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Inci Izmir SB, Aktan ZD, Ercan ES. The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder. J Atten Disord 2024; 28:1555-1576. [PMID: 39092505 DOI: 10.1177/10870547241267379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVE The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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Cho Y, Kim AY, Lee S, Lee H. Recent updates on treatment patterns in patients with treated attention-deficit/hyperactivity disorders from a nationwide real-world database in South Korea. Int Clin Psychopharmacol 2024; 39:240-249. [PMID: 38477521 DOI: 10.1097/yic.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
The prevalence of attention-deficit/hyperactivity disorder (ADHD) is steadily increasing across Korea. We analyzed ADHD patients with ADHD medications (Rx) characteristics and treatment patterns compared to patients without Rx and identified the differences between pediatric-/adult- and active-/transient-patients with Rx. Using a nationwide claims dataset from 2020 to 2021, we conducted a prevalence-based cross-sectional study and analyzed the recent patients' characteristics and patterns among ADHD patients. Among 132 017 ADHD patients with Rx, differences from 20 312 without Rx across all characteristics except sex. We found significant differences in characteristics and treatment patterns between pediatric-/adult- and active-/transient-patients with Rx. Age-specific sex ratios notably diverged in pediatric patients (61.2%), but remained similar in adults, revealing significant psychiatric comorbidities differences. Active-patients peaked at 6-11 years (41.4%), while transient-patients at 18-30 years (36.1%). Predominantly, methylphenidate (89.7%), atomoxetine (27.8%), and clonidine (2.8%) were prescribed, with 85% experiencing treatment changes within methylphenidate formulations. In pediatric patients, extended-release methylphenidate was preferred (56.1%), adults favored oral delivery system methylphenidate (71.5%), and active-patients had higher treatment rates than transient-patients across all patterns, with low monotherapy rates. This study provides epidemiologic insights into recent characteristics and treatment patterns of ADHD patients with Rx in Korea, providing valuable evidence for identifying those actively receiving ADHD treatment in future healthcare policy decisions.
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Affiliation(s)
- Yoon Cho
- Department of Biohealth Regulatory Science, Graduate School of Ajou University
| | - Ah-Young Kim
- Research Institute of Pharmaceutical Science and Technology (RIPST)
| | - Sukhyang Lee
- Department of Biohealth Regulatory Science, Graduate School of Ajou University
- Research Institute of Pharmaceutical Science and Technology (RIPST)
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
| | - Hankil Lee
- Department of Biohealth Regulatory Science, Graduate School of Ajou University
- Research Institute of Pharmaceutical Science and Technology (RIPST)
- College of Pharmacy, Ajou University, Suwon, Republic of Korea
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Karagoz Tanigor E, Ozbek A, Ozyurt G, Pekcanlar Akay A. Comparisons of clinical subtypes, symptom severity, global functioning, emotional and behavior problems, and CPT test profiles in children and adolescents with ADHD with and without co-occurring internet gaming disorder. Nord J Psychiatry 2024; 78:247-254. [PMID: 38319235 DOI: 10.1080/08039488.2024.2311705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES This study aims to assess whether the presence of Internet Gaming Disorder (IGD) is associated with disease severity, Attention Deficit Hyperactivity Disorder(ADHD) presentation, emotional problems, behavioral problems, and CPT profile in patients with ADHD. METHOD Forty children with IGD and sixty-four patients without IGD were included in the study, all of whom had a diagnosis of ADHD. Comorbid psychiatric disorders were determined using The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Conners's Parent Rating Scale-Revised Short form (CPRS-RS), The Strengths and Difficulties Questionnaire (SDQ), Internet Gaming Disorder Questionnaire (IGD-20), and MOXO Continuous Performance Test (MOXO d-CPT) were performed on the children, and Clinical Global Impression (CGI), Children's Global Assessment Scale (CGAS), comorbidities and ADHD presentations were evaluated. RESULTS The IGD group was found to have the combined presentation of ADHD more commonly, and their CGI, CGAS, SDQ behavior problems subscale, cognitive problems, attention problems, and ADHD index in the CPRS-RS questionnaire were found to be higher (p < 0.05). No differences were found in attention, timing, impulsiveness, and hyperactivity scores in CPT between groups (p > 0.05). CONCLUSION Our study has shown that children with both ADHD and IGD had more severe symptoms, more behavioral problems, and differences regarding the prevalence of the ADHD presentations when compared to children having ADHD without IGD. Longitudinal studies with higher sample sizes are required to investigate this possible connection in the context of a cause-effect relationship and draw a conclusion.
