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Palacio-Ortiz JD, Palacios-Cruz L, Martínez-Zamora M, Valencia-Echeverry J, Macias-Duran J, López-Jaramillo CA. Looking beyond psychosocial adversity and sex: Clinical factors associated with ADHD and other psychiatric disorders in a non-Caucasian sample of high-risk siblings. Psychiatry Res 2024; 339:115997. [PMID: 38941862 DOI: 10.1016/j.psychres.2024.115997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/30/2024]
Abstract
This study examined the association of clinical factors, independent of sex and high psychosocial adversity (HPAd), with the presence of ADHD or other mental disorders, specifically within a middle-income country with a non-Caucasian population. A multi-centric cross-sectional study was conducted in three sites in Colombia. Our study recruited trios of an ADHD proband, one sibling, and one parent. We used valid instruments for assessing parents and siblings. The sample included 223 siblings, an average age of 12.3 (SD 3.9), and 51.1% Females. The ADHD recurrence risk ratio (λ) was 12. The clinical factors mainly associated with the presence of ADHD, independent of sex and HPAd, were 1) Pregnancy and childbirth complications, 2) Delayed psychomotor development, 3) Temperament, and 4) Sleep disturbances. Our research showed that, independently of HPAd and the male sex, there were other clinical factors associated with ADHD and other psychiatric disorders in this population. These findings need to be replicated in similar populations globally.
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Affiliation(s)
- Juan David Palacio-Ortiz
- Grupo de Investigación en Psiquiatría GIPSI, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Lino Palacios-Cruz
- Laboratorio de Epidemiologia Clínica, Programa PROMETEO/TDAH, Subdirección de investigaciones Clínicas, Dirección de Neurociencias, Instituto Nacional de Psiquiatría Ramon de la Fuente, CDMX, Mexico
| | | | - Johanna Valencia-Echeverry
- Grupo de Investigación en Psiquiatría GIPSI, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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2
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Kian N, Samieefar N, Rezaei N. Prenatal risk factors and genetic causes of ADHD in children. World J Pediatr 2022; 18:308-319. [PMID: 35235183 DOI: 10.1007/s12519-022-00524-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 02/07/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a common disease among children; it affected 5-7% of the population in 2015. ADHD is a multifactorial disease, and its etiology is still not clearly understood. DATA SOURCES This narrative review has been done by searching the PubMed and Embase databases using attention deficit/hyperactivity disorder, ADHD, risk factors; genetics; pediatrics; psychiatrics as keywords. RESULTS ADHD is considered to be a hereditary disorder in which genes play the fundamental role in the pathogenesis; however, findings from genetic-environmental studies support the hypothesis that genetic factors can exert effects on an individual's condition by determining his/her responses to environmental exposures, especially those during the prenatal stage. CONCLUSION ADHD is considered as a hereditary disorder in which genes and prenatal risk factors play fundamental roles in the pathogenesis.
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Affiliation(s)
- Naghmeh Kian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noosha Samieefar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran.,USERN Office, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran. .,Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Harikrishnan U, Sailo GL. Prevalence of Emotional and Behavioral Problems among School-Going Adolescents: A Cross-Sectional Study. Indian J Community Med 2021; 46:232-235. [PMID: 34321732 PMCID: PMC8281858 DOI: 10.4103/ijcm.ijcm_451_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 03/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background Adolescence is a period of several emotional, mental, and behavioral changes, and many adolescent problems are manifested in the form of emotional problems, conduct problems, hyperactivity, and peer-related problems. The objectives of the current study are to assess the prevalence of emotional and behavioral problems across gender and location. It analyzes the Strengths and Difficulties Questionnaire (SDQ) total score with sociodemographic details among school-going adolescents in Kollam district. Materials and Methods A cross-sectional study of 600 school-going adolescents between Class VIII to XII from the rural and urban areas in Kollam district was carried out using a cluster sampling method. A self-reported SDQ was administered to the respondents. Results The findings indicate that a little more than a tenth of school-going adolescents had emotional and behavioral problems and multiple regression analysis revealed a significant association in SDQ total score with the type of schools, settings, and socioeconomic status. Conclusion Early detection, periodical assessment, and intervention in the schools with the aid of mental health professionals can help adolescents in coping with different issues and for a healthy transition into adulthood.
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Affiliation(s)
- U Harikrishnan
- Department of Social Work, School of Social Sciences, Mizoram University, Aizawl, Mizoram, India
| | - Grace Lalhlupuii Sailo
- Department of Social Work, School of Social Sciences, Mizoram University, Aizawl, Mizoram, India
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Ahn B, Joung YS, Kwon JY, Lee DI, Oh S, Kim BU, Cha JY, Kim JH, Lee JY, Shin HY, Seo YS. Effects of equine-assisted activities on attention and quality of life in children with cerebral palsy in a randomized trial: examining the comorbidity with attention-deficit/hyperactivity disorder. BMC Pediatr 2021; 21:135. [PMID: 33740922 PMCID: PMC7976699 DOI: 10.1186/s12887-021-02597-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background Attention problems and decreased quality of life are frequently accompanied in Cerebral Palsy (CP), which can negatively affect rehabilitation of physical disability. However, the majority of affected children remain untreated in the aspects of attention or psychosocial factors. Equine-Assisted Activities and Therapies (EAAT) use horse as a therapeutic modality including grooming as well as mounted riding activities in which patients exercise and experience mounted stimulation. It is known to help improve attention in children with ADHD, so that it can be an exercise therapy that is expected to improvement of attention as well as rehabilitating effects in CP patients. EAA may be a promising strategy to address the unmet need for CP patients. This study aims to investigate the efficacy of EAA for children with CP, those with both CP and ADHD and confirm the comorbidity between CP and ADHD. Methods Forty-six children with cerebral palsy participated in this study. For the exercise group, they participated in a 40-min session twice a week for a 16-week period, while the control group engaged in daily life without any special treatments. Each children individually were assessed on attention and psychological wellbeing at baseline and post-treatment. Comorbidity were identified based on the Diagnostic and Statistical Manual of Mental Disorder 5th edition (DSM-5) and confirmed by Korean Kiddie-Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Results Perseveration rated using the Conner’s Performance Test (CPT) showed a significant decrease only in the exercise group (p < .024). However, no significant improvement in children’s quality of life was observed after EAA program compared with control group. Among the total participants, fifteen children (31.91%) were diagnosed with ADHD. When conducting an additional analysis with the subsample of CP patients diagnosed with ADHD, the d’, commission error and perseveration showed a significant decrease only in the exercise group. Children with CP and ADHD reported an improvement in quality of life both in exercise and control group, but only in the exercise group social functioning exhibited a significant difference. Conclusion The positive effects of the EAA on attention and quality of life were confirmed. Children with CP in the exercise group were more capable to sustain their attention longer. Those with CP and ADHD showed an increase in attention and perceived to have better social skills after receiving 16 weeks of EAA compared to those in the control group. Considering high comorbidity of CP and ADHD, it seems that the EAA program could be the better alternative treatment for CP with attentional problem. The results of this study will contribute to growing evidence for the efficacy of EAA in children especially with CP and ADHD. Trial registration This trial was registered on ClinicalTrials.gov (NCT03870893). Registered 26 July 2017.
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Affiliation(s)
- Bomi Ahn
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Yoo-Sook Joung
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Jeong-Yi Kwon
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Ik Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Soohwan Oh
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Byoung-Uk Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Jung Yoon Cha
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Ji-Hae Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 115 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Ji Young Lee
- Samsung Equestrian Team, Bugok dong, Gunposi, Gyeonggido, Republic of Korea
| | - Hye Yeon Shin
- Samsung Equestrian Team, Bugok dong, Gunposi, Gyeonggido, Republic of Korea
| | - Yun Sik Seo
- Samsung Equestrian Team, Bugok dong, Gunposi, Gyeonggido, Republic of Korea
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Stanford CE, Hastings RP, Riby DM, Archer HJ, Page SE, Cebula K. Psychological distress and positive gain in mothers of children with autism, with or without other children with neurodevelopmental disorders. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:479-484. [PMID: 35937166 PMCID: PMC9351565 DOI: 10.1080/20473869.2020.1812347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 06/15/2023]
Abstract
Although a wealth of literature has focused on the parenting experiences of mothers of children with autism spectrum disorder (ASD), there is a lack of research about mothers who are parenting a child with ASD, and who have other children with neurodevelopmental disorders. In this matched-comparison study, 10 mothers of a child with ASD and other typically developing children (ASD-TD) were compared to 10 mothers of a child with ASD who also had other children with neurodevelopmental disorders (ASD-NDD). Mothers completed self-report measures of mental health and positive gain. Results indicated no significant between-group differences for mental health, although mothers in the ASD-NDD group reported increased positive gain compared to mothers in the ASD-TD group. Further research is needed to understand practical support needs and theory development.
