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Xu Y, Lin S, Tao J, Liu X, Zhou R, Chen S, Vyas P, Yang C, Chen B, Qian A, Wang M. Correlation research of susceptibility single nucleotide polymorphisms and the severity of clinical symptoms in attention deficit hyperactivity disorder. Front Psychiatry 2022; 13:1003542. [PMID: 36213906 PMCID: PMC9538111 DOI: 10.3389/fpsyt.2022.1003542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To analyze the correlation between susceptibility single nucleotide polymorphisms (SNPs) and the severity of clinical symptoms in children with attention deficit hyperactivity disorder (ADHD), so as to supplement the clinical significance of gene polymorphism and increase our understanding of the association between genetic mutations and ADHD phenotypes. METHODS 193 children with ADHD were included in our study from February 2017 to February 2020 in the Children's ADHD Clinic of the author's medical institution. 23 ADHD susceptibility SNPs were selected based on the literature, and multiple polymerase chain reaction (PCR) targeted capture sequencing technology was used for gene analysis. A series of ADHD-related questionnaires were used to reflect the severity of the disease, and the correlation between the SNPs of specific sites and the severity of clinical symptoms was evaluated. R software was used to search for independent risk factors by multivariate logistic regression and the "corplot" package was used for correlation analysis. RESULTS Among the 23 SNP loci of ADHD children, no mutation was detected in 6 loci, and 2 loci did not conform to Hardy-Weinberg equilibrium. Of the remaining 15 loci, there were 9 SNPs, rs2652511 (SLC6A3 locus), rs1410739 (OBI1-AS1 locus), rs3768046 (TIE1 locus), rs223508 (MANBA locus), rs2906457 (ST3GAL3 locus), rs4916723 (LINC00461 locus), rs9677504 (SPAG16 locus), rs1427829 (intron) and rs11210892 (intron), correlated with the severity of clinical symptoms of ADHD. Specifically, rs1410739 (OBI1-AS1 locus) was found to simultaneously affect conduct problems, control ability and abstract thinking ability of children with ADHD. CONCLUSION There were 9 SNPs significantly correlated with the severity of clinical symptoms in children with ADHD, and the rs1410739 (OBI1-AS1 locus) may provide a new direction for ADHD research. Our study builds on previous susceptibility research and further investigates the impact of a single SNP on the severity of clinical symptoms of ADHD. This can help improve the diagnosis, prognosis and treatment of ADHD.
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Affiliation(s)
- Yunyu Xu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuangxiang Lin
- Department of Radiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Jiejie Tao
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinmiao Liu
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
| | - Ronghui Zhou
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuangli Chen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Punit Vyas
- School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Chuang Yang
- Department of Psychiatry, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bicheng Chen
- Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, Zhejiang Provincial Top Key Discipline in Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Andan Qian
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meihao Wang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, China
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352
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Cochran DM, Jensen ET, Frazier JA, Jalnapurkar I, Kim S, Roell KR, Joseph RM, Hooper SR, Santos HP, Kuban KCK, Fry RC, O’Shea TM. Association of prenatal modifiable risk factors with attention-deficit hyperactivity disorder outcomes at age 10 and 15 in an extremely low gestational age cohort. Front Hum Neurosci 2022; 16:911098. [PMID: 36337853 PMCID: PMC9630552 DOI: 10.3389/fnhum.2022.911098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 10/03/2022] [Indexed: 12/31/2022] Open
Abstract
Background The increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts. Methods We examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life. Results Elevated maternal BMI and maternal diabetes were each associated with a 55-65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes. Conclusion Contrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes.
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Affiliation(s)
- David M. Cochran
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worcester, MA, United States
- *Correspondence: David M. Cochran,
| | - Elizabeth T. Jensen
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jean A. Frazier
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worcester, MA, United States
| | - Isha Jalnapurkar
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worcester, MA, United States
| | - Sohye Kim
- Eunice Kennedy Shriver Center, UMass Chan Medical School, Worcester, MA, United States
| | - Kyle R. Roell
- Department of Environmental Sciences and Engineering, Institute for Environmental Health Solutions, University of North Carolina School, Chapel Hill, NC, United States
| | - Robert M. Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States
| | - Stephen R. Hooper
- Department of Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Hudson P. Santos
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, United States
| | - Karl C. K. Kuban
- Division of Neurology (Pediatric Neurology), Department of Pediatrics, Boston Medical Center and Boston University, Boston, MA, United States
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Institute for Environmental Health Solutions, University of North Carolina School, Chapel Hill, NC, United States
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States
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353
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Ponnou S, Thomé B. ADHD diagnosis and methylphenidate consumption in children and adolescents: A systematic analysis of health databases in France over the period 2010-2019. Front Psychiatry 2022; 13:957242. [PMID: 36299551 PMCID: PMC9590284 DOI: 10.3389/fpsyt.2022.957242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
CONTEXT ADHD is the most common mental disorder in school-aged children. In France, methylphenidate is the only drug authorized for ADHD. Here, we describe the pattern of ADHD diagnosis and methylphenidate prescription to children and adolescents from 2010 to 2019. METHODS We conducted a retrospective cohort study of all beneficiaries of the French general health insurance scheme (87% of the population, 58 million people). We extracted information for all children and adolescents aged 0-17 years who received: (1) A diagnosis of ADHD (34,153 patients). (2) At least one methylphenidate prescription (144,509 patients). We analyzed the clinical, demographic, institutional, and social parameters associated with ADHD diagnosis and methylphenidate consumption in France. RESULTS The ADHD diagnosis among children and adolescents increased by 96% between 2010 and 2019. ADHD diagnosis affects more boys than girls. About 50.6% of children hospitalized with a diagnosis of ADHD in 2017 also had another psychiatric diagnosis. The rate of children hospitalized with an ADHD diagnosis and treated with MPH varied between 56.4 and 60.1%. The median duration of MPH treatment for a 6-year-old ADHD child initiated in 2011 is 7.1 years. In 2018, 62% of ADHD children were receiving at least one psychotropic medication. Between 2010 and 2019, methylphenidate prescription increased by +56% for incidence and +116% for prevalence. The prevalence of methylphenidate prescription reached between 0.61 and 0.75% in 2019. Boys are predominantly medicated. The median duration of treatment among 6-year-olds in 2011 was 5.5 years. The youngest children received the longest treatment duration. Diagnoses associated with methylphenidate prescription did not always correspond to the marketing authorization. Among children receiving the first prescription of methylphenidate, 22.8% also received one or more other psychotropic drugs during the same year. A quarter of initiations and half of renewals were made outside governmental recommendations. Educational and psychotherapeutic follow-up decreased from 4.1% in 2010 to 0.8% in 2019. French children and adolescents, who were the youngest in their class were more likely to be diagnosed (55%) and prescribed methylphenidate (54%). Children from disadvantaged families had an increased risk of ADHD diagnosis (41.4% in 2019) and methylphenidate medication (25.7% in 2019).
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Affiliation(s)
- Sébastien Ponnou
- CIRNEF (EA 7454), University of Rouen Normandy, Mont-Saint-Aignan, France
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354
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Ji Y, Choi TY, Lee J, Yoon S, Won GH, Jeong H, Kang SW, Kim JW. Characteristics of Attention-Deficit/Hyperactivity Disorder Subtypes in Children Classified Using Quantitative Electroencephalography. Neuropsychiatr Dis Treat 2022; 18:2725-2736. [PMID: 36437880 PMCID: PMC9697401 DOI: 10.2147/ndt.s386774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study used quantitative electroencephalography (QEEG) to investigate the characteristics of attention-deficit/hyperactivity disorder (ADHD) subtypes in children. PATIENTS AND METHODS There were 69 subjects (42 with ADHD and 27 neurotypical (NT)) in this study. A semi-structured interview was conducted with each participant for psychiatric diagnostic evaluation. We measured the absolute and relative power in 19 channels and analyzed QEEG using the following frequency ranges: delta (1-4 Hz), theta (4-8 Hz), alpha 1 (8-10 Hz), alpha 2 (10-12 Hz), beta 1 (12-15 Hz), beta 2 (15-20 Hz), beta 3 (20-30 Hz), and gamma (30-45 Hz). Group analyses and EEG noise preprocessing were conducted using iSyncBrain, a cloud-based, artificial intelligence EEG analysis platform. Analysis of covariance adjusted for IQ, age, and sex was used. RESULTS QEEG analysis revealed three ADHD subtypes, characterized by (A) elevated relative fast alpha and beta power, (B) elevated absolute slow frequency (delta and theta power), or (C) elevated absolute and relative beta power. A significant difference was found in the Korean ADHD Rating Scale (K-ARS) among the four groups (df=3, F=8.004, p<0.001); group C had the highest score (25.31±11.16), followed by group A (21.67±13.18). The score of group B (12.64±7.84) was similar to that of the NT group (11.07±6.12) and did not reach the cut-off point of the K-ARS. In the Wender-Utah Rating Scale (WURS), group B score (55.82±23.17) was significantly higher than the NT group score (42.81±13.26). CONCLUSION These results indicate that children with ADHD do not constitute a neurophysiologically homogenous group. Children with QEEG subtype B (elevated slow frequency) may be difficult to distinguish from normal children using the K-ARS, which is the most common screening tool for ADHD. Moreover, parents of children with this subtype may be less sensitive to observing ADHD symptoms.
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Affiliation(s)
- Yoonmi Ji
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Seoyoung Yoon
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Geun Hui Won
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | | | - Seung Wan Kang
- iMediSync Inc, Seoul, Republic of Korea.,National Standard Reference Data Center for Korean EEG, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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355
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Zendarski N, Guo S, Sciberras E, Efron D, Quach J, Winter L, Bisset M, Middeldorp CM, Coghill D. Examining the Educational Gap for Children with ADHD and Subthreshold ADHD. J Atten Disord 2022; 26:282-295. [PMID: 33317376 DOI: 10.1177/1087054720972790] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The present study examined the impact of Attention Deficit Hyperactivity Disorder (ADHD) on core educational outcomes in two large community cohorts of Australian school children. METHOD Academic (reading and numeracy) and non-academic (school engagement, attendance, peer victimization, and parental expectations) outcomes were compared between children with ADHD, subthreshold ADHD, and controls when children were in grade 5 (M age = 10.5). Data were drawn from the Longitudinal Study of Australian Children birth cohort (LSAC; N = 3,540) and the Children's Attention Project (CAP; N = 356). RESULTS Both subthreshold ADHD and ADHD groups had poorer outcomes on all measures, with medium effects sizes. Differences were not evident between subthreshold ADHD and ADHD groups. CONCLUSIONS Educational outcomes examined in this study highlight the educational risk for upperprimary school children with ADHD or subthreshold ADHD, in comparison to their peers. Monitoring these outcomes is necessary to inform policy, practice, and intervention.