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Affiliation(s)
- Ezgi Karagoz Tanigor
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
- Department of Child and Adolescent Psychiatry, Izmir Katip Celebi University Faculty of Medicine, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Aylin Ozbek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Celebi University Faculty of Medicine, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Öğütlü H, Kütük ÖM, Tufan AE, Akay AP, Gündoğdu ÖY, Ercan ES. The detect consensus report on Attention Deficit/Hyperactivity Disorder and its management among Turkish children and adolescents (Detect: consensus report on ADHD among Turkish youth). Front Psychiatry 2024; 15:1372341. [PMID: 38577402 PMCID: PMC10993048 DOI: 10.3389/fpsyt.2024.1372341] [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: 01/17/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common and heritable neurodevelopmental disorders which may last through the life-span. A consensus report on diagnosis and management of ADHD among Turkish youth was prepared previously. However, the participants as well as the management options were rather limited and developments in the past decade necessitated a revision and update of the consensus. Therefore, this review aims to summarize the consensus among Child and Adolescent Psychiatrists from Türkiye on the nature and management of pediatric ADHD. For those aims, the etiology of ADHD, diagnostic and evaluation process, epidemiology, developmental presentations, differential diagnoses and comorbidities, course/outcome and pharmacological as well as non-pharmacological management options were reviewed and suggestions for clinical practice are presented. Since ADHD is a chronic disorder with wide-ranging effects on functionality that is frequently accompanied by other mental disorders, a multidimensional therapeutic approach is recommended. However, since the disorder has neurobiological basis, pharmacotherapy represents the mainstay of treatment. Additional therapies may include psychosocial therapy, behavioral therapy, school-based therapeutic approaches, and family education. This review provides recommendations for ADHD at the national and global levels. It contains information about ADHD that will contribute to and facilitate clinicians' decision-making processes. It is advisable to consider this guideline in clinical practice.
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Affiliation(s)
- Hakan Öğütlü
- Child and Adolescent Psychiatry Department, Cognitive Behavioral Psychotherapies Association, Ankara, Türkiye
| | - Özlem Meryem Kütük
- Child and Adolescent Psychiatry Department, Medical Faculty, Baskent University, Adana, Türkiye
| | - Ali Evren Tufan
- Child and Adolescent Psychiatry Department, Medical Faculty, Bolu Abant Izzet Baysal University, Bolu, Türkiye
| | - Aynur Pekcanlar Akay
- Child and Adolescent Psychiatry Department, Medical Faculty, Dokuz Eylul University, Izmir, Türkiye
| | - Özlem Yildiz Gündoğdu
- Child and Adolescent Psychiatry Department, Medical Faculty, Kocaeli University, Kocaeli, Türkiye
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Türkiye
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钟 琳, 张 静, 左 彭. [The mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:259-264. [PMID: 36946160 PMCID: PMC10032079 DOI: 10.7499/j.issn.1008-8830.2210035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/05/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To study the mediating role of emotion regulation strategies between symptoms and anxiety problems in children with attention deficit hyperactivity disorder (ADHD). METHODS Convenience cluster sampling was performed to select 435 eligible children with ADHD from 10 211 students in 10 elementary schools in Kashgar of Xinjiang Uygur Autonomous Region. SNAP-IV Assessment Scale, Emotion Regulation Questionnaire for Children and Adolescents, and Conners Parent Symptoms Questionnaire were used to obtain relevant information. The Spearman correlation analysis and the moderated mediation method were used for data analysis. RESULTS For the children with ADHD, the score of cognitive reappraisal was negatively correlated with the scores of symptoms and anxiety problems (rs=-0.254 and -0.270 respectively, P<0.001), and the score of symptoms was positively correlated with the score of anxiety problems (rs=0.329, P<0.001). The analysis of mediating effect showed that cognitive reappraisal played a partial mediating role between symptoms and anxiety problems, with a 95% confidence interval of 0.008-0.027, and the mediating effect accounted for 16.10% of the total effect. In addition, sex played a regulatory role in this mediation model (P<0.001). CONCLUSIONS Cognitive reappraisal plays a mediating role between symptoms and anxiety problems in children with ADHD, while sex regulates the relationship of symptoms with cognitive reappraisal and anxiety problems in these children.