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Affiliation(s)
- Catherine E. Stanford
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | | | - Heather J. Archer
- Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sarah E. Page
- County Durham and Darlington NHS Foundation Trust, Darlington, UK
| | - Katie Cebula
- Institute for Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
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6
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Deshmukh P, Patel D. Mindfulness and ADHD (Attention Deficit Hyperactivity Disorder) in Adolescents. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00197-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Chen H, Song Y, Li X. Use of deep learning to detect personalized spatial-frequency abnormalities in EEGs of children with ADHD. J Neural Eng 2019; 16:066046. [DOI: 10.1088/1741-2552/ab3a0a] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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8
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Chen H, Song Y, Li X. A deep learning framework for identifying children with ADHD using an EEG-based brain network. Neurocomputing 2019. [DOI: 10.1016/j.neucom.2019.04.058] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Huang X, Zhang Q, Gu X, Hou Y, Wang M, Chen X, Wu J. LPHN3 gene variations and susceptibility to ADHD in Chinese Han population: a two-stage case-control association study and gene-environment interactions. Eur Child Adolesc Psychiatry 2019; 28:861-873. [PMID: 30406846 DOI: 10.1007/s00787-018-1251-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/31/2018] [Indexed: 12/18/2022]
Abstract
Polymorphisms in latrophilin 3 (LPHN3) were recently reported to be associated with attention-deficit/hyperactivity disorder (ADHD), and subsequently other researchers tried to replicate the findings in different populations. This study was aimed to confirm the role of the LPHN3 in ADHD and explore the potential interactions with environmental risk factors in Chinese Han population. We examined the association of LPHN3 with ADHD in a population of 473 ADHD children and 585 controls. As a supplement of ADHD diagnosis, Conners Parent Symptom Questionnaire (PSQ) was used to evaluate ADHD symptoms. Blood lead levels (BLLs) were measured by atomic absorption spectrophotometry and other potential environmental risk factors were determined via a questionnaire filled out by the parents. Finally, after validation in an independent sample (284 cases and 390 controls), we observed significant associations between LPHN3 variants rs1868790 and ADHD risk in combined stage within codominant model [TA/AA: OR (95% CI) = 1.636 (1.325-2.021)], dominant model [OR (95% CI) = 1.573 (1.288-1.922)], and additive model [OR (95% CI) = 1.535 (1.266-1.862)]. Furthermore, rs1868790 significantly interacted with BLLs and maternal stress to modify ADHD susceptibility (P < 0.05), and rs1868790 was found to be related with ADHD symptoms (P < 0.05). Expression quantitative trait loci analysis further indicated that rs1868790 took part in the regulation of LPHN3 gene expression. As the first study to comprehensively explore the role of LPHN3 in ADHD in Chinese children, our research suggests that LPHN3 gene has a significant effect on the ADHD in a Chinese population.
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Affiliation(s)
- Xin Huang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qi Zhang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xue Gu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Yuwei Hou
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Min Wang
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xinzhen Chen
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China.,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jing Wu
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13, Hangkong Road, Wuhan, 430030, People's Republic of China. .,Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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Chen H, Chen W, Song Y, Sun L, Li X. EEG characteristics of children with attention-deficit/hyperactivity disorder. Neuroscience 2019; 406:444-456. [PMID: 30926547 DOI: 10.1016/j.neuroscience.2019.03.048] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/26/2019] [Accepted: 03/20/2019] [Indexed: 11/18/2022]
Abstract
The electroencephalogram (EEG) is an informative neuroimaging tool for studying attention-deficit/hyperactivity disorder (ADHD); one main goal is to characterize the EEG of children with ADHD. In this study, we employed the power spectrum, complexity and bicoherence, biomarker candidates for identifying ADHD children in a machine learning approach, to characterize resting-state EEG (rsEEG). We built support vector machine classifiers using a single type of feature, all features from a method (relative spectral power, spectral power ratio, complexity or bicoherence), or all features from all four methods. We evaluated effectiveness and performance of the classifiers using the permutation test and the area under the receiver operating characteristic curve (AUC). We analyzed the rsEEG from 50 ADHD children and 58 age-matched controls. The results show that though spectral features can be used to build a convincing model, the prediction accuracy of the model was unfortunately unstable. Bicoherence features had significant between-group differences, but classifier performance was sensitive to brain region used. rsEEG complexity of ADHD children was significantly lower than controls and may be a suitable biomarker candidate. Through a machine learning approach, 14 features from various brain regions using different methods were selected; the classifier based on these features had an AUC of 0.9158 and an accuracy of 84.59%. These findings strongly suggest that the combination of rsEEG characteristics obtained by various methods may be a tool for identifying ADHD.
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Affiliation(s)
- He Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Wenqing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Yan Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Li Sun
- Peking University Sixth Hospital / Institute of Mental Health, Key Laboratory of Ministry of Health (Peking University), Beijing 100191, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
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Wei HT, Pan TL, Hsu JW, Huang KL, Bai YM, Ko NY, Su TP, Li CT, Tsai SJ, Lin WC, Chen TJ, Chen MH. Risks of bipolar disorder, depressive disorder, and traumatic brain injury among siblings of patients with attention-deficit hyperactivity disorder. J Affect Disord 2019; 245:335-339. [PMID: 30419534 DOI: 10.1016/j.jad.2018.11.057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/06/2018] [Accepted: 11/03/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies have suggested that the unaffected siblings of patients with attention-deficit hyperactivity disorder (ADHD) experience deficits in attention, impulsivity control, and behavior inhibition, which are associated with health-risk behaviors. However, risks to mental and physical health among the unaffected siblings of ADHD probands have rarely been investigated. METHODS Using the Taiwan National Health Insurance Research Database, 5128 unaffected siblings of ADHD probands born between 1980 and 2000 were included in our study along with 20,512 age- and sex-matched controls, and they were followed from 1996 or birth until the end of 2011. Mental and physical health risks, including affective disorders, traumatic brain injury (TBI), and sexually transmitted infection were identified during the follow-up period. RESULTS Logistic regression analyses with adjustments for demographic data showed that the unaffected siblings were more likely to develop unipolar depression (odds ratio [OR]: 1.76, 95% confidence interval [CI]: 1.39-2.22), bipolar disorder (OR: 2.10, 95% CI: 1. 09-4.05), and TBI (OR: 1.24, 95% CI: 1.14-1.36) than were the control group. DISCUSSION The unaffected siblings of patients with ADHD were prone to developing unipolar depression, bipolar disorder, and TBI later in life.
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Affiliation(s)
- Han-Ting Wei
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Kunming Branch, Taipei City Hospital, Taipei, Taiwan; Branch of Linsen, Chinese Medicine and Kunming, Taipei City Hospital, Taipei, Taiwan
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Research Center for Food and Cosmetic Safety, Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University and Hospital, Tainan, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Riesgo de trastorno por déficit de atención e hiperactividad y otros trastornos psiquiátricos de los hermanos de pacientes con TDAH. ACTA ACUST UNITED AC 2019; 48:44-49. [DOI: 10.1016/j.rcp.2017.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/25/2017] [Accepted: 06/05/2017] [Indexed: 01/12/2023]
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13
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Uchida M, Fitzgerald M, Woodworth H, Carrellas N, Kelberman C, Biederman J. Subsyndromal Manifestations of Depression in Children Predict the Development of Major Depression. J Pediatr 2018; 201:252-258.e1. [PMID: 30007773 PMCID: PMC6153024 DOI: 10.1016/j.jpeds.2018.05.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/30/2018] [Accepted: 05/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the utility of assessing subsyndromal symptoms of major depressive disorder in childhood, indexed through the Child Behavior Checklist (CBCL) anxiety/depression scale, in predicting risk of developing major depressive disorder in adolescent and young adult years. STUDY DESIGN The sample consisted of 537 children, 6-17 years of age, originally ascertained for a longitudinal family genetic study of youth with and without attention-deficit hyperactivity disorder and their first-degree relatives who were followed prospectively and blindly for 10 years from childhood into young adult years. Children with full diagnosis major depressive disorder at baseline were excluded. For analysis, the sample was stratified into 4 groups based on the presence or absence of parental mood disorders and by the presence or absence of subsyndromal scores on the CBCL anxiety/depression scale at baseline assessment in childhood. RESULTS Children of parents with mood disorders plus subsyndromal scores on the CBCL anxiety/depression scale at baseline (n = 22) had the highest risk for developing major depressive disorder and anxiety disorders at the 10-year follow-up when compared with the other groups. Children with either subsyndromal scores on the CBCL anxiety/depression scale at baseline alone (n = 22) or parental mood disorders alone (n = 172) had intermediate outcomes. CONCLUSION The CBCL anxiety/depression scale was useful in identifying children at high risk for the development of major depressive disorder and anxiety disorders at the 10-year prospective follow-up. Furthermore, our results emphasized the importance of familial psychiatric history in youth with subthreshold symptoms of depression. Parental mood disorder and subthreshold anxiety/depressive symptoms were predictive of developing depression.
