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García-Hermoso A, Ezzatvar Y, Izquierdo M, López-Gil JF. Can an active lifestyle reduce the risk of obesity in adulthood among adolescents with Attention-Deficit/Hyperactivity Disorder symptoms? An ambispective cohort study. Psychiatry Res 2024; 334:115770. [PMID: 38350293 DOI: 10.1016/j.psychres.2024.115770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
Various studies have associated Attention-Deficit/Hyperactivity Disorder (ADHD) with obesity, but the role of physical activity in this connection is uncertain. This study examined whether adopting an active lifestyle can mitigate the link between adolescent ADHD and the risk of adult obesity. Longitudinal data from the Add Health Study (Waves I, III, and V) were used. Participants self-reported ADHD symptoms (hyperactivity/impulsivity, inattention, combined) during Wave III and self-assessed their recent moderate-to-vigorous physical activity. An "active lifestyle" required meeting activity criteria in both adolescence (Wave I) and adulthood (Wave III-V). Of 2609 participants, 1.42 % exhibited combined ADHD symptoms. A non-linear relationship was observed between inattentive/hyperactive scores and body mass index (BMI) and waist circumference (WC). Individuals with ≥ 6 hyperactivity/impulsivity symptoms had higher BMI (1.29 kg/m²) and WC (1.27 cm) at adulthood. Logistic regressions indicate that, compared to individuals without ADHD maintaining an active lifestyle, both inactive participants with and without ADHD show an elevated risk of obesity (odds ratio [OR]=1.56 to 2.63) and abdominal obesity in adulthood (OR = 1.51 to 2.50). Mediation analysis models further confirm these findings, suggesting that physical activity may explain this association. Though exact mechanisms warrant further exploration, adopting an active lifestyle offers promise for reducing obesity risk among individuals with ADHD symptoms.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), IdiSNA, Universidad Pública de Navarra (UPNA), Pamplona, Spain.
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Hospital Universitario de Navarra (HUN), IdiSNA, Universidad Pública de Navarra (UPNA), Pamplona, Spain
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Vanzella-Yang A, Vergunst F, Domond P, Vitaro F, Tremblay RE, Bégin V, Côté S. Childhood behavioral problems are associated with the intergenerational transmission of low education: a 16-year population-based study. Eur Child Adolesc Psychiatry 2024; 33:595-603. [PMID: 36932229 DOI: 10.1007/s00787-023-02193-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
The intergenerational transmission of low educational attainment is well-documented, but little is known about how behavioral problems in childhood explain this association. Drawing upon a population-based cohort study (n = 3020) linked to administrative records, we investigated the extent to which inattentive, internalizing, externalizing, and prosocial behaviors at child ages 6-8 years accounted for associations between parental education and child's risk of failing to graduate from high school. We adjusted for economic, demographic, cognitive, and perinatal factors, as well as parental mental health. Using logistic regressions and the Karlson-Holm-Breen decomposition method, we found that childhood behaviors together explained 19.5% of the association between mother's education and child's high school graduation status at age 22/23, and 13.7% of the association between father's education and this same outcome. Inattentive behaviors were most strongly associated with failure to graduate from high school, while the role of other behaviors was modest or negligible. Inattentive behaviors may represent a mediational pathway between parental education and child education. Early interventions targeting inattentive behaviors could potentially enhance the prospects of intergenerational educational mobility.
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Affiliation(s)
- Adam Vanzella-Yang
- School of Public Health, University of Montreal, Montreal, Canada.
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
| | - Francis Vergunst
- School of Public Health, University of Montreal, Montreal, Canada
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Special Needs Education, University of Oslo, Oslo, Norway
| | - Pascale Domond
- School of Public Health, University of Montreal, Montreal, Canada
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
- Department of Pediatrics and Department of Psychology, University of Montreal, Montreal, Canada
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Vincent Bégin
- Department of Psychoeducation, University of Sherbrooke, Sherbrooke, Canada
| | - Sylvana Côté
- School of Public Health, University of Montreal, Montreal, Canada
- Sainte-Justine Hospital Research Center, University of Montreal, 3175 Côte Sainte-Catherine, Montreal, QC, H3T 1C5, Canada
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Thamrongsak C, Chirdkiatgumchai V, Jotikasthira W, Kiewngam P, Kanchongkittiphon W, Manuyakorn W. Improvement of inattentive and hyperactive symptoms after real-life rhinitis treatment in school-aged children. Int J Pediatr Otorhinolaryngol 2022; 157:111138. [PMID: 35429872 DOI: 10.1016/j.ijporl.2022.111138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Rhinitis treatment may improve attention-deficit/hyperactivity symptoms in children. The current study evaluated changes in inattentive and hyperactive symptoms after treatment in children with chronic rhinitis. METHODS Children aged 5-18 years with chronic rhinitis were enrolled in a 3-month prospective study. The nasal provocation test for house dust mites (HDM) and evaluation of allergen sensitization, including the skin prick test and the Phadiatop test, were performed. The severity of rhinitis was assessed according to the ARIA guideline. The total nasal symptom score and the Vanderbilt ADHD Diagnostic Rating Scale (VADRS) score for assessing inattentive and hyperactive symptoms were recorded at baseline and at 1 and 3 months after rhinitis treatment. Children with rhinitis were classified into the following two groups: HDM-induced allergic rhinitis (AR group) and non-allergic rhinitis to HDM (NAR group) based on the NPT. RESULTS Overall, 83 children completed the 3-month prospective study, and they had a mean age of 9.12 ± 2.89 years and 44.6% were boys. After rhinitis treatment, VADRS scores assessed by the parents and teachers were significantly decreased compared with those at baseline (p = 0.005). In subgroup analysis, 61 (73.49%) children had AR, and 22 (26.5%) children had NAR. No significant difference in the baseline VADRS score was found between the AR and NAR groups. After treatment, VADRS scores assessed by the parents and teachers were significantly decreased only in the AR group (p < 0.001). Forty-five (54.2%) children had moderate persistent rhinitis, 29 (34.9%) had mild persistent rhinitis, and 9 (10.8%) had mild intermittent symptoms. There were no differences in baseline VADRS scores assessed by the parents and teachers among children with mild intermittent, mild persistent, or moderate persistent symptoms. The total nasal symptom score and VADRS score were significantly decreased after treatment for all severities of rhinitis compared with those at baseline. A greater baseline VADRS score was associated with substantial improvement of inattentive and hyperactive symptoms after treatment. CONCLUSION Early treatment for rhinitis may improve inattentive and hyperactive symptoms in school-aged children.
