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Thinggaard CM, Dalgård C, Möller S, Christesen HBT, Bilenberg N. Vitamin D status in pregnancy and cord blood is associated with symptoms of attention-deficit hyperactivity disorder at age 5 years: Results from Odense Child Cohort. Aust N Z J Psychiatry 2024:48674241272018. [PMID: 39152569 DOI: 10.1177/00048674241272018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
BACKGROUND Vitamin D status in pregnancy may affect offspring neurodevelopment. OBJECTIVE The objective was to investigate the association between serum 25-hydroxyvitamin D in cord blood and pregnancy and symptoms of attention-deficit hyperactivity disorder in 5-year-old offspring. METHOD In Odense Child Cohort, Denmark, 944 mother-child pairs had data on pregnancy or cord serum 25-hydroxyvitamin D and parent-rated attention-deficit hyperactivity disorder symptom score by Child Behavior Checklist for ages 1.5-5 years. Adjusted multiple linear regression and two-stage exposure analyses were performed for serum 25-hydroxyvitamin D associations to the attention-deficit hyperactivity disorder symptom score. RESULTS The mean (standard deviation) serum 25-hydroxyvitamin D in cord blood was 48.0 (21.8) nmol/L; early pregnancy was 65.5 (20.2) nmol/L and late pregnancy was 79.3 (25.7) nmol/L. The median (interquartile range) age of child at examination was 5.2 (5.1-5.4) years and median (interquartile range) attention-deficit hyperactivity disorder symptom score was 2 (0-3) points. In adjusted analyses, serum 25-hydroxyvitamin D of <25 nmol/L and <32 nmol/L in cord blood and <25 nmol/L in early pregnancy was associated with 0.9 [95% confidence interval: 0.4, 1.3], 0.5 [0.1, 0.9] and 2.1 [0.8, 3.4] points higher attention-deficit hyperactivity disorder symptom score vs reference. In the two-stage exposure analysis, attention-deficit hyperactivity disorder symptom score decreased by 0.4 points per 25 nmol/L increase in serum 25-hydroxyvitamin D. Moreover, serum 25-hydroxyvitamin D of <25 nmol/L in early pregnancy and cord was associated with a five-fold and a two-fold risk of attention-deficit hyperactivity disorder symptom score ⩾90th percentile, adjusted odds ratio [95% confidence interval] = 4.9 [1.3, 19.0] and 2.2 [1.2, 3.9]. CONCLUSION In this cohort, serum 25-hydroxyvitamin D <25 nmol/L in cord blood and early pregnancy were risk factors for higher attention-deficit hyperactivity disorder symptom score in 5-year-old children, suggesting a protective effect of vitamin D on attention-deficit hyperactivity disorder traits at preschool age.
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Affiliation(s)
- Camilla Munk Thinggaard
- Department of Child and Adolescent Psychiatry, Mental Health Hospital and University Clinic, Region of Southern Denmark, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Acute and Medical Department, Aalborg University Hospital, Thisted, Denmark
| | - Christine Dalgård
- Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN - Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Henrik Boye Thybo Christesen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Psychiatry, Mental Health Hospital and University Clinic, Region of Southern Denmark, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Overgaard KR, Oerbeck B, Friis S, Pripp AH, Aase H, Biele G, Ingeborgrud CB, Polanczyk GV, Zeiner P. Early and repeated screening detects children with persistent attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2024; 33:1807-1815. [PMID: 37624573 PMCID: PMC11211128 DOI: 10.1007/s00787-023-02284-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Preschool screening of attention-deficit/hyperactivity disorder (ADHD) has been found too inaccurate to be clinically useful. This may be due to the known instability of ADHD symptoms from preschool onwards, and the use of a single screening only. We hypothesized that by identifying a group of children with persistent ADHD from preschool to school age and repeating the screening, the clinical usefulness of screening would increase. This study is part of the prospective longitudinal, population-based Norwegian Mother, Father and Child Cohort Study, with a diagnostic parent interview at 3.5 years and follow-up with parent questionnaires at ages 5 and 8 years (n = 707). We identified a group classified with ADHD at all three time points (persistent ADHD). We then used the Child Behavior Checklist ADHD DSM-oriented scale at ages 3.5 and 5 years to investigate the accuracies of single- and two-stage screening at different thresholds to identify children with persistent ADHD. About 30% of the children were classified with ADHD at least once across time (at ages 3.5, 5, and/or 8 years), but only 4% (n = 30) had persistent ADHD. At all thresholds, the two-stage screening identified children with persistent ADHD more accurately than single screening, mainly due to a substantial reduction in false positives. Only a small group of children were classified with persistent ADHD from preschool to school age, underlining that future screening studies should distinguish this group from those with fluctuating symptoms when estimating screening accuracies. We recommend a two-stage screening process to reduce false positives.
