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1.
Sci Rep ; 14(1): 13889, 2024 06 17.
Artículo en Inglés | MEDLINE | ID: mdl-38880826

RESUMEN

Children with attention deficit/hyperactivity disorder (ADHD) typically exhibit difficulties in emotion regulation. It has been shown that the dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) are crucially involved in these deficient processes. In this study, we aimed to explore the impact of electrical stimulation over the left dlPFC and right vmPFC on emotion regulation in children with ADHD. Twenty-four children with ADHD completed the Emotional Go/No-Go and Emotional 1-Back tasks while undergoing transcranial direct current stimulation (tDCS) in three separate sessions, each with a different electrode placement: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. During both real tDCS conditions, the accuracy of pre-potent inhibitory control and working memory performance improved, but not speed. This study provides evidence that the left dlPFC and the right vmPFC are involved in emotion regulation in ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Regulación Emocional , Estimulación Transcraneal de Corriente Directa , Humanos , Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Estimulación Transcraneal de Corriente Directa/métodos , Niño , Masculino , Femenino , Regulación Emocional/fisiología , Corteza Prefrontal/fisiopatología , Memoria a Corto Plazo/fisiología , Emociones/fisiología , Corteza Prefontal Dorsolateral/fisiología , Adolescente
2.
Iran J Child Neurol ; 17(1): 81-90, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36721828

RESUMEN

Objective: Attention-Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that may be associated with impaired Theory of Mind (ToM) and social cognition. ToM is a domain in social cognition, referring to one's ability to attribute beliefs, intents, perspectives, and understandings to oneself or others and to understand others' mental states. Materials & Methods: The present study enrolled 52 ADHD of adolescents and 41 healthy age-matched controls in this study. This study applied The Reading the Mind in The Eyes Task (RMET) and Theory of Mind Assessment Scale (Th.o.m.a.s.) for all participants. The results of these tasks were compared between the two study groups. Results: No significant differences were found between these two study groups regarding ToM abilities using mean scores in the Th.o.m.a.s. inventory and the RMET. Furthermore, no association was found between the mean score in the ToM (in both study groups) and this study's parameters of gender, mean age, birth rank, family structure, and income. Conclusion: This study did not support the hypothesis that adolescents with ADHD perform worse on ToM tasks.

3.
JAMA Psychiatry ; 80(1): 22-30, 2023 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-36449318

RESUMEN

Importance: Integrated care for children is rarely studied, especially in low- and middle-income countries, where generalists often provide mental health care. Objectives: To explore the effect of adding a child and youth component to an existing adult collaborative care program on mental health outcomes and receipt of care. Design, Setting, and Participants: This cluster randomized trial was conducted within an adult collaborative care program in Tehran, Iran. General practitioners (GPs), their 5- to 15-year-old patients, and patients' parents were included. Children and youths coming for routine medical visits who scored greater than the cutoff on the Strengths and Difficulties Questionnaire (SDQ) were followed up for 6 months. The study was conducted from May 2018 to October 2019, and analysis was conducted from March 2020 to August 2021. Interventions: GPs were randomized to either a 2.5-day training on managing common child mental health problems (intervention) or refresher training on identification and referral (control). Main Outcomes and Measures: Primary outcome was change in SDQ total problems score; secondary outcomes included discussion of psychosocial issues by the GPs and receipt of mental health care during the follow-up period. Results: Overall, 49 GPs cared for 389 children who scored greater than the cutoff on the SDQ (216 children in intervention group, 173 in control group). Patients' mean (SD) age was 8.9 (2.9) years (range, 5 to 15 years), and 182 (47%) were female patients. At 6 months, children in the intervention group had greater odds of receiving mental health care during the study (odds ratio [OR], 3.0; 95% CI, 1.1 to 7.7), parents were more likely to report that intervention GPs had discussed parent (OR, 2.1; 95% Cl, 1.1 to 3.8) and child (OR, 2.0; 95% Cl, 0.9 to 4.8) psychosocial issues, and intervention GPs were more likely to say they had provided counseling (OR, 1.8; 95% Cl, 1.02 to 3.3). However, there was no greater improvement in SDQ scores among children seen by intervention vs control GPs. Adjusted for clustering within GP, the variables used for balanced allocation (practice size, practice ownership, and study wave), and the other variables associated with change in SDQ scores over time, there was not a significant time-treatment interaction at either the 3- or 6-month follow-up points (linear combination of coefficients for intervention, 0.57 [95% CI, -1.07 to 2.22] and -0.08 [95%CI, -1.76 to 1.56], respectively). In a subgroup of GPs with practices composed of 50% or more children, children seen by intervention GPs improved to a significantly greater extent (-3.6 points; 95% CI, -6.7 to -0.46 points; effect size d = 0.66; 95% CI, 0.30 to 1.01) compared with those seen by control GPs. Conclusions and Relevance: In this cluster randomized trial, GP training on managing common child mental health problems did not demonstrate greater improvement in child SDQ scores. Child mental health training for GPs in collaborative care can improve children's access to mental health care, but prior experience working with children and their families may be required for GPs to use a brief training in a way that improves child outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT03144739.