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Affiliation(s)
- Nardia Zendarski
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Shuaijun Guo
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Emma Sciberras
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Deakin University, Geelong, Australia
| | - Daryl Efron
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Department General Medicine, Royal Children's Hospital, Melbourne Australia
| | - Jon Quach
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Matthew Bisset
- Murdoch Children's Research Institute, Melbourne, Australia.,Deakin University, Geelong, Australia
| | - Christel M Middeldorp
- The University of Queensland, Brisbane, Australia.,Children's Health Queensland Hospital and Health Service, Brisbane Australia
| | - David Coghill
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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356
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Sarfi M, Eikemo M, Welle-Strand GK, Muller AE, Lehmann S. Mental health and use of health care services in opioid-exposed school-aged children compared to foster children. Eur Child Adolesc Psychiatry 2022; 31:495-509. [PMID: 33590310 PMCID: PMC8940845 DOI: 10.1007/s00787-021-01728-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022]
Abstract
Given the concerns raised regarding the effects of prenatal exposure to methadone and buprenorphine on the developmental outcomes of the children, this study assessed mental health and use of services in a national sample of school-aged children (N = 78) born to women enrolled in opioid maintenance treatment during pregnancy, compared with a group of foster children (N = 140). The majority of the opioid-exposed children lived with their birth parent(s) at the time of assessment (N = 62), while 16 lived in foster homes. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) and the Reactive Attachment Disorder scale. Teachers completed the SDQ. Three kinds of services were included in measuring service use: school-based education services, child mental health services, and hospital-based habilitation services. The main finding of the study is that children prenatally exposed to methadone or buprenorphine living with their family of origin had significantly better mental health status than their foster-placed counterparts and that of the comparison group of foster children. In addition, the exposed children living at home had less child welfare involvement, and only half of them were using any of the three services measured. The odds for using services increased significantly in accordance with increasing mental health problems, independent of group affiliation, indicating a need-based access to services. In line with other studies, we found that the odds for using one or more services was 2.3 times greater for boys than for girls. Our results contribute to a more-nuanced understanding of the developmental outcomes of prenatal exposure to methadone and buprenorphine, and factors associated with increased service use in groups of at-risk children.
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Affiliation(s)
- Monica Sarfi
- SERAF-Norwegian Centre for Addiction Research, University of Oslo, Blindern, Box 1039, 0315, Oslo, Norway. .,Vestre Viken Hospital Trust, Drammen, Norway.
| | - Marie Eikemo
- Department of Psychology, The Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Gabrielle K. Welle-Strand
- SERAF-Norwegian Centre for Addiction Research, University of Oslo, Blindern, Box 1039, 0315 Oslo, Norway
| | | | - Stine Lehmann
- Department of Health Promotion and development, The Faculty of Psychology, University of Bergen, Bergen, Norway ,Regional Centre for Child and Youth Mental Health and Child Welfare-West, NORCE Norwegian Research Centre, Bergen, Norway
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357
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Wang A, Duan L, Huang H, Ma J, Zhang Y, Ma Q, Guo Y, Li Z, Cheng X, Zhu J, Zhou G, Ba Y. Association between fluoride exposure and behavioural outcomes of school-age children: a pilot study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:232-241. [PMID: 32281876 DOI: 10.1080/09603123.2020.1747601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
To assess the association between fluoride exposure and children's behavioural outcomes, we recruited 325 resident school-age children (7-13 years old) lived in Tongxu County of Henan Province in China. We measured urinary fluoride (UF) concentrations using the ion-selective electrode method. Children's behavioural outcomes were assessed by Conners' Parent Rating Scale-Revised, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and ADHD index. It turned out that each 1.0 mg/L increment in UF concentration corresponded with an elevation in the psychosomatic problem score of 4.01 (95% CI: 2.74, 5.28) and a 97% (OR = 1.97, 95% CI: 1.19, 3.27) increase in the prevalence of psychosomatic problems after adjusting for potential influencing factors. The sensitivity analysis results were consistent with those observed in our preliminary analysis. Our study suggests that fluoride exposure is positively related to the behavioural problem in school-age children, psychosomatic problem in particular.
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Affiliation(s)
- Anqi Wang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Leizhen Duan
- Department of Medical Services, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Hui Huang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jun Ma
- Department of Endemic Disease, Kaifeng Center for Disease Control and Prevention, Kaifeng, Henan, P. R. China
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Qiang Ma
- Teaching and Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yao Guo
- Nursing College of Henan University of Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Zhiyuan Li
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Xuemin Cheng
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jingyuan Zhu
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Guoyu Zhou
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yue Ba
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
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358
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Chutko L, Yakovenko E, Surushkina S, Anisimova T, Sergeev A, Didur M, Cherednichenko D. Emotional and behavioral dysregulation in children with attention deficit hyperactivity disorder. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:100-107. [DOI: 10.17116/jnevro2022122061100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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359
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Hughes AM, Sanderson E, Morris T, Ayorech Z, Tesli M, Ask H, Reichborn-Kjennerud T, Andreassen OA, Magnus P, Helgeland Ø, Johansson S, Njølstad P, Davey Smith G, Havdahl A, Howe LD, Davies NM. Body mass index and childhood symptoms of depression, anxiety, and attention-deficit hyperactivity disorder: A within-family Mendelian randomization study. eLife 2022; 11:74320. [PMID: 36537070 PMCID: PMC9767454 DOI: 10.7554/elife.74320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Higher BMI in childhood is associated with emotional and behavioural problems, but these associations may not be causal. Results of previous genetic studies imply causal effects but may reflect influence of demography and the family environment. Methods This study used data on 40,949 8-year-old children and their parents from the Norwegian Mother, Father and Child Cohort Study (MoBa) and Medical Birth Registry of Norway (MBRN). We investigated the impact of BMI on symptoms of depression, anxiety, and attention-deficit hyperactivity disorder (ADHD) at age 8. We applied within-family Mendelian randomization, which accounts for familial effects by controlling for parental genotype. Results Within-family Mendelian randomization estimates using genetic variants associated with BMI in adults suggested that a child's own BMI increased their depressive symptoms (per 5 kg/m2 increase in BMI, beta = 0.26 S.D., CI = -0.01,0.52, p=0.06) and ADHD symptoms (beta = 0.38 S.D., CI = 0.09,0.63, p=0.009). These estimates also suggested maternal BMI, or related factors, may independently affect a child's depressive symptoms (per 5 kg/m2 increase in maternal BMI, beta = 0.11 S.D., CI:0.02,0.09, p=0.01). However, within-family Mendelian randomization using genetic variants associated with retrospectively-reported childhood body size did not support an impact of BMI on these outcomes. There was little evidence from any estimate that the parents' BMI affected the child's ADHD symptoms, or that the child's or parents' BMI affected the child's anxiety symptoms. Conclusions We found inconsistent evidence that a child's BMI affected their depressive and ADHD symptoms, and little evidence that a child's BMI affected their anxiety symptoms. There was limited evidence of an influence of parents' BMI. Genetic studies in samples of unrelated individuals, or using genetic variants associated with adult BMI, may have overestimated the causal effects of a child's own BMI. Funding This research was funded by the Health Foundation. It is part of the HARVEST collaboration, supported by the Research Council of Norway. Individual co-author funding: the European Research Council, the South-Eastern Norway Regional Health Authority, the Research Council of Norway, Helse Vest, the Novo Nordisk Foundation, the University of Bergen, the South-Eastern Norway Regional Health Authority, the Trond Mohn Foundation, the Western Norway Regional Health Authority, the Norwegian Diabetes Association, the UK Medical Research Council. The Medical Research Council (MRC) and the University of Bristol support the MRC Integrative Epidemiology Unit.
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Affiliation(s)
- Amanda M Hughes
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom
| | - Eleanor Sanderson
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom
| | - Tim Morris
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom
| | - Ziada Ayorech
- PROMENTA Research Centre, Department of Psychology, University of OsloOsloNorway,Nic Waals Institute, Lovisenberg Diaconal HospitalOsloNorway
| | - Martin Tesli
- Department of Mental Disorders, Norwegian Institute of Public HealthOsloNorway,Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University HospitalOsloNorway
| | - Helga Ask
- PROMENTA Research Centre, Department of Psychology, University of OsloOsloNorway,Department of Mental Disorders, Norwegian Institute of Public HealthOsloNorway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public HealthOsloNorway,Institute of Clinical Medicine, University of OsloOsloNorway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University HospitalOsloNorway,Institute of Clinical Medicine, University of OsloOsloNorway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public HealthOsloNorway
| | - Øyvind Helgeland
- Center for Diabetes Research, Department of Clinical Science, University of BergenBergenNorway
| | - Stefan Johansson
- Department of Clinical Science, University of BergenBergenNorway,Department of Medical Genetics, Haukeland University HospitalBergenNorway
| | - Pål Njølstad
- Mohn Center for Diabetes Precision Medicine, Department of Clinical Science, University of BergenBergenNorway,Children and Youth Clinic, Haukeland University HospitalBergenNorway
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom
| | - Alexandra Havdahl
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom,PROMENTA Research Centre, Department of Psychology, University of OsloOsloNorway,Nic Waals Institute, Lovisenberg Diaconal HospitalOsloNorway,Department of Mental Disorders, Norwegian Institute of Public HealthOsloNorway
| | - Laura D Howe
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom
| | - Neil M Davies
- Medical Research Council Integrative Epidemiology Unit, University of BristolBristolUnited Kingdom,Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield GroveBristolUnited Kingdom,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and TechnologyHøgskoleringenNorway
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360
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Attention Deficit Hyperactivity Disorder and Bipolar Disorder: Diagnosis, Treatments, and Clinical Considerations: A Narrative Review. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint3010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Attention-deficit Hyperactivity Disorder is one of the most common childhood mental health disorders, affecting about 5.6% of the population worldwide. Several studies have specifically shown a high prevalence of comorbid mood disorders, such as depression and bipolar disorder (BD), in those diagnosed with ADHD. Several common symptoms of ADHD are also found in BD, which are characterized by alternating periods of euthymia and mood disturbances. The inattention and impulsivity of ADHD can be seen in manic and hypomanic episodes of BD. Over the past decade, there has been an increased interest in research between the correlation of ADHD and pediatric bipolar disorder (PBD) in children. Some experts hypothesize that more children are comorbidly diagnosed with ADHD and PBD because of how many clinicians treat children with ADHD. Other factors, which may affect the dual diagnoses of ADHD and PBD, are overlapping diagnostic criteria for the two disorders, the inevitable biases seen when one disorder is diagnosed without the other, and related risk factors leading to prodromal relationships. By examining clinical trials, a better understanding of whether ADHD and PBD have a stepwise progression or if other factors influence these comorbidities, such as blurred lines of diagnostic criteria. Those with ADHD are also at an increased risk of impairment at work and in social settings. This manuscript explores both progression of this disease and its clinical connections to other disorders.
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361
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INTERSTAARS: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial. Transl Psychiatry 2021; 11:644. [PMID: 34930893 PMCID: PMC8688472 DOI: 10.1038/s41398-021-01698-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 07/02/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is first diagnosed during middle childhood, when patterns of difficulty are often established. Pre-emptive approaches that strengthen developing cognitive systems could offer an alternative to post-diagnostic interventions. This proof-of-concept randomised controlled trial (RCT) tested whether computerised gaze-based attention training is feasible and improves attention in infants liable to develop ADHD. Forty-three 9- to 16-month-old infants with a first-degree relative with ADHD were recruited (11/2015-11/2018) at two UK sites and randomised with minimisation by site and sex to receive 9 weekly sessions of either (a) gaze-contingent attention training (intervention; n = 20); or (b) infant-friendly passive viewing of videos (control, n = 23). Sessions were delivered at home with blinded outcome assessments. The primary outcome was a composite of attention measures jointly analysed via a multivariate ANCOVA with a combined effect size (ES) from coefficients at baseline, midpoint and endpoint (Registration: ISRCTN37683928 ). Uptake and compliance was good but intention-to-treat analysis showed no significant differences between 20 intervention and 23 control infants on primary (ES -0.4, 95% CI -0.9 to 0.2; Complier-Average-Causal Effect ES -0.6, 95% CI -1.6 to 0.5) or secondary outcomes (behavioural attention). There were no adverse effects on sleep but a small increase in post-intervention session fussiness. Although feasible, there was no support for short-term effects of gaze-based attention training on attention skills in early ADHD. Longer-term outcomes remain to be assessed. The study highlights challenges and opportunities for pre-emptive intervention approaches to the management of ADHD.
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362
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Baweja R, Soutullo CA, Waxmonsky JG. Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care. World J Psychiatry 2021; 11:1206-1227. [PMID: 35070771 PMCID: PMC8717033 DOI: 10.5498/wjp.v11.i12.1206] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.