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Affiliation(s)
- Mai Uchida
- Department of Psychiatry, Clinical and Research Programs in Pediatric Psychopharmacology and Adult Attention-Deficit Hyperactivity Disorder, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
| | - Maura Fitzgerald
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Hilary Woodworth
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Nicholas Carrellas
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Caroline Kelberman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA
| | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
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Niarchou M, Calkins ME, Moore TM, Tang SX, McDonald-McGinn DM, Zackai EH, Emanuel BS, Gur RC, Gur RE. Attention Deficit Hyperactivity Disorder Symptoms and Psychosis in 22q11.2 Deletion Syndrome. Schizophr Bull 2018; 44:824-833. [PMID: 29040797 PMCID: PMC6007411 DOI: 10.1093/schbul/sbx113] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE 22q11.2 Deletion Syndrome (22q11.2DS) is associated with increased risk for schizophrenia in adulthood while Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent diagnosis in childhood. Inattention symptoms are pronounced in 22q11.2DS and given that attentional impairment is a core feature of schizophrenia, inattention symptoms may reflect underlying ADHD, psychosis, or both. We investigate whether inattention is associated with psychosis in 22q11.2DS and in other groups at risk for psychosis but without the deletion (ND) (idiopathic clinical risk and first degree family members of individuals with schizophrenia). METHODS One hundred thirty-seven individuals with 22q11.2DS (mean age: 14.0), 84 ND individuals with subthreshold psychosis (mean age: 16.9) and 31 ND individuals with family history of psychosis (mean age: 17.0) were included in the study. Psychopathology was assessed using research diagnostic assessments. RESULTS ADHD total symptoms were associated with overall levels of subthreshold psychosis symptoms in 22q11.2DS (β = .8, P = .04). Inattention symptoms were specifically associated with positive (β = .5, P = .004), negative (β = .5, P = .03), and disorganized (β = .5, P < .001) symptoms, while hyperactivity-impulsivity symptoms were associated with disorganized symptoms (β = .5, P = .01). The prevalence of ADHD inattention symptoms was higher in 22q11.2DS with subthreshold psychosis compared to ND individuals with subthreshold psychosis (P < .001), even when adjusting for cognitive impairment and overall psychopathology. The pattern was similar when comparing individuals with 22q11.2DS and ND individuals with family history of psychosis. CONCLUSIONS This is the first study to examine the associations between ADHD symptoms and psychosis in 22q11.2DS. Our findings support a potentially important role of ADHD inattention symptoms in psychosis in 22q11.2DS.
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Affiliation(s)
- Maria Niarchou
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK,Institute of Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Monica E Calkins
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tyler M Moore
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sunny X Tang
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Donna M McDonald-McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Elaine H Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Beverly S Emanuel
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ruben C Gur
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Raquel E Gur
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA,Department of Child and Adolescent Psychiatry, The Children’s Hospital of Philadelphia, Philadelphia, PA,To whom correspondence should be addressed; Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, 10th Floor Gates Building, 3400 Spruce Street, Philadelphia, PA 19104, US; tel: +12156622915, fax: +12156627903, e-mail:
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Shivers CM, Dykens EM. Adolescent Siblings of Individuals With and Without Intellectual and Developmental Disabilities: Self-Reported Empathy and Feelings About Their Brothers and Sisters. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:62-77. [PMID: 28095054 DOI: 10.1352/1944-7558-122.1.62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Siblings of brothers or sisters with intellectual and developmental disabilities (IDD) are important but understudied family members. As many previous studies have relied on parent report of sibling outcomes, the use of sibling self-report is an important addition to the research. This study assessed the feelings of adolescent siblings toward their brothers or sisters with and without IDD, as well as broader aspects of sibling empathy. Data were collected via a national, online survey from 97 parent-sibling pairs. Siblings of individuals with IDD reported higher levels of anxiety toward the target child than did siblings of typically developing individuals. Sibling feelings toward the target child were related to both parental and target child factors, but only among families of individuals with IDD.
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Affiliation(s)
- Carolyn M Shivers
- Carolyn M. Shivers, Virginia Tech; and Elisabeth M. Dykens, Vanderbilt University
| | - Elisabeth M Dykens
- Carolyn M. Shivers, Virginia Tech; and Elisabeth M. Dykens, Vanderbilt University
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16
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Fridman M, Banaschewski T, Sikirica V, Quintero J, Erder MH, Chen KS. Factors associated with caregiver burden among pharmacotherapy-treated children/adolescents with ADHD in the Caregiver Perspective on Pediatric ADHD survey in Europe. Neuropsychiatr Dis Treat 2017; 13:373-386. [PMID: 28223810 PMCID: PMC5308565 DOI: 10.2147/ndt.s121391] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Burden on caregivers of children/adolescents with attention-deficit/hyperactivity disorder (ADHD) is multidimensional, but incompletely understood. OBJECTIVE To analyze caregiver burden across the concepts of work, social/family life, and parental worry/stress, in relation to selected contributing factors. METHODS The online Caregiver Perspective on Pediatric ADHD survey was fielded in ten European countries. Analysis included children/adolescents (6-17 years) who were receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers recorded their child's/adolescent's symptoms "on"/"off" medication (ie, when the caregiver reported that the child/adolescent forgot/chose not to take medication, before the onset of medication effect, or medication worn off). Effects of ADHD severity, comorbidities, and medication adherence on each burden outcome were assessed (multiple regression models). RESULTS In total, 2,326 caregivers were included (children/adolescents' mean age: 11.5 years, 80% male). Caregivers reported missed/altered work, avoiding social activity, increased parental worry/stress, and strain on family life, despite using ADHD pharmacotherapy. Child/adolescent comorbidities and ADHD severity were significantly related to all burden concepts measured; the strongest comorbidity associations were with altered work (odds ratios [ORs] =1.68 [95% confidence interval {CI} 1.33, 2.12], 1.87 [1.37, 2.54], 3.47 [2.51, 4.78] for 1, 2, 3+ comorbidities, respectively) and planning the day around the child/adolescent (OR =1.42 [95% CI 1.17, 1.72], 1.73 [1.33, 2.15], 2.65 [1.99, 3.53]); the strongest severity associations were: quitting a job (OR =1.41 [95% CI 1.26, 1.59]) and planning a day around the child/adolescent (OR =1.26 [95% CI 1.20, 1.32]). Increased medication adherence was most associated with reducing the caregiver burden for altered work (OR =0.57 [95% CI 0.45, 0.72]), worrying about how they are being perceived as a parent (OR =0.68 [0.56, 0.83]), and avoiding social activity (OR =0.56 [0.45, 0.68]), but not family or stress burden. CONCLUSION Burdens related to work, social activity, family life, and parental worry/stress were experienced by the caregivers of children/adolescents with ADHD, despite using ADHD pharmacotherapy. Better understanding of clinical/treatment characteristics most associated with the components of caregiver burden may help improve ADHD management and may ease caregiver burden.
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Affiliation(s)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Vanja Sikirica
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Javier Quintero
- Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - M Haim Erder
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Kristina S Chen
- Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA
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Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review. J Adolesc Health 2016; 59:135-43. [PMID: 27209327 PMCID: PMC5576000 DOI: 10.1016/j.jadohealth.2016.03.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 03/20/2016] [Accepted: 03/21/2016] [Indexed: 12/17/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school-age children. This review is intended to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents. PubMed, PsychInfo, and Science Citation Index databases were searched from March 1990 to 2015 with the keywords: ADHD, primary care/pediatrics, and children/adolescents. Abstracts addressing diagnosis and/or treatment with 105 citations were identified including supplementary treatment guidelines/books. Adolescent ADHD presents with significant disturbances in attention, academic performance, and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis, and limited training and time for PCPs to conduct thorough evaluations. The evidence base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification, and treatment of conditions associated with ADHD that emerge during adolescence such as substance use disorders. Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care psychiatric models, to assist in determining the optimal care for patients at this critical period.
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Ma N, Furber G, Roberts R, Winefield H. Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems. J Ment Health 2015; 25:165-8. [PMID: 26617080 DOI: 10.3109/09638237.2015.1101413] [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: 11/13/2022]
Abstract
BACKGROUND Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). AIMS The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). METHODS Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. RESULTS The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). CONCLUSIONS The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.