Asunto(s)
Médicos Generales , Adulto , Adolescente , Humanos , Niño , Femenino , Preescolar , Masculino , Salud Mental , Irán , Consejo , Evaluación de Resultado en la Atención de Salud
4.
Health Sci Rep ; 5(5): e696, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35989943

RESUMEN

Introduction: Owing to the considerable mortality caused by Covid-19, different countries have made some decisions for dealing with this virus, one of which was quarantine. It was shown that a range of behavioral and emotional changes may exacerbate in children while staying more at home, and parents may then experience these positive or negative behavioral changes. The present study was conducted to examine the experiences of families with children with psychiatric disorders in a psychiatric outpatient clinic in Iran. Method: The phenomenological method, which is a qualitative approach, was used in this study. The population was the parents of children with psychiatric disorders referred to the pediatric psychiatric clinic of Imam Hossein Hospital. Sampling was purposeful, which continued until data saturation. Finally, the number of included participants reached 14. As well, the Colaizzi method was used for data analysis. Results: The results of this study included 12 secondary codes and 10 tertiary codes, which were divided into three main thematic groups as follows: effective factors for improving behavior, effective factors for worsening behavior, and affective factors on creating a new behavior during quarantine. Conclusion: In conclusion, quarantine, social restrictions, closure of schools, and online classes can affect the mental health status of children and adolescents in different ways, especially in children with a history of psychiatric disorders.

5.
Front Psychiatry ; 12: 665326, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34248702

RESUMEN

In recent years, the application of virtual reality (VR) for therapeutic purposes has escalated dramatically. Favorable properties of VR for engaging patients with autism, in particular, have motivated an enormous body of investigations targeting autism-related disabilities with this technology. This study aims to provide a comprehensive meta-analysis for evaluating the effectiveness of VR on the rehabilitation and training of individuals diagnosed with an autism spectrum disorder. Accordingly, we conducted a systematic search of related databases and, after screening for inclusion criteria, reviewed 33 studies for more detailed analysis. Results revealed that individuals undergoing VR training have remarkable improvements with a relatively large effect size with Hedges g of 0.74. Furthermore, the results of the analysis of different skills indicated diverse effectiveness. The strongest effect was observed for daily living skills (g = 1.15). This effect was moderate for other skills: g = 0.45 for cognitive skills, g = 0.46 for emotion regulation and recognition skills, and g = 0.69 for social and communication skills. Moreover, five studies that had used augmented reality also showed promising efficacy (g = 0.92) that calls for more research on this tool. In conclusion, the application of VR-based settings in clinical practice is highly encouraged, although their standardization and customization need more research.

6.
Data Brief ; 21: 1216-1219, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30456235

RESUMEN

The purpose of this data article is to present the prevalence of Internet addiction in people with a history of substance abuse disorder in Kerman during 2016-2017. For this purpose, 223 people with the history of substance abuse disorder in three cities of Kerman province completed the demographic form and Young׳s Internet addiction questionnaire. Demographic characteristics of participants was analyzed and presented here. Young׳s Addiction Commitment Questionnaire contains 20 questions, each with a score of 1 to 5. The history of participants about the drug abuse was investigated. In addition, the prevalence of Internet addiction among the participants was evaluated. The internet addiction is more common in people with a history of drug abuse which may be a behavioral substitute for drug addiction.

7.
J Dent (Shiraz) ; 19(3): 197-205, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30175189

RESUMEN

STATEMENT OF THE PROBLEM: It is postulated that attention deficit/hyperactivity disorder (ADHD) with or without medication has an inhibitory effect on the children's growth and development. PURPOSE: This study aimed to assess the dental age and cervical vertebral maturation (CVM) stage in ADHD patients with or without medication. MATERIALS AND METHOD: This cross-sectional study evaluated the pretreatment panoramic and lateral cephalograms of 129 patients (70 males, 59 females aged 8-14 years). Demirjian index and Baccetti's CVM index were used to determine the dental age and CVM stage, respectively. The subjects were evaluated in two groups of ADHD (case, n=59) and healthy individuals (control, n=70). The ADHD patients were divided into two groups of AWT (ADHD with Treatment, n=43) and AW (ADHD without treatment, n=16) based on the use of methylphenidate. Paired t-test was used to compare the mean dental age between the groups. Linear and ordered logistic regression models were used to detect differences between the groups. The association between dental and chronological age was assessed by using Pearson correlation coefficient (p< 0.05). RESULTS: After age and sex adjustment, the skeletal maturity stage was found to be similar to the control group based on the presence of the disorder or use of medication (p= 0.711 and p= 0.436, respectively). Similarly, the patients' dental age was similar to the controls in AW and AWT groups (p= 0.180 and p= 0.421, respectively). The correlation between dental age and chronological age was 0.79 in AWT, 0.88 in AW, and 0.88 in control group (p< 0.001 for all the three). CONCLUSION: After age and sex adjustment, the dental and skeletal age of ADHD patients with or without Methylphenidate treatment do no manifest a significant delay compared with the controls.

