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Razavinia F, Ebrahimiyan A, Faal Siahkal S, Ghazinezhad N, Abedi P. Vitamins B 9 and B 12 in children with attention deficit hyperactivity disorder (ADHD). INT J VITAM NUTR RES 2024; 94:476-484. [PMID: 38904980 DOI: 10.1024/0300-9831/a000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Background: Attention deficit hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder that begins before age 12. Given the role of B group vitamins in cell metabolism, synthesis of nucleotides, and neurotransmitters, the present study systematically investigated the plasma levels of vitamins B9 and B12 in children with ADHD. Methods: We searched electronic databases including Web of Science, MEDLINE, EMBASE, Scopus, Iran MEDEX, Cochran database, and SID from conception to June 2023. Full-text case-control or cross-sectional studies were included in this study. Participants in the case group were children with ADHD aged 6-12 years. Review Manager Software (RevMan 5.4) was used for statistical analyses. Standardized mean differences (SMD) with 95% CIs were used to determine the differences between the two groups. Results: Six studies were included in the present meta-analysis. They included 982 children, of whom, 204 were girls and 744 were boys. The mean age of the children was 8.86±2.03 years. The level of vitamin B9 was significantly different between children with and without ADHD [SMD -0.80, 95% CI (-1.55, -0.04)]. Vitamin B12 was significantly lower in children with ADHD [SMD -0.29, 95% CI (-0.42, -0.16)]. However, due to high heterogeneity (I2 = 93%), sensitivity analysis was used, I2 fell to 21%, and significant difference was observed between the two groups [SMD -0.19, 95% CI (-0.34, -0.04)]. Conclusion: The results of this systematic review showed that the level of vitamins B9 and B12 in children with ADHD was significantly lower than that in healthy children.
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Affiliation(s)
- Fatemeh Razavinia
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Ebrahimiyan
- Midwifery Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Faal Siahkal
- Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran
| | - Neda Ghazinezhad
- Faculty of Medical Sciences, Department of Reproductive Health and Midwifery, Tarbiat Modares University, Tehran, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundisahpur University of Medical Sciences, Ahvaz, Iran
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Zhu Y, Wang NN, Pan D, Wang S. Risk of Overweight and Obesity in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. Child Obes 2024; 20:119-127. [PMID: 36952326 DOI: 10.1089/chi.2022.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
This study was performed to explore the association between attention-deficit/hyperactivity disorder (ADHD) and the risk of overweight/obesity in both children and adolescents. The PubMed, Web of Science, and Cochrane Library databases were searched for relevant studies published before July 12, 2022. Studies with data for calculating the odds ratio (OR) of childhood overweight/obesity and ADHD were included. The literature value was assessed by the cross-sectional evaluation criteria proposed by the Agency for Healthcare Research and Quality (AHRQ). All analyses were conducted using StataSE 11 and RevMan 5.3 software with random-effects models. This review included a total of 16 studies covering 14,981 cases and 128,916 controls.According to the meta-analysis, children with ADHD had a significant risk for co-occurring overweight and obesity [OR 1.56; 95% confidence intervals (CI) 1.32-1.85], especially boys (OR 1.45; 95% CI 1.10-1.90), people in Asia (OR 3.25; 95% CI 1.70-6.21) and Europe (OR 1.85; 95% CI 1.61-2.12), and patients not using medication (OR 1.54; 95% CI 1.22-1.94).ADHD has a significant association with overweight and obesity in both children and adolescents, which may be altered by factors such as geography, gender, and medication use. Timely treatment should be provided to children and adolescents diagnosed with ADHD to inhibit the emergence of overweight and obesity.
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Affiliation(s)
- Yixuan Zhu
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Nian-Nian Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P.R. China
- Department of Public Health, School of Medicine, Xizang Minzu University, Xianyang, P.R. China
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Johnstad PG. Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use. Front Public Health 2024; 11:1268339. [PMID: 38249418 PMCID: PMC10797041 DOI: 10.3389/fpubh.2023.1268339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however. Objective The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons. Methods Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency. Results From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses. Conclusion This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
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Hutt Vater C, Biederman J, DiSalvo M, O'Connor H, Parker H, Woodworth KY, Wozniak J, Faraone SV. Growth Trajectories in Stimulant Treated Children and Adolescents: A Qualitative Review of the Literature from Comprehensive Datasets and Registries. J Child Adolesc Psychopharmacol 2023; 33:344-355. [PMID: 37966364 PMCID: PMC10771885 DOI: 10.1089/cap.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) treatment with stimulant products has been shown to be safe and effective; however, there are remaining concerns about their possible adverse effects on growth trajectories. We conducted a systematic review of the extant literature derived from ecologically valid databases and registries to assess the body of knowledge about the effects of stimulants on growth trajectories in naturalistic samples. Methods: Using PubMed and PsycINFO, we searched for articles published before February 8, 2023 that focused on growth findings associated with stimulant treatment in pediatric ADHD from comprehensive datasets derived from naturalistic population studies. Results: Of the 1070 articles initially identified, 12 met all inclusion criteria. Sample sizes ranged from 157 to 163,820 youths. Seven of 10 articles examining height found significant decreases in height associated with chronic stimulant treatment that normalized over time in 2 studies. Three articles found no significant association between stimulant treatment and height. No clear associations were identified between cumulative duration and dose of stimulant treatment and adult height. All articles examining weight and six of eight articles examining body mass index (BMI) found significant initial decreases that tended to normalize then increase over time. Longer duration of stimulant medication use was predominantly associated with significant weight and BMI reductions. The effects of stimulant dose on weight and BMI were mostly weak and clinically insignificant. Most studies found no significant association between age at start of stimulant treatment and change in height, weight, or BMI. Most studies did not find significant sex effects in relation to growth parameters. Conclusions: This review of ecologically informative samples revealed that the effects of stimulant treatment on growth trajectories are mainly small and transient. These effects seem to be clinically insignificant for most youth with ADHD who receive stimulant treatment from childhood onto adolescence and adulthood.