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Affiliation(s)
- Nylanda Ma
- a School of Psychology, University of Adelaide , Adelaide , South Australia , Australia and
| | - Gareth Furber
- b Health Economics and Social Policy Group, University of South Australia, City East Campus , Adelaide , South Australia , Australia
| | - Rachel Roberts
- a School of Psychology, University of Adelaide , Adelaide , South Australia , Australia and
| | - Helen Winefield
- a School of Psychology, University of Adelaide , Adelaide , South Australia , Australia and
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Pastura G, Doering T, Gasparetto EL, Mattos P, Araújo AP. Exploratory analysis of diffusion tensor imaging in children with attention deficit hyperactivity disorder: evidence of abnormal white matter structure. ACTA ACUST UNITED AC 2015; 8:65-71. [DOI: 10.1007/s12402-015-0185-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 11/05/2015] [Indexed: 11/28/2022]
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20
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Shyu YC, Yuan SS, Lee SY, Yang CJ, Yang KC, Lee TL, Wang LJ. Attention-deficit/hyperactivity disorder, methylphenidate use and the risk of developing schizophrenia spectrum disorders: A nationwide population-based study in Taiwan. Schizophr Res 2015; 168:161-7. [PMID: 26363968 DOI: 10.1016/j.schres.2015.08.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/18/2022]
Abstract
This study estimated the risk of developing psychotic disorders by comparing children with ADHD to non-ADHD controls, and to examine whether methylphenidate (MPH) treatment influences the risks of psychotic disorders. A nationwide cohort of patients who were newly diagnosed with ADHD (n=73,049) and age- and gender-matched controls (n=73,049) were selected from Taiwan's National Health Insurance database from January 2000 to December 2011. All participants were observed until December 31, 2011. Cox regression models were used to estimate the effects of ADHD diagnosis and MPH use on subsequent outcomes. Having a diagnosis of any psychotic disorder and of schizophrenia were set as two different outcomes and were analyzed separately. Compared to the control group, the ADHD group showed significantly increased risk of developing any psychotic disorder (adjusted hazard ratio [aHR], 5.20; 95% confidence interval [CI], 4.30-6.30) and schizophrenia (aHR, 4.65; 95% CI, 3.59-6.04). Compared to ADHD patients without psychosis, patients with ADHD who developed psychosis had significantly older age at first diagnosis of ADHD (9.4±3.3years vs. 10.6±4.0years). Among patients with ADHD, MPH use significantly increased the risk of developing any psychotic disorder (aHR, 1.20; 95% CI, 1.04-1.40), but did not increase the risk of developing schizophrenia (aHR, 1.16; 95% CI, 0.94-1.42). The results indicated that previous diagnoses of ADHD are a powerful indicator of developing psychotic disorders. Nevertheless, the specific mechanisms of the relationships between ADHD, MPH use and psychotic disorders need further elucidation in future clinical studies.
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Affiliation(s)
- Yu-Chiau Shyu
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Institute of Molecular Biology, Academia Sinica, Nankang, Taipei, Taiwan
| | - Shin-Sheng Yuan
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Ju Yang
- Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Kang-Chung Yang
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Tung-Liang Lee
- Department of Experimental Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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21
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Wade M, Prime H, Madigan S. Using Sibling Designs to Understand Neurodevelopmental Disorders: From Genes and Environments to Prevention Programming. BIOMED RESEARCH INTERNATIONAL 2015; 2015:672784. [PMID: 26258141 PMCID: PMC4518166 DOI: 10.1155/2015/672784] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/05/2015] [Accepted: 06/28/2015] [Indexed: 01/30/2023]
Abstract
Neurodevelopmental disorders represent a broad class of childhood neurological conditions that have a significant bearing on the wellbeing of children, families, and communities. In this review, we draw on evidence from two common and widely studied neurodevelopmental disorders-autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD)-to demonstrate the utility of genetically informed sibling designs in uncovering the nature and pathogenesis of these conditions. Specifically, we examine how twin, recurrence risk, and infant prospective tracking studies have contributed to our understanding of genetic and environmental liabilities towards neurodevelopmental morbidity through their impact on neurocognitive processes and structural/functional neuroanatomy. It is suggested that the siblings of children with ASD and ADHD are at risk not only of clinically elevated problems in these areas, but also of subthreshold symptoms and/or subtle impairments in various neurocognitive skills and other domains of psychosocial health. Finally, we close with a discussion on the practical relevance of sibling designs and how these might be used in the service of early screening, prevention, and intervention efforts that aim to alleviate the negative downstream consequences associated with disorders of neurodevelopment.
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Affiliation(s)
- Mark Wade
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street W., Toronto, ON, Canada M5S 1V6
| | - Heather Prime
- Department of Applied Psychology and Human Development, University of Toronto, 252 Bloor Street W., Toronto, ON, Canada M5S 1V6
| | - Sheri Madigan
- Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4
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Jang B, Song J, Kim J, Kim S, Lee J, Shin HY, Kwon JY, Kim YH, Joung YS. Equine-Assisted Activities and Therapy for Treating Children with Attention-Deficit/Hyperactivity Disorder. J Altern Complement Med 2015; 21:546-53. [PMID: 26167851 DOI: 10.1089/acm.2015.0067] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate clinical effects of equine-assisted activities and therapy (EAA/T) for treating attention-deficit/hyperactivity disorder (ADHD) in children age 6-13 years. METHODS This 12-week, prospective, open-label trial included 24 sessions of EAA/T. Twenty participants (19 boys and 1 girl) completed 12 weeks of EAA/T. Various clinical tests were administered at baseline and after EAA/T. Assessments included the investigator-administered ADHD-Rating Scale (ARS-I), Clinical Global Impressions (CGI)-Severity Scale, Clinical Global Impressions-Improvement Scale (CGI-I), Gordon Diagnostic System, Korea-Child Behavior Checklist (K-CBCL), Self-Esteem Scale, second edition of the Bruininks-Oseretsky test of motor proficiency (BOT-2), and quantitative electroencephalography. The primary efficacy measure was the response rate. RESULTS The response rate was 90% based on a 30% or greater decline in the ARS-I score or 85% based on CGI-I scores of 1 or 2. The mean±standard deviation ARS-I score decreased from 33.65±6.42 at baseline to 16.80±6.86 after 12 weeks of EAA/T (p<0.001, paired t-test). EAA/T also resulted in significant improvement in the social problems subscale of the K-CBCL and in the manual dexterity, bilateral coordination, and total motor composite subscales of the BOT-2. The theta/beta ratio on electroencephalography was decreased significantly at the Pz electrode after 12 weeks of EAA/T. CONCLUSION This is the first study demonstrating that EAA/T is effective for improving core ADHD symptoms. On the basis of these results, EAA/T could be a viable treatment strategy as a part of a multimodal therapy for children with ADHD.
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Affiliation(s)
| | - Jihye Song
- 1 Hae-sol Psychiatric Clinic , Seoul, Korea
| | - Jiwon Kim
- 2 Samsung Biomedical Research Institute , Seoul, Korea
| | - Seonwoo Kim
- 2 Samsung Biomedical Research Institute , Seoul, Korea
| | - Jiyoung Lee
- 3 Samsung RD Center , Samsung Equestrian Team, Gunpo-si, Gyeonggi-do, Korea
| | - Hye-Yeon Shin
- 3 Samsung RD Center , Samsung Equestrian Team, Gunpo-si, Gyeonggi-do, Korea
| | - Jeong-Yi Kwon
- 4 Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Yun-Hee Kim
- 4 Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
| | - Yoo-Sook Joung
- 5 Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Korea
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Ma N, Roberts R, Winefield H, Furber G. The prevalence of psychopathology in siblings of children with mental health problems: a 20-year systematic review. Child Psychiatry Hum Dev 2015; 46:130-49. [PMID: 24652033 DOI: 10.1007/s10578-014-0459-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
While the importance of looking at the entire family system in the context of child and adolescent mental health is well recognised, siblings of children with mental health problems (MHPs) are often overlooked. The existing literature on the mental health of these siblings needs to be reviewed. A systematic search located publications from 1990 to 2011 in four electronic databases. Thirty-nine relevant studies reported data on the prevalence of psychopathology in siblings of target children with MHPs. Siblings of target children had higher rates of at least one type of psychopathology than comparison children. Risk of psychopathology varied across the type of MHP in the target child. Other covariates included sibling age and gender and parental psychopathology. Significant variations and limitations in methodology were found in the existing literature. Methodological guidelines for future studies are outlined. Implications for clinicians, parents, and for future research are discussed.