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Affiliation(s)
- Kristin Romvig Overgaard
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Beate Oerbeck
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
| | - Svein Friis
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Guido Biele
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Guilherme V Polanczyk
- Faculdade de Medicina FMUSP, Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PO box 4959, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Peterson BS, Trampush J, Brown M, Maglione M, Bolshakova M, Rozelle M, Miles J, Pakdaman S, Yagyu S, Motala A, Hempel S. Tools for the Diagnosis of ADHD in Children and Adolescents: A Systematic Review. Pediatrics 2024; 153:e2024065854. [PMID: 38523599 DOI: 10.1542/peds.2024-065854] [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: 01/26/2024] [Indexed: 03/26/2024] Open
Abstract
CONTEXT Correct diagnosis is essential for the appropriate clinical management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. OBJECTIVE This systematic review provides an overview of the available diagnostic tools. DATA SOURCES We identified diagnostic accuracy studies in 12 databases published from 1980 through June 2023. STUDY SELECTION Any ADHD tool evaluation for the diagnosis of ADHD, requiring a reference standard of a clinical diagnosis by a mental health specialist. DATA EXTRACTION Data were abstracted and critically appraised by 1 reviewer and checked by a methodologist. Strength of evidence and applicability assessments followed Evidence-based Practice Center standards. RESULTS In total, 231 studies met eligibility criteria. Studies evaluated parental ratings, teacher ratings, youth self-reports, clinician tools, neuropsychological tests, biospecimen, EEG, and neuroimaging. Multiple tools showed promising diagnostic performance, but estimates varied considerably across studies, with a generally low strength of evidence. Performance depended on whether ADHD youth were being differentiated from neurotypically developing children or from clinically referred children. LIMITATIONS Studies used different components of available tools and did not report sufficient data for meta-analytic models. CONCLUSIONS A valid and reliable diagnosis of ADHD requires the judgment of a clinician who is experienced in the evaluation of youth with and without ADHD, along with the aid of standardized rating scales and input from multiple informants across multiple settings, including parents, teachers, and youth themselves.
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Affiliation(s)
- Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, California
- Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Joey Trampush
- Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, California
| | - Morah Brown
- Southern California Evidence Review Center, Los Angeles, California
| | | | - Maria Bolshakova
- Southern California Evidence Review Center, Los Angeles, California
| | - Mary Rozelle
- Southern California Evidence Review Center, Los Angeles, California
| | - Jeremy Miles
- Southern California Evidence Review Center, Los Angeles, California
| | - Sheila Pakdaman
- Southern California Evidence Review Center, Los Angeles, California
| | - Sachi Yagyu
- Southern California Evidence Review Center, Los Angeles, California
| | - Aneesa Motala
- Southern California Evidence Review Center, Los Angeles, California
| | - Susanne Hempel
- Southern California Evidence Review Center, Los Angeles, California
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Honaker MG, Weitlauf AS, Swanson AR, Hooper M, Sarkar N, Wade J, Warren ZE. Paisley: Preliminary validation of a novel app-based e-Screener for ASD in children 18-36 months. Autism Res 2023; 16:1963-1975. [PMID: 37602567 PMCID: PMC10857772 DOI: 10.1002/aur.2997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
The purpose of this study was to assess the validity of an autism e-screener, Paisley, when utilized in a clinical research setting via a tablet application. The Paisley application used a series of play-based activities, all of which incorporated varying aspects of the ASD-PEDS. Participants included children (18-36 months; n = 198) referred for evaluation of autism spectrum disorder (ASD) and community providers (n = 66) with differing levels of familiarity with ASD. Community providers administered the Paisley application to children who then completed a comprehensive psychological evaluation. Based on comprehensive evaluation, 75% of children met diagnostic criteria for ASD. Paisley scores were significantly higher for children diagnosed with ASD (15.06) versus those not diagnosed (9.34). The newly determined cutoff ASD-PEDS cutoff score of 13 had significantly higher specificity and positive predictive value than the originally proposed cutoff of 11. Results support the use of Paisley by community providers to identify autism risk in toddlers. Limitations and strengths of the work, as well as opportunities for future clinical validation, are described.