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Affiliation(s)
- Chloe Hutt Vater
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hannah O'Connor
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Haley Parker
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - K. Yvonne Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Janet Wozniak
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephen V. Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, New York, USA
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von HIPPEL PAULT, FRISVOLD DAVIDE. Have States Reduced Obesity by Legislating More Physical Activity in Elementary School? Milbank Q 2023; 101:204-248. [PMID: 36913506 PMCID: PMC10037682 DOI: 10.1111/1468-0009.12604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
Policy Points Between 1998 and 2016, 24 states and the District of Columbia passed laws meant to increase the time that children spent in physical education (PE) or other school-based physical activity (PA). Schools largely disregarded changes to PE/PA laws, which did not increase the time that children spent in PE or recess and did not reduce body mass index, overweight, or obesity. Closer oversight of schools would be needed to improve compliance with state PE and PA laws. Yet, even with better compliance, we estimate that PE and PA policies would be inadequate to reverse the obesity epidemic. Policies should also address consumption, both inside and outside of school. CONTEXT To control childhood obesity, leading medical organizations have recommended increasing the time that children spend in physical education (PE) and other school-based physical activity (PA). Yet, it is unknown how many states have passed laws that codify these recommendations, and it is unknown what effect changing state laws has had on obesity or the time that children actually spent in PE and PA. METHODS We joined state laws to national samples of 13,920 children from two different cohorts of elementary students. One cohort attended kindergarten in 1998; the other attended kindergarten in 2010; both cohorts were followed from kindergarten through fifth grade. We estimated the effects of changes to state laws in a regression with state and year fixed effects. FINDINGS Twenty-four states and the District of Columbia increased the time that children were recommended or required to spend in PE or PA. These changes in state policies did not increase actual time spent in PE or recess, did not affect average body mass index (BMI) or BMI Z score, and did not affect the prevalence of overweight or obesity. CONCLUSION Increasing the PE or PA time required or recommended by state laws has not slowed the obesity epidemic. Many schools have failed to comply with state laws. A back-of-the-envelope calculation suggests that, even with better compliance, the legislated changes in PE laws might not have changed energy balance enough to reduce obesity prevalence.
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Affiliation(s)
- PAUL T. von HIPPEL
- Center for Health and Social PolicyLyndon B. Johnson School of Public AffairsUniversity of TexasAustinUSA
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Thorsteinsdottir S, Njardvik U, Bjarnason R, Olafsdottir AS. Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial. Nutrients 2022; 14:4000. [PMID: 36235654 PMCID: PMC9571701 DOI: 10.3390/nu14194000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents' worries about their children's diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8-12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children's problematic mealtime behaviors in the long term.
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Affiliation(s)
- Sigrun Thorsteinsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
| | - Urdur Njardvik
- Faculty of Psychology, School of Health Sciences, University of Iceland, Saemundargata 12, 102 Reykjavik, Iceland
| | - Ragnar Bjarnason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Laeknagardur 4th Floor, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland
- Department of Pediatrics, National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland
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Ryu SA, Choi YJ, An H, Kwon HJ, Ha M, Hong YC, Hong SJ, Hwang HJ. Associations between Dietary Intake and Attention Deficit Hyperactivity Disorder (ADHD) Scores by Repeated Measurements in School-Age Children. Nutrients 2022; 14:nu14142919. [PMID: 35889876 PMCID: PMC9322602 DOI: 10.3390/nu14142919] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in school-age children and adolescents. However, the reported associations between ADHD and single nutrient intake are inconsistent. The aim of the study was to investigate the relationships between dietary intake changes and the prevalence of ADHD over time with repeat measurements using data from the Children Health and Environment Research (CHEER). To assess changes over time, we used data obtained in 2006 and 2008 (Phases 1 and 2). In this study, there were 2899 children aged 8 years or older in Phase 1 and 2120 children aged 9 years or older in Phase 2 from Korea, and the ADHD scores and dietary intake of 1733 children in Phases 1 and 2 were used in the final analysis. The YN group refers to children whose disease had improved in Phase 2, and the NY group refers to children diagnosed with ADHD in Phase 2. A notable within-group result was the increase in vegetable protein (p = 0.03) in the YN group. A between-group comparison showed that significant changes in nutrient intake could be confirmed most in the NY group, and the YN group tended to have a lower nutrient intake than the NY group. In the correlation of changes in nutrient intake and three subtypes (combined, AD, and HD), the total fat (p = 0.048) and animal protein (p = 0.099) showed a positive correlation with the prevalence of AD. Vegetable iron (p = 0.061 and p = 0.044, respectively), zinc (p = 0.022 and p = 0.007, respectively), vegetable protein (p = 0.074), and calcium (p = 0.057) had inhibitory effects on ADHD and its subtype. In conclusion, management of dietary and nutritional status should be considered to ameliorate ADHD and its subtypes in school-age children, and these relationships require further exploration in other settings.