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Affiliation(s)
- Nylanda Ma
- School of Psychology, University of Adelaide, North Tce, Adelaide, SA, 5005, Australia,
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Child impact on family functioning: a multivariate analysis in multiplex families with children and mothers both affected by attention-deficit/hyperactivity disorder (ADHD). ACTA ACUST UNITED AC 2015; 7:211-23. [PMID: 25588606 DOI: 10.1007/s12402-014-0164-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Abstract
ADHD seriously impacts family functioning, even the more in families with simultaneous parental and child ADHD. The aim of the study was to examine associations between family impact of child ADHD and child, mother and family characteristics in multiplex families with children and mothers both affected by ADHD. One hundred and forty-four mother-child pairs were assessed (children: mean age 9.4 ± 1.7 years, 73.6 % male). Family impact of child ADHD was rated by mothers using the Family Impact Questionnaire (FIQ). Multiple linear regression analyses were performed with child and maternal psychopathology and basic family characteristics such as employment, partnership status and number of children as predictors and FIQ subscores as criteria. Rates of variance explained by family variables were 49 % for negative feelings towards the child, 37 % for impact on partnership, 31 % for impact on social life and 27 % for impact on finances (p < .001, respectively). Pearson correlations with family impact were especially strong for child externalizing symptoms, maternal ADHD and co-morbid symptoms of the mother. The strongest independent predictor was oppositional defiant child behaviour. In ADHD multiplex families, mothers' perception of the impact of an ADHD child on its family can be explained to a substantial degree by child psychopathology, maternal psychopathology and basic family characteristics. Although a cross-sectional design does not allow for causal interpretations, the findings of this study offer important targets for the treatment of ADHD in a family context pointing to the need for assessing and treating parental mental health and co-morbid symptoms besides ADHD core symptoms.
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Narkunam N, Hashim AH, Sachdev MK, Pillai SK, Ng CG. Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience. Asia Pac Psychiatry 2014; 6:207-16. [PMID: 23857633 DOI: 10.1111/j.1758-5872.2012.00216.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 06/13/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a chronic debilitating illness with onset in early childhood. The objective of this study was to look at the impact of children with ADHD on their parents. METHODS All parents with children diagnosed as having ADHD attending the Psychiatry Adolescent and Child Unit, University Malaya were included in this study. Their parenting stress was assessed using the Parent Stress Index. RESULTS A total of 95 parents participated in the study. The proportion of parents who reported significant stress in this study was much higher than in most studies (n = 69, 73%). Significant correlation was found between the severity of the child's disorder (Children's Global Assessment Scale [CGAS] score) and the parents' stress level (OR 0.16, 95% CI 0.05-0.51). Mothers were significantly more stressed than fathers (OR 0.16, 95% CI 0.05-0.51) and non-Malay parents more stressed than the Malay parents (OR 3.92, 95% CI 1.29-11.94). Parents with children older than 12 years of age were six times more stressed than parents with children younger than 12 years old (OR 6.47, 95% CI 1.55-27.01). Stressed parents acknowledged that having a child with ADHD was their biggest worry. DISCUSSION Stress has marked consequences on any person and has important bearings on their mental health. Stress among parents needs be looked into when treating children with ADHD.
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Affiliation(s)
- Neelaveni Narkunam
- Department of Psychiatry and Mental Health, Selayang Hospital, Selangor, Malaysia
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Langberg JM, Froehlich TE, Loren REA, Martin JE, Epstein JN. Assessing children with ADHD in primary care settings. Expert Rev Neurother 2014; 8:627-41. [DOI: 10.1586/14737175.8.4.627] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Lee HJ, Park J, Kim HW. Clinical Characteristics and Neuropsychological Profiles of the Children with ADHD and Their Siblings. Soa Chongsonyon Chongsin Uihak 2013. [DOI: 10.5765/jkacap.2013.24.4.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Dalsgaard S, Mortensen PB, Frydenberg M, Maibing CM, Nordentoft M, Thomsen PH. Association between Attention-Deficit Hyperactivity Disorder in childhood and schizophrenia later in adulthood. Eur Psychiatry 2013; 29:259-63. [PMID: 24016863 DOI: 10.1016/j.eurpsy.2013.06.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/11/2013] [Accepted: 06/18/2013] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To estimate the risk of schizophrenia in adulthood among children and adolescents with ADHD compared to the background population. SUBJECTS/MATERIALS AND METHODS Two hundred and eight youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of schizophrenia were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of schizophrenia for cases with ADHD, compared to the normal population, was calculated as risk ratios. Hazard ratios (HR's) by Cox regression were calculated in the predictor analyses. RESULTS Mean age for ADHD cases at follow-up was 31.1years. Schizophrenia diagnoses were given to 3.8% of these cases. Compared to the general population, RR of schizophrenia in cases with ADHD was 4.3 (95% CI 1.9-8.57). DISCUSSION AND CONCLUSION This prospective follow-up study found children with ADHD to be at higher risk of later schizophrenia than controls. If replicated, these results warrant increased focus on the possible emergence symptoms of schizophrenia or schizophreniform psychosis during clinical follow-up of patients with ADHD.
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Affiliation(s)
- S Dalsgaard
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark; Department for Child and Adolescent Psychiatry, Hospital of Telemark, Kragerø, Norway; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark.
| | - P B Mortensen
- National Centre for Register-based Research, Department of Economics and Business, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - M Frydenberg
- Section of Biostatistics, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - C M Maibing
- Psychiatric Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - M Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark; Psychiatric Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - P H Thomsen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
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Arcos-Burgos M, Londoño AC, Pineda DA, Lopera F, Palacio JD, Arbelaez A, Acosta MT, Vélez JI, Castellanos FX, Muenke M. Analysis of brain metabolism by proton magnetic resonance spectroscopy (1H-MRS) in attention-deficit/hyperactivity disorder suggests a generalized differential ontogenic pattern from controls. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2012; 4:205-12. [PMID: 23012086 PMCID: PMC3508358 DOI: 10.1007/s12402-012-0088-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 07/02/2012] [Indexed: 12/27/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder of childhood. Preliminary studies with proton magnetic resonance spectroscopy ((1)H-MRS) of the brain have reported differences in brain metabolite concentration-to-Cr ratios between individuals with ADHD and unaffected controls in several frontal brain regions including anterior cingulate cortex. Using multivoxel (1)H-MRS, we compared 14 individuals affected with ADHD to 20 individuals without ADHD from the same genetic isolate. After controlling by sex, age, and multiple testing, we found significant differences at the right posterior cingulate of the Glx/Cr ratio density distribution function between ADHD cases and controls (P < 0.05). Furthermore, we found several interactions of metabolite concentration-to-Cr ratio, age, and ADHD status: Ins/Cr and Glx/Cr ratios at the left posterior cingulate, and NAA/Cr at the splenius, right posterior cingulate, and at the left posterior cingulate. We also found a differential metabolite ratio interaction between ADHD cases and controls for Ins/Cr and NAA/Cr at the right striatum. These results show that: (1) NAA/Cr, Glx/Cr, and Ins/Cr ratios, as reported in other studies, exhibit significant differences between ADHD cases and controls; (2) differences of these metabolite ratios between ADHD cases and controls evolve in specific and recognizable patterns throughout age, a finding that replicates previous results obtained by structural MRI, where is demonstrated that brain ontogeny follows a different program in ADHD cases and controls; (3) Ins/Cr and NAA/Cr ratios, at the right striatum, interact in a differential way between ADHD cases and controls. As a whole, these results replicate previous 1H-MRS findings and add new intriguing differential metabolic and ontogeny patterns between ADHD cases and controls that warrant further pursue.
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Affiliation(s)
- Mauricio Arcos-Burgos
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
- John Curtin School of Medical Research, The Australian National University, Canberra ACT, Australia
| | - Ana C. Londoño
- Neurosciences Group, University of Antioquia, Medellín, Colombia
- Neurological Institute of Antioquia, Medellín, Colombia
| | - David A. Pineda
- Neurosciences Group, University of Antioquia, Medellín, Colombia
| | - Francisco Lopera
- Neurosciences Group, University of Antioquia, Medellín, Colombia
| | | | - Andres Arbelaez
- Neurosciences Group, University of Antioquia, Medellín, Colombia
| | - Maria T. Acosta
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jorge I. Vélez
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Francisco Xavier Castellanos
- New York University Child Study Center, New York, NY
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
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The behavioural profile of children with attention-deficit/ hyperactivity disorder and of their siblings. Eur Child Adolesc Psychiatry 2012; 21:157-64. [PMID: 22297660 DOI: 10.1007/s00787-012-0249-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 01/19/2012] [Indexed: 10/14/2022]
Abstract
The behavioural profiles in N = 69 index children with attention-deficit/hyperactivity disorder (ADHD),N = 32 siblings with ADHD, N = 35 siblings without ADHD, and N = 36 normal controls were compared by the use of standardized parent and teacher rating scales. The four groups were matched by age and IQ. The behavioural profiles of the two ADHD groups were very similar not only in the behavioural domains of ADHD, but also in scales measuring emotional and conduct problems. Siblings without ADHD shared more similarities with normal controls except for more emotional problems. These general trends were stronger in the parent compared to the teacher ratings. These findings indicate that not only ADHD-related but also other behaviours show a strong family aggregation. The informant differences may reflect context dependent differences in child behaviour and contrast effects particularly in parental ratings.