8.
Data Brief ; 19: 2336-2339, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30246098

RESUMEN

There is a positive relationship between attention-deficit hyperactivity disorder and tendency toward drug use in numerous studies. The present study was aimed to investigate the relationship between polymorphism of serotonin receptor 1B gene (HTR1B) and Dopamine beta-hydroxylase gene (DBH) with attention-deficit hyperactivity disorder in adults with or without substance use disorders. In the present case-control study, as many as 355 individuals entered the present study and was categorized in different groups: control healthy group, substance use disorders group, and attention-deficit hyperactivity disorder group. For confirming attention-deficit hyperactivity disorder in adults, demographic and Conners forms were used. Moreover, SCID-I questionnaire was used to confirm or reject the individual׳s suffering from substance use disorders and other psychiatric diseases. The polymorphism of abovementioned genes was conducted by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). In case of DBH gene-Rs2519152, the findings indicated that TT, TC, and CC genotypes and T and C alleles are not different in the attention-deficit hyperactivity disorder group, substance use disorder group, the group with patients suffering from both disorders, and control group. Moreover, the frequency of TT, TA, and AA genotypes as well as T and A alleles was same in the attention-deficit hyperactivity disorder group, substance use disorder group, the group with patients suffering from both disorders, and control group.

9.
Iran J Psychiatry ; 11(2): 99-103, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27437006

RESUMEN

OBJECTIVE: The aim of this study was to compare creativity in children with and without attention deficit hyperactivity disorder. METHOD: This was an analytic and descriptive study. Participants were 33 children aged 7-12 years selected from a child and adolescent psychiatric clinic at Imam Hossein hospital (Tehran, Iran), who were diagnosed with ADHD by a child and adolescent psychiatrist. They met the DSM-IV diagnostic criteria for ADHD and had no comorbidity according to K-SADS (Kiddi-Scadule for Affective disorders and Schizophrenia). They were requested not to take any medication. They took the Figural TTCT (Torrance Test of Creativity Thinking) and Raven Intelligence test after using medication. Thirty-three age and sex-matched children selected from the regional schools were recruited for the control group. They did not have any psychiatric disorders according to K-SADS. The Figural TTCT and Raven Intelligence test were conducted for the controls as well. RESULTS: No statistically significant difference was found in the intelligence score and the mean±SD of the total score of creativity between children with ADHD (125.2 ± 42.6) and the control group (130.6 ± 47.5) (P value = 0.49). Children with ADHD had worse function in fluency and flexibility items and were not different in originality and elaboration items. CONCLUSION: The creativity of children with ADHD is not different from that of the control group.

10.
Indian J Pediatr ; 83(3): 254-7, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26264632

RESUMEN

The aim of the present study was to compare the parenting styles in parents with and without adult attention deficit hyperactivity disorder (ADHD) who had children with ADHD. It was a case-control study with convenience sampling strategy. Participants were recruited from the parents of previously diagnosed children with ADHD referred to Imam Hossein Hospital, Tehran/ Iran. Ninety parents with adult ADHD and 120 normal parents were chosen by Conner's Adult ADHD Screening Scale (CAARS) and psychiatrist interview. Using Baumrind Parenting Styles Questionnaire and Arnold Parenting Scale, parenting styles were assessed in both the groups. Results from independent samples t-test indicated that Authoritarian parenting style (F = 0.576, p 0.022) and Over reacting style (F = 7.976, p 0.045) were significantly higher in cases. On the other hand, controls were using Permissive style (F = 0.131, p 0.044) more than cases. The results are consistent with prior studies; these findings can improve the content of parent training for children with ADHD, who have adult ADHD themselves.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Responsabilidad Parental/psicología , Padres/psicología , Adulto , Estudios de Casos y Controles , Niño , Femenino , Humanos , Irán , Masculino , Encuestas y Cuestionarios
11.
Iran Red Crescent Med J ; 17(7): e22996, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26421175