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Affiliation(s)
- Su-a Ryu
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea; (S.-a.R.); (H.A.)
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Korea;
| | - Hyojin An
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea; (S.-a.R.); (H.A.)
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea; (H.-J.K.); (M.H.)
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea; (H.-J.K.); (M.H.)
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 08826, Korea;
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Hyo-Jeong Hwang
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Korea;
- Correspondence: ; Tel.: +82-2-3399-1653; Fax: +82-2-3399-1655
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Browne NT, Cuda SE. Nutritional and activity recommendations for the child with normal weight, overweight, and obesity with consideration of food insecurity: An Obesity Medical Association (OMA) Clinical Practice Statement 2022. OBESITY PILLARS (ONLINE) 2022; 2:100012. [PMID: 37990712 PMCID: PMC10661897 DOI: 10.1016/j.obpill.2022.100012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) details nutritional and activity recommendations for the child with normal weight, overweight, and obesity (Appendix A) with consideration of food insecurity. This CPS is intended to provide clinicians with an overview of clinical practices applicable to children and adolescents with body mass indices in the normal range and body mass indices greater than or equal to the 85th percentile for their ages, particularly those with adverse consequences resulting from increased body mass. The information in this CPS is based on scientific evidence, supported by the medical literature, and derived from the clinical experiences of members of the OMA. Methods The scientific information and clinical guidance in this CPS is based upon referenced evidence and derived from the clinical perspectives of the authors. Results This OMA Clinical Practice Statement details nutritional and activity recommendations for the child with normal weight, overweight, and obesity with consideration of food insecurity. In addition, this CPS addresses nutritional recommendations for complications related to the disease of obesity as well as providing guidance on food insecurity as it impacts children with obesity and their families. Conclusions This OMA Clinical Practice Statement on nutritional and activity recommendations for the child with normal weight, overweight, and obesity with consideration of food insecurity is an overview of current recommendations. These recommendations provide a roadmap to the improvement of the health of children and adolescents with obesity, especially those with metabolic, physiological, and psychological complications.
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Affiliation(s)
| | - Suzanne E. Cuda
- Alamo City Healthy Kids and Families, 1919 Oakwell Farms Parkway, Ste 145, San Antonio, TX, 78218, USA
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Rojo-Marticella M, Arija V, Alda JÁ, Morales-Hidalgo P, Esteban-Figuerola P, Canals J. Do Children with Attention-Deficit/Hyperactivity Disorder Follow a Different Dietary Pattern than That of Their Control Peers? Nutrients 2022; 14:1131. [PMID: 35334788 PMCID: PMC8949924 DOI: 10.3390/nu14061131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/15/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents. A current area of interest is the association between ADHD and food consumption. The aim of this study was to determine the food consumption and dietary patterns of children with and without ADHD in relation to their age and ADHD presentation. The study involved 259 preschoolers aged 3 to 6 years old (57 with ADHD and 202 controls) and 475 elementary-school-age children, aged 10 to 12 years old (213 with ADHD and 262 controls) from Spain. ADHD was diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (5th edition) from Schedule for Affective Disorders and Schizophrenia for School-Age Children interviews. Eating data were collected using a food consumption frequency questionnaire, and principal component analysis was carried out to analyze dietary patterns. Western-like, sweet, and healthy patterns were identified. The ADHD group was negatively associated with the healthy pattern (p < 0.001) and positively associated with the Western-like diet (p = 0.004). Children with inattentive presentation showed lower adherence (12.2%) to a healthy pattern than that of the control group (39.9%) (p < 0.001). There is an association between ADHD and dietary habits; children with inattentive presentation may particularly be at risk of unhealthy eating habits.
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Affiliation(s)
- Meritxell Rojo-Marticella
- Nutrition and Mental Health Research Group (NUTRISAM), Rovira i Virgili University (URV), 43201 Reus, Spain; (M.R.-M.); (V.A.); (P.M.-H.); (P.E.-F.)
