RESUMO
Attention deficit hyperactivity disorder (ADHD) is a very common disorder in children and adults. A connection with sleep disorders, and above all, disorders of the circadian rhythm are the subject of research and debate. The circadian system can be represented on different levels. There have been a variety of studies examining 24-h rhythms at the behavioral and endocrine level. At the molecular level, these rhythms are based on a series of feedback loops of core clock genes and proteins. In this paper, we compared the circadian rhythms at the behavioral, endocrine, and molecular levels between children with ADHD and age- and BMI-matched controls, complementing the previous data in adults. In a minimally invasive setting, sleep was assessed via a questionnaire, actigraphy was used to determine the motor activity and light exposure, saliva samples were taken to assess the 24-h profiles of cortisol and melatonin, and buccal mucosa swaps were taken to assess the expression of the clock genes BMAL1 and PER2. We found significant group differences in sleep onset and sleep duration, cortisol secretion profiles, and in the expression of both clock genes. Our data suggest that the analysis of circadian molecular rhythms may provide a new approach for diagnosing ADHD in children and adults.
RESUMO
Objective: The present study aimed to validate the German version of the Conners Early Childhood (EC)™ among German-speaking children. Method: A total of 720 parental and 599 childcare provider ratings of 2- to 6-year-old children were surveyed throughout Germany. Validity was assessed by calculating exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs), and a series of multivariate analyses of variance (MANOVAs) to analyze associations between Conners EC™ symptom ratings and sociodemographic variables. In addition, parent and childcare provider ratings of Conners EC™ scales were correlated with a number of other well-validated German measures assessing preschoolers' behaviors. Results: Although the EFA yielded different factors than the original scales, CFA revealed acceptable to good model fits. Conclusion: Overall, we confirmed the factor structure of the Conners EC's™ American original within the German validation. The use of the American factor structure is justified and can be recommended to facilitate international research on psychopathology in early childhood.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Criança , Pré-Escolar , Análise Fatorial , Alemanha , Humanos , Pais , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Electroconvulsive Therapy (ECT) of a 15-year-old female patient suffering from a severe delusional depression: a case report Abstract. OBJECTIVE: Electroconvulsive Therapy (ECT) is a modern therapy of severe psychiatric disorders. However, ECT is rarely used in treating children and adolescents with psychiatric disorders. This case report refers about a 15-year-old female patient suffering from severe depressive episodes with psychotic symptoms treated with ECT. METHOD: After unsuccessful combined behavioral therapy and medication, the patient received a total of 11 ECT treatments with right unilateral electrode placement. The severity of depressive symptoms was assessed by self (BDI-II) and external (HDRS21) scores before, during and after treatment. RESULTS: A rapid decline of depressive symptoms was observed. CONCLUSION: ECT provides a safe and effective method for the treatment of severe depressive disorders in childhood and adolescence and should be included earlier than usual into the standard therapeutic concepts.