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Cordeiro ML, Farias AC, Whybrow PC, Felden EPG, Cunha A, da Veiga V, Benko CR, McCracken JT. Receiver Operating Characteristic Curve Analysis of Screening Tools for Bipolar Disorder Comorbid With ADHD in Schoolchildren. J Atten Disord 2020; 24:1403-1412. [PMID: 26721636 DOI: 10.1177/1087054715620897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/15/2022]
Abstract
Objective: We compared Child Behavior Checklist (CBCL)-AAA (Attention Problems, Aggressive Behavior, and Anxious/Depressed) and Parent-Young Mania Rating Scale (P-YMRS) profiles in Brazilian children with ADHD, pediatric-onset bipolar disorder (PBD), and PBD + ADHD. Method: Following analyses of variance or Kruskal-Wallis tests with multiple-comparison Least Significant Difference (LSD) or Dunn's Tests, thresholds were determined by Mann-Whitney U Tests and receiver operating characteristic (ROC) plots. Results: Relative to ADHD, PBD and PBD + ADHD groups scored higher on the Anxious/Depressed, Thought Problems, Rule-Breaking, and Aggressive Behavior subscales and Conduct/Delinquency Diagnostic Scale of the CBCL; all three had similar attention problems. The PBD and PBD + ADHD groups scored higher than the ADHD and healthy control (HC) groups on all CBCL problem scales. The AAA-profile ROC had good diagnostic prediction of PBD + ADHD. PBD and PBD-ADHD were associated with (similarly) elevated P-YMRS scores. Conclusion: The CBCL-PBD and P-YMRS can be used to screen for manic behavior and assist in differential diagnosis.
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Affiliation(s)
- Mara L Cordeiro
- University of California, Los Angeles, USA.,Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil.,Faculdades Pequeno Príncipe, Curitiba, Brazil
| | - Antonio C Farias
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil.,Children's Hospital Pequeno Príncipe, Curitiba, Brazil
| | | | | | | | | | - Cássia R Benko
- Pelé Pequeno Príncipe Research Institute, Curitiba, Brazil
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Bara TS, Farias AC, Felden EPG, Cordeiro ML. Receiver operating characteristic curve analysis of the Child Behavior Checklist and Teacher's Report Form for assessing autism spectrum disorder in preschool-aged children. Neuropsychiatr Dis Treat 2017; 14:95-102. [PMID: 29343961 PMCID: PMC5749382 DOI: 10.2147/ndt.s151185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social, behavioral, and communication impairments with an estimated prevalence of 1 in 68 school-aged children. There is a need for objective and easily applicable instruments for early identification of autistic children to enable initiation of early interventions during a very sensitive period of brain development and, consequently, optimize prognosis. Here, we tested the utility of the Child Behavior Checklist (CBCL) and the Caregiver-Teacher's Report Form (C-TRF) scales for assessing ASD in Brazil, where ASD screening research is emergent. SUBJECTS AND METHODS A total of 70 children (2-5 years old, both sexes) were enrolled, including an ASD group (n=39) and a non-ASD control group (n=31). The preschool versions of the CBCL and C-TRF were applied. The CBCL and C-TRF results were compared between the ASD and non-ASD control groups with Mann-Whitney U tests and receiver operating characteristic analyses. RESULTS The CBCL and C-TRF were found to have moderate accuracy for the dimensions withdrawn and autism spectrum problems, and to correlate with each other. CONCLUSION The CBCL and C-TRF may aid in early ASD detection.