- Research Centre for Behavioral Assessment (CRAMC), Department of Psychology, Rovira i Virgili University (URV), 43007 Tarragona, Spain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM), Rovira i Virgili University (URV), 43201 Reus, Spain; (M.R.-M.); (V.A.); (P.M.-H.); (P.E.-F.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Rovira i Virgili University (URV), 43204 Reus, Spain
| | - José Ángel Alda
- Attention Deficit Hyperactivity Disorder Unit, Sant Joan de Déu Hospital, 08950 Barcelona, Spain;
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
| | - Paula Morales-Hidalgo
- Nutrition and Mental Health Research Group (NUTRISAM), Rovira i Virgili University (URV), 43201 Reus, Spain; (M.R.-M.); (V.A.); (P.M.-H.); (P.E.-F.)
- Research Centre for Behavioral Assessment (CRAMC), Department of Psychology, Rovira i Virgili University (URV), 43007 Tarragona, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Rovira i Virgili University (URV), 43204 Reus, Spain
| | - Patricia Esteban-Figuerola
- Nutrition and Mental Health Research Group (NUTRISAM), Rovira i Virgili University (URV), 43201 Reus, Spain; (M.R.-M.); (V.A.); (P.M.-H.); (P.E.-F.)
- Research Centre for Behavioral Assessment (CRAMC), Department of Psychology, Rovira i Virgili University (URV), 43007 Tarragona, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Rovira i Virgili University (URV), 43204 Reus, Spain
| | - Josefa Canals
- Nutrition and Mental Health Research Group (NUTRISAM), Rovira i Virgili University (URV), 43201 Reus, Spain; (M.R.-M.); (V.A.); (P.M.-H.); (P.E.-F.)
- Research Centre for Behavioral Assessment (CRAMC), Department of Psychology, Rovira i Virgili University (URV), 43007 Tarragona, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), Rovira i Virgili University (URV), 43204 Reus, Spain
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Thorsteinsdottir S, Olafsdottir AS, Brynjolfsdottir B, Bjarnason R, Njardvik U. Odds of fussy eating are greater among children with obesity and anxiety. Obes Sci Pract 2022; 8:91-100. [PMID: 35127125 PMCID: PMC8804926 DOI: 10.1002/osp4.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Fussy eating has been associated with autism spectrum disorder (ASD), attention-deficit/hyperactive disorder (ADHD), anxiety, and depression. Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Understanding fussy eating in children with obesity and comorbid disorders is important as acceptance of healthy foods tends to be low, especially in children with sensory sensitivities. OBJECTIVES Investigate the prevalence of fussy eating in a cross-sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders. METHODS One hundred and four children referred to family-based obesity treatment in Iceland 2011-2016, mean age 12.0 (SD = 3.0), mean body mass index standard deviation score 3.5 (SD = 0.9). Binary logistic regression was used to estimate the relationship between fussy eating and disorders, adjusting for medication use. RESULTS A large minority (41.6%) were fussy eaters and 48.9% had at least one comorbid disorder. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively. Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02-16.58, p = 00.046), adjusting for medication use. The odds of being a fussy eater were not increased for other disorders; ASD, ADHD, or depression. CONCLUSIONS In children attending obesity treatment, fussy eating was common. Clinical care models in pediatric obesity treatment should address fussy eating, especially in children with anxiety.
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Affiliation(s)
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport and Leisure StudiesUniversity of IcelandReykjavikIceland
| | | | - Ragnar Bjarnason
- Department of PediatricsLandspitali University HospitalReykjavikIceland
- Faculty of MedicineUniversity of IcelandReykjavikIceland
| | - Urdur Njardvik
- Faculty of PsychologyUniversity of IcelandReykjavikIceland
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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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Kase BE, Rommelse N, Chen Q, Li L, Andersson A, Du Rietz E, Vos M, Cortese S, Larsson H, Hartman CA. Longitudinal Associations Between Symptoms of ADHD and BMI From Late Childhood to Early Adulthood. Pediatrics 2021; 147:peds.2020-036657. [PMID: 34039717 DOI: 10.1542/peds.2020-036657] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Attention-deficit/hyperactivity disorder (ADHD) and obesity are 2 frequent conditions that co-occur, which has implications for the management of both conditions. We hypothesized that ADHD symptoms predict BMI and vice versa from late childhood (10-12 years) up to early adulthood (20-22 years). METHODS Participants were adolescents in the Netherlands (n = 2773, 52.5% male, mean age = 11 years at baseline, 5 waves up to mean age 22) from the Tracking Adolescents' Individual Lives Survey cohort. We examined bidirectional relationship between ADHD symptoms (hyperactivity/impulsivity and inattention) and BMI using the random intercept cross-lagged panel model. Time-varying covariates were pubertal status, stimulant use, depressive symptoms, and family functioning, and socioeconomic status was a time-invariant covariate. RESULTS We found a time-invariant association of BMI with hyperactivity and impulsivity, but not with inattention, which was slightly stronger in female adolescents (female: r = 0.102; male: r = 0.086, P < .05). No longitudinal direct effects were found between ADHD symptoms and BMI during this period. CONCLUSIONS Over the course of adolescence, the link between ADHD and BMI is stable and is predominantly with hyperactive and impulsive symptoms rather than inattention. There was no direct effect of ADHD symptoms on BMI increase nor of BMI on enhanced ADHD symptoms during this developmental period. The findings point to a shared genetic or familial background and/or potential causal effects established already earlier in childhood, thus suggesting that intervention and prevention programs targeting overweight and obesity in children with ADHD should be implemented in early childhood.