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Affiliation(s)
- Chatsuda Thamrongsak
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Vilawan Chirdkiatgumchai
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wanlapa Jotikasthira
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Potjanee Kiewngam
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Wiparat Manuyakorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Chamberlain SR, Cortese S, Grant JE. Screening for adult ADHD using brief rating tools: What can we conclude from a positive screen? Some caveats. Compr Psychiatry 2021; 106:152224. [PMID: 33581449 PMCID: PMC7116749 DOI: 10.1016/j.comppsych.2021.152224] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/16/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022] Open
Abstract
Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent but often overlooked and undertreated. Left untreated, it is linked to increased risk of untoward outcomes including unemployment, relationship breakups, substance use, driving accidents and other mental health conditions. Several brief screening tools have been developed for adult ADHD. The most frequently used is the World Health Organization's Adult ADHD Self-Report Scale (ASRS V1.1). Here, we show in two independent population samples (UK: N = 642, USA: N = 579) that the tool resulted in considerable overestimation of ADHD, indicating probable ADHD in 26.0% and 17.3% of participants, as compared to expected prevalence of 2.5%. The estimated positive predictive value was only ~11.5%. Both samples had normal levels of trait impulsivity as assessed using the Barratt Impulsiveness Scale. The data indicate that using the ASRS in general population samples will result in 7-10 times over-identification of ADHD. We use these results to highlight how such tools should most appropriately be used. When being used to determine possible cases (such as for onward referral to an ADHD specialist) they should be complemented by clinical assessment - we give examples of how non-specialists might determine this. When measuring ADHD symptoms dimensionally, researchers should be mindful that the ASRS captures impulsive symptoms other than those due to ADHD. Lastly, we note the need to screen for impulse control disorders (e.g., gambling disorder) when using such tools to measure ADHD, be it for onward referral, or for dimensional research studies.
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Affiliation(s)
- Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK,Southern Health NHS Foundation Trust, Southampton, UK,Department of Psychiatry, University of Cambridge, UK,Corresponding author at: Department of Psychiatry, University of Southampton, Southampton SO14 3DT, UK.
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK,Solent NHS Trust, Southampton, UK,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA
| | - Jon E. Grant
- Department of Psychiatry, University of Chicago, USA
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Orinstein AJ, Stevens MC. Brain activity in predominantly- inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task. Psychiatry Res 2014; 223:121-8. [PMID: 24953999 PMCID: PMC4120259 DOI: 10.1016/j.pscychresns.2014.05.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 03/18/2014] [Accepted: 05/18/2014] [Indexed: 10/25/2022]
Abstract
Previous functional neuroimaging studies have found brain activity abnormalities in attention-deficit/hyperactivity disorder (ADHD) on numerous cognitive tasks. However, little is known about brain dysfunction unique to the predominantly-inattentive subtype of ADHD (ADHD-I), despite debate as to whether DSM-IV-defined ADHD subtypes differ in etiology. This study compared brain activity of 18 ADHD-I adolescents (ages 12-18) and 20 non-psychiatric age-matched control participants on a functional magnetic resonance image (fMRI) auditory oddball attention task. ADHD-I participants had significant activation deficits to infrequent target stimuli in bilateral superior temporal gyri, bilateral insula, several midline cingulate/medial frontal gyrus regions, right posterior parietal cortex, thalamus, cerebellum, and brainstem. To novel stimuli, ADHD-I participants had reduced activation in bilateral lateral temporal lobe structures. There were no brain regions where ADHD-I participants had greater hemodynamic activity to targets or novels than controls. Brain activity deficits in ADHD-I participants were found in several regions important to attentional orienting and working memory-related cognitive processes involved in target identification. These results differ from those in previously studied adolescents with combined-subtype ADHD, who had a lesser magnitude of activation abnormalities in frontoparietal regions and relatively more discrete regional deficits to novel stimuli. The divergent findings suggest different etiological factors might underlie attention deficits in different DSM-IV-defined ADHD subtypes, and they have important implications for the DSM-V reconceptualization of subtypes as varying clinical presentations of the same core disorder.
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Affiliation(s)
| | - Michael C. Stevens
- Olin Neuropsychiatry Research Center, The Institute of Living, Hartford, CT, USA,Yale University School of Medicine, New Haven, CT, USA,Corresponding author: Olin Neuropsychiatry Research Center, Whitehall Building, The Institute of Living/Hartford Hospital, Hartford, CT 06106, USA. Tel.: +1 (860) 545-7552; Fax: +1 (860) 545-7797;
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