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Affiliation(s)
- Raman Baweja
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Cesar A Soutullo
- Louis A. Faillace, MD Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77054, United States
| | - James G Waxmonsky
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
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363
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Selinus EN, Durbeej N, Zhan Y, Lichtenstein P, Lundström S, Ekblom M. Inattention and hyperactivity symptoms in childhood predict physical activity in adolescence. BMC Psychiatry 2021; 21:629. [PMID: 34922483 PMCID: PMC8684227 DOI: 10.1186/s12888-021-03603-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity has been documented to influence several aspects of physical and mental health. Growing evidence shows that physical activity can improve attention. Less is known about how symptoms of inattention and hyperactivity / impulsivity in childhood are associated with physical activity in adolescence. We aimed to explore this relationship further. METHODS We used a cohort of 3949 Swedish children (1884 boys and 2065 girls) with data collected at ages 9 (or 12) and 15. We investigated the influence of symptoms of inattention and hyperactivity / impulsivity in childhood - age 9/12 (inattention and hyperactivity/impulsivity separately) on self-rated physical activity at age 15, using multiple logistic regression models. We considered potential confounders such as sex, parental education level, physical activity in childhood and neurodevelopmental comorbidity. A cluster robust sandwich estimator was applied to adjust the standard errors for the nested twin data when computing the regression models. RESULTS Symptoms of inattention in childhood (9/12) predicted less physical activity in adolescence (age 15) (OR = 0.83 CI = 0.78-0.89), whereas the opposite was true for hyperactivity/impulsivity (OR = 1.08 CI = 1.02-1.10). These associations still remained when taking possible confounders into account including neurodevelopmental and neurodevelopmental related comorbidity. CONCLUSIONS These findings support the importance of helping children and adolescents with inattention symptoms to engage in physical activity in suitable settings.
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Affiliation(s)
- Eva Norén Selinus
- Region Vastmanland - Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Uppsala, Sweden. .,The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
| | - Natalie Durbeej
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research & Education, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden ,grid.8993.b0000 0004 1936 9457Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Yiqiang Zhan
- German Center for Neurogenerative Diseases, Ulm, Germany ,grid.4714.60000 0004 1937 0626Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- grid.4714.60000 0004 1937 0626Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Lundström
- grid.8761.80000 0000 9919 9582Center for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Göteborg, Sweden ,grid.8761.80000 0000 9919 9582Gillberg Neuropsychiatry Centre, University of Gothenburg, Göteborg, Sweden
| | - Maria Ekblom
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatry Research & Education, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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364
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Ceccarelli C, Bakolis I, Tekola B, Kinfe M, Borissov A, Girma F, Abdurahman R, Zerihun T, Hanlon C, Hoekstra RA. Validation of the Communication Profile-Adapted in Ethiopian children with neurodevelopmental disorders. Glob Ment Health (Camb) 2021; 8:e45. [PMID: 34966545 PMCID: PMC8679817 DOI: 10.1017/gmh.2021.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/21/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) are conditions affecting a child's cognitive, behavioural, and emotional development. Appropriate and validated outcome measures for use in children with NDDs in sub-Saharan Africa are scarce. The aim of this study was to validate the Communication Profile Adapted (CP-A), a measure developed in East Africa to assess caregivers' perception of communication among children with NDDs. METHODS We adapted the CP-A for use in Ethiopia, focusing on the communicative mode (CP-A-mode) and function (CP-A-function) scales. The CP-A was administered to a representative sample of caregivers of children with NDDs and clinical controls. We performed an exploratory factor analysis and determined the internal consistency, test-retest reliability, within-scale, known-group, and convergent validity of the identified factors. RESULTS Our analysis included N = 300 participants (N = 139 cases, N = 139 clinical controls, N = 22 who did not meet criteria for either cases or controls). Within the CP-A-mode, we identified two factors (i.e. verbal and physical communication); the CP-A-function scale was unidimensional. Combining both scales into one summary variable (the CP-A-total) resulted in a scale with excellent internal consistency and test-retest reliability (Cronbach's alpha = 0.97; Kappa = 0.60-0.95, p < 0.001; ICC = 0.97, p < 0.001). Testing known-group validity, the CP-A-total scores were significantly higher for controls than cases (Δ mean = 33.93, p < 0.001). Convergent validity assessment indicated that scores were negatively and moderately correlated with clinical severity (ρ = -0.25, p = 0.04). CONCLUSION The CP-A is a valid tool for the assessment of communication among children with NDDs in Ethiopia. It holds promise as a brief, quantitative, and culturally appropriate outcome measure for use in sub-Saharan Africa.
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Affiliation(s)
- Caterina Ceccarelli
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bethlehem Tekola
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mersha Kinfe
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anton Borissov
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fikirte Girma
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rehana Abdurahman
- Department of Psychiatry, Yekatit 12 Hospital and Medical College, Addis Ababa, Ethiopia
| | - Tigist Zerihun
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Department of Health Services and Population Research and WHO Collaborating Centre for Mental Health Research and Capacity-Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
| | - Rosa A. Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
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365
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Abstract
OBJECTIVE We aimed to understand the association between MW frequency and clinical measures, context regulation of MW and group differences in task performance. METHOD 27 adults with ADHD and 29 controls performed tasks manipulating demand on working memory and sustained attention, and recorded their MW frequency using probes. RESULTS A significant association between MW frequency and the clinical measures was demonstrated. Along with increased MW frequency, individuals with ADHD reported decreasing MW frequency during increasing demands on working memory (context regulation), but not on sustained attention (deficient context regulation). Controls, however, maintained continuous task focus across all conditions. Group differences in task performance were no longer significant after adding MW frequency as a covariate. CONCLUSION Deficient context regulation during increasing demands on sustained attention suggests that sustained attention deficits may play a more important role in regulation of MW in ADHD. MW frequency might also underpin performance deficits in ADHD.
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Affiliation(s)
- Natali Bozhilova
- King’s College London, De
Crespigny Park, UK,Natali Bozhilova, Social, Genetic
and Developmental Psychiatry Centre, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, De Crespigny Park,
London SE5 8AF, UK.
| | - Giorgia Michelini
- King’s College London, De
Crespigny Park, UK,University of California Los
Angeles, USA
| | | | | | - Katya Rubia
- King’s College London, De
Crespigny Park, UK
| | - Philip Asherson
- King’s College London, De
Crespigny Park, UK,Natali Bozhilova, Social, Genetic
and Developmental Psychiatry Centre, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London, De Crespigny Park,
London SE5 8AF, UK.
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366
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Children and adolescents with ADHD followed up to adulthood: a systematic review of long-term outcomes. Acta Neuropsychiatr 2021; 33:283-298. [PMID: 34384511 DOI: 10.1017/neu.2021.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective is to highlight the clinical and social outcomes among adults who suffered from Attention-Deficit Hyperactivity Disorder (ADHD) in their childhood/adolescence. PubMed, PsycINFO, and Scopus databases were searched for prospective studies published during the last 5 years addressing patients with ADHD in childhood/adolescence followed-up to adulthood. We also included studies published before 2015 reported in other reviews with similar outcomes. Thousand four-hundred and eighty-five studies were identified, but only 39 were included for qualitative analysis and 27 for quantitative analysis. Overall, we found that ADHD persisted into adulthood with a mean rate of 43% and was mainly associated with both substance/alcohol use disorders and antisocial behavior and, less frequently, with anxiety and depressive disorders. The prevalence of persistent ADHD in adulthood reported by studies published after 2011 (55%) was higher than that reported by studies published previously from 1985 to 2011 (34%), suggesting a greater focus on ADHD in recent years. Our results highlight that ADHD can be considered not only a neurodevelopmental disorder, but also a persistent and complex condition, with detrimental consequences for quality of life in adulthood.
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367
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Lin A, Forsyth JK, Hoftman GD, Kushan-Wells L, Jalbrzikowski M, Dokuru D, Coppola G, Fiksinski A, Zinkstok J, Vorstman J, Nachun D, Bearden CE. Transcriptomic profiling of whole blood in 22q11.2 reciprocal copy number variants reveals that cell proportion highly impacts gene expression. Brain Behav Immun Health 2021; 18:100386. [PMID: 34841284 PMCID: PMC8607166 DOI: 10.1016/j.bbih.2021.100386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 10/31/2021] [Indexed: 11/24/2022] Open
Abstract
22q11.2 reciprocal copy number variants (CNVs) offer a powerful quasi-experimental "reverse-genetics" paradigm to elucidate how gene dosage (i.e., deletions and duplications) disrupts the transcriptome to cause further downstream effects. Clinical profiles of 22q11.2 CNV carriers indicate that disrupted gene expression causes alterations in neuroanatomy, cognitive function, and psychiatric disease risk. However, interpreting transcriptomic signal in bulk tissue requires careful consideration of potential changes in cell composition. We first characterized transcriptomic dysregulation in peripheral blood from reciprocal 22q11.2 CNV carriers using differential expression analysis and weighted gene co-expression network analysis (WGCNA) to identify modules of co-expressed genes. We also assessed for group differences in cell composition and re-characterized transcriptomic differences after accounting for cell type proportions and medication usage. Finally, to explore whether CNV-related transcriptomic changes relate to downstream phenotypes associated with 22q11.2 CNVs, we tested for associations of gene expression with neuroimaging measures and behavioral traits, including IQ and psychosis or ASD diagnosis. 22q11.2 deletion carriers (22qDel) showed widespread expression changes at the individual gene as well as module eigengene level compared to 22q11.2 duplication carriers (22qDup) and controls. 22qDup showed increased expression of 5 genes within the 22q11.2 locus, and CDH6 located outside of the locus. Downregulated modules in 22qDel implicated altered immune and inflammatory processes. Celltype deconvolution analyses revealed significant differences between CNV and control groups in T-cell, mast cell, and macrophage proportions; differential expression of individual genes between groups was substantially attenuated after adjusting for cell composition. Individual gene, module eigengene, and cell proportions were not significantly associated with psychiatric or neuroanatomic traits. Our findings suggest broad immune-related dysfunction in 22qDel and highlight the importance of understanding differences in cell composition when interpreting transcriptomic changes in clinical populations. Results also suggest novel directions for future investigation to test whether 22q11.2 CNV effects on macrophages have implications for brain-related microglial function that may contribute to psychiatric phenotypes in 22q11.2 CNV carriers.
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Affiliation(s)
- Amy Lin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jennifer K. Forsyth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of Washington, WA, USA
| | - Gil D. Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Deepika Dokuru
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Giovanni Coppola
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ania Fiksinski
- Wilhelmina Children's Hospital & University Medical Center Utrecht, Brain Center, the Netherlands
- Maastricht University, Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, the Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry and Brain Center, University Medical Center Utrecht, the Netherlands
| | - Jacob Vorstman
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Daniel Nachun
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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368
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Zerón-Rugerio MF, Carpio-Arias TV, Ferreira-García E, Díez-Noguera A, Cambras T, Alda JÁ, Izquierdo-Pulido M. ADHD subtypes are associated differently with circadian rhythms of motor activity, sleep disturbances, and body mass index in children and adolescents: a case-control study. Eur Child Adolesc Psychiatry 2021; 30:1917-1927. [PMID: 33063173 DOI: 10.1007/s00787-020-01659-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022]
Abstract
To date, few studies have examined the circadian pattern of motor activity in children and adolescents newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). The objective was to study the circadian pattern of motor activity in subjects with ADHD (medication naïve) and to investigate the relationships between alterations in circadian patterns, the ADHD subtype (combined or inattentive), sleep disturbances and body mass index (BMI). One-hundred twenty children and adolescents (60 medication naïve ADHD and 60 controls) were included in a gender- and age-matched case-control study. ADHD was diagnosed according to the DSM-IV-TR, the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, and the Conner's Parents Rating Scale-Revised. Circadian rhythms of motor activity and sleep parameters were measured using actigraphy and the Sleep Disturbance Scale for Children. BMI and dietary intake were also evaluated. ADHD patients showed a trend towards eveningness and greater sleep disturbances than controls. Additionally, patients with ADHD-combined had significantly higher mean values of motor activity and showed a significant delay in bedtime. Furthermore, among ADHD-C patients hyperactivity symptoms were significantly associated with the least 5 h of activity. Regarding patients with ADHD-inattentive, increased fragmentation of the circadian pattern was associated with inattention symptoms, and they also showed a significant increase in BMI of 2.52 kg/m2 [95% CI 0.31, 4.73] in comparison with controls. Our findings highlight the potential use of actigraphy as a clinical tool to aid in the diagnosis of ADHD. It should be noted that evaluating motor activity variables could also allow the differentiation between ADHD subtypes.