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Şahan N, Atasavun Uysal S, Çak HT. Motor Proficiency, Manual Dexterity, and Visual Perception in School-age Children With ADHD: Contribution of Different Comorbidities. J Psychiatr Pract 2023; 29:122-136. [PMID: 36928199 DOI: 10.1097/pra.0000000000000695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is often comorbid with a number of other psychiatric conditions. The goal of this study was to investigate whether motor skills, manual dexterity, and visual perception differ in the presence of ADHD and comorbid psychiatric conditions in school-age boys by comparing them to a group of children with typical development (TD). We evaluated 81 boys 6 to 10 years of age in 5 groups: ADHD only (n=18); ADHD+specific learning disorders (ADHD+SLDs) (n=17); ADHD+oppositional defiant disorder (n=16); ADHD+anxiety disorders (n=15); and TD (n=15). The participants with ADHD only and those with ADHD+comorbidity had significantly lower scores than the participants in the TD group in every area we evaluated. The lowest scores were observed in the ADHD+SLD group in all motor skills domains except for the fine motor precision field. Furthermore, the group with ADHD+SLD had statistically significantly lower scores than the 3 other groups with ADHD+comorbidity in 3 areas: balance, upper extremity coordination, and speed and agility. Motor problems in patients with ADHD and comorbid conditions may not be a focus of attention in clinics. However, especially in the case of comorbid conditions accompanying ADHD, it is important to consider problems in motor skills, manual dexterity, and visual perception in evaluation and treatment to increase these children's quality of life.
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Inci Izmir SB, Ipci M, Ercan ES. Methylphenidate significantly improves neurocognitive impairments in children with ADHD. Psychiatry Res 2022; 311:114492. [PMID: 35306379 DOI: 10.1016/j.psychres.2022.114492] [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: 09/30/2020] [Revised: 02/25/2022] [Accepted: 03/05/2022] [Indexed: 01/02/2023]
Abstract
This study aimed to investigate the effects of methylphenidate (MPH) on scores on a neurocognitive test battery for individuals with various presentations of attention deficit/hyperactivity disorder (ADHD) and the effect of comorbidities on executive function. This study included 861 children and adolescents aged 7-17 years who were diagnosed with ADHD according to DSM-V criteria. The CNS Vital Signs Battery was utilized to compare the neuropsychological characteristics and MPH treatment responses of patients with predominantly inattentive (ADHD-I) and combined (ADHD-C) presentations of ADHD. Before MPH administration, a statistically significant difference was observed between groups only for complex attention. In addition, the overall prevalence rate of psychiatric comorbidities was 45.5%, and no statistically significant differences were found in the ADHD-I group pre- versus post-MPH administration. Prior to the administration of MPH, statistically significant differences were observed within the ADHD-C group between those with or without comorbidities. However, after MPH administration, these differences between the groups disappeared. The effects of MPH on improving scores on neuropsychological subtests were similar between the groups with different presentations of ADHD. Additionally, MPH treatment was effective despite the presence of comorbidities.
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Affiliation(s)
| | - Melis Ipci
- Hasan Kalyoncu University, Psychology Department, Gaziantep, Turkey
| | - Eyüp Sabri Ercan
- Ege University, Child and Adolescent Psychiatry Department, Medical Faculty, Izmir, Turkey
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Gökçe S, Yazgan Y, Aslan Genç H, Çarkaxhiu Bulut G, Kayan E, Poyraz Fındık OT, Ayaz AB, Yusufoğlu C, Ayyıldız D, Budak B, Atabay E, Yılmaz SS, Kaytanlı U, Akın E. Predictors of ADHD persistence in elementary school children who were assessed in earlier grades: A prospective cohort study from Istanbul, Turkey. Brain Dev 2021; 43:495-504. [PMID: 33349455 DOI: 10.1016/j.braindev.2020.11.013] [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: 08/14/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders among school-age children worldwide. In a more recent follow-up study, Biederman et al. found that 78% of children diagnosed with ADHD between the ages of 6-17 years continued to have a full (35%) or a partial persistence after eleven years. OBJECTIVE In this study, it was aimed to identify the factors contributing to the persistence of ADHD symptoms in elemantary school children who were prospectively assessed both in their earlier and upper grades. METHODS The sample was drawn from a previous community-based study where ADHD symptoms in 3696 first/or second graders were examined in regard to their school entry age. Two years after, the families of the children that participated in the initial study were called by phone and invited to a re-evaluation session. Among those who were reached, 154 were consequently eligible and were assessed with Swanson, Nolan and Pelham questionnaire (SNAP-IV), Conners' rating scales (CRS) and the Kiddie schedule for affective disorders and schizophrenia (K-SADS). RESULTS Of the 154 children, 81 had been evaluated to have "probable ADHD" by the initial interview. Among these 81 children, 50 (61.7%) were indeed diagnosed with ADHD after two years. Initial scores of the teacher reported SNAP-IV inattention subscale predicted the ADHD diagnosis after two years, with an odds ratio of 1.0761 (p = 0.032, Wald: 4.595). CONCLUSIONS Our results suggest that high inattention symptom scores reported by the teacher in the earlier grades, might predict an ADHD diagnosis in upper grades.
