Analysis of the effectiveness of a training program for parents of children with ADHD in a hospital environment.

INTRODUCTION: Regarding the Attention Deficit Hyperactivity Disorder (ADHD), treatments combined with pharmacological, psychoeducational and parents training programs interventions are recommended. Parenting programs have been proven efficacy in the experimental area, but there is few data about their effectiveness and feasibility in the professional area. The objective of the study is to analyze the effectiveness of a parenting program implemented in a hospital setting to improve internalized and externalized behaviors as well as parenting styles in a sample of ADHD children. METHODOLOGY: A training program for behavior management was applied to parents of 21 children with ADHD in a quasi-experimental pretest-posttest design, using measures from Child Behavior Checklist (CBCL) and Parenting Scale. RESULTS: Post-treatment data showed significant improvements specially on emotional, anxiety and oppositional defiant disorder measures. A significant but moderate improvement was found on ADHD, and non-significant on conduct problem measure. Additionally, there were moderate but significant improvements in parenting styles. CONCLUSIONS: Data support the effectiveness and feasibility of parent training programs for children with ADHD applied in hospital settings as they improve a large part of associated symptoms and parenting styles.

No radiographic sacroiliitis progression was observed in patients with early spondyloarthritis at 6 years: results of the Esperanza multicentric prospective cohort.

OBJECTIVE: To estimate the 6-year radiographic progression of sacroiliitis in patients with early spondyloarthritis (SpA). PATIENTS AND METHODS: Sacroiliac joint (SIJ) radiographs (baseline and 6 years) of 94 patients with recent-onset SpA from the Esperanza cohort were scored, blindly and in a random order, by nine readers. The modified New York criteria were used to define the presence of sacroiliitis. As the gold standard for radiographic (r) sacroiliitis, the categorical opinion of at least five readers was used. Progression was defined as the shift from non-radiographic (nr) to r-sacroiliitis. RESULTS: In the 94 SIJ radiographs (baseline and 6 years), 78/94 (83%) pairs of radiographs had not changed from baseline to 6 years. Sacroiliitis was present in 20 patients at baseline (21.3%) and in 18 (19.2%) patients at 6 years; 11 patients had sacroiliitis at both the baseline and final visits; 9 patients changed from baseline r-sacroiliitis to nr-sacroiliitis at 6 years, and 7 changed from baseline nr-sacroiliitis to r-sacroiliitis at 6 years. The mean continuous change score (range: -8 to +8) was 2.80 at baseline and 2.55 at 6 years (mean net progression of -0.25). The reliability of the readers was fair (mean inter-reader kappa of 0.375 (0.146-0.652) and mean agreement of 73.7% (58.7-90%)). CONCLUSION: In the early SpA Esperanza cohort, progression from nr-axSpA to r-axSpA over 6 years was not observed, although the SIJ radiographs scoring has limitations to detect low levels of radiographic progression.

Low-frequency transcranial magnetic stimulation in patients with fibromyalgia and major depression.

OBJECTIVE: To study the efficacy of low-frequency transcranial magnetic stimulation in patients with fibromyalgia and major depression. DESIGN: Twenty-eight patients were randomly assigned to receive 20 sessions of real or sham transcranial magnetic stimulation of the right dorsolateral prefrontal cortex. The main stimulation parameters were 15 trains at 110% of the motor threshold for 60 seconds at a frequency of 1 Hz. Blinded external evaluators administered the fibromyalgia scales (FibroFatigue, Likert pain) and the depression scales (Hamilton Depression Rating Scale, Clinical Global Impression) during the study. RESULTS: Both treatment groups (real and sham) improved their scores in some of the scales (FibroFatigue and Clinical Global Impression), although there were no differences between them. No improvements were observed in the Likert Pain Scale in either of the groups. CONCLUSION: With the methodology used in this study, patients with fibromyalgia and major depression who received real magnetic stimulation did not present significant differences in symptoms with respect to those who received sham magnetic stimulation.