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Yang LK, Shang CY, Gau SSF. Psychiatric comorbidities in adolescents with attention-deficit hyperactivity disorder and their siblings. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:281-92. [PMID: 21586194 DOI: 10.1177/070674371105600507] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Despite high psychiatric comorbidities in adolescents with clinical diagnosis of attention-deficit hyperactivity disorder (ADHD), little is known about psychiatric comorbidities in their siblings. We investigated the psychiatric comorbid conditions in adolescents with ADHD, their siblings, and healthy control subjects from their school. METHOD The sample included 136 adolescent probands with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria; 136 siblings (47 affected and 89 unaffected) and 136 age- and sex-matched healthy school control subjects. All participants and their parents received the structured psychiatric interviews for current and lifetime DSM-IV psychiatric disorders of the participants. RESULTS The rate of ADHD (34.6%) in the siblings of probands with ADHD was about 7 times higher than in the general population. Probands with ADHD were significantly more likely than unaffected siblings (OR 6.38; 95% CI 3.43 to 11.88) and healthy school control subjects (OR 9.60; 95% CI 5.31 to 17.34) to have a DSM-IV psychiatric disorder, including oppositional defiant disorder (ODD), conduct disorder (CD), tic disorders, major depressive disorder, specific phobia (more than control subjects only), nicotine use disorder, and sleep disorders. The affected siblings were significantly more likely than healthy school control subjects to have ODD, CD, specific phobia, and to have consumed alcohol (ORs ranging from 2.30 to 20.16). CONCLUSIONS Our findings suggest that siblings of probands with ADHD have increased risks for ADHD and that the affected siblings have more psychiatric comorbidities than healthy school control subjects. It warrants early identification of ADHD symptoms and other psychiatric comorbid conditions as well in siblings of adolescents with ADHD.
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Affiliation(s)
- Li-Kuang Yang
- Child and Adolescent Psychiatry Fellow, Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Child and Adolescent Psychiatry Fellow, Department of Psychiatry, Beitou Armed Forces Hospital, Taipei, Taiwan
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Rommelse NN, Geurts HM, Franke B, Buitelaar JK, Hartman CA. A review on cognitive and brain endophenotypes that may be common in autism spectrum disorder and attention-deficit/hyperactivity disorder and facilitate the search for pleiotropic genes. Neurosci Biobehav Rev 2011; 35:1363-96. [DOI: 10.1016/j.neubiorev.2011.02.015] [Citation(s) in RCA: 249] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 02/25/2011] [Accepted: 02/27/2011] [Indexed: 02/01/2023]
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A common variant of the latrophilin 3 gene, LPHN3, confers susceptibility to ADHD and predicts effectiveness of stimulant medication. Mol Psychiatry 2010; 15:1053-66. [PMID: 20157310 DOI: 10.1038/mp.2010.6] [Citation(s) in RCA: 199] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) has a very high heritability (0.8), suggesting that about 80% of phenotypic variance is due to genetic factors. We used the integration of statistical and functional approaches to discover a novel gene that contributes to ADHD. For our statistical approach, we started with a linkage study based on large multigenerational families in a population isolate, followed by fine mapping of targeted regions using a family-based design. Family- and population-based association studies in five samples from disparate regions of the world were used for replication. Brain imaging studies were performed to evaluate gene function. The linkage study discovered a genome region harbored in the Latrophilin 3 gene (LPHN3). In the world-wide samples (total n=6360, with 2627 ADHD cases and 2531 controls) statistical association of LPHN3 and ADHD was confirmed. Functional studies revealed that LPHN3 variants are expressed in key brain regions related to attention and activity, affect metabolism in neural circuits implicated in ADHD, and are associated with response to stimulant medication. Linkage and replicated association of ADHD with a novel non-candidate gene (LPHN3) provide new insights into the genetics, neurobiology, and treatment of ADHD.
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Gau SSF, Shang CY. Executive functions as endophenotypes in ADHD: evidence from the Cambridge Neuropsychological Test Battery (CANTAB). J Child Psychol Psychiatry 2010; 51:838-49. [PMID: 20085608 DOI: 10.1111/j.1469-7610.2010.02215.x] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Little is known about executive functions among unaffected siblings of children with attention deficit/hyperactivity disorder (ADHD), and there is lack of such information from non-Western countries. We examined verbal and nonverbal executive functions in adolescents with ADHD, unaffected siblings and controls to test whether executive functions could be potential endophenotypes for ADHD. METHODS We assessed 279 adolescents (age range: 11-17 years) with a childhood diagnosis of DSM-IV ADHD, 136 biological siblings (108 unaffected, 79.4%), and 173 unaffected controls by using psychiatric interviews, the Wechsler Intelligence Scale for Children - 3rd edition (WISC-III), including digit spans, and the tasks involving executive functions of the Cambridge Neuropsychological Test Automated Battery (CANTAB): Intra-dimensional/Extra-dimensional Shifts (IED), Spatial Span (SSP), Spatial Working Memory (SWM), and Stockings of Cambridge (SOC). RESULTS Compared with the controls, adolescents with ADHD and unaffected siblings had a significantly shorter backward digit span, more extra-dimensional shift errors in the IED, shorter spatial span length in the SSP, more total errors and poorer strategy use in the SWM, and fewer problems solved in the minimum number of moves and shorter initial thinking time in the SOC. The magnitudes of the differences in the SWM and SOC increased with increased task difficulties. In general, neither persistent ADHD nor comorbidity was associated with increased deficits in executive functions among adolescents with ADHD. CONCLUSIONS The lack of much difference in executive dysfunctions between unaffected siblings and ADHD adolescents suggests that executive dysfunctions may be useful cognitive endophenotypes for ADHD genetic studies.
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Affiliation(s)
- Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan.
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Elia J, Vetter VL. Cardiovascular effects of medications for the treatment of attention-deficit hyperactivity disorder: what is known and how should it influence prescribing in children? Paediatr Drugs 2010; 12:165-75. [PMID: 20481646 DOI: 10.2165/11532570-000000000-00000] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The effective medications currently marketed for attention-deficit hyperactivity disorder (ADHD) have central and peripheral catecholaminergic effects that have been shown to result in statistically significant increases in heart rate and blood pressure. The impact of these medications on serious cardiovascular events in healthy children is unknown, but serious cardiovascular events related to ADHD medications are considered rare. However, children with cardiac pathology may be at greater risk given that increased sympathetic tone has been reported as a causal factor in generating ventricular arrhythmias in adults with coronary artery disease, and physical exercise has been consistently reported as a trigger for increased risk of sudden cardiac death in athletes with underlying cardiovascular disease. ADHD has high co-morbidity with anxiety and depression. These conditions in adults have been reported to have their own cardiovascular risks that may be compounded by interactions resulting from combined pharmacotherapeutic treatments; this interaction has not been evaluated in children. High rates of ADHD reported in subjects with cardiac pathology, as well as in patients with genetic disorders associated with cardiovascular pathology, also suggest that the prevalence of cardiac pathology in ADHD subjects may be greater than that in the general population. Currently, the US FDA and Health Canada require warnings on prescription labeling information for ADHD medications, suggesting that these medications should not generally be used in children or adults with 'known' serious cardiac pathology. Family history, medical history, and physical examination have very low sensitivity for identifying serious cardiac pathology, but this can be markedly enhanced in many instances with the use of electrocardiography, which has high specificity and sensitivity. Identifying and managing underlying cardiovascular pathology may not eliminate the risk of serious cardiovascular events but may increase the safety of using medication frequently required for effective management of ADHD. When the very common and serious consequences from untreated ADHD are also considered in the assessment of risks and benefits, even in the presence of cardiac pathology, it seems that the prescribing of ADHD medications in children should remain unchanged.
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Affiliation(s)
- Josephine Elia
- The Children's Hospital of Philadelphia, Science Center, Philadelphia, Pennsylvania 19104, USA.
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Pastura GMC, Mattos P, Araújo APDQC. Academic performance in ADHD when controlled for comorbid learning disorders, family income, and parental education in Brazil. J Atten Disord 2009; 12:469-73. [PMID: 19218543 DOI: 10.1177/1087054708320401] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Scholastic achievement in a nonclinical sample of ADHD children and adolescents was evaluated taking into consideration variables such as comorbid learning disorders, family income, and parental education which may also be associated with poor academic performance. METHOD After screening for ADHD in 396 students, the authors compared academic performance of 26 ADHD individuals and 31 controls paired for gender, age, and intelligence level considering both mathematics and Portuguese language scores. Learning disorders were investigated and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) criteria were met using structured interviews. RESULTS The prevalence of academic underachievement was 2.98 times higher in students with ADHD, the most frequent subtype being predominantly inattentive. Parental educational level, family income, and comorbid learning disorders could not explain the discrepancies between ADHD students and controls. CONCLUSIONS ADHD seems to be associated with poor academic performance even in the absence of comorbid learning disorders, lower family income, and parental educational level.