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Affiliation(s)
- Bezawit E Kase
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Nanda Rommelse
- Department of Psychiatry, Radboud University Medical Center, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Lin Li
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | | | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Melissa Vos
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Clinical and Experimental Sciences (CNS and Psychiatry), University of Southampton, Southampton, United Kingdom.,Solent National Health Services Trust, Southampton, United Kingdom.,Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York, New York; and.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands;
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13
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Gurka MJ, Siddiqi SU, Filipp SL, Mercado R, Thompson LA, Janicke DM, Shenkman EA. Attention deficit hyperactivity disorder medications and BMI trajectories: The role of medication type, sex and age. Pediatr Obes 2021; 16:e12738. [PMID: 33064373 PMCID: PMC8276278 DOI: 10.1111/ijpo.12738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) and the medications used to treat it are associated with obesity. Stimulants lead to weight loss, while antipsychotics and antidepressants lead to weight gain. Little is known, however, how alpha-2-agonists impact weight, or the independent effect on BMI of these four classes of medications, which are often prescribed concurrently. We aimed to estimate the proximal change in BMI associated with start of medication and to assess whether medication-specific departures in BMI varied by age and sex. STUDY DESIGN We analysed longitudinal electronic health records from children (4-19 years) with an ADHD diagnosis seen at one healthcare system (2011-2018). Their BMI z-scores were fit as a cubic function of age via a mixed model, separately by sex and adjusting for race/ethnicity. From this model, we estimated annual changes in BMI-z after medication, allowing changes to vary by age and sex. RESULTS Among the 22 714 children with ADHD (mean initial age = 10.0), 4335 (19.1%) were never prescribed ADHD medication. The others (80.9%) experienced departures in BMI-z after start of all four medication classes, which varied across age and sex (interaction P-values < .01). All medications had larger impacts at younger ages. As expected, decreased BMI-z was observed with stimulants, while antidepressants and antipsychotics led to BMI-z increases; alpha-agonists also were associated with BMI-z increases. CONCLUSIONS This longitudinal study revealed that ADHD medications are independently associated with proximal changes in BMI-z after initiation, significantly varying by sex and age. Future research should study further the interactions of these medications on long-term impacts on obesity.
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Affiliation(s)
- Matthew J. Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Siraj U. Siddiqi
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Stephanie L. Filipp
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Rebeccah Mercado
- Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - Lindsay A. Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
| | - David M. Janicke
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida,Institute for Child Health Policy, University of Florida, Gainesville, Florida
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14
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Kazda L, Bell K, Thomas R, McGeechan K, Sims R, Barratt A. Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Scoping Review. JAMA Netw Open 2021; 4:e215335. [PMID: 33843998 PMCID: PMC8042533 DOI: 10.1001/jamanetworkopen.2021.5335] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged ≤18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included. Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCE This review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.
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Affiliation(s)
- Luise Kazda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katy Bell
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rae Thomas
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Kevin McGeechan
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Sims
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Alexandra Barratt
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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15
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[Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders]. Prax Kinderpsychol Kinderpsychiatr 2021; 70:182-197. [PMID: 33641646 DOI: 10.13109/prkk.2021.70.3.182] [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: 11/27/2022]
Abstract
Overweight/Obesity of Children and Adolescents and its Association with Internalising and Externalising Disorders Research in child and adolescent psychiatry increasingly deals with the association between mental disorder and weight. This paper provides an overview of national and international studies on the relationship between body composition and mental illness in children and adolescents, with a focus on the representation of individual internalizing and externalizing disturbance patterns. The majority of studies in this area are based on the so-called one-compartment model of body composition in terms of the Body Mass Index (BMI) or on the classification as "overweight" or "obese". Associations between mental disorders and body composition were described in two directions: On one hand, both externalising and internalising symptoms are associated with obesity, and on the other hand there are also more psychopathological symptoms among overweight children and adolescents. Longitudinal studies suggest effects in both directions. While externalising symptoms and weight are thought to be related from infancy on, this connection seems to be evident for internalising disorders not earlier than for early school age. It is also known from the literature that psychopharmacological medication affects weight and body growth - especially with psychostimulants, but also with neuroleptics and antidepressants. We found only a few studies describing the relationship between body composition and psyche in more complex models with two or more compartments.