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Affiliation(s)
- María Fernanda Zerón-Rugerio
- Department of Nutrition, Food Science, and Gastronomy, University of Barcelona, Av. Prat de la Riba 171. Recinte Torribera. Edifici Verdaguer, Santa Coloma de Gramenet, 08921, Barcelona, Spain.,Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
| | | | | | - Antoni Díez-Noguera
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Trinitat Cambras
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain
| | - Jose Ángel Alda
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Deu Barcelona, Barcelona, Spain
| | - Maria Izquierdo-Pulido
- Department of Nutrition, Food Science, and Gastronomy, University of Barcelona, Av. Prat de la Riba 171. Recinte Torribera. Edifici Verdaguer, Santa Coloma de Gramenet, 08921, Barcelona, Spain. .,Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain.
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369
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Yuan D, Zhang M, Huang Y, Wang X, Jiao J, Huang Y. Noradrenergic genes polymorphisms and response to methylphenidate in children with ADHD: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27858. [PMID: 34797323 PMCID: PMC8601359 DOI: 10.1097/md.0000000000027858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 11/03/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is the most common childhood-onset neurodevelopmental disorder, and methylphenidate (MPH) is considered one of the first-line medicine for ADHD. Unfortunately, this medication is only effective for some children with ADHD. This meta-analysis was conducted to evaluate whether noradrenergic gene polymorphisms impact the efficacy of MPH in children with ADHD. METHODS Candidate gene studies published in English until March 1, 2020, were identified through literature searches on PubMed, Web of Science, and Embase. Data were pooled from individual clinical trials considering MPH pharmacogenomics. According to the heterogeneity, the odds ratio and mean differences were calculated by applying fixed-effects or random-effects models. RESULTS This meta-analysis includes 15 studies and 1382 patients. Four polymorphisms of the NET gene (rs5569, rs28386840, rs2242446, rs3785143) and 2 polymorphisms of the α2A-adrenergic receptor gene (ADRA2A) gene (MspI and DraI) were selected for the analysis. In the pooled data from all studies, T allele carriers of the rs28386840 polymorphism were significantly more likely to respond to MPH (P < .001, ORTcarriers = 2.051, 95% confidence interval [CI]:1.316, 3.197) and showed a relationship with significantly greater hyperactive-impulsive symptoms improvement (P < .001, mean difference:1.70, 95% CI:0.24, 3.16). None of the ADRA2A polymorphisms correlated significantly with MPH response as a whole. However, G allele carriers of the MspI polymorphism showed a relationship with significantly inattention symptoms improvement (P < .001, mean difference:0.31, 95% CI: 0.15, 0.47). CONCLUSION Our meta-analysis results indicate that the noradrenergic gene polymorphisms may impact MPH response. The NET rs28386840 is linked to improved MPH response in ADHD children. And the ADRA2A MspI is associated with inattention symptom improvements. Further investigations with larger samples will be needed to confirm these results.Registration: PROSPERO (no. CRD42021265830).
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Affiliation(s)
- Danfeng Yuan
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Manxue Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yan Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xinwei Wang
- Crestwood Preparatory College, Toronto, Canada
| | - Jian Jiao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Huang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
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370
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The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials. Nutrients 2021; 13:nu13114059. [PMID: 34836314 PMCID: PMC8618748 DOI: 10.3390/nu13114059] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 12/18/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD. Objective: This is a systematic review focused on the contribution of iron and zinc in the progression of ADHD among children and adolescents, and how therapies including these elements are tolerated along with its effectiveness (according to PRISMA guidelines). Method: The scientific literature was screened for randomized controlled trials published between January 2000 to July 2021. The databases consulted were Medline, PsycINFO, Web of Science, and Google Scholar. Two independent reviewers screened studies, extracted data, and assessed quality and risk of bias (CONSORT, NICE, and Cochrane checklists used). Conclusion: Nine studies met the eligibility criteria and were selected. Evidence was obtained regarding the contribution of iron-zinc supplementation in the treatment of ADHD among young individuals. The discussion was focused on how the deficits of these elements contribute to affectation on multiple ADHD correlates, and potential mechanisms explaining the mediational pathways. Evidence also suggested that treating ADHD with diet interventions might be particularly useful for specific subgroups of children and adolescents, but further investigations of the effects of these diet interventions are needed.
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371
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Liu L, Feng X, Li H, Cheng Li S, Qian Q, Wang Y. Deep learning model reveals potential risk genes for ADHD, especially Ephrin receptor gene EPHA5. Brief Bioinform 2021; 22:bbab207. [PMID: 34109382 PMCID: PMC8575025 DOI: 10.1093/bib/bbab207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Although genome-wide association studies (GWAS) identify the risk ADHD-associated variants and genes with significant P-values, they may neglect the combined effect of multiple variants with insignificant P-values. Here, we proposed a convolutional neural network (CNN) to classify 1033 individuals diagnosed with ADHD from 950 healthy controls according to their genomic data. The model takes the single nucleotide polymorphism (SNP) loci of P-values $\le{1\times 10^{-3}}$, i.e. 764 loci, as inputs, and achieved an accuracy of 0.9018, AUC of 0.9570, sensitivity of 0.8980 and specificity of 0.9055. By incorporating the saliency analysis for the deep learning network, a total of 96 candidate genes were found, of which 14 genes have been reported in previous ADHD-related studies. Furthermore, joint Gene Ontology enrichment and expression Quantitative Trait Loci analysis identified a potential risk gene for ADHD, EPHA5 with a variant of rs4860671. Overall, our CNN deep learning model exhibited a high accuracy for ADHD classification and demonstrated that the deep learning model could capture variants' combining effect with insignificant P-value, while GWAS fails. To our best knowledge, our model is the first deep learning method for the classification of ADHD with SNPs data.
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Affiliation(s)
- Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & the Key Laboratory of Mental Health, Ministry of Health (Peking University), 100191, Beijing, China
| | - Xikang Feng
- School of Software, Northwestern Polytechnical University, Xi’an, 710072, Shaanxi, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & the Key Laboratory of Mental Health, Ministry of Health (Peking University), 100191, Beijing, China
| | - Shuai Cheng Li
- Department of Computer Science, City University of Hong Kong, Kowloon Tong, Hong Kong, China
| | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & the Key Laboratory of Mental Health, Ministry of Health (Peking University), 100191, Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital) & the Key Laboratory of Mental Health, Ministry of Health (Peking University), 100191, Beijing, China
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372
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Grazioli S, Rosi E, Mauri M, Crippa A, Tizzoni F, Tarabelloni A, Villa FM, Chiapasco F, Reimers M, Gatti E, Bertella S, Molteni M, Nobile M. Patterns of Response to Methylphenidate Administration in Children with ADHD: A Personalized Medicine Approach through Clustering Analysis. CHILDREN 2021; 8:children8111008. [PMID: 34828721 PMCID: PMC8623097 DOI: 10.3390/children8111008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/05/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022]
Abstract
Individual responses to methylphenidate (MPH) can significantly differ in children with attention-deficit/hyperactivity disorder (ADHD) in terms of the extent of clinical amelioration, optimal dosage needed, possible side effects, and short- and long-term duration of the benefits. In the present repeated-measures observational study, we undertook a proof-of-concept study to determine whether clustering analysis could be useful to characterize different clusters of responses to MPH in children with ADHD. We recruited 33 children with ADHD who underwent a comprehensive clinical, cognitive, and neurophysiological assessment before and after one month of MPH treatment. Symptomatology changes were assessed by parents and clinicians. The neuropsychological measures used comprised pen-and-paper and computerized tasks. Functional near-infrared spectroscopy was used to measure cortical hemodynamic activation during an attentional task. We developed an unsupervised machine learning algorithm to characterize the possible clusters of responses to MPH in our multimodal data. A symptomatology improvement was observed for both clinical and neuropsychological measures. Our model identified distinct clusters of amelioration that were related to symptom severity and visual-attentional performances. The present findings provide preliminary evidence that clustering analysis can potentially be useful in identifying different responses to MPH in children with ADHD, highlighting the importance of a personalized medicine approach within the clinical framework.
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Affiliation(s)
- Silvia Grazioli
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Eleonora Rosi
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
- Correspondence:
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
- PhD in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Federica Tizzoni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Arianna Tarabelloni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Filippo Maria Villa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Federica Chiapasco
- MD Course in Medicine and Surgery, Humanitas University, Via Manzoni 56, 20089 Milan, Italy; (F.C.); (M.R.)
| | - Maria Reimers
- MD Course in Medicine and Surgery, Humanitas University, Via Manzoni 56, 20089 Milan, Italy; (F.C.); (M.R.)
| | - Erika Gatti
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Silvana Bertella
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy; (S.G.); (M.M.); (A.C.); (F.T.); (A.T.); (F.M.V.); (E.G.); (S.B.); (M.M.); (M.N.)
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373
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Acland EL, Jambon M, Malti T. Children's emotion recognition and aggression: A multi-cohort longitudinal study. Aggress Behav 2021; 47:646-658. [PMID: 34369593 DOI: 10.1002/ab.21989] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 11/05/2022]
Abstract
Difficulty recognizing negative emotions (NEs) in children is linked to increased antisocial traits and externalizing problems. However, crucial aspects of this relation remain unclear, such as: whether NE recognition is associated with externalizing problems in general or only a particular subcomponent (i.e., aggression); whether subcomponents of NE recognition (i.e., insensitivity and misspecifications) are relatively more important; and how these relations change over the course of development. We assessed emotion recognition, overt aggression, attention deficit hyperactivity disorder (ADHD) symptoms, and oppositional defiant disorder (ODD) symptoms in an ethnically diverse sample of Canadian children (N = 150; 4-year-olds, N = 148; 8-year-olds) and followed up with them 1 year later (86.9% retention). Emotion recognition was assessed using a behavioral task and caregivers reported on children's externalizing symptoms. Children with lower NE recognition had higher initial, but not subsequent, overt aggression, even when controlling for nonaggressive externalizing symptoms (i.e., ADHD and ODD symptoms). NE recognition was not concurrently or longitudinally associated with nonaggressive externalizing symptoms. Age and gender did not moderate these findings. Both higher NE insensitivity (e.g., reporting a sad face appears neutral) and misspecifications (e.g., reporting a sad face appears angry) were significantly associated with higher concurrent overt aggression. In conclusion, both NE insensitivity and misspecifications were found to be uniquely important for children's overt aggression. These findings highlight the importance of different forms of NE recognition and differentiating between aggressive and nonaggressive externalizing problems in children.