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Listug-Lunde L, Zevenbergen AA, Petros TV. Psychological symptomatology in siblings of children with ADHD. J Atten Disord 2008; 12:239-47. [PMID: 18460639 DOI: 10.1177/1087054708316253] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Studies utilizing parent-report measures have identified above average levels of internalizing and externalizing problems in siblings of children diagnosed with ADHD. Scant research has examined siblings' self-report on standardized measures of emotional functioning. The current study examined parent-reported and child self-reported symptoms of siblings of children with ADHD compared with a control group. METHOD Measures completed included the Children's Depression Inventory, the Multidimensional Anxiety Scale for Children, the Child Behavior Checklist and the Disruptive Behavior Rating Scale. RESULTS Parent-report measures indicated that siblings of children with ADHD had higher levels of internalizing, hyperactivity, and inattention problems compared with control siblings. Significant differences between groups were not revealed on child self-report measures. CONCLUSIONS Although parent-report measures continue to demonstrate higher levels of symptoms for siblings of children diagnosed with ADHD compared with control siblings, there are no indications that self-reported internalizing symptoms are different.
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Rommelse NNJ, Altink ME, Oosterlaan J, Buschgens CJM, Buitelaar J, Sergeant JA. Support for an independent familial segregation of executive and intelligence endophenotypes in ADHD families. Psychol Med 2008; 38:1595-1606. [PMID: 18261248 DOI: 10.1017/s0033291708002869] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Impairments in executive functioning (EF) and intelligence quotient (IQ) are frequently observed in children with attention deficit hyperactivity disorder (ADHD). The aim of this paper was twofold: first, to examine whether both domains are viable endophenotypic candidates for ADHD and second to investigate whether deficits in both domains tend to co-segregate within families. METHOD A large family-based design was used, including 238 ADHD families (545 children) and 147 control families (271 children). Inhibition, visuospatial and verbal working memory, and performance and verbal IQ were analysed. RESULTS Children with ADHD, and their affected and non-affected siblings were all impaired on the EF measures and verbal IQ (though unimpaired on performance IQ) and all measures correlated between siblings. Correlations and sibling cross-correlations were not significant between EF and IQ, though they were significant between the measures of one domain. Group differences on EF were not explained by group differences on IQ and vice versa. The discrepancy score between EF and IQ correlated between siblings, indicating that siblings resembled each other in their EF-IQ discrepancy instead of having generalized impairments across both domains. Siblings of probands who had an EF but not IQ impairment, showed a comparable disproportionate lower EF score in relation to IQ score. The opposite pattern was not significant. CONCLUSIONS The results supported the viability of EF and IQ as endophenotypic candidates for ADHD. Most findings support an independent familial segregation of both domains. Within EF, similar familial factors influenced inhibition and working memory. Within IQ, similar familial factors influenced verbal and performance IQ.
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Affiliation(s)
- N N J Rommelse
- Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam, The Netherlands.
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De Sanctis VA, Trampush JW, Harty SC, Marks DJ, Newcorn JH, Miller CJ, Halperin JM. Childhood maltreatment and conduct disorder: independent predictors of adolescent substance use disorders in youth with attention deficit/hyperactivity disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2008; 37:785-93. [PMID: 18991129 PMCID: PMC2628748 DOI: 10.1080/15374410802359650] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11 years old were screened for histories of childhood maltreatment, and SUD diagnoses were formulated in accordance with the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. Lifetime history of problematic substance use was obtained for each parent at baseline. Childhood maltreatment predicted SUD outcome over and above that accounted for by childhood conduct disorder and problematic parental substance use, two potent predictors of adolescent SUDs.
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Ruchkin V, Lorberg B, Koposov R, Schwab-Stone M, Sukhodolsky DG. ADHD symptoms and associated psychopathology in a community sample of adolescents from the European north of Russia. J Atten Disord 2008; 12:54-63. [PMID: 17712166 DOI: 10.1177/1087054707305169] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the prevalence of ADHD symptoms and their relationship to psychopathology in adolescents from the European North of Russia. METHOD The prevalence of ADHD symptoms is assessed by teacher reports in 536 adolescents. Internalizing and externalizing problems are assessed by teacher ratings and student self-reports. RESULTS Prevalence of individual ADHD symptoms ranges between 3.3% and 35%. Only 8.9% of boys and 3.6% of girls have positive ratings on six items in either inattention or hyperactivity subtype. These adolescents fare significantly worse regarding externalizing but not internalizing problems. Compared to girls with ADHD, boys with ADHD report higher levels of violent and nonviolent delinquency and are described by teachers as having more conduct problems. Possible ADHD status is associated with depressive symptoms in boys but not in girls. CONCLUSION The estimates of ADHD prevalence rates obtained in this study are similar to those of other countries, suggesting the need for identification and treatment of the disorder. Evaluation of associated disruptive behavior disorders and depression, particularly in boys, is warranted.
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Affiliation(s)
- Vladislav Ruchkin
- Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
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Zwaigenbaum L, Thurm A, Stone W, Baranek G, Bryson S, Iverson J, Kau A, Klin A, Lord C, Landa R, Rogers S, Sigman M. Studying the emergence of autism spectrum disorders in high-risk infants: methodological and practical issues. J Autism Dev Disord 2007; 37:466-80. [PMID: 16897376 DOI: 10.1007/s10803-006-0179-x] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Detecting early signs of autism is essential for timely diagnosis and initiation of effective interventions. Several research groups have initiated prospective studies of high-risk populations including infant siblings, to systematically collect data on early signs within a longitudinal design. Despite the potential advantages of prospective studies of young children at high-risk for autism, there are also significant methodological, ethical and practical challenges. This paper outlines several of these challenges, including those related to sampling (e.g., defining appropriate comparison groups), measurement and clinical implications (e.g., addressing the needs of infants suspected of having early signs). We suggest possible design and implementation strategies to address these various challenges, based on current research efforts in the field and previous studies involving high-risk populations.
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Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Paediatrics, McMaster Children's Hospital at McMaster University, Hamilton, Ontario, Canada.
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Jain M, Palacio LG, Castellanos FX, Palacio JD, Pineda D, Restrepo MI, Muñoz JF, Lopera F, Wallis D, Berg K, Bailey-Wilson JE, Arcos-Burgos M, Muenke M. Attention-deficit/hyperactivity disorder and comorbid disruptive behavior disorders: evidence of pleiotropy and new susceptibility loci. Biol Psychiatry 2007; 61:1329-39. [PMID: 16950213 DOI: 10.1016/j.biopsych.2006.06.026] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2006] [Revised: 05/22/2006] [Accepted: 06/14/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) comorbid with oppositional defiant disorder (ODD) or conduct disorder (CD) and substance abuse/dependence seems to represent a specific subset within the phenotypic ADHD spectrum. METHODS We applied complex segregation and linkage analyses in a set of multigenerational families densely segregating ADHD comorbid with ODD, CD, alcohol abuse/dependence, and nicotine dependence. RESULTS Our data suggest that ADHD cosegregates with disruptive behaviors as a unique, phenotypically variable trait as evidenced by highly significant pair-wise linkages among: ADHD and ODD (logarithm of odds [LOD]=14.19), ADHD and CD (LOD=5.34), ODD and CD (LOD=6.68), and CD and alcohol abuse/dependence (LOD=3.98). In addition to previously reported ADHD susceptibility loci, we found evidence of linkage for comorbid ADHD phenotypes to loci at 8q24, 2p21-22.3, 5p13.1-p13.3, 12p11.23-13.3, 8q15, and 14q21.1-22.2. These results were replicated with an affected status phenotype derived from latent class clusters. CONCLUSIONS Patterns of cosegregation of ADHD with comorbidities can inform our understanding of the inheritance patterns not only of ADHD but also of disruptive behavioral disorders and alcohol abuse/dependence. Refining the comorbid ADHD phenotype by determining the cosegregation profile of specific comorbidities might be a powerful tool for defining significant regions of linkage.
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Affiliation(s)
- Mahim Jain
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892-3717, USA
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Nutt DJ, Fone K, Asherson P, Bramble D, Hill P, Matthews K, Morris KA, Santosh P, Sonuga-Barke E, Taylor E, Weiss M, Young S. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2007; 21:10-41. [PMID: 17092962 DOI: 10.1177/0269881106073219] [Citation(s) in RCA: 185] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is an established diagnosis in children, associated with a large body of evidence on the benefits of treatment. Adolescents with ADHD are now leaving children's services often with no readily identifiable adult service to support them, which presents problems as local pharmacy regulations often preclude the prescription of stimulant drugs by general practitioners (GPs). In addition, adults with ADHD symptoms are now starting to present to primary care and psychiatry services requesting assessment and treatment. For these reasons, the British Association for Psychopharmacology (BAP) thought it timely to hold a consensus conference to review the body of evidence on childhood ADHD and the growing literature on ADHD in older age groups. Much of this initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence. We hope that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here.