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Affiliation(s)
- Sebla Gökçe
- Maltepe University Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey.
| | - Yankı Yazgan
- Marmara University, Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Herdem Aslan Genç
- Koç University Hospital, Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Gresa Çarkaxhiu Bulut
- Maltepe University Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Esengül Kayan
- İstanbul Gelişim University Faculty of Psychology, İstanbul, Turkey
| | | | - Ayşe Burcu Ayaz
- Marmara University, Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Canan Yusufoğlu
- Erenkoy Research and Training Hospital for Neurology and Psychiatry, İstanbul, Turkey
| | - Didem Ayyıldız
- Marmara University, Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey
| | - Burcu Budak
- Medeniyet University Hospital, Istanbul, Turkey
| | - Ender Atabay
- Marmara University, Faculty of Medicine, Child and Adolescent Psychiatry, İstanbul, Turkey
| | | | - Umut Kaytanlı
- Zeynep Kamil Research and Training Hospital, İstanbul, Turkey
| | - Elif Akın
- Erenkoy Research and Training Hospital for Neurology and Psychiatry, İstanbul, Turkey
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Fu D, Wu DD, Guo HL, Hu YH, Xia Y, Ji X, Fang WR, Li YM, Xu J, Chen F, Liu QQ. The Mechanism, Clinical Efficacy, Safety, and Dosage Regimen of Atomoxetine for ADHD Therapy in Children: A Narrative Review. Front Psychiatry 2021; 12:780921. [PMID: 35222104 PMCID: PMC8863678 DOI: 10.3389/fpsyt.2021.780921] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/28/2021] [Indexed: 12/12/2022] Open
Abstract
Atomoxetine, a selective norepinephrine (NE) reuptake inhibitor, was approved for attention deficit/hyperactivity disorder (ADHD) treatment in children, adolescents and adults. We searched the database PubMed/MEDLINE (2000 to October 1, 2021). Only publications in English were considered. Atomoxetine inhibits the presynaptic norepinephrine transporter (NET), preventing the reuptake of NE throughout the brain along with inhibiting the reuptake of dopamine in specific brain regions such as the prefrontal cortex (PFC). The novel mechanism of atomoxetine also includes several new brain imaging studies and animal model studies. It is mainly metabolized by the highly polymorphic drug metabolizing enzyme cytochrome P450 2D6 (CYP2D6). Atomoxetine is effective and generally well tolerated. ADHD is often accompanied by multiple comorbidities. A series of studies have been published suggesting that atomoxetine is effective in the treatment of ADHD symptoms for children with various types of comorbidity. In some cases, it is possible that atomoxetine may have a positive influence on the symptoms of comorbidities. Atomoxetine can be administered either as a single daily dose or split into two evenly divided doses, and has a negligible risk of abuse or misuse. The latest guideline updated that clinical dose selection of atomoxetine was recommended based on both CYP2D6 genotype and the peak concentration. To have a more comprehensive understanding of atomoxetine, this review sets the focus on the mechanism, clinical efficacy and dosage regimen in detail, and also touches on those studies regarding adverse reactions of atomoxetine.