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16
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Turan S, Tunctürk M, Çıray RO, Halaç E, Ermiş Ç. ADHD and Risk of Childhood Adiposity: a Review of Recent Research. Curr Nutr Rep 2021; 10:30-46. [PMID: 33400254 DOI: 10.1007/s13668-020-00346-w] [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] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE OF REVIEW Attention deficit/hyperactivity disorder (ADHD) is considered as a risk factor for childhood adiposity and obesity. Studies on ADHD have provided limited data concerning the connections between eating habits, body mass index, and obesity. The purpose of this review was to examine the current literature regarding recent cohort and cross-sectional studies to determine the links between ADHD and childhood adiposity. RECENT FINDINGS Studies in this review were classified into dietary features, nutritional status, neuroimaging findings, genetic overlapping, behavioral, cognitive, and neurocognitive aspects that play a role in mediating and moderating the relationship between ADHD and obesity. While ADHD, childhood adiposity, and overweight/obesity co-occur in children and adolescents, this relationship is largely explained by a variety of multidirectional factors.
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Affiliation(s)
- Serkan Turan
- Department of Child and Adolescent Psychiatry, Tekirdağ State Hospital, Tekirdağ, Turkey.
| | - Mustafa Tunctürk
- Department of Child and Adolescent Psychiatry, Bakirkoy Mazhar Osman Psychiatric Hospital, Istanbul, Turkey
| | - Remzi Oğulcan Çıray
- Department of Child and Adolescent Psychiatry, Dokuz Eylül University Medical Faculty, Izmir, Turkey
| | - Eren Halaç
- Department of Child and Adolescent Psychiatry, Dokuz Eylül University Medical Faculty, Izmir, Turkey
| | - Çağatay Ermiş
- Department of Child and Adolescent Psychiatry, Dokuz Eylül University Medical Faculty, Izmir, Turkey
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17
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Larroya A, Pantoja J, Codoñer-Franch P, Cenit MC. Towards Tailored Gut Microbiome-Based and Dietary Interventions for Promoting the Development and Maintenance of a Healthy Brain. Front Pediatr 2021; 9:705859. [PMID: 34277527 PMCID: PMC8280474 DOI: 10.3389/fped.2021.705859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/31/2021] [Indexed: 01/07/2023] Open
Abstract
Mental health is determined by a complex interplay between the Neurological Exposome and the Human Genome. Multiple genetic and non-genetic (exposome) factors interact early in life, modulating the risk of developing the most common complex neurodevelopmental disorders (NDDs), with potential long-term consequences on health. To date, the understating of the precise etiology underpinning these neurological alterations, and their clinical management pose a challenge. The crucial role played by diet and gut microbiota in brain development and functioning would indicate that modulating the gut-brain axis may help protect against the onset and progression of mental-health disorders. Some nutritional deficiencies and gut microbiota alterations have been linked to NDDs, suggesting their potential pathogenic implications. In addition, certain dietary interventions have emerged as promising alternatives or adjuvant strategies for improving the management of particular NDDs, at least in particular subsets of subjects. The gut microbiota can be a key to mediating the effects of other exposome factors such as diet on mental health, and ongoing research in Psychiatry and Neuropediatrics is developing Precision Nutrition Models to classify subjects according to a diet response prediction based on specific individual features, including microbiome signatures. Here, we review current scientific evidence for the impact of early life environmental factors, including diet, on gut microbiota and neuro-development, emphasizing the potential long-term consequences on health; and also summarize the state of the art regarding the mechanisms underlying diet and gut microbiota influence on the brain-gut axis. Furthermore, we describe the evidence supporting the key role played by gut microbiota, diet and nutrition in neurodevelopment, as well as the effectiveness of certain dietary and microbiome-based interventions aimed at preventing or treating NDDs. Finally, we emphasize the need for further research to gain greater insight into the complex interplay between diet, gut microbiome and brain development. Such knowledge would help towards achieving tailored integrative treatments, including personalized nutrition.
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Affiliation(s)
- Ana Larroya
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain
| | - Jorge Pantoja
- Department of Pediatrics, University Hospital De la Plana, Vila-Real, Castellón, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
| | - Pilar Codoñer-Franch
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain.,Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
| | - María Carmen Cenit
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain.,Department of Pediatrics, University Hospital De la Plana, Vila-Real, Castellón, Spain.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Valencia, Spain
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18
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Ravi P, Khan S. Attention Deficit Hyperactivity Disorder: Association With Obesity and Eating Disorders. Cureus 2020; 12:e12085. [PMID: 33489503 PMCID: PMC7805502 DOI: 10.7759/cureus.12085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most common treatable psychiatric illnesses that affect all age groups from children to adults. Most commonly it is diagnosed in childhood or during teenage years. It can affect the mental and physical health of an individual and disrupt normal academic, career, and social functioning. The quality of life of the individual is affected; thus if diagnosed and treated, the results are good. Obesity and eating disorders are one of the comorbidities associated with ADHD and can lead to various other health problems. This study was done to find out the association between ADHD, obesity, eating disorders, and the effect of medication. We collected data from various studies through multiple electronic databases such as PubMed and Google Scholar. We found 8610 relevant articles and finally narrowed it down to 30 using various criteria. An association was found between ADHD, obesity, and eating disorders, although the mechanism linking ADHD, obesity, and eating disorders still remains unclear according to most studies. Some studies say ADHD medication helps in losing gained weight; some say they do not affect the weight.