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Affiliation(s)
- Erinn L. Acland
- Department of Psychology University of Toronto Toronto Canada
- Centre for Child Development, Mental Health, and Policy University of Toronto Mississauga Mississauga Canada
| | - Marc Jambon
- Department of Psychology University of Toronto Toronto Canada
- Centre for Child Development, Mental Health, and Policy University of Toronto Mississauga Mississauga Canada
| | - Tina Malti
- Department of Psychology University of Toronto Toronto Canada
- Centre for Child Development, Mental Health, and Policy University of Toronto Mississauga Mississauga Canada
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374
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Kanevski M, Booth JN, Oldridge J, McDougal E, Stewart TM, McGeown S, Rhodes SM. The relationship between cognition and mathematics in children with attention-deficit/hyperactivity disorder: a systematic review. Child Neuropsychol 2021; 28:394-426. [PMID: 34724883 DOI: 10.1080/09297049.2021.1985444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive processes play an imperative role in children's mathematics learning. Difficulties in cognitive functioning are a core feature of Attention Deficit Hyperactivity Disorder (ADHD) in children, who also tend to show lower levels of mathematics attainment than their typically developing peers. This review (registration number: CRD42020169708) sought to aggregate findings from studies assessing the relationship between cognition and mathematics in children with a clinical ADHD diagnosis aged 4-12 years. A total of 11,799 studies published between 1992 and August 2020 were screened for eligibility using various database (PsycINFO, PubMed, SCOPUS, EMBASE, ERIC, Web of Science, and additional sources), from which four studies met inclusion criteria. A narrative synthesis was conducted on the correlations between mathematics and cognitive domains, including an evaluation of the risk of bias within the studies. Across four studies meeting inclusion criteria, memory, inhibitory control, and processing speed were assessed. The results showed a positive association between cognition and mathematics performance in this population. The strength of associations across these studies varied as a function of the cognitive domain in question, means by which mathematics performance was assessed, as well as whether confounding factors such as age and IQ were controlled for. Collectively, this review demonstrates a lack of research in this area and points to various methodological considerations for identifying the association between cognition and mathematics performance in ADHD.
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Affiliation(s)
- Margarita Kanevski
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Josephine N Booth
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Jessica Oldridge
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Emily McDougal
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tracy M Stewart
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Sarah McGeown
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Sinead M Rhodes
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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375
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Ani C. Editorial: New insights into self-harm among children and young people - renewed links with inequality, new opportunities for recognition and new treatment option. Child Adolesc Ment Health 2021; 26:301-302. [PMID: 34644000 DOI: 10.1111/camh.12512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
Supporting children and young people (CYP) who self-harm (SH) is an important work of Child and Adolescent Mental Health Services (CAMHS). This theme is reflected in three papers in this issue. Starting with risk factors, Marraccini and colleagues found that compared with adolescents, preadolescent children with suicidal behavior were more likely to be male, from a Black ethnic background, or to have a neurodevelopmental disorder such as autism spectrum condition (ASC) or ADHD. These authors' finding of increased school-related stressors emphasizes the importance of educational adjustments in reducing the risk of SH among CYP with ASC and ADHD. Ward and Curran's study suggests that screening for ADHD symptoms among CYP who present with SH may improve early identification of those affected by ADHD-especially among females. Finally, Ramsey and colleagues found that coupling dialectical behavioral therapy (DBT) with a specific intervention targeting self-criticism reduced episodes of SH more than standard DBT alone. Given the link between SH and suicide, improving understanding of the risk factors, early identification, and new treatment options for SH remain important.
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Affiliation(s)
- Cornelius Ani
- Imperial College London, London, UK
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, UK
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376
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Periyasamy R, Vibashan VS, Varghese GT, Aleem MA. Machine Learning Techniques for the Diagnosis of Attention-Deficit/Hyperactivity Disorder from Magnetic Resonance Imaging: A Concise Review. Neurol India 2021; 69:1518-1523. [PMID: 34979636 DOI: 10.4103/0028-3886.333520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a neuro-developmental disease commonly seen in children and it is diagnosed via extensive interview procedures, behavioral studies, third-party observations, and comprehensive personal history. ADHD causes regional atrophy in brain regions and alters the pattern of functional brain connectivity networks. Automated/computerized methods based on magnetic resonance imaging (MRI) can replace subjective methods for the identification of ADHD. Objectives The aim of this study was to analyze various machine-learning algorithms for ADHD by feeding in vital input features extracted from functional brain connectivity and different existing methods and to review factors crucial for the diagnosis of ADHD. Methods This paper is a concise review of machine learning methods for the diagnosis of ADHD from MRI. Techniques for feature extraction, dimensionality reduction/feature selection, and classification, employed in the computerized techniques for the diagnosis of ADHD from MRI and the accuracy of classification offered by the individual methods, are focussed on the review. Conclusions Machine learning algorithms with features of functional brain connectivity networks as input, with hierarchical sparse feature elimination, exhibits the highest accuracy. Augmentation of the behavioral features does not contribute much to increased accuracy. The level of accuracy offered by the frameworks meant for the computer-aided diagnosis of ADHD, available in the literature, does not justify their feasibility in clinical practice. Computerized methods that exploit highly specific biomarkers of ADHD like brain iron concentration in Globus Pallidus, Putamen, Caudate nucleus, and thalamus as features are not available.
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Affiliation(s)
- R Periyasamy
- Department of Instrumentation and Control, National Institute of Technology, Tiruchirappalli, Tamil Nadu, India
| | - V S Vibashan
- Department of Instrumentation and Control, National Institute of Technology, Tiruchirappalli, Tamil Nadu, India
| | - George Tom Varghese
- Department of Electronics and Instrumentation, St. Joseph's College of Engineering and Technology, Palai, Kerala, India
| | - M A Aleem
- Department of Neurology, K. A. P Viswanatham Government Medical College and MGM Government Hospital, Tiruchirappalli, Tamil Nadu, India
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377
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Yackobovitch-Gavan M, Mimouni-Bloch A, Gabbay U, Carmi D, Goldstein B, Keinan-Boker L, Bloch S, Meyerovitch J. Sex-Specific Long-Term Height and Body Mass Index Trajectories of Children Diagnosed with Attention-Deficit/Hyperactivity Disorder and Treated with Stimulants. J Pediatr 2021; 238:296-304.e4. [PMID: 34293373 DOI: 10.1016/j.jpeds.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the sex-specific effects of stimulants in children with attention-deficit/hyperactivity disorder (ADHD) on body mass index (BMI) z and height z trajectories. STUDY DESIGN A retrospective cohort study using the database of Israel Clalit Health Services was performed. Participants included 5- to 18-year-old insured patients with documentation of at least 2 consecutive prescriptions of stimulant drugs for ADHD. Participants were further compared with sex- and age-matched insured control patients without ADHD. RESULTS A total of 4561 (66% boys) participants with ADHD were included. Of these, 2151 (70% boys) had follow-up data for ≥2 years of treatment. A decline of ≥1 SD in height and BMI z score was observed in 10.1% and 13.2% of the cohort, respectively. During ≥2 years follow-up, boys had a greater decline in height z score (~0.2 SD) than girls (~0.06 SD). Boys' height z score continued to decline after 1 and ≥2 years, and girls' height z score declined after 1 year, and then stabilized. The trajectory of BMI z score of boys and girls was similar, showing a greater decline after 1 year, followed by an incline after ≥2 years. Younger age at stimulants initiation, better adherence, longer treatment duration, and lower socioeconomic status were correlated with a greater impact on growth attenuation. The non-ADHD group (n = 4561, 66% boys) had baseline height z score and BMI z score similar to those in children with ADHD before treatment initiation. Height z score and BMI z score were greater in children without ADHD compared with children with ADHD following 1 year of treatment (P < .001). CONCLUSIONS These findings highlight the importance of growth monitoring accompanied with dietary counseling in children with ADHD treated with stimulants.
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Affiliation(s)
- Michal Yackobovitch-Gavan
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Mimouni-Bloch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology and Developmental Unit, Loewenstein Rehabilitation Medical Center, Raanana, Israel
| | - Uri Gabbay
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Quality Unit, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
| | - Doron Carmi
- Shoham Community Pediatric Center, Clalit Health Services, Shoham, Israel
| | - BatEl Goldstein
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel; Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Stav Bloch
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Meyerovitch
- The Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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378
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Kerekes N, Sanchéz-Pérez AM, Landry M. Neuroinflammation as a possible link between attention-deficit/hyperactivity disorder (ADHD) and pain. Med Hypotheses 2021; 157:110717. [PMID: 34717072 DOI: 10.1016/j.mehy.2021.110717] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/01/2021] [Accepted: 10/17/2021] [Indexed: 12/17/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and pathological pain are two complex syndromes of multifactorial origin. Despite their prevalence and broad impacts, these conditions are seldom recognized and managed simultaneously. The co-existence of neuropsychiatric conditions (such as ADHD) and altered pain perception and chronic pain has been noted in children, and the comorbidity of ADHD and chronic pain is well documented in adults. Pathophysiological studies have suggested dysfunction of the dopaminergic system as a common neurochemical basis for comorbid ADHD and pain. Considerable evidence supports the role of neuroinflammation in the pathophysiology of both. We suggest that central neuroinflammation underlies altered pain perception and pain sensitization in persons with ADHD. Based on our hypothesis, targeting neuroinflammation may serve as a potential new therapeutic intervention to treat ADHD and comorbid pain in children and adolescents and a preventive strategy for the development of chronic pain in adults with ADHD.
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Affiliation(s)
- Nóra Kerekes
- Department of Health Sciences, University West, Trollhättan 461 86, Sweden.
| | - Ana Maria Sanchéz-Pérez
- Neurobiotechnology Laboratory, Faculty of Health Sciences, Institute of Advanced Materials (INAM), University Jaume I, Castellon 120 71, Spain
| | - Marc Landry
- University of Bordeaux, CNRS, Institute for Neurodegenrative Diseases, IMN, UMR 5293, F-33000 Bordeaux, France
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379
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Nationwide Rate of Adult ADHD Diagnosis and Pharmacotherapy from 2015 to 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111322. [PMID: 34769839 PMCID: PMC8582649 DOI: 10.3390/ijerph182111322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/30/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022]
Abstract
There is a paucity of published literature on the epidemiology of adult attention-deficit/hyperactivity disorder (ADHD). We investigated the time trends of the diagnostic and pharmacotherapy incidence of ADHD, including the first used medication, in the adult population based on a Korean population-based database from 2015 to 2018. The number of diagnosed cases of ADHD significantly increased from 7782 in 2015 to 17,264 in 2018 (p = 0.03), which is 0.02% to 0.04% of the total population. Similarly, the number of pharmacotherapy cases of ADHD significantly increased from 3886 in 2015 to 12,502 in 2018 (p = 0.01), which is 0.01% to 0.03% of total population. The most commonly used medication at the initiation of pharmacotherapy shifted from Penid in 2015 to Concerta in 2018. Furthermore, combination therapy with two or more drugs was the preferred method in 2016–2018. In conclusion, the identified diagnoses and pharmacotherapy incidences were very low, highlighting the need to improve the public’s awareness of adult ADHD.
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380
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The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). Eur Child Adolesc Psychiatry 2021:10.1007/s00787-021-01871-x. [PMID: 34677682 PMCID: PMC8532460 DOI: 10.1007/s00787-021-01871-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022]
Abstract
ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems.
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381
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Hajal NJ, Loo SK. Emerging biomarkers for child & family intervention studies: A review of EEG studies of parenting. Biol Psychol 2021; 166:108200. [PMID: 34653549 DOI: 10.1016/j.biopsycho.2021.108200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 02/01/2023]
Abstract
Most interventions for childhood mental health problems require significant parental involvement, and treatment programs are increasingly incorporating components aimed at enhancing parents' own self-regulation in the context of potentially stressful parent-child interactions. This paper discusses the promise of EEG in examining the rapidly unfolding perceptual, cognitive, emotional, and regulatory processes that occur in parenting, in hopes of ultimately informing child and family interventions. First, we review two separate bodies of work that have used EEG with parents: one examining event-related potential (ERP) measures, and the other examining frontal alpha asymmetry (FAA). We discuss benefits of each within the study of parenting, and also suggest other EEG metrics (such as event-related time-frequency analyses) that can be leveraged to fill current gaps in our knowledge. Finally, we discuss the potential for these findings to inform clinical work with children and families, such as identifying biomarkers that could aid in assessment, treatment recommendations, and monitoring response to interventions.