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Affiliation(s)
- Di Fu
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China.,School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Dan-Dan Wu
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hong-Li Guo
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ya-Hui Hu
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Xia
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xing Ji
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Wei-Rong Fang
- School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Yun-Man Li
- School of Basic Medical Sciences and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jing Xu
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Department of Pharmacy, Pharmaceutical Sciences Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qian-Qi Liu
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, Nanjing, China
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İpÇİ M, İncİ İzmİr SB, TÜrkÇapar MH, Özdel K, ArdiÇ ÜA, Ercan ES. Psychiatric Comorbidity in the Subtypes of ADHD in Children and Adolescents with ADHD According to DSM-IV. ACTA ACUST UNITED AC 2020; 57:283-289. [PMID: 33354119 DOI: 10.29399/npa.24807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 05/13/2020] [Indexed: 11/07/2022]
Abstract
Introduction The prevalence rate of psychiatric comorbidity in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) was 60-80%. The objective of this study was to examine comorbid disorders associated with ADHD and the subtypes of ADHD in children and adolescents with the diagnosis of ADHD. Method The study included 326 children and adolescents aged between 8-15 years who were diagnosed with ADHD for the first time as a result of an interview by psychiatry, in a child adolescent psychiatry clinic in İzmir. Sociodemographic form, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version were used to assess psychiatric comorbidity. Results The comorbidities accompanied ADHD were disruptive behavior disorder (28.8%), depressive disorder (13.2%), obsessive-compulsive disorder (9.5%) and anxiety disorder (6.1%). When the subtypes of ADHD were assessed according to psychiatric comorbidity, oppositional defiant disorder and conduct disorder were frequently seen with ADHD combined type, whereas anxiety disorder was more frequent with ADHD inattentive type. Discussion Comorbidity in ADHD Combined type increases the severity of disease, delays treatment response and exacerbates prognosis. Therefore, it is very important to determine which psychiatric diagnosis accompany with ADHD.
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Affiliation(s)
- Melis İpÇİ
- Hasan Kalyoncu University, Institute of Social Sciences, Department of Clinical Psychology, Gaziantep, Turkey
| | - Sevim Berrin İncİ İzmİr
- Ege University Substance Addiction Toxicology and Pharmaceutical Sciences Institute, İzmir, Turkey
| | - Mehmet Hakan TÜrkÇapar
- Social Sciences University of Ankara, Faculty of Humanities and Social Sciences Department of Psychology, Ankara, Turkey
| | - Kadir Özdel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ülkü Akyol ArdiÇ
- Denizli State Hospital, Child and Adolescent Psychiatry, Denizli, Turkey
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Liu JB, Xue ZP, Lin L, Xu JC, Sun YM, Lu JP. [Moderated mediation analysis for symptoms of attention deficit/hyperactivity disorder with the symptoms of anxiety in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:768-773. [PMID: 32669176 PMCID: PMC7389617 DOI: 10.7499/j.issn.1008-8830.2002121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/09/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the moderated mediation for attention deficit/hyperactivity disorder (ADHD) with the symptoms of anxiety in children. METHODS A total of 12 271 students were included with an average age of 8.9±1.9 years, including 6 743 male students and 5 508 female students, and 20 students with missing data on gender. Child psychological trauma questionnaires (parents version) and Conners questionnaires (parent version) were completed by the parents of primary school students. The data was studied by univariate analysis, multivariate analysis and moderated mediation analysis. RESULTS The results of the univariate analysis showed that in all subjects, boys, and girls, the scores of hyperactivity index and childhood trauma were positively correlated with the score of anxiety (P<0.01), and ADHD and childhood trauma positively predicted anxiety disorder (P<0.001). The results of the multivariate analysis showed that in all subjects, boys, and girls, the scores of hyperactivity index (ADHD symptoms) and childhood trauma positively predicted the score of anxiety (P<0.001), and both ADHD and childhood trauma positively predicted anxiety disorder (P<0.001). The results of the moderated mediation analysis showed that childhood trauma was a mediating factor for the relationship between hyperactivity index and anxiety index in boys and girls (P<0.05), and sex moderated the relationship between hyperactivity index and anxiety index (P<0.001). CONCLUSIONS ADHD symptoms/ADHD are closely associated with anxiety symptoms/anxiety disorder. Childhood trauma exerts a mediating effect on the relationship between ADHD symptoms and anxiety symptoms, and sex moderates the relationship between ADHD symptoms and anxiety symptoms.
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Affiliation(s)
- Jian-Bo Liu
- Peking University Shenzhen Graduate School, Shenzhen, Guangdong 518020, China.