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Affiliation(s)
- Prithvi Ravi
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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19
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Davallow Ghajar L, DeBoer MD. Children With Attention-Deficit/Hyperactivity Disorder Are at Increased Risk for Slowed Growth and Short Stature in Early Childhood. Clin Pediatr (Phila) 2020; 59:401-410. [PMID: 32009447 DOI: 10.1177/0009922820902437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Our objective was to evaluate the risk of short stature in children with attention-deficit/hyperactivity disorder (ADHD) and the effect of ADHD and its treatment on height-for-age z score (HAZ) and body mass index-for-age z score (BMIZ) in early childhood. We evaluated 7603 children from the Early Childhood Longitudinal Study-Kindergarten Cohort 2011 and found that children with ADHD had lower HAZ at second and fourth grades and lower BMIZ at K to fourth grade. Children with ADHD at fourth grade had almost 4 times higher odds of short stature. Children with ADHD at K grew at a slower rate from K to fourth grade (difference in ΔHAZ = 0.23, 95% confidence interval = 0.04-0.42) and had less gain in BMI (difference in ΔBMIZ = 0.16, 95% confidence interval = 0.03-0.29). Longer duration of ADHD medication use was associated with lower HAZ at fourth grade and slower growth from K to fourth grade. These data may assist pediatricians in considering risk of poor growth in children with ADHD.
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20
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Anderson PM, Butcher KF, Schanzenbach DW. Understanding recent trends in childhood obesity in the United States. ECONOMICS AND HUMAN BIOLOGY 2019; 34:16-25. [PMID: 30910341 DOI: 10.1016/j.ehb.2019.02.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 05/06/2023]
Abstract
The prevalence of childhood obesity in the United States has more than tripled over the last four decades from 5 percent in 1978 to 18.5 percent in 2016. There is evidence for a break in trend in recent years: after growing from 0.4 to 0.7 percentage point per year between 1978 and 2004, the rate of increase has slowed to 0.1 percentage point per year from 2004 to 2016. To better understand these trends, in this paper we analyze a range of datasets that collect information on childhood obesity. We analyze the data overall, across the age distribution, across birth cohorts, and for subgroups of interest. We find steady increases in cohort-level obesity prevalence through approximately age 10, with levels unchanged thereafter, suggesting a need for additional interventions at early ages. We find that the prevalence of obesity has diverged by race and gender in recent years, especially among children entering kindergarten. Compared with 5-year-olds in 1997, 5-year-olds in 2010 were 2 percentage points more likely to be obese overall. Black and Hispanic 5-year-olds were 5 and 3 percentage points more likely to be obese, respectively, while whites had a 1 percentage point increase in obesity. However, overall and among all subgroups the rate of growth in obesity from kindergarten through 3rd grade has declined in recent years. Together, these findings can inform a future research literature that aims to target obesity interventions where they will be most impactful.
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21
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Dietary Profiles, Nutritional Biochemistry Status, and Attention-Deficit/Hyperactivity Disorder: Path Analysis for a Case-Control Study. J Clin Med 2019; 8:jcm8050709. [PMID: 31109092 PMCID: PMC6572510 DOI: 10.3390/jcm8050709] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/10/2019] [Accepted: 05/12/2019] [Indexed: 12/13/2022] Open
Abstract
This study aims to investigate dietary and nutritional biochemistry profiles of attention-deficit/hyperactivity disorder (ADHD) and to explore their potential relationship by path analysis. We enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. Compared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration. Children with ADHD had more intake of nutrient-poor foods such as high sugar and high fat foods, and had less intake of vegetable, fruit, protein-rich foods than their counterpart. SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD. In conclusion, an unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status, and managing diet and nutrition conditions should be considered to improve ADHD symptoms in children.