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Affiliation(s)
- Nastassia J Hajal
- Dept. of Psychiatry & Biobehavioral Sciences, Division of Population Behavioral Health, 760 Westwood Plaza, A8-153, Los Angeles, CA 90095, USA.
| | - Sandra K Loo
- Dept. of Psychiatry & Biobehavioral Sciences, Division of Child & Adolescent Psychiatry, 760 Westwood Plaza, Los Angeles, CA 90095, USA
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382
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Looman KIM, Cecil CAM, Grosserichter‐Wagener C, Kiefte‐de Jong JC, Zelm MC, Moll HA. Associations between T cells and attention problems in the general pediatric population: The Generation R study. JCPP ADVANCES 2021. [DOI: 10.1002/jcv2.12038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kirsten I. M. Looman
- Generation R Study Group Erasmus MC University Medical Center Rotterdam The Netherlands
- Department of Pediatrics Sophia Children's Hospital Erasmus MC University Medical Center Rotterdam The Netherlands
| | - Charlotte A. M. Cecil
- Department of Child and Adolescent Psychiatry/Psychology Erasmus MC University Medical Center Rotterdam The Netherlands
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
- Molecular Epidemiology Department of Biomedical Data Sciences Leiden University Medical Center Leiden The Netherlands
| | | | - Jessica C. Kiefte‐de Jong
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam The Netherlands
- Department of Public Health and Primary Care/LUMC Campus The Hague Leiden University Medical Center Leiden The Netherlands
| | - Menno C. Zelm
- Department of Immunology and Pathology Central Clinical School Monash University and Alfred Hospital Melbourne Victoria Australia
| | - Henriëtte A. Moll
- Department of Pediatrics Sophia Children's Hospital Erasmus MC University Medical Center Rotterdam The Netherlands
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383
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Khan MU, Balbontin C, Bliemer M, Aslani P. Using discrete choice experiment to investigate patients' and parents' preferences for initiating ADHD medication. J Ment Health 2021; 32:373-385. [PMID: 34632936 DOI: 10.1080/09638237.2021.1979495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The decision to initiate medication is complex and is influenced by a variety of factors. There is limited information on the relative importance of factors that influence the initiation of ADHD medication. AIMS To investigate the factors, and their relative importance, that influence the decision to initiate medication in adults, and parents of children, with ADHD. METHODS A discrete choice experiment was conducted using eight choice tasks made up of five attributes that described the outcomes of initiating medication. A mixed multinomial logit model was used to estimate preferences for medication. RESULTS Respondents' overall preferences for initiating medication were negative (Mean (β)= -0.72705, p < 0.1), however, significant heterogeneity was noted in preferences (SD: 0.93604, p < 0.001). Side-effects were the most important factor for both adults (Relative importance (RI) = 40.39%) and parents (RI = 41.99%). Improvement in education had a greater weighting in adults' decision-making compared to parents (RI = 36.93% vs 30.47%) while improvement in aggressive (RI = 14.38% vs 11.84%) and social behaviour (RI = 12.59% vs 10.37%) was more important to parents. CONCLUSIONS Important differences in preferences of patients and parents were identified, highlighting that the decision to initiate medication is influenced differently in different individuals and groups.
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Affiliation(s)
- Muhammad Umair Khan
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Camila Balbontin
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, Camperdown, NSW, Australia
| | - Michiel Bliemer
- Institute of Transport and Logistics Studies, The University of Sydney Business School, The University of Sydney, Camperdown, NSW, Australia
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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384
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Sulkama S, Puurunen J, Salonen M, Mikkola S, Hakanen E, Araujo C, Lohi H. Canine hyperactivity, impulsivity, and inattention share similar demographic risk factors and behavioural comorbidities with human ADHD. Transl Psychiatry 2021; 11:501. [PMID: 34599148 PMCID: PMC8486809 DOI: 10.1038/s41398-021-01626-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/15/2021] [Indexed: 02/08/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder impairing the quality of life of the affected individuals. The domestic dog can spontaneously manifest high hyperactivity/impulsivity and inattention which are components of human ADHD. Therefore, a better understanding of demographic, environmental and behavioural factors influencing canine hyperactivity/impulsivity and inattention could benefit both humans and dogs. We collected comprehensive behavioural survey data from over 11,000 Finnish pet dogs and quantified their level of hyperactivity/impulsivity and inattention. We performed generalised linear model analyses to identify factors associated with these behavioural traits. Our results indicated that high levels of hyperactivity/impulsivity and inattention were more common in dogs that are young, male and spend more time alone at home. Additionally, we showed several breed differences suggesting a substantial genetic basis for these traits. Furthermore, hyperactivity/impulsivity and inattention had strong comorbidities with compulsive behaviour, aggressiveness and fearfulness. Multiple of these associations have also been identified in humans, strengthening the role of the dog as an animal model for ADHD.
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Affiliation(s)
- Sini Sulkama
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Jenni Puurunen
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Milla Salonen
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Salla Mikkola
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Emma Hakanen
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - César Araujo
- grid.7737.40000 0004 0410 2071Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Hannes Lohi
- Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland. .,Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland. .,Folkhälsan Research Center, Helsinki, Finland.
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385
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Ekhlasi A, Motie Nasrabadi A, Mohammadi MR. Analysis of Effective Connectivity Strength in Children with Attention Deficit Hyperactivity Disorder Using Phase Transfer Entropy. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:374-382. [PMID: 35082849 PMCID: PMC8725178 DOI: 10.18502/ijps.v16i4.7224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/16/2021] [Accepted: 07/20/2021] [Indexed: 11/24/2022]
Abstract
Objective: This study aimed to investigate differences in brain networks between healthy children and children with attention deficit hyperactivity disorder (ADHD) during an attention test. Method : To fulfill this, we constructed weighted directed graphs based on Electroencephalography (EEG) signals of 61 children with ADHD and 60 healthy children with the same age. Nodes of graphs were 19 EEG electrodes, and the edges were phase transfer entropy (PTE) between each pair of electrodes. PTE is a measure for directed connectivity that determines the effective relationship between signals in linear and nonlinear coupling. Connectivity graphs of each sample were constructed using PTE in the five frequency bands as follows: delta, theta, alpha, beta, and gamma. To investigate the differences in connectivity strength of each node after the sparsification process with two values (0.5 and 0.25), the permutation statistical test was used with the statistical significance level of p<0.01. Results: The results indicate stronger inter-regional connectivity in the prefrontal brain regions of the control group compared to the ADHD group. However, the strength of inter-regional connectivity in the central regions of the ADHD group was higher. A comparison of the prefrontal regions between the two groups revealed that the areas of the Fp1 electrode (left prefrontal) in healthy individuals play stronger transmission roles. Conclusion: Our research can provide new insights into the strength and direction of connectivity in ADHD and healthy individuals during an attention task.
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Affiliation(s)
- Ali Ekhlasi
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ali Motie Nasrabadi
- Department of Biomedical Engineering, School of Engineering, Shahed University, Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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386
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Arsac England T, Tuthill D. Can parents believe websites' information about methylphenidate's side effects? Arch Dis Child 2021; 106:1015-1017. [PMID: 33785529 PMCID: PMC8461403 DOI: 10.1136/archdischild-2020-320007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/21/2020] [Accepted: 02/20/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Attention deficit and hyperactivity disorder (ADHD) is one of the most common behavioural disorders, affecting around 5% of the global population. Methylphenidate is recommended as the first-line drug treatment for ADHD for children over the age of 5 in the UK. It can have many side effects and it is important that families are well informed. Other than their healthcare professionals and friends, the major information source for families is the internet. AIMS To evaluate the validity of online information regarding the adverse effects of methylphenidate. METHODS Side-effects of methylphenidate hydrochloride listed in the British National Formulary for Children (BNFC) were taken as the 'gold standard' and compared with online websites for accuracy. The first 10 websites found on each of nine different search engines were used as comparators. RESULTS From the 90 hits, 10 top hits found in each of 9 search engines, 25 unique websites were identified. A quarter (six sites; 24%) documented only side-effects that all appeared in the BNFC. Three quarters (19 websites; 76%) had at least one side-effect that did not appear in the BNFC; with six websites documenting more than five side-effects not found in the BNFC. CONCLUSIONS Methylphenidate's frequent use makes it important that the general public are provided with accurate, reliable and easily accessible information. Most websites have dependable quality information on side effects, but several seem to list excessive side-effects.
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Affiliation(s)
| | - David Tuthill
- Paediatrics, Children's Hospital for Wales, Cardiff, UK
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387
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Long-term medication for ADHD and development of cognitive functions in children and adolescents. J Psychiatr Res 2021; 142:204-209. [PMID: 34375772 DOI: 10.1016/j.jpsychires.2021.07.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/06/2021] [Accepted: 07/31/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Long-term effects of ADHD medication on cognitive functions are not well known. This study investigates development of cognitive functions and ADHD symptoms on well-controlled medication for 1 year in children and adolescents. STUDY DESIGN This study is part of an ongoing open uncontrolled trial of long-term medication for ADHD in children and adolescents aged 6-18 years with any form of ADHD, and frequently comorbid autism spectrum disorder (ASD, 29%) or autistic traits (24%). Other comorbidities were oppositional defiant disorder, dyslexia/language disorder, borderline intellectual functioning, developmental coordination disorder. This analysis includes 87 participants (61 boys, 26 girls) who completed Wechsler tests at baseline and after 12 months. ADHD symptoms were investigator-rated on the ADHD Rating Scale-IV at the same time points. RESULTS The whole group of children and adolescents showed significant improvements in Wechsler Full Scale IQ (FSIQ, mean at baseline 92.6, at 12 months 97.95), and on the Index Scales Verbal Comprehension, Working Memory and Processing Speed, after one year of well-controlled ADHD medication. Comorbid dyslexia/language impairment predicted a larger rise in FSIQ, but not gender, ADHD presentation or comorbid ASD. Robust improvements in ADHD symptoms were observed (mean ADHD-Rating Scale score at baseline 34.6, and at 12 months 18.3). CONCLUSIONS Cognitive test scores and ADHD symptoms were improved on well-controlled medication for 1 year in children and adolescents with ADHD, autism and other comorbidities. The main study limitation is the open uncontrolled trial design.
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388
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Sager G, Vatansever Z, Batu U, Çağ Y, Akin Y. Neuropsychiatric comorbidities in genetic/idiopathic generalized epilepsies and their effects on psychosocial outcomes. Epilepsy Behav 2021; 124:108339. [PMID: 34600282 DOI: 10.1016/j.yebeh.2021.108339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Idiopathic/genetic generalized epilepsy (GGE) accounts for 15-20% of all epilepsy cases. Neuropsychiatric comorbidities and disorders, such as attention-deficit hyperactivity disorder (ADHD), academic failure, and poor social competence, are present at a higher rate in patients with epilepsy compared with the general population. In this study, we aimed to determine the frequency of neuropsychiatric comorbidities in GGE subgroups, and to reveal the risk factors in the patient group with neuropsychiatric comorbidities. MATERIAL AND METHOD This hospital-based, cross-sectional study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Patients with seizure-controlled GGE were invited to a semi-structured interview at the hospital. Variables [photosensitivity, valproic acid (VPA) resistance, timing of the neuropsychiatric comorbidities Attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and low academic performance), seizure control, and timing of the antiepileptic treatment] were statistically analyzed and evaluated in terms of their association with GGE subgroups [Generalized tonic-clonic seizures alone (EGTGS), juvenile myoclonic epilepsy (JME), and juvenile absence epilepsy (JAE)], RESULTS: Total 101 patients with GGE were included in the study and the mean age was 13.94 ± 1.66 years. A total of 12.9% (n = 13) of the patients had EGTGS, 49.5% (n = 50) had JME, and 37.6% (n = 38) had JAE. VPA resistance, photosensitivity, and the presence of neuropsychiatric symptoms before the starting of epilepsy were found to be risk factors in the GGE group with neuropsychiatric comorbidities compared with the group without neuropsychiatric comorbidities (p < 0.001). The subgroups of GGE did not show any relationship with psychiatric disorders, including ADHD, ODD, and low academic performance (neuropsychiatric comorbidities) (p > 0.005). No correlation was found between seizure control and decline in neuropsychiatric symptoms (p > 0.05). CONCLUSION In this study, the onset of psychiatric symptoms prior to the onset of epilepsy, photosensitivity, and VPA resistance were the most important factors affecting neuropsychiatric comorbidities. The JME, JAE, and EGTCS subgroups, early initiation of antiepileptic treatment, and seizure control were found to have no effect on poor psychosocial outcome and neuropsychiatric comorbidities.