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Affiliation(s)
- Makayla G Honaker
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), Nashville, Tennessee, USA
| | - Amy S Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), Nashville, Tennessee, USA
| | - Amy R Swanson
- Vanderbilt Kennedy Center, Treatment and Research Institute for Autism Spectrum Disorders (TRIAD), Nashville, Tennessee, USA
- Adaptive Technology Consulting, Nashville, Tennessee, USA
| | - Madison Hooper
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Nilanjan Sarkar
- Adaptive Technology Consulting, Nashville, Tennessee, USA
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Joshua Wade
- Adaptive Technology Consulting, Nashville, Tennessee, USA
| | - Zachary E Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Special Education, Vanderbilt University, Nashville, Tennessee, USA
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Andreasen JJ, Tobiasen BB, Jensen RC, Boye H, Jensen TK, Bilenberg N, Andersen MS, Glintborg D. Maternal cortisol in 3rd trimester is associated with traits of neurodevelopmental disorder in offspring. Odense Child Cohort. Psychoneuroendocrinology 2023; 154:106293. [PMID: 37207405 DOI: 10.1016/j.psyneuen.2023.106293] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/12/2023] [Accepted: 05/13/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Prenatal cortisol exposure is essential for neurodevelopment. Maternal cortisol levels could be associated with offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). AIM To investigate associations between maternal 3rd trimester cortisol and offspring traits of ASD and ADHD. MATERIAL AND METHODS Mother-child pairs were included from the prospective study Odense Child Cohort. Morning serum cortisol and 24-hour urine cortisol/cortisone were collected at gestational week 27-30. Offspring ASD and ADHD traits were assessed at age three and five years using the Child Behavior Checklist. Maternal cortisol measurements and offspring ASD and ADHD traits assessment were available in (n = 1131; 52% boys) mother-child pairs at age three and (n = 717; 54% boys) at five years of age. Maternal 24-hour urine measurement was available in a subset, at offspring three years of age (n = 300) and at five years of age (n = 217). Associations between maternal cortisol (continuous and tertiles) and offspring ASD or ADHD traits were examined in regression models adjusted for offspring sex, maternal age, pre-pregnancy BMI, parity, maternal education level, parental psychiatric disorders, and maternal smoking and stratified for offspring sex. RESULTS Maternal mean age ( ± SD) was 30 years ( ± 4.4) and median BMI (25%; 75% percentiles) 23.5 kg/m2 (21.3; 26.6). Higher maternal serum cortisol levels were associated with higher prevalence of offspring ASD traits at three years of age in the total study cohort and in boys after stratifying for offspring sex. In the total population, tertiles of serum cortisol showed a significant dose-response relationship to ASD traits in unadjusted and adjusted models (p-values for linear trend, p < 0.01 and p = 0.02, respectively). In offspring at five years, associations between maternal cortisol and offspring ASD traits were non-significant (all p-values > 0.2). Maternal cortisol was not associated with offspring ADHD traits (all p-values > 0.07) in offspring at three and five years. Maternal 24-hour urine cortisol, cortisone, or cortisol/cortisone ratio were not associated with offspring ASD or ADHD traits. CONCLUSION Higher maternal serum cortisol in 3rd trimester was associated with offspring ASD traits at three years of age in the whole study cohort and in boys, but not in girls. This association was non-significant at five years of age.