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Affiliation(s)
- D J Nutt
- Psychopharmacology Unit, University of Bristol, Bristol, and Bethlem Royal Hospital, Kent, UK.
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Frazier TW, Youngstrom EA, Glutting JJ, Watkins MW. ADHD and achievement: meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. JOURNAL OF LEARNING DISABILITIES 2007; 40:49-65. [PMID: 17274547 DOI: 10.1177/00222194070400010401] [Citation(s) in RCA: 350] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This article presents results from two interrelated studies. The first study conducted a meta-analysis of the published literature since 1990 to determine the magnitude of achievement problems associated with attention-deficit/hyperactivity disorder (ADHD). Effect sizes were significantly different between participants with and without ADHD (sample weighted r = .32, sample weighted d = . 71; p = .001). Effects were also examined according to the moderators of age, gender, achievement domain (reading, math, spelling), measurement method (standardized tests vs. grades, parent/teacher ratings, etc.), sample type (clinical vs. nonclinical), and system used to identify ADHD (DSM-III-R vs. DSM-IV). Significant differences emerged from the moderator comparisons. The second study, using averaged effect sizes from the first study as a baseline for comparison, investigated achievement levels for an understudied age group with ADHD, namely, college students. Unlike previous studies at the college level, the sample incorporated both student and parent ratings (N = 380 dyads). The results were comparable to outcomes from the meta-analysis for college students and adults. Analyses demonstrated modest (R = .21) but meaningful predictive validity across 1 year to end-of-first-year grades. However, unlike earlier studies with children and adolescents, student ratings were as predictive as parent ratings. Findings are discussed in terms of the impact of moderator variables on ADHD and achievement.
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Affiliation(s)
- Thomas W Frazier
- Section of Behavioral Medicine, The Cleveland Clinic, Shaker Medical Campus, OH 44104, USA.
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Abstract
Attention-deficit hyperactivity disorder (ADHD) in girls is a topic of growing research and clinical interest. For many years, girls with ADHD have been ignored and overshadowed by hyperkinetic and impulsive boys, but they are now attracting interest in an effort to understand the similarities and differences in the prevalence, symptoms, familial risk, comorbidities and treatment of ADHD in the two sexes. A review of past and current literature finds that the symptoms of ADHD are not sex specific, but that identification of girls with ADHD is hampered by parental and teacher bias, and confusion. Girls are more likely to be inattentive without being hyperactive or impulsive, compared with boys. Girls and boys share the same familial risk patterns, as well as similar, although not identical, comorbidity or impairment patterns. The risk of non-treatment is as great in girls as it is in boys; up to 70-80% of identified children will have persistent symptoms and impairment that extends into adolescence and adulthood. Treatment modalities are equally effective in girls and boys. Stimulants, non-stimulants and behavioural modalities are the mainstays of effective treatment.
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Affiliation(s)
- Jud Staller
- SUNY Upstate Medical University, Syracuse, New York 13210, USA.
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Schilling V, Petermann F, Hampel P. Psychosoziale Situation bei Familien von Kindern mit ADHS. ACTA ACUST UNITED AC 2006. [DOI: 10.1024/1661-4747.54.4.293] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Erste Studien belegen, dass die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) nicht nur mit einer ungünstigen Entwicklung des erkrankten Kindes oder Jugendlichen verbunden ist, sondern auch Auswirkungen auf die psychosoziale Situation aller Familienmitglieder hat. Die Pilotstudie ging der Frage nach, ob sich die Lebensqualität der Eltern von Kindern mit ADHS von der Lebensqualität der Eltern gesunder Kinder unterscheidet. Außerdem war von Interesse, inwieweit das Ausmaß des hyperkinetischen Verhaltens des erkrankten Kindes mit der psychosozialen Anpassung der gesunden Geschwister und der Lebensqualität der Eltern verbunden ist. Insgesamt 48 Elternteile beurteilten das Ausmaß hyperkinetischen Verhaltens der gesunden Geschwister sowie ihre eigene Lebensqualität. Die Eltern mit einem an ADHS erkrankten Kind schätzten zusätzlich das Ausmaß hyperkinetischen Verhaltens des erkrankten Kindes sowie die psychischen Auffälligkeiten der gesunden Geschwister ein. Die Ergebnisse legen nahe, dass das psychische Wohlbefinden der Eltern mit einem an ADHS erkrankten Kind gegenüber Eltern gesunder Kinder beeinträchtigt ist. Des Weiteren hing das Ausmaß des hyperkinetischen Verhaltens des erkrankten Kindes positiv mit den internalisierenden und Aufmerksamkeitsproblemen der gesunden Geschwister zusammen. Das Ausmaß des hyperkinetischen Verhaltens des erkrankten Kindes war außerdem mit einem beeinträchtigten psychischen Wohlbefinden des Elternteils assoziiert. Die Befunde unterstreichen die Forderung nach familienorientierten Interventionsmaßnahmen in der Behandlung von ADHS, die die psychosoziale Anpassung aller Familienmitglieder berücksichtigen.
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Affiliation(s)
- Vera Schilling
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Petra Hampel
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
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Lemelin G, Lafortune D, Fortier I. Les caractéristiques familiales des enfants présentant un trouble déficitaire de l'attention avec ou sans hyperactivité: Recension critique des écrits. CANADIAN PSYCHOLOGY-PSYCHOLOGIE CANADIENNE 2006. [DOI: 10.1037/cp2006011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Seidman LJ, Biederman J, Monuteaux MC, Valera E, Doyle AE, Faraone SV. Impact of gender and age on executive functioning: do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years? Dev Neuropsychol 2005; 27:79-105. [PMID: 15737943 DOI: 10.1207/s15326942dn2701_4] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
ADHD is known to have neuropsychological correlates, characterized mainly by executive function (EF) deficits. However, most available data are based on studies of boys through age 12. Our goal was to assess whether girls with ADHD express neuropsychological features similar to those found in boys, and whether these impairments are found in both preteen and teen samples. Participants were 101 girls and 103 boys with DSM-III-R ADHD, and 109 comparison girls and 70 boys without ADHD, ages 9 to 17 years. Information on neuropsychological performance was obtained in a standardized manner blind to clinical status. Primary regression analyses controlled for age, socioeconomic status, learning disability, and psychiatric comorbidity. Girls and boys with ADHD were significantly more impaired on some measures of EFs than healthy comparisons but did not differ significantly from each other. With the exception of 1 test score there were no significant Sex x Diagnosis interactions. Moreover, there were no more significant interactions among age, gender, and diagnosis than would be expected by chance. Neuropsychological measures of EFs were comparably impaired in girls compared to boys with ADHD, and these impairments are found at ages 9 to 12 and ages 13 to 17. These findings suggest that executive dysfunctions are correlates of ADHD regardless of gender and age, at least through the late teen years.
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Affiliation(s)
- Larry J Seidman
- Pediatric Psychopharmacology Unit, Psychiatry Service, Massachusetts General Hospital, Boston, MA 02114, USA.
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Birnbaum HG, Kessler RC, Lowe SW, Secnik K, Greenberg PE, Leong SA, Swensen AR. Costs of attention deficit-hyperactivity disorder (ADHD) in the US: excess costs of persons with ADHD and their family members in 2000. Curr Med Res Opin 2005; 21:195-206. [PMID: 15801990 DOI: 10.1185/030079904x20303] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study is to provide a comprehensive estimate of the cost of ADHD by consider ing the healthcare and work loss costs of persons with ADHD, as well as those costs imposed on their family members. METHODS Excess per capita healthcare (medical and prescription drug) and work loss (disability and work absence) costs of treated ADHD patients (ages 7 years-44 years) and their family members (under 65 years of age) were calculated using administrative claims data from a single large company; work loss costs are from disability data or imputed for medically related work loss days. Excess costs are the additional costs of patients and their family members over and above those of comparable control individuals. The excess costs of untreated individuals with ADHD and their family members were also estimated. All per capita costs were extrapolated using published prevalence and treatment rates and population data; the prevalence of persons with ADHD was based upon the literature. RESULTS The total excess cost of ADHD in the US in 2000 was $31.6 billion. Of this total, $1.6 billion was for the ADHD treatment of patients, $12.1 billion was for all other healthcare costs of persons with ADHD, $14.2 billion was for all other healthcare costs of family members of persons with ADHD, and $3.7 billion was for the work loss cost of adults with ADHD and adult family members of persons with ADHD. CONCLUSION The annual cost of ADHD in the US is substantial. Both treated and untreated persons with ADHD, as well as their family members, impose consider able economic burdens on the healthcare system as a result of this condition. While these first estimates of the cost of ADHD to the nation are suggestive of its substantial economic burden, future research needs to refine and build on this analysis, particularly in the context of a model to control for related co-morbidities. Similarly, since these results are based on data from a single company for the period 1996-1998, the analysis should be validated with more representative, current data.
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