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Affiliation(s)
- Gunes Sager
- Department of Pediatric Neurology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.
| | - Zeynep Vatansever
- Department of Child and Adolescent Psychiatry Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Utku Batu
- Department of Pediatrics, Van Education and Research Hospital, Van, Turkey
| | - Yakup Çağ
- Department of Pediatrics, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Yasemin Akin
- Department of Pediatrics, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
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389
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Slagboom MN, Bröer C, Berg J. Negotiating ADHD: Pragmatic medicalization and creolization in urban India. Soc Sci Med 2021; 289:114400. [PMID: 34563868 DOI: 10.1016/j.socscimed.2021.114400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
Although a growing number of studies have demonstrated differences in responses to ADHD-like behaviours, very few studies have focused on theorizing diversity in the way ADHD is framed and approached globally. To contribute to the study of medicalization in a global context, this study examines the discursive field in which care professionals explain and treat ADHD among children in metropolitan India and addresses the need for an analytic framework to grasp the variations in the way ADHD is understood and approached. Building on the concepts of pragmatic medicalization and creolization, we study ADHD discourses in India asking 'What is at stake' and 'What matters most'? In this mixed methods study, 64 care professionals regularly involved in assessing ADHD-like behaviour completed an online Q-sort, and 21 professionals participated in face-to-face interviews. The Q-data were subjected to factor analysis. The interviews were analyzed using qualitative content analyses. Our study identified six distinct ADHD discourses, which showed that care professionals combine explanatory and treatment models. Professionals adapt their explanations and treatments of ADHD to parents' worries regarding academic performance, family prestige, stigma and side effects of allopathic medicine. Our findings indicate that an awareness of local concerns and adjustments to structural opportunities can diversify how ADHD-like behaviour is framed and responded to. This study demonstrates that medicalization operates between the emerging institutions of care and the everyday concerns of families and care professionals and reveals the need to examine conflicting stakes as drivers of diverse responses to ADHD diagnosis and treatment in India and the rest of the world.
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Affiliation(s)
- M Nienke Slagboom
- Public Health and Primary Care, Leiden University Medical Centre, the Netherlands.
| | - Christian Bröer
- Political Sociology, University of Amsterdam, the Netherlands
| | - Jonathan Berg
- Health Policy & Management, Erasmus University Rotterdam, the Netherlands
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390
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Fernández G, Krapacher F, Ferreras S, Quassollo G, Mari MM, Pisano MV, Montemerlo A, Rubianes MD, Bregonzio C, Arias C, Paglini MG. Lack of Cdk5 activity is involved on Dopamine Transporter expression and function: Evidences from an animal model of Attention-Deficit Hyperactivity Disorder. Exp Neurol 2021; 346:113866. [PMID: 34537209 DOI: 10.1016/j.expneurol.2021.113866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
Attention deficit/Hyperactivity disorder (ADHD) is one of the most diagnosed psychiatric disorders nowadays. The core symptoms of the condition include hyperactivity, impulsiveness and inattention. The main pharmacological treatment consists of psychostimulant drugs affecting Dopamine Transporter (DAT) function. We have previously shown that genetically modified mice lacking p35 protein (p35KO), which have reduced Cdk5 activity, present key hallmarks resembling those described in animal models useful for studying ADHD. The p35KO mouse displays spontaneous hyperactivity and shows a calming effect of methylphenidate or amphetamine treatment. Interestingly, dopaminergic neurotransmission is altered in these mice as they have an increased Dopamine (DA) content together with a low DA turnover. This led us to hypothesize that the lack of Cdk5 activity affects DAT expression and/or function in this animal model. In this study, we performed biochemical assays, cell-based approaches, quantitative fluorescence analysis and functional studies that allowed us to demonstrate that p35KO mice exhibit decreased DA uptake and reduced cell surface DAT expression levels in the striatum (STR). These findings are supported by in vitro observations in which the inhibition of Cdk5 activity in N2a cells induced a significant increase in constitutive DAT endocytosis with a concomitant increase in DAT localization to recycling endosomes. Taken together, these data provide evidences regarding the role of Cdk5/p35 in DAT expression and function, thus contributing to the knowledge of DA neurotransmission physiology and also providing therapeutic options for the treatment of DA pathologies such as ADHD.
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Affiliation(s)
- Guillermo Fernández
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Favio Krapacher
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Soledad Ferreras
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Gonzalo Quassollo
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Macarena Mariel Mari
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Victoria Pisano
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Antonella Montemerlo
- Instituto de Investigaciones en Fisicoquímica de Córdoba, INFIQC-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Dolores Rubianes
- Instituto de Investigaciones en Fisicoquímica de Córdoba, INFIQC-CONICET, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Claudia Bregonzio
- Instituto de Farmacología Experimental Córdoba, IFEC-CONICET, Departamento de Farmacología, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carlos Arias
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Investigaciones Psicológicas, IIPSI-CONICET, Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María Gabriela Paglini
- Laboratory of Neurophysiology, Instituto de Investigación Médica Mercedes y Martín Ferreyra, INIMEC-CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina; Instituto de Virología "Dr. J. M. Vanella", Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
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391
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Umair HM, Sandler RD, Alunno A, Matucci-Cerinic M, Hughes M. Association between central nervous system stimulants used to treat attention deficit hyperactivity disorder (ADHD) and Raynaud's phenomenon: A scoping review. Semin Arthritis Rheum 2021; 51:1200-1204. [PMID: 34655948 DOI: 10.1016/j.semarthrit.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/27/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022]
Abstract
The association between central nervous (CNS) stimulants used to treat attention deficit hyperactivity disorder (ADHD) and Raynaud's phenomenon (RP) has received little attention to date. Our aim was to map the existing literature on aetiopathogenesis, clinical presentation and management of peripheral vasculopathy, with a focus on RP, secondary to drug therapy for ADHD. We searched the PubMed® database (01/11/1951 to 01/08/2020) and included articles written in English, which focussed on CNS stimulants used to treat ADHD and RP. The search identified 150 articles 9 of which were eligible for inclusion (70 patients). The majority of studies (n = 6) related to children or adolescents; however, adult cases were also identified. Peripheral vascular manifestations included attacks of RP (new and worsening) and cold sensitivity (acrocyanosis and perniosis). Irreversible ischaemic complications including digital autoamputation and lower limb critical digital ischaemia have also been reported. The implicated causative CNS stimulants were Methylphenidate (n = 5), Dextroamphetamine (n = 4), Atomoxetine (n = 2), and Lisdexamphetamine (n = 2). Complete resolution of RP symptoms was observed in half (n = 5) of studies upon drug cessation. Other therapeutic strategies have included dose reduction and switching to an alternative drug therapy. A potential autoimmune association has also been postulated including drug-induced autoimmunity and new cases of systemic sclerosis which have been potentially attributed to treatment. Future research is required to understand the association between CNS stimulant drug therapies for ADHD and peripheral vascular manifestations, including RP.
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Affiliation(s)
- Hafiz M Umair
- Department of Rheumatology, Royal Hallamshire Hospitals, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Robert D Sandler
- Department of Rheumatology, Royal Hallamshire Hospitals, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - Alessia Alunno
- Internal Medicine and Nephrology Unit, Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, Florence, Italy; Unit of Immunology, Rheumatology, Allergy and Rare diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy
| | - Michael Hughes
- Department of Rheumatology, Tameside Hospital, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK; The University of Manchester, Manchester, UK.
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392
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Common and Unique Genetic Background between Attention-Deficit/Hyperactivity Disorder and Excessive Body Weight. Genes (Basel) 2021; 12:genes12091407. [PMID: 34573389 PMCID: PMC8464917 DOI: 10.3390/genes12091407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023] Open
Abstract
Comorbidity studies show that children with ADHD have a higher risk of being overweight and obese than healthy children. This study aimed to assess the genetic alternations that differ between and are shared by ADHD and excessive body weight (EBW). The sample consisted of 743 Polish children aged between 6 and 17 years. We analyzed a unique set of genes and polymorphisms selected for ADHD and/or obesity based on gene prioritization tools. Polymorphisms in the KCNIP1, SLC1A3, MTHFR, ADRA2A, and SLC6A2 genes proved to be associated with the risk of ADHD in the studied population. The COMT gene polymorphism was one that specifically increased the risk of EBW in the ADHD group. Using the whole-exome sequencing technique, we have shown that the ADHD group contains rare and protein-truncating variants in the FBXL17, DBH, MTHFR, PCDH7, RSPH3, SPTBN1, and TNRC6C genes. In turn, variants in the ADRA2A, DYNC1H1, MAP1A, SEMA6D, and ZNF536 genes were specific for ADHD with EBW. In this way, we confirmed, at the molecular level, the existence of genes specifically predisposing to EBW in ADHD patients, which are associated with the biological pathways involved in the regulation of the reward system, intestinal microbiome, and muscle metabolism.
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393
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Herrera-Gutiérrez E, Gómez-Amor J, López-Ortuño J, Navarro-Noguera M, Villanueva-Blasco VJ. Cognitive and personality differences between adolescents with and without attention deficit/hyperactivity disorder. Acta Psychol (Amst) 2021; 219:103386. [PMID: 34365275 DOI: 10.1016/j.actpsy.2021.103386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The relationships between cognitive and personality profile in teenagers with and without ADHD were assessed. METHOD Two groups of teenagers, one with ADHD (N = 135; mean age = 13.93) and another group without ADHD (N = 199, mean age = 14.29) were evaluated using the K-BIT and 16PF-APQ tests. RESULTS In cognitive variables, the results revealed that the ADHD group returned higher scores in the Matrices subtest and the IQ test. In personality variables, the group with ADHD exhibited higher scores in Tough-Mindedness and lower scores in Self-Control than the group without the disorder. The canonical correlation analysis applied to each group revealed a differing pattern of interrelationships between the cognitive-personality variables in the two groups. In adolescents with ADHD, we observed that higher scores in cognitive variables were associated with a more extroverted personality and less self-control, while in adolescents without ADHD, higher scores in cognitive variables were associated with less tough-mindedness and lower levels of self-control. CONCLUSIONS The cognitive and personality variables of adolescents with and without ADHD differ. These results will be useful for establishing a cognitive and personality profile for this section of the population. The educational implications of the study are under discussion.