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Affiliation(s)
- Jonas Jannick Andreasen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Bror Bastian Tobiasen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Richard Christian Jensen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Odense University Hospital, Odense C, Denmark; Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Henriette Boye
- Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Denmark; OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Denmark
| | - Tina Kold Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, Odense University Hospital, Odense C, Denmark; Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Denmark; OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Denmark
| | - Niels Bilenberg
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Child and Adolescent Mental Health Odense, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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Kasatkin VN, Borodina ID, Deviaterikova AA, Malykh SB, Karelin AF. Identification of behavioral disorders using the Achenbach questionnaire in children with tumors of the posterior cranial fossa after completion of special treatment (pilot research). ONCOHEMATOLOGY 2022. [DOI: 10.17650/1818-8346-2022-17-4-158-165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background. The increase in life expectancy of children who survived cancer leads to new tasks for doctors, psychologists and rehabilitation specialists to assessing the consequences of the experienced disease and its treatment. The most common disorders in children who have survived oncological diseases are behavioral disorders, a decrease in mood background, as well as chronic fatigue.Aim. To identify predictors of behavioral disorders in children who have survived central nervous system oncological diseases.Materials and methods. The study involved 52 children with central nervous system tumors aged 6 to 17 years. The median time after completion of therapy in this group of patients was 18 (3–117) months.Results. As a result of the study, it was shown that such treatment parameters as the degree of tumor malignancy and the radiation therapy volume are associated with behavioral disorders in children who have survived cancer. In such children, a reduced mood background was revealed, and the older the child, the higher the probability of a reduced mood background. A reduced mood background is also associated with the use of vincristine preparation. Children who have a residual tumor are more likely to complain of unpleasant sensations in the body. All children, despite the specifics of their treatment, complain of constant fatigue, which affects their daily activity.Conclusion. Thus, factors that are associated with behavioral disorders in children who have survived oncological diseases in the central nervous system were identified.
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Affiliation(s)
| | - I. D. Borodina
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia
| | - A. A. Deviaterikova
- Peoples’ Friendship University of Russia; Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia
| | - S. B. Malykh
- Psychological Institute of Russian Academy of Education
| | - A. F. Karelin
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia
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Kapogiannis A, Makris G, Darviri C, Artemiadis A, Klonaris D, Tsoli S, Bachourou T, Stefanaki C, Papanikolaou K, Chrousos G, Pervanidou P. The Greek Version of the Vanderbilt ADHD Diagnostic Parent Rating Scale for Follow-up Assessment in Prepubertal Children with ADHD. INTERNATIONAL JOURNAL OF DISABILITY, DEVELOPMENT AND EDUCATION 2022; 69:1726-1735. [DOI: 10.1080/1034912x.2020.1802647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- August Kapogiannis
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Gerasimos Makris
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Artemios Artemiadis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Dionysios Klonaris
- Center of Continuing Education and Lifelong Learning, University of Ioannina, Ioannina, Greece
| | - Sofia Tsoli
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, National and Kapodistrian, University of Athens Ringgold Standard Institution, Athens, Greece
| | - Theodora Bachourou
- School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charikleia Stefanaki
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Katerina Papanikolaou
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - George Chrousos
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioural Pediatrics, First Department of Pediatrics, School of Medicine National and Kapodistrian University of Athens Ringgold Standard Institution, Athens, Greece
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Pham C, Vryer R, O’Hely M, Mansell T, Burgner D, Collier F, Symeonides C, Tang MLK, Vuillermin P, Gray L, Saffery R, Ponsonby AL. Shortened Infant Telomere Length Is Associated with Attention Deficit/Hyperactivity Disorder Symptoms in Children at Age Two Years: A Birth Cohort Study. Int J Mol Sci 2022; 23:ijms23094601. [PMID: 35562991 PMCID: PMC9104809 DOI: 10.3390/ijms23094601] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/13/2022] Open
Abstract
Environmental factors can accelerate telomere length (TL) attrition. Shortened TL is linked to attention deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. The onset of ADHD occurs as early as preschool-age, but the TL-ADHD association in younger children is unknown. We investigated associations between infant TL and ADHD symptoms in children and assessed environmental factors as potential confounders and/or mediators of this association. Relative TL was measured by quantitative polymerase chain reaction in cord and 12-month blood in the birth cohort study, the Barwon Infant Study. Early life environmental factors collected antenatally to two years were used to measure confounding. ADHD symptoms at age two years were evaluated by the Child Behavior Checklist Attention Problems (AP) and the Attention Deficit/Hyperactivity Problems (ADHP). Associations between early life environmental factors on TL or ADHD symptoms were assessed using multivariable regression models adjusted for relevant factors. Telomere length at 12 months (TL12), but not at birth, was inversely associated with AP (β = −0.56; 95% CI (−1.13, 0.006); p = 0.05) and ADHP (β = −0.66; 95% CI (−1.11, −0.21); p = 0.004). Infant secondhand smoke exposure at one month was independently associated with shorter TL12 and also higher ADHD symptoms. Further work is needed to elucidate the mechanisms that influence TL attrition and early neurodevelopment.