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Camacho-Conde JA, Climent G. Attentional profile of adolescents with ADHD in virtual-reality dual execution tasks: A pilot study . APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:81-90. [PMID: 32400210 DOI: 10.1080/21622965.2020.1760103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is highly prevalent in children and adolescents, with estimated prevalence ranges from 5.9 to 7.1% globally and 1 to 6.8% in Spain. This has commonly been associated with deficits in attention threads and executive functions. This paper aims to study the cognitive-executive performance of adolescents between the ages of 17 and 23 with an ADHD diagnosis, relative to a control group. The total sample consisted of 120 male participants who were given the Nesplora Aquarium test. Dual execution tasks assessed attention, response speed, and inhibition capability. When comparing the experimental and control groups, statistically significant differences were detected in processing speed, selective attention, and cognitive inhibition [general execution (T_correct_n) (p = 0.008), attention arousal (T_omission_n) (p = 0.008), and processing speed (T_correctreactime_mean) (p = 0.008)]. We demonstrate that a new virtual reality tool, designed to measure attention in people over the age of 16 years, is effective at measuring attention and working memory. In addition, item difficulty and discrimination values were also acceptable.
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Affiliation(s)
| | - Gema Climent
- Department of I + I+I, Nesplora Technology & Behavior, San Sebastian, Spain
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Arruda MA, Arruda R, Guidetti V, Bigal ME. ADHD Is Comorbid to Migraine in Childhood: A Population-Based Study. J Atten Disord 2020; 24:990-1001. [PMID: 28587507 DOI: 10.1177/1087054717710767] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g., migraine), and to headache frequency. Method: Informed consent and analyzable data were obtained for 5,671 children aged 5 to 12 years (65.9% of the target sample). Parents and teachers were interviewed using validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Relative risks were modeled using univariate and multivariate analyses. Results: As contrasted to nonheadache controls, the prevalence of ADHD was significantly higher in children with migraine (p < .001) but not in those with tension-type headaches. In children with migraine, risk of ADHD increased as a function of headache frequency (p < .05). Conclusion: Migraine and frequent migraine are comorbid to ADHD. Future studies should focus on the impact of the association on the burden to the children and their families.
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Araz Altay M, Görker I, Demirci Şipka B, Bozatlı L, Ataş T. Attention Deficit Hyperactivity Disorder and Psychiatric Comorbidities. EURASIAN JOURNAL OF FAMILY MEDICINE 2020. [DOI: 10.33880/ejfm.2020090104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This study aims to obtain current information on the clinical features of attention deficit hyperactivity disorder cases, comorbid psychiatric disorders and psychiatric drug use.
Methods: All patients between the ages of 6 and 18 years who were admitted to our outpatient clinic and diagnosed with attention deficit hyperactivity disorder were included in the study. The files of the patients were examined and their demographic characteristics, symptoms, psychiatric diagnoses and drug profiles were recorded. The pattern of the psychiatric disorders accompanied by attention deficit hyperactivity disorder cases and the differences according to age and gender were analyzed. The differences were determined in patients with psychiatric comorbidity compared to those without.
Result: The mean age of the 777 patients included in the study was 11.1±2.94 and 76.6% were boys. 60.9% of attention deficit hyperactivity disorder patients had comorbid psychiatric disorders. The most common psychiatric comorbidities were specific learning disability (23.6%), oppositional defiant disorder (12.9%) and conduct disorder (12.1%). There was no difference between the genders in terms of the incidence of psychiatric comorbidities. The rate of psychiatric comorbidity was significantly higher in adolescents than in children. A psychotropic medication was used in 86.4% of the cases and psychotropic polypharmacy was present in 31.5%. The rate of polypharmacy was significantly higher in the group with psychiatric comorbidity.
Conclusion: Attention deficit hyperactivity disorder is frequently accompanied by other psychiatric disorders and the psychiatric comorbidity leads to a more complicated clinical profile. Approximately one-third of attention deficit hyperactivity disorder patients have psychiatric polypharmacy and these patients should be carefully monitored. Primary care physicians who are frequently confronted with attention deficit hyperactivity disorder cases should be careful about psychiatric comorbidities.