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394
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Muratori P, Conversano C, Levantini V, Masi G, Milone A, Villani S, Bögels S, Gemignani A. Exploring the Efficacy of a Mindfulness Program for Boys With Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder. J Atten Disord 2021; 25:1544-1553. [PMID: 32338110 DOI: 10.1177/1087054720915256] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: This study was the first attempt to explore the efficacy of a mindfulness protocol for children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), and their parents. Method: Fifty male children with ADHD and ODD diagnosis, aged 8 to 12, were randomly assigned to the mindfulness intervention (n = 25) or the wait-list (n = 25) group. Outcome measures included children, parents', and teachers' reports and objective measures of attention. Results: Children from the intervention group had a greater reduction in hyperactive behaviors in the school context (effect size [ES] = 0.59) and a greater improvement in visual sustained attention (ES = 0.77) and in Avoidance and Fusion Questionnaire scores (ES = 0.43) than those in the wait-list control group. No significant effect of the intervention on aggressive behaviors was revealed. Conclusion: A mindfulness intervention for children and their parents showed partial beneficial effects in children with ADHD + ODD.
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395
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Levi-Shachar O, Gvirts HZ, Goldwin Y, Bloch Y, Shamay-Tsoory S, Boyle D, Maoz H. The association between symptom severity and theory of mind impairment in children with attention deficit/hyperactivity disorder. Psychiatry Res 2021; 303:114092. [PMID: 34252635 DOI: 10.1016/j.psychres.2021.114092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 11/19/2022]
Abstract
The aim was to investigate the correlation between ADHD symptom severity and impairments in "theory of mind" (ToM) and empathy, and the improvement in these functions following the administration of methylphenidate (MPH). Fifty children aged 6-12 years with ADHD participated in the study. Symptom severity was assessed using the Swanson, Nolan and Pelham Questionnaire-IV (SNAP-IV). ToM performance was assessed using the "ToM test" and the "Faux-Pas Recognition Test". A significant negative correlation was found between the SNAP-IV Conners index, the oppositional and deportment subscales, and ToM test scores. MPH administration improved ToM scores in a magnitude that was negatively correlated with baseline performance. Additionally, Children with more severe behavioral problems showed greater improvement in ToM following administration of MPH. We conclude that severity of ADHD symptoms, most notably behavioral symptoms, is correlated with deficits in ToM. Administration of MPH improves ToM performance, with the greatest improvement occurring in children with more severe behavioral symptoms.
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Affiliation(s)
- Orit Levi-Shachar
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petah-Tikva, Israel
| | - Hila Z Gvirts
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
| | | | - Yuval Bloch
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Shalvata Mental Health Center, Hod-Hasharon, Israel
| | | | - Dennis Boyle
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagai Maoz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Shalvata Mental Health Center, Hod-Hasharon, Israel.
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396
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Ward RJ, Kovshoff H, Kreppner J. School staff perspectives on ADHD and training: understanding the needs and views of UK primary staff. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2021. [DOI: 10.1080/13632752.2021.1965342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rebecca J Ward
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Hanna Kovshoff
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Jana Kreppner
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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397
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Munawar K, Choudhry FR, Lee SH, Siau CS, Kadri NBM, Binti Sulong RM. Acceptance and commitment therapy for individuals having attention deficit hyperactivity disorder (ADHD): A scoping review. Heliyon 2021; 7:e07842. [PMID: 34466706 PMCID: PMC8385395 DOI: 10.1016/j.heliyon.2021.e07842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/28/2021] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Acceptance and commitment therapy (ACT) has accumulated increasing evidence-base for a broad range of mental health issues. Considering that ACT encourages broad and flexible patterns of behaviour and neutralizes the pervasive psychological processes proposed to be caused by most individuals' distress, such a modality may be effective for ADHD. This review aimed to give a synthesis of the studies, so far, focusing on the usefulness of ACT approaches among individuals having ADHD. DESIGN/METHODS This scoping review searched studies exploring the effectiveness of ACT approaches for individuals with ADHD across eight electronic databases (Medline, Embase, PsycInfo, ScienceDirect, PubMed, Emcare, Scopus, and Google Scholar). This review was based on a total of two quasi-experimental and four experimental studies. RESULTS A thematic analysis was suggested based on the PRISMA guidelines. Overall, the review presented preliminary evidence demonstrating the use of ACT among individuals with ADHD. It was found that the ACT was used to treat a variety of behavioural and psychosocial outcomes, which included reducing ADHD symptoms (e.g., impulsivity, inattention, inflexibility, etc.) and other sequelae related to the ADHD diagnosis such as poor quality of life, academic procrastination, depression and anxiety symptoms, and psychological maladjustment. CONCLUSIONS This review revealed that ACT was a flexible approach that could be adapted to deliver both targeted treatment of ADHD symptomatology and more general psychosocial issues. It could also be delivered in group or individual formats. Nevertheless, although the findings of the present scoping review indicate promising results, more research is needed.
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Affiliation(s)
- Khadeeja Munawar
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Fahad Riaz Choudhry
- Department of Psychology, Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, 53100, Malaysia
| | - Sook Huey Lee
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nursyuhaidah Binti Mohd Kadri
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Rose Manisah Binti Sulong
- Department of Psychology, Faculty of Social Sciences & Liberal Arts, UCSI University Malaysia, UCSI Heights 1, Jalan Puncak Menara Gading, Taman Connaught, Cheras, 56000, Kuala Lumpur, Malaysia
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398
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Yorgidis E, Beiner L, Blazynski N, Schneider-Momm K, Clement HW, Rauh R, Schulz E, Clement C, Fleischhaker C. Individual Behavioral Reactions in the Context of Food Sensitivities in Children with Attention-Deficit/Hyperactivity Disorder before and after an Oligoantigenic Diet. Nutrients 2021; 13:2598. [PMID: 34444758 PMCID: PMC8401786 DOI: 10.3390/nu13082598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 01/07/2023] Open
Abstract
The influence of food intake on behavior problems of children with Attention-Deficit/Hyperactivity Disorder (ADHD) was already described in the early 20th century. Eliminating food components by using the Oligoantigenic Diet (OD) leads to reduction of ADHD symptoms for more than two-thirds of patients. The aim of our study was to reveal how to identify foods having an impact on ADHD symptomatology. Therefore, 28 children with ADHD participating in this uncontrolled, open trial were examined before and after a restricted elimination diet. They kept a daily 24-h recall nutrition and behavior journal and filled out the abbreviated Conners' scale (ACS) to identify foods which increased ADHD symptoms. The study was completed by 16 children (13 m/3 f). After four weeks of elimination diet the individual food sensitivities were identified in a reintroduction phase. A repetitive increase of ADHD symptoms by at least two points in ACS after food introduction hints at food sensitivity. Twenty-seven food sensitivity reactions were identified. Most of the participants were sensitive to more than one food. Food intolerances could not be identified without preceding OD. The combination of OD and subsequent food challenge appears as a valid method to identify individual food sensitivity in ADHD.
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Affiliation(s)
| | | | | | | | | | | | | | - Christina Clement
- Correspondence: (C.C.); (C.F.); Tel.: +49-761-270-68620 (C.F.); Fax: +49-761-270-69490 (C.F.)
| | - Christian Fleischhaker
- Correspondence: (C.C.); (C.F.); Tel.: +49-761-270-68620 (C.F.); Fax: +49-761-270-69490 (C.F.)
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399
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Ikeda T, Inoue A, Tanaka D, Hashimoto T, Sutoko S, Tokuda T, Kyutoku Y, Maki A, Yamagata T, Dan I, Monden Y. Visualizing Neuropharmacological Effects of Guanfacine Extended Release in Attention Deficit Hyperactivity Disorder Using Functional Near-Infrared Spectroscopy. FRONTIERS IN NEUROERGONOMICS 2021; 2:657657. [PMID: 38235230 PMCID: PMC10790846 DOI: 10.3389/fnrgo.2021.657657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 06/04/2021] [Indexed: 01/19/2024]
Abstract
Objective: In the current study, we explored the neural substrate for acute effects of guanfacine extended release (GXR) on inhibitory control in school-aged children with attention deficit hyperactivity disorder (ADHD), using functional near-infrared spectroscopy (fNIRS). Methods: Following a GXR washout period, 12 AD HD children (6-10 years old) performed a go/no-go task before and 3 h after GXR or placebo administration, in a randomized, double-blind, placebo-controlled, crossover design study. In the primary analysis, fNIRS was used to monitor the right prefrontal cortical hemodynamics of the participants, where our former studies showed consistent dysfunction and osmotic release oral system-methylphenidate (OROS-MPH) and atomoxetine hydrochloride (ATX) elicited recovery. We examined the inter-medication contrast, comparing the effect of GXR against the placebo. In the exploratory analysis, we explored neural responses in regions other than the right prefrontal cortex (PFC). Results: In the primary analysis, we observed no significant main effects or interactions of medication type and age in month (two-way mixed ANCOVA, Fs < 0.20, all ps > .05). However, in the post-hoc analysis, we observed significant change in the oxy-Hb signal in the right angular gyrus (AG) for inter-medication (one sample t-test, p < 0.05, uncorrected, Cohen's d = 0.71). Conclusions: These results are different from the neuropharmacological effects of OROS-MPH and ATX, which, in an upregulated manner, reduced right PFC function in ADHD children during inhibitory tasks. This analysis, while limited by its secondary nature, suggested that the improved cognitive performance was associated with activation in the right AG, which might serve as a biological marker to monitor the effect of GXR in the ADHD children.
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Affiliation(s)
- Takahiro Ikeda
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
| | - Akari Inoue
- Applied Cognitive Neuroscience Laboratory, Faculty of Science and Engineering, Chuo University, Bunkyo, Japan
| | - Daisuke Tanaka
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
| | - Tamao Hashimoto
- Applied Cognitive Neuroscience Laboratory, Faculty of Science and Engineering, Chuo University, Bunkyo, Japan
| | - Stephanie Sutoko
- Center for Exploratory Research, Research and Development Group, Hitachi, Ltd., Hiki, Japan
| | - Tatsuya Tokuda
- Applied Cognitive Neuroscience Laboratory, Faculty of Science and Engineering, Chuo University, Bunkyo, Japan
| | - Yasushi Kyutoku
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Bunkyo, Japan
| | - Atsushi Maki
- Center for Exploratory Research, Research and Development Group, Hitachi, Ltd., Hiki, Japan
| | - Takanori Yamagata
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
| | - Ippeita Dan
- Applied Cognitive Neuroscience Laboratory, Faculty of Science and Engineering, Chuo University, Bunkyo, Japan
- Center for Development of Advanced Medical Technology, Jichi Medical University, Shimotsuke, Japan
| | - Yukifumi Monden
- Department of Pediatrics, Jichi Medical University, Shimotsuke, Japan
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400
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Bong SH, Kim JW. The Role of Quantitative Electroencephalogram in the Diagnosis and Subgrouping of Attention-Deficit/Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2021; 32:85-92. [PMID: 34285632 PMCID: PMC8262972 DOI: 10.5765/jkacap.210010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 12/03/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) leads to functional decline in academic performance, interpersonal relationships, and development in school-aged children. Early diagnosis and appropriate intervention can significantly reduce the functional decline caused by ADHD. Currently, there is no established biological marker for ADHD. Some studies have suggested that various indicators from the quantitative electroencephalogram (QEEG) may be useful biological markers for the diagnosis of ADHD. Until the 2010s, theta/beta ratio (TBR) was a biomarker candidate for ADHD that consistently showed high diagnostic value. However, limitations of TBR have recently been reported. Studies have demonstrated that phase-amplitude coupling, especially theta phase-gamma amplitude coupling, are related to cognitive dysfunction and may assist in the diagnosis of ADHD. As yet, the underlying mechanism is not clearly established, and the clinical efficacy of these biomarkers needs to be proven through well-controlled studies. Based on the heterogeneous characteristics of ADHD, subgrouping through QEEG plays a key role in diagnosis and treatment planning. Sophisticated, well-designed studies and meta-analyses are necessary to confirm these findings.
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Affiliation(s)
- Su Hyun Bong
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Korea
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