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Affiliation(s)
- Tiago S Bara
- Neurosciences Core, Pelé Pequeno Príncipe Research Institute
- Faculdades Pequeno Príncipe
| | - Antonio C Farias
- Neurosciences Core, Pelé Pequeno Príncipe Research Institute
- Faculdades Pequeno Príncipe
- Department of Neuropediatrics, Children’s Hospital, Pequeno Príncipe
- School of Medicine, University Positivo, Curitiba
| | - Erico PG Felden
- Centro de Ciências da Saúde e do Esporte (CEFID) da Universidade do Estado de Santa Catarina, Florianópolis, Brazil
| | - Mara L Cordeiro
- Neurosciences Core, Pelé Pequeno Príncipe Research Institute
- Faculdades Pequeno Príncipe
- Department of Psychiatry and Biobehavior Sciences, David Geffen School of Medicine, Semel Institute for Neusroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Benko CR, Farias AC, Farias LG, Pereira EF, Louzada FM, Cordeiro ML. Potential link between caffeine consumption and pediatric depression: A case-control study. BMC Pediatr 2011; 11:73. [PMID: 21867528 PMCID: PMC3180267 DOI: 10.1186/1471-2431-11-73] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 08/25/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early-onset depressive disorders can have severe consequences both from developmental and functional aspects. The etiology of depressive disorders is complex and multi-factorial, with an intricate interaction among environmental factors and genetic predisposition. While data from studies on adults suggest that caffeine is fairly safe, effects of caffeine in children, who are in period of rapid brain development, are currently unknown. Furthermore, systematic research addressing the relationship between depressive symptoms in children and caffeine consumption is lacking.The present study examined the effects of caffeine consumption on depressed mood in children with depression and non-depressed participants. METHODS Children and adolescents (n = 51) already enrolled in an ongoing longitudinal study, aged 9-12 years, were assessed for depressive symptoms with the Children Depressive Inventory (CDI). Psychopathological symptoms were assessed with the Child Behavioral Checklist (CBCL) and eating habits were assessed with the Nutrition-Behavior Inventory (NBI) 1. The children were compared to control children without psychopathology attending public schools in a Southern Brazilian city. RESULTS Participants with CDI scores ≥ 15 (mean = 19; S.D. = 4) also had high NBI scores (mean = 52; S.D. = 19, p < 0.001) suggestive of a relationship between depressive symptoms and environmental factors, in this case nutrition/behavior. Additional linear regression adjusted statistical analysis, considering the factors of consumption of sweets and caffeine individually, showed that caffeine, but not sweets, was associated with depressive symptoms. CONCLUSIONS These findings indicate that depressed children consume more caffeinated drinks than non-depressed children. Nonetheless while a strong association between depressive symptoms and caffeine consumption among children was found, further research should investigate whether or not this association is due to a cause and effect relationship.
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Affiliation(s)
- Cássia R Benko
- Department of Neuropsychopharmacology - Pelé Pequeno Príncipe Research Institute, Av. Silva Jardim 1632, Curitiba, 80250-200 PR, Brazil
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba, 80230-020, PR, Brazil
- Department of Psychology, Children's Hospital Pequeno Príncipe, Av. Desembargador Motta 1070, Curitiba, 80250-060, PR, Brazil
| | - Antonio C Farias
- Department of Neuropsychopharmacology - Pelé Pequeno Príncipe Research Institute, Av. Silva Jardim 1632, Curitiba, 80250-200 PR, Brazil
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba, 80230-020, PR, Brazil
- Department of Neuropediatrics, Children's Hospital Pequeno Príncipe, Av. Desembargador Motta 1070, Curitiba, 80250-060, PR, Brazil
| | - Lucilene G Farias
- Department of Neuropsychopharmacology - Pelé Pequeno Príncipe Research Institute, Av. Silva Jardim 1632, Curitiba, 80250-200 PR, Brazil
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba, 80230-020, PR, Brazil
| | - Erico F Pereira
- Department of Physiology, Federal University of Parana, Curitiba, 81531-990, PR, Brazil
| | - Fernando M Louzada
- Department of Physiology, Federal University of Parana, Curitiba, 81531-990, PR, Brazil
| | - Mara L Cordeiro
- Department of Neuropsychopharmacology - Pelé Pequeno Príncipe Research Institute, Av. Silva Jardim 1632, Curitiba, 80250-200 PR, Brazil
- Faculdades Pequeno Príncipe, Av. Iguaçu, 333, Curitiba, 80230-020, PR, Brazil
- Department of Psychiatry and Biobehavioral Sciences of the David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 700 Westwood Plaza, Los Angeles, 90025, CA, USA
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Cordeiro ML, Farias AC, Cunha A, Benko CR, Farias LG, Costa MT, Martins LF, McCracken JT. Co-Occurrence of ADHD and high IQ: a case series empirical study. J Atten Disord 2011; 15:485-90. [PMID: 20576645 DOI: 10.1177/1087054710370569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and ADHD. METHOD Students attending public schools, in the first to fifth grades, were referred to our Research Center for behavioral and/or learning difficulties. These children completed clinical, psychiatric, psychological, and pedagogical evaluations for assessment of IQ, ADHD, learning, and other emotional or behavioral disorders. RESULTS Fifteen of the participants were identified to have a full-scale IQ ≥ 120. Data show that 10 of these high-IQ children met the DSM-IV criteria diagnosis for ADHD combined type, 5 met criteria for current oppositional-defiant disorder, 2 had current major depression, and 2 had a learning disorder. Here we present the results as a case series. CONCLUSION Our data support the hypothesis that ADHD is a valid diagnosis in children with high IQs.