Keywords: Child psychiatry, attention deficit hyperactivity disorder, mental disorders, Family practice
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Affiliation(s)
- Mengühan Araz Altay
- Department of Child and Adolescent PsychiatryTrakya University School of Medicine,
| | - Işık Görker
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine
| | - Begüm Demirci Şipka
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine
| | - Leyla Bozatlı
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine
| | - Tuğçe Ataş
- Department of Child and Adolescent Psychiatry, Trakya University School of Medicine
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Ramy H, El Sheikh M, Sultan M, Bassim R, Eid M, Ali R, El Missiry M. Risk factors influencing severity of attention deficit hyperactivity disorder in a sample of preparatory school students in Cairo. Clin Child Psychol Psychiatry 2018; 23:542-555. [PMID: 29451009 DOI: 10.1177/1359104518755218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. Severity of symptoms is associated with more behavioral problems, poor academic performance, and persistence of symptoms into adulthood. METHODS To examine the clinical and social correlates that may be identified as risk factors associated with ADHD severity in a sample of adolescent ADHD school students. A total of 925 students were recruited from two public and two private schools from eastern Cairo. They were interviewed using Conners-Wells Adolescent Self-Report-short version (CASS-S); students scoring more than 65 were further interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL) to confirm the diagnosis, then Conners-Wells Adolescent Self-Report-long version (CASS-L) to assess severity and Wechsler Intelligence Scale for Children (WISC) to ascertain intellectual ability. RESULTS About 10.3% of cases were severe, 5.7% were moderate, and 83.9% were mild. Severity was significantly associated with female gender, psychiatric comorbidity, family problems, conduct symptoms, and poor anger management. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ( DSM-IV) hyperactive-impulsive type was the only predictive factor of ADHD severity. CONCLUSIONS The diagnosis of hyperactive-impulsive subtype may predict the severity of ADHD symptoms.
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Affiliation(s)
- Hisham Ramy
- Institute of Psychiatry, Ain Shams University, Egypt
| | | | - Marwa Sultan
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Rasha Bassim
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Maissa Eid
- Institute of Psychiatry, Ain Shams University, Egypt
| | - Ramy Ali
- Institute of Psychiatry, Ain Shams University, Egypt
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Zhan C, Liu Y, Wu K, Gao Y, Li X. Structural and Functional Abnormalities in Children with Attention-Deficit/Hyperactivity Disorder: A Focus on Subgenual Anterior Cingulate Cortex. Brain Connect 2017; 7:106-114. [PMID: 28173729 DOI: 10.1089/brain.2016.0444] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD), characterized by developmentally inappropriate inattention, hyperactivity/impulsivity, or a combination of both, is a major public health problem. Neuroimaging studies have revealed associations of these cognitive impairments with structural and functional deficits all over the brain. Existing findings are not fully consistent because of the heterogeneity of study samples and diversity of research techniques. In this study, we propose to utilize a multimodal magnetic resonance imaging (MRI) approach to study the structural and functional brain networks in children with ADHD-combined type (ADHD-C) with a focus on the subgenual anterior cingulate cortex (sgACC). Diffusion tensor imaging (DTI) and resting-state functional MRI (rs-fMRI) data from 32 children with ADHD-C and 32 group-matched controls were involved. Network-based statistic analysis of the rs-fMRI data revealed a disconnected functional network between the sgACC and multiple regions in the occipital lobe and cerebellum, whereas the DTI data showed disrupted white matter integrity in the subgenual cingulum bundle (sgCB). Post hoc region of interest (ROI)-based analyses showed significantly increased fluctuation of the spontaneous brain activity in the sgACC and higher radial diffusivity in the sgCB in the ADHD group. Both the rs-fMRI and DTI ROI-based measures were significantly correlated with clinical measures that examine behavioral capacities of attention and inhibitory control. Findings of this study suggest that functional alterations in the sgACC and white matter under development in the sgCB may impact each other, and together contribute to impaired attention and inhibitory control function in children with ADHD.
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Affiliation(s)
- Chenyang Zhan
- 1 Department of Radiology, Albert Einstein College of Medicine , Bronx, New York
| | - Yuhong Liu
- 2 Department of Mathematics and Computer Science, Philander Smith College , Little Rock, Arkansas
| | - Kai Wu
- 3 Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology , Guangzhou, China
| | - Yu Gao
- 4 Department of Psychology, Brooklyn College and the Graduate Center of the City University of New York , Brooklyn, New York
| | - Xiaobo Li
- 5 Department of Biomedical Engineering, New Jersey Institute of Technology , Newark, New Jersey.,6 Department of Electric and Computer Engineering, New Jersey Institute of Technology , Newark, New Jersey.,7 Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York
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