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Affiliation(s)
- Cindy Pham
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
| | - Regan Vryer
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Martin O’Hely
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Toby Mansell
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - David Burgner
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Fiona Collier
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Christos Symeonides
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Mimi L. K. Tang
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Peter Vuillermin
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Lawrence Gray
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- School of Medicine, Deakin University, Geelong, VIC 3220, Australia
| | - Richard Saffery
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia; (C.P.); (R.V.); (M.O.); (T.M.); (D.B.); (C.S.); (M.L.K.T.); (P.V.); (R.S.)
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC 3052, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3052, Australia
- Child Health Research Unit, Barwon Health, Geelong, VIC 3220, Australia; (F.C.); (L.G.)
- Correspondence:
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Merrill SM, Moore SR, Gladish N, Giesbrecht GF, Dewey D, Konwar C, MacIssac JL, Kobor MS, Letourneau NL. Paternal adverse childhood experiences: Associations with infant DNA methylation. Dev Psychobiol 2021; 63:e22174. [PMID: 34333774 DOI: 10.1002/dev.22174] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 06/17/2021] [Accepted: 06/24/2021] [Indexed: 12/14/2022]
Abstract
Adverse childhood experiences (ACEs), or cumulative childhood stress exposures, such as abuse, neglect, and household dysfunction, predict later health problems in both the exposed individuals and their offspring. One potential explanation suggests exposure to early adversity predicts epigenetic modification, especially DNA methylation (DNAm), linked to later health. Stress experienced preconception by mothers may associate with DNAm in the next generation. We hypothesized that fathers' exposure to ACEs also associates with their offspring DNAm, which, to our knowledge, has not been previously explored. An epigenome-wide association study (EWAS) of blood DNAm (n = 45) from 3-month-old infants was regressed onto fathers' retrospective ACEs at multiple Cytosine-phosphate-Guanosine (CpG) sites to discover associations. This accounted for infants' sex, age, ethnicity, cell type proportion, and genetic variability. Higher ACE scores associated with methylation values at eight CpGs. Post-hoc analysis found no contribution of paternal education, income, marital status, and parental postpartum depression, but did with paternal smoking and BMI along with infant sleep latency. These same CpGs also contributed to the association between paternal ACEs and offspring attention problems at 3 years. Collectively, these findings suggested there were biological associations with paternal early life adversity and offspring DNAm in infancy, potentially affecting offspring later childhood outcomes.
