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Paracha H, Parker Davidson K, Dixon C, Wilde Z. A Novel Intervention to Simultaneously Address the Dual Pathologies of Breathing Disorders During Sleep and Undiagnosed Attention Deficit Hyperactivity Disorder in School-Aged Children Ages 5-12. J Atten Disord 2024; 28:293-301. [PMID: 38031843 DOI: 10.1177/10870547231211024] [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: 12/01/2023]
Abstract
PURPOSE To evaluate the improvement of ADHD related symptoms in school-aged children ages 5 to 12 in treatment with a monobloc appliance (MOA) for Sleep Disordered Breathing (SDB). METHODS A retrospective review of questionnaire scores of ADHD symptoms from school-aged children being treated with a MOA for SDB. Data was obtained from parent survey questionnaires of 40 school-aged children in three dental offices in treatment with an MOA for SDB showing symptoms of ADHD yet to be confirmed with a formal diagnosis between 2019 and 2021. ADHD symptom scores were ascertained by a parent survey questionnaire completed at the initial visit before MOA treatment, and 2 to 6 months, and 7+ months during MOA treatment. RESULTS At the 7+ month endpoint, 17 of the 28 (61%) children ages 5 to 12 saw at least a 1-point drop in the sum of their questionnaire scores indicating an improvement in ADHD symptoms after initiating treatment with an MOA. Although there was a reduction of the overall average symptom score from the initial visit to 2 to 6 months (M = 4.06, SD ± 1.55), a statistically significant improvement in ADHD symptoms occurred at the 7+ month endpoint (M = 15.29, SD ± 4.50) during MOA treatment. CONCLUSIONS Treatment with an MOA may be highly effective in addressing the dual pathologies of SDB and ADHD in school-age children ages 5 to 12.
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Gómez-Álzate AM, Hidalgo-López C, García-Valencia J, Martínez-Zamora M, Aguirre-Acevedo DC, Cuartas-Arias M, Arcos-Burgos M, Valencia-Evhecerry J, Lopez-Jaramillo C, Palacio-Ortiz JD. Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:193-200. [PMID: 37923415 DOI: 10.1016/j.rcpeng.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/23/2021] [Indexed: 11/07/2023]
Abstract
OBJECTIVE We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.
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Affiliation(s)
- Alejandra María Gómez-Álzate
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Catalina Hidalgo-López
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Jenny García-Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Marta Martínez-Zamora
- Departamento de Psicología, Universidad CES, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Mauricio Cuartas-Arias
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Johanna Valencia-Evhecerry
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Carlos Lopez-Jaramillo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia.
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Soltani A, Schworer EK, Esbensen AJ. The Mediatory Role of Executive Functioning on the Association Between Sleep and Both Everyday Memory and ADHD Symptoms in Children and Youth With Down Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:82-95. [PMID: 36548372 PMCID: PMC9793936 DOI: 10.1352/1944-7558-128.1.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/12/2022] [Indexed: 06/17/2023]
Abstract
People with Down syndrome (DS) commonly experience challenges with sleep, executive functioning, everyday memory, and symptoms of attention deficit hyperactivity disorder (ADHD). A path analysis was conducted to determine if executive function mediated the relationship between sleep problems and both everyday memory and ADHD symptoms. Parents of 96 children and youth with DS completed questionnaires related to sleep, executive functioning, everyday memory, and ADHD symptoms. Results showed that executive functioning fully mediated the relation between sleep and both everyday memory and ADHD symptoms. Implications for education and intervention for children and youth with DS are discussed.
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Affiliation(s)
- Amanallah Soltani
- Department of Educational Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Emily K. Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Keshen AR, Hilbert A, Taylor V, Harris AL, Trappenberg N, Sadek J, Frank GKW, Murray SB. Effect of stimulant medication on loss of control eating in youth with attention deficit/hyperactivity disorder: a prospective, observational case series study protocol. J Eat Disord 2022; 10:152. [PMID: 36320022 PMCID: PMC9628055 DOI: 10.1186/s40337-022-00674-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/21/2022] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Loss of control eating (LOC-E) in youth predicts the later development of full-syndrome binge-eating disorder (BED), and therefore, could be a relevant target for prevention treatments. To develop these treatments, it is important to understand the underlying disease processes and mechanisms. Based on the putative role of neurocognitive impairments in the pathogenesis of LOC-E, treatments that modulate these neurocognitive factors warrant further exploration. For instance, stimulants are an effective treatment for impulsivity in youth with attention deficit/hyperactivity disorder (ADHD) and have been shown to improve symptoms of BED in adults. Notably, stimulants have not been examined as a treatment for LOC-E in youth. To explore this gap, we aim to measure change in LOC-E episodes and secondary outcomes in youth with comorbid ADHD and LOC-E who are being started on stimulants. METHODS We will collect prospective observational data on forty 8-to-13-year-old youth diagnosed with comorbid ADHD and LOC-E who are initiating a stimulant for ADHD. Prior to stimulant initiation, participants will complete baseline measures including LOC-E episode frequency in the last 3 months (primary outcome), and secondary outcomes including disordered eating cognitions, emotions and behaviors, ADHD symptom severity, parental LOC-E, impulsivity and reward sensitivity, and anxiety/mood severity. Outcome measurements will be gathered again at 3-months after initiating the stimulant. Within-patient standardized effect sizes with 95% confidence intervals will be calculated from baseline to 3-month follow-up for all outcomes. DISCUSSION Many individuals with LOC-E or binge eating do not fully remit over the course of psychotherapy. Whereas psychotherapy may address psychological and sociocultural domains associated with LOC-E, some individuals with neurocognitive impairments (e.g., ADHD) and neurobiological deficits (e.g., low intrasynaptic dopamine or norepinephrine) may benefit from adjunctive treatment that targets those factors. This will be the first study to provide pilot data for future studies that could examine both the effect of stimulants on LOC-E in youth and underlying mechanisms. TRIAL REGISTRATION Trial registration number: NCT05592119.