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Farias AC, Cunha A, Benko CR, McCracken JT, Costa MT, Farias LG, Cordeiro ML. Manganese in children with attention-deficit/hyperactivity disorder: relationship with methylphenidate exposure. J Child Adolesc Psychopharmacol 2010; 20:113-8. [PMID: 20415606 DOI: 10.1089/cap.2009.0073] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder that affects children worldwide. The etiology of ADHD is complex and not fully understood. Earlier studies associated elevated levels of manganese (Mn) with learning problems, attention deficits, and ADHD. Furthermore, it has also been shown that the dopamine (DA) system, the primary site of action of pharmacological ADHD treatments, is influenced by high levels of Mn. Recent studies have suggested that Mn accumulates in dopaminergic neurons via the presynaptic dopamine transporter (DAT). A role for altered functioning of the dopaminergic system in the etiology of ADHD has been well established through neurochemical, neurophysiological, imaging, and genetics studies. Methylphenidate (MPH) is a psychostimulant commonly used to manage ADHD symptoms. The pharmacotherapeutic effect of MPH occurs primarily through its action of inhibiting DAT, and thus increasing dopamine, as well as other catecholamines, at the synapse. We assessed a group of children with ADHD and matched control children without psychopathology attending public schools in a southern Brazilian city and reported elevated serum concentrations of Mn in treatment-naïve children with ADHD compared to normal controls. Interestingly, children with ADHD receiving concurrent MPH showed no difference in Mn serum levels versus controls. We then prospectively assessed the impact of naturalistic treatment with MPH and determined that Mn concentrations were significantly reduced from baseline values following MPH exposure.
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Affiliation(s)
- Antonio C Farias
- Department of Neuropsychopharmacology, Pelé Pequeno Príncipe Research Institute, Av. Silva Jardim 1632, Curitiba, Parana, Brazil
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O'Neill P, Trombley L, Gundel M, Hunter T, Nicklas JA, Ferreira ML, Bugallo MJ, Farias AC, Lohr A, Diamantopoulos M, Raskin S. Identification of a new Lesch-Nyhan syndrome mutation (HPRTBrasil) and analysis of potentially heterozygous females. Arq Neuropsiquiatr 1999; 57:907-11. [PMID: 10683677 DOI: 10.1590/s0004-282x1999000600001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The mutation in the hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene has been determined in two brothers affected with Lesch-Nyhan syndrome. Female members of the family who are at risk for being heterozygous carriers of the HPRT mutation were also studied to determine whether they carry the mutation. DNA sequencing revealed that the boys' mother is heterozygous for the mutation in her somatic cells, but that three maternal aunts are not heterozygous. Such carrier information is important for the future pregnancy plans of at-risk females. The mutation, an A-->T transversion at cDNA base 590 (590A-->T), results in an amino acid change of glutamic acid to valine at codon 197, and has not been reported previously in a Lesch-Nyhan syndrome male. This mutation is designated HPRTBrasil.
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Affiliation(s)
- P O'Neill
- Genetics Laboratory, University of Vermont, Burlington, USA
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