 10 years (SD 1 year 2 months, range 7 years 10 months to 13 years); for the ADHD-HI group, 9 years 11 months (SD 1 year 2 months), range 7 years 11 months to 12 years 6 months); and for the ADHD-C group 10 years 2 months (SD 1 year 4 months, range 8 to 13 years). The Australian Disruptive Behaviours Scale and Connors' Parent Rating Scale-Revised were used to assess ADHD symptomatology. Verbal IQ was estimated using two verbal subtests of the Wechsler Intelligence Scale for Children, and movement ability was assessed using the Movement Assessment Battery for Children (MABC) and the Purdue Pegboard test. Findings demonstrated that the children with ADHD had significantly poorer movement ability than control children. A high percentage of these children displayed movement difficulties consistent with developmental coordination disorder (DCD). In addition, the current study found that the type and degree of movement difficulty differed between subtypes. The Total Impairment score, as derived from the MABC, was less severe for the ADHD-HI group than the other two ADHD groups, but more severe than for the control group. Males with ADHD-PI and ADHD-C had significantly poorer fine motor ability (p < 0.001) than control males, whereas the ADHD-HI group did not differ significantly from any of the other groups. As children with ADHD only and the control group did not differ significantly on fine motor ability but were significantly better than children categorized with both ADHD and DCD, it was argued that poorer fine motor ability found in children with ADHD could not be attributed to deficits in attention and concentration, but rather to factors relating to their motor ability.
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Affiliation(s)
- Thelma M Pitcher
- School of Psychology, Curtin University of Technology, Perth, Australia
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1097
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Kirley A, Lowe N, Hawi Z, Mullins C, Daly G, Waldman I, McCarron M, O'Donnell D, Fitzgerald M, Gill M. Association of the 480 bp DAT1 allele with methylphenidate response in a sample of Irish children with ADHD. Am J Med Genet B Neuropsychiatr Genet 2003; 121B:50-4. [PMID: 12898575 DOI: 10.1002/ajmg.b.20071] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Several studies have implicated the dopamine transporter gene (DAT1) as conferring susceptibility to attention deficit hyperactivity disorder (ADHD), in particular, a VNTR situated at the 3' end of the gene. In addition, the 10-repeat VNTR allele associated with ADHD has been reported to be associated with an over-active transporter protein (DAT). Thus children possessing this variant might be particularly responsive to methylphenidate, a drug known to act by blocking DAT. We have examined this hypothesis and now report an association between the 10-repeat VNTR DAT1 polymorphism and retrospectively rated methylphenidate response in a sample of 119 Irish children with ADHD (chi(2) = 7.918, df = 1, P = 0.005). Our findings suggest a role for the 10-repeat DAT1 risk allele in medication response and may help to predict positive clinical outcome in ADHD.
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Affiliation(s)
- Aiveen Kirley
- Departments of Psychiatry and Genetics, Trinity College Dublin, Dublin, Ireland.
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1098
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Kratochvil CJ, Vaughan BS, Harrington MJ, Burke WJ. Atomoxetine: a selective noradrenaline reuptake inhibitor for the treatment of attention-deficit/hyperactivity disorder. Expert Opin Pharmacother 2003; 4:1165-74. [PMID: 12831341 DOI: 10.1517/14656566.4.7.1165] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Atomoxetine (Strattera, Eli Lilly & Co.) is a selective noradrenaline reuptake inhibitor that has been studied for use in the treatment of attention-deficit/hyperactivity disorder (ADHD). So far, two open-label and seven randomised, double-blind, placebo-controlled, clinical trials have been published, six in youths and three in adults. Each of these trials has shown a positive response as measured by the primary efficacy measures, the ADHD-IV Rating Scale (ADHD RS) or the Conners Adult ADHD Rating Scale (CAARS). Atomoxetine has generally been well tolerated. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults. Atomoxetine is the first nonstimulant approved by the FDA for the treatment of ADHD and the first medication approved for the treatment of adult ADHD.
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1099
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Kahn RS, Khoury J, Nichols WC, Lanphear BP. Role of dopamine transporter genotype and maternal prenatal smoking in childhood hyperactive-impulsive, inattentive, and oppositional behaviors. J Pediatr 2003; 143:104-10. [PMID: 12915833 DOI: 10.1016/s0022-3476(03)00208-7] [Citation(s) in RCA: 213] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To examine the joint effects of a dopamine transporter (DAT) polymorphism and maternal prenatal smoking on childhood hyperactivity-impulsivity and inattentiveness. STUDY DESIGN A cohort of 161 children was followed prospectively from age 6 months to 60 months. Primary outcomes were the DSM-IV hyperactive-impulsive and inattentive scales of the Conners' Parent Rating Scale Revised-Long Version (CPRS R:L). A secondary outcome was the oppositional scale. Predictors included DAT genotype and maternal report of prenatal smoking. Children homozygous for the 480-bp DAT allele (DAT +/+) were compared with all other children (DAT +/- or -/-). RESULTS In multivariate analyses, children with both prenatal smoke exposure and the DAT +/+ genotype had significantly elevated hyperactive-impulsive scores (beta, 7.5; SE, 2.9; P<.01) compared with children with no smoke exposure and DAT +/- or -/-. Inattentive scores were not significantly elevated in this group, but oppositional scores were a full standard deviation higher. Neither prenatal smoke exposure alone nor DAT +/+ genotype alone was significantly associated with increased scores. CONCLUSIONS Child hyperactivity-impulsivity and oppositional behaviors were associated with a DAT polymorphism but only when the child also had exposure to maternal prenatal smoking. This study emphasizes the importance of incorporating environmental cofactors in genetic studies of attention deficit hyperactivity disorder.
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Affiliation(s)
- Robert S Kahn
- Division of General and Community Pediatrics, and Children's Environmental Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
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Youngstrom EA, Findling RL, Calabrese JR. Who are the comorbid adolescents? Agreement between psychiatric diagnosis, youth, parent, and teacher report. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2003; 31:231-45. [PMID: 12774858 DOI: 10.1023/a:1023244512119] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The investigators examined the rates of psychiatric comorbidity for externalizing and internalizing behavior problems, using semistructured diagnostic interview and parent, teacher, and youth report on the Achenbach checklists. The study also evaluated the effects of conjunctive, compensatory, and disjunctive data combination strategies. Using the same data and identical diagnostic thresholds, between 5 and 74% of 189 youths presenting to an outpatient clinic were identified as having comorbid internalizing and externalizing problems. Parent report and semistructured interview indicated the highest comorbidity rates. Despite good cross-source agreement (rs .29-.58), there was very little agreement about which specific youths presented with comorbid internalizing and externalizing problems (kappas .14-.40). Results also indicate that single DSM-IV disorders, such as bipolar disorder, can manifest "comorbid" patterns of behavior problems on checklists.
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Affiliation(s)
- Eric A Youngstrom
- Department of Psychology, Case Western Reserve University, Cleveland, Ohio 44106-7123, USA.
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