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Affiliation(s)
- Aaron R Keshen
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada. .,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Victoria Taylor
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Anastasia L Harris
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Nami Trappenberg
- Eating Disorder Program, Nova Scotia Health Authority, Halifax, NS, Canada
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Guido K W Frank
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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Associations between Family Functioning and Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD): A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10081502. [PMID: 36011159 PMCID: PMC9408192 DOI: 10.3390/healthcare10081502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Poor family functioning is linked with poor child ADHD symptoms. However, there are many dimensions of family functioning. Thus, this study aims to find the association between each dimension of family functioning and controlled ADHD symptoms in an Asian culture. This cross-sectional study involved caregivers of 113 Thai children with ADHD ages 4–16 years old who visited the Outpatient Department at Maharaj Nakorn Chiang Mai Hospital between October 2017 and March 2018. The caregivers completed the Chulalongkorn Family Inventory and the SNAP-IV Thai version. Logistic regression was used to examine each dimension of family functioning adjusting for potential confounders. In univariate analyses, six of the seven dimensions of family functioning were associated with controlled ADHD symptoms. In multivariate analyses, findings revealed that good family roles (aOR 7.48, 95% CI = 1.56 to 35.85, p = 0.01) and behavior control (aOR 2.56, 95% CI = 1.08 to 6.03, p = 0.03) were associated with controlled ADHD symptoms. In children with ADHD with poor symptom control, the assessment of family functioning could be helpful. Developing a more specific intervention for caregivers that promotes good family roles and behavioral control may be beneficial.
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Caring for adolescents and young adults with attention-deficit/hyperactivity disorder in primary care: seizing opportunities to address youth mental health needs. Curr Opin Pediatr 2022; 34:306-312. [PMID: 35792652 DOI: 10.1097/mop.0000000000001127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To provide primary care providers (PCPs) with updated practical guidance around the assessment and management of attention-deficit/hyperactivity disorder (ADHD) in adolescents and young adults (AYA). RECENT FINDINGS Of the three different presentations of ADHD delineated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Predominantly Inattentive presentation is the most common among AYA. Multiple rating scales exist to assist clinicians in identifying ADHD symptoms and monitoring treatment effects. Importantly, ADHD frequently persists into adulthood with negative impacts in many life domains if left untreated. It is important for PCPs to provide support for AYA as they transition to adulthood, as treatment adherence often drops sharply at that time, and, once treatment is discontinued, it is rarely restarted. Further, clinicians should be aware of the negative psychological, behavioral, and social impacts that COVID-19 has had on AYA with ADHD. SUMMARY AYA with ADHD often seek care first from PCPs. However, diagnosis and management of ADHD among AYA are challenging, and many clinicians feel ill-equipped, creating concern that many youth may go undiagnosed and untreated. Despite these long-standing challenges, recent advances have opened up critical opportunities for PCPs to proactively address ADHD in primary care settings and make a profound impact on youth as they seek to realize their full potential.
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Ronen GM, Rosenbaum PL, Streiner DL. Patient perspectives in pediatric neurology: a critical shift in the paradigm of outcome measurement. Dev Med Child Neurol 2022; 64:149-155. [PMID: 34091886 DOI: 10.1111/dmcn.14954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 01/19/2023]
Abstract
This review explores children's self-reported outcome measurements in pediatric neurology. We examine the following questions: (1) What is meant by patient-reported health, functioning, and quality of life outcomes? (2) How can patients express whether the interventions they receive do more good than harm? (3) Why and how should pediatric neurology patients help determine the outcomes of interest? (4) What tools and recommendations are available to evaluate the outcomes of interest? Applying patients' perspectives across the processes of evaluation of medical interventions has become an important expectation. These developments, consistent with current healthcare goals, coincide with the evolution of pediatric neurology into a sophisticated diagnostic-interventional field that aims to prolong survival, decrease impairments and symptoms, and improve patients' well-being - the recognized essential endpoints of interest in all medicine.
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Affiliation(s)
- Gabriel M Ronen
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Peter L Rosenbaum
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Institute for Applied Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David L Streiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Gómez-Álzate AM, Hidalgo-López C, García-Valencia J, Martínez-Zamora M, Aguirre-Acevedo DC, Cuartas-Arias M, Arcos-Burgos M, Valencia-Evhecerry J, Lopez-Jaramillo C, Palacio-Ortiz JD. Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00077-9. [PMID: 34147265 DOI: 10.1016/j.rcp.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/20/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.
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Affiliation(s)
- Alejandra María Gómez-Álzate
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Catalina Hidalgo-López
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García-Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Mauricio Cuartas-Arias
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Johanna Valencia-Evhecerry
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Lopez-Jaramillo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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