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Affiliation(s)
- Sarah M Merrill
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Sarah R Moore
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Nicole Gladish
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Gerald F Giesbrecht
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Deborah Dewey
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Chaini Konwar
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Julia L MacIssac
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada
| | - Michael S Kobor
- BC Children's Hospital Research Institute Vancouver, Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Molecular Medicine and Therapeutics, Vancouver, British Columbia, Canada.,Program in Child and Brain Development, CIFAR, Toronto, Ontario, Canada
| | - Nicole L Letourneau
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.,Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.,Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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10
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Gomez R, Vance A, Watson S, Stavropoulos V. ROC Analyses of Relevant Conners 3-Short Forms, CBCL, and TRF Scales for Screening ADHD and ODD. Assessment 2019; 28:73-85. [PMID: 31535569 DOI: 10.1177/1073191119876023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Receiver operating characteristic curve analysis was used to examine and compare the diagnostic accuracy of the Conners 3-Parent Short Form (C 3-P(S)), and the Conners 3-Teacher Short Form (C 3-T(S)) inattention and hyperactivity/impulsivity scales, and the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF) attention problems scales, to distinguish those with and without attention deficit/hyperactivity disorder (ADHD). It also examined and compared the diagnostic accuracy of the C 3-P(S) and C 3-T(S) Aggression (AG) scales, and the CBCL and TRF Aggressive Behavior (AB) scales, to distinguish those with and without oppositional defiant disorder (ODD). The study used archival data (N = 150-261) involving a large group of clinic-referred children aged between 6 and 11 years who had been interviewed for clinical diagnosis of ADHD and ODD using the Anxiety Disorders Interview Schedule for Children (ADISC-IV) as the reference standard, and then administered one or more of the screening measures. The findings provided empirical support for the use of the C 3-P(S) and CBCL for identifying ADHD and ODD, with the CBCL aggressive behavior scale having better ability to detect ODD. The implications of the findings for using the screening scales for diagnoses of ADHD and ODD are discussed.
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Affiliation(s)
- Rapson Gomez
- Federation University Australia, Ballarat, Victoria, Australia
| | - Alasdair Vance
- Royal Children's Hospital, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Shaun Watson
- Federation University Australia, Ballarat, Victoria, Australia
| | - Vasileios Stavropoulos
- Cairnmillar Institute, Melbourne, Victoria, Australia.,National and Kapodistrian University of Athens, Athens, Greece
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Rodriguez MC, Wade TJ, Veldhuizen S, Missiuna C, Timmons B, Cairney J. Emotional and Behavioral Problems in 4- and 5-Year Old Children With and Without Motor Delays. Front Pediatr 2019; 7:474. [PMID: 31803697 PMCID: PMC6877720 DOI: 10.3389/fped.2019.00474] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/29/2019] [Indexed: 12/22/2022] Open
Abstract
Background: An increased prevalence of psychological and behavioral conditions has been observed in youth and adolescents with DCD. The majority of research examining the relationship between motor skill proficiency and psychological problems has focused on older children and adolescents. The aim of the present study was to examine the relationship between motor skill proficiency and emotional and behavioral problems among pre-school age children with DCD to help determine how young children are when more severe problems begin to emerge (i.e., symptoms meet clinical thresholds) and the prevalence of comorbidity. Methods: Children 4 to 5 years of age (n = 589) from the Coordination and Activity Tracking in CHildren (CATCH) study were divided into two groups: at risk for DCD (rDCD; n = 288) and typically developing (TD; n = 301). Inclusion in the rDCD group required a score ≤16th percentile on the Movement Assessment Battery for Children-2. Emotional and behavioral problems were assessed using the Child Behavior Checklist (CBCL) 1.5 to 5 year parent-report questionnaire. CBCL data were scored using the CBCL syndrome scales as well as the DSM V revised scale scoring. Results: Seven children had missing or incomplete data on the CBCL and were excluded from the present analysis, leaving 582 participants. The mean age was 5.0 (SD 0.6) years and 57% of children were male (TD: 48% male, rDCD group: 67% male). After adjusting for sex, rDCD children scored significantly higher on all CBCL syndrome scales, all DSM-V scales, and all three summative scales. They were also significantly more likely to score at or above the syndrome scale clinical threshold on anxiety, withdrawn, emotionally reactive, aggression, ADHD, internalizing, externalizing, and total problems; and above the DSM-V thresholds on depression and autism. In addition, rDCD status was associated with a higher probability of meeting criteria for one, two, or more disorders in an ordinal logistic regression model. Conclusion: Preschool-age children with rDCD have more parent-reported psychological problems, and are more likely to be above the clinical threshold for many psychological problems and meet criteria for multiple conditions.
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Affiliation(s)
- M Christine Rodriguez
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Terrance J Wade
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Scott Veldhuizen
- Infant and Child Health Lab, McMaster University, Hamilton, ON, Canada
| | - Cheryl Missiuna
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Brian Timmons
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - John Cairney
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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