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22
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Hari Dass SA, McCracken K, Pokhvisneva I, Chen LM, Garg E, Nguyen TTT, Wang Z, Barth B, Yaqubi M, McEwen LM, MacIsaac JL, Diorio J, Kobor MS, O'Donnell KJ, Meaney MJ, Silveira PP. A biologically-informed polygenic score identifies endophenotypes and clinical conditions associated with the insulin receptor function on specific brain regions. EBioMedicine 2019; 42:188-202. [PMID: 30922963 PMCID: PMC6491717 DOI: 10.1016/j.ebiom.2019.03.051] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Activation of brain insulin receptors modulates reward sensitivity, inhibitory control and memory. Variations in the functioning of this mechanism likely associate with individual differences in the risk for related mental disorders (attention deficit hyperactivity disorder or ADHD, addiction, dementia), in agreement with the high co-morbidity between insulin resistance and psychopathology. These neurobiological mechanisms can be explored using genetic studies. We propose a novel, biologically informed genetic score reflecting the mesocorticolimbic and hippocampal insulin receptor-related gene networks, and investigate if it predicts endophenotypes (impulsivity, cognitive ability) in community samples of children, and psychopathology (addiction, dementia) in adults. METHODS Lists of genes co-expressed with the insulin receptor in the mesocorticolimbic system or hippocampus were created. SNPs from these genes (post-clumping) were compiled in a polygenic score using the association betas described in a conventional GWAS (ADHD in the mesocorticolimbic score and Alzheimer in the hippocampal score). Across multiple samples (n = 4502), the biologically informed, mesocorticolimbic or hippocampal specific insulin receptor polygenic scores were calculated, and their ability to predict impulsivity, risk for addiction, cognitive performance and presence of Alzheimer's disease was investigated. FINDINGS The biologically-informed ePRS-IR score showed better prediction of child impulsivity and cognitive performance, as well as risk for addiction and Alzheimer's disease in comparison to conventional polygenic scores for ADHD, addiction and dementia. INTERPRETATION This novel, biologically-informed approach enables the use of genomic datasets to probe relevant biological processes involved in neural function and disorders. FUND: Toxic Stress Research network of the JPB Foundation, Jacobs Foundation (Switzerland), Sackler Foundation.
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Affiliation(s)
- Shantala A Hari Dass
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Kathryn McCracken
- John Abbott College, Sainte-Anne-de-Bellevue, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Irina Pokhvisneva
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Lawrence M Chen
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Elika Garg
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Thao T T Nguyen
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Zihan Wang
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Barbara Barth
- McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Moein Yaqubi
- McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Lisa M McEwen
- Centre for Molecular Medicine and Therapeutics, BC Children's Hospital Research Institute, Department of Medical Genetics, The University of British Columbia, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Julie L MacIsaac
- Centre for Molecular Medicine and Therapeutics, BC Children's Hospital Research Institute, Department of Medical Genetics, The University of British Columbia, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Josie Diorio
- Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Michael S Kobor
- Centre for Molecular Medicine and Therapeutics, BC Children's Hospital Research Institute, Department of Medical Genetics, The University of British Columbia, 938 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
| | - Kieran J O'Donnell
- Department of Psychiatry, Faculty of Medicine, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada
| | - Michael J Meaney
- Department of Psychiatry, Faculty of Medicine, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, 117609, Singapore
| | - Patricia P Silveira
- Department of Psychiatry, Faculty of Medicine, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Sackler Institute for Epigenetics & Psychobiology, McGill University, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada.
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23
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Bowling AB, Tiemeier HW, Jaddoe VWV, Barker ED, Jansen PW. ADHD symptoms and body composition changes in childhood: a longitudinal study evaluating directionality of associations. Pediatr Obes 2018; 13:567-575. [PMID: 29869385 DOI: 10.1111/ijpo.12288] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/25/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is linked to increased risk of overweight/obesity among children and adults. Studies have also implicated obesity as a risk factor for ADHD. However, no studies have evaluated bidirectional, longitudinal associations between childhood fat mass and ADHD symptom severity. OBJECTIVES We investigate bidirectional associations between ADHD symptoms and measures of body composition between ages 1.5 and 9. We further examine effects of specific eating patterns linked to ADHD on associations between symptom severity and body composition. METHODS The study utilized data from children (N = 3903) participating in the Generation R cohort (Netherlands). Children were enrolled at birth and retained regardless of ADHD symptoms over time. Cross-lagged and change models examined bidirectional associations between body composition (body mass index/dual-energy X-ray absorptiometry) and ADHD symptoms at four time points in childhood. RESULTS A child with a clinically concerning ADHD symptom z-score two standard deviations above the mean at age 6 would be expected to experience about 0.22 kg greater fat mass gain measured via dual-energy x-ray absorptiometry between ages 6 and 9, even if they displayed healthy eating patterns (95% CI: 0.11 - 0.28, p < 0.001). Conversely, fat mass at any age did not predict worse ADHD symptoms later. CONCLUSIONS Beginning in early childhood, more ADHD symptoms predict higher fat mass at later ages. We did not find evidence of a reverse association. Based on these and prior findings, lifestyle counselling during treatment for children with a diagnosis of ADHD should be considered, even if they are diagnosed in early childhood and do not yet have a body mass index of clinical concern.
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Affiliation(s)
- A B Bowling
- Department of Health Sciences, Merrimack College, North Andover, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - H W Tiemeier
- 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.,Department of Psychiatry, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - V W V Jaddoe
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - E D Barker
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, The Netherlands
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