RESUMEN

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) can lead to drastic problems for the patient and its worldwide prevalence is 5%-12%. It also has many comorbidities with other disorders, and the genetic contribution seems the most significant cause. OBJECTIVES: The current study was conducted to investigate the association between norepinephrine transporter-3081 (A/T) polymorphisms and ADHD in Iranian population. PATIENTS AND METHODS: Participants were chosen from children and adolescents diagnosed with ADHD referred to Imam Hoseyn Hospital. A child and adolescent psychiatrist confirmed the diagnosis using the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL) semi-structural interview. The control group was from pupils of schools in Tehran (capital city of Iran) who had no history or presence of psychiatric and medical complications. Also, a child and adolescent psychiatrist confirmed their health using the K-SADS-PL semi-structural interview. Genetic examinations were DNA distraction, Polymerase Chain Reaction (PCR), and Restricted Fragment Length Polymorphism (RFLP), which were conducted according to standard protocols. The statistical analysis was performed using chi-square and Fisher's exact test in SPSS version 21. RESULTS: The percentages of ADHD subtypes for combined, inattentive, and hyperactive/impulsive were 72.2%, 17.2%, and 11.9%, respectively. There was no significant association between norepinephrine transporter polymorphism and ADHD (P = 0.81). Moreover, no significant relationship was found between gender [male (P = 0.92) and female (P = 0.63)] and polymorphism. No significant association was found between subtypes of ADHD [combined (P = 0.46), inattentive (P = 0.41), hyperactive/impulsive (P = 0.32)] and polymorphism SCL6A2. This lack of association can also be seen in gender in every subtype. CONCLUSIONS: The results of the study show no significant association between norepinephrine transporter polymorphism SCL6A2 and ADHD.

12.
Iran J Pediatr ; 25(1): e265, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26199694

RESUMEN

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. OBJECTIVES: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. PATIENTS AND METHODS: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated in a 6-week, double-blind clinical trial with risperidone (0.5-1.5 mg/d) and methylphenidate (5-20 mg/d), in two divided doses. Treatment outcomes were assessed using the Parent ADHD Rating Scale and Conners Rating Scale. Patients were assessed by a child psychiatrist at baseline, 2, 4 and 6 weeks after the medication started. Side effects were also rated by side effects questionnaire. RESULTS: There were no significant differences between the two protocols on the Parent ADHD Rating Scale scores (P > 0.05) and Parent Conners Rating Scale scores (P > 0.05). Both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment for parent ADHD Rating Scale (P < 0.001) and Parent Conners Rating Scale (P < 0.001). The most common adverse effects seen with risperidone were daytime drowsiness and anorexia (20%), and with methylphenidate it was anorexia (55%). CONCLUSIONS: Results of this study show that risperidone may be effective and well tolerated for ADHD in preschool children, but more researches are needed to clarify the potential benefits and adverse effects in long term use and comorbid conditions.

13.
Iran Red Crescent Med J ; 17(2): e23095, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25793118

RESUMEN

BACKGROUND: Bipolar disorder (BPD) is a common and severe mood disorder. Although genetic factors have important rolesin the etiology of bipolar disorder, no specific gene has been identified in relation to this disorder. Monoamine oxidase gene is suggested to be associated with bipolar disorder in many studies. OBJECTIVES: This study aimed to investigatethe role of MAOA gene polymorphisms in the etiology of bipolar disorder in Iranian population. PATIENTS AND METHODS: This study is a case-control study, with convenient sampling. Three common polymorphisms, a CA microsatellite, a VNTR, and a RFLP were typed in 156 bipolar patients and 173 healthy controls. Patients were chosen from Imam Hossein General Hospital, Psychiatry Ward (Tehran/Iran). Controlsamples for this study consisted of 173 healthy individuals recruitedby convenient sampling. Allelic distributions of these polymorphisms were analyzed in bipolar and control groups to investigate any association with MAOA gene. RESULTS: Significant associations were observed regarding MAOA-CA (P = 0.016) and MAOA-VNTR (P = 0.004) polymorphisms in the bipolar females. There was no association between MAOA-RFLP and bipolar disorder. CONCLUSIONS: The obtained results confirm some previous studies regardinga gender specific association of MAOA gene with the bipolar disorder.

14.
Int J High Risk Behav Addict ; 3(4): e22156, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25741485

RESUMEN

BACKGROUND: Victims of abuse comprise a significant proportion of all child psychiatric admissions, with an estimated 30% incidence of lifetime of physical and sexual abuse among child and adolescent outpatients, and as high as 55% among psychiatric inpatients. OBJECTIVES: The present study was conducted to examine the effects of therapeutic intervention and parent management training on parenting skill of abusive parents. PATIENTS AND METHODS: The study population consisted of all children who were referred to Child Psychiatric and Pediatric Departments of Imam Hossein Hospital, Tehran, IR Iran diagnosed with child abuse. Children and their families were visited by a psychiatrist for psychiatric problems. Later, the necessary interventions were taken for the children. To study the effect of intervention, parents completed 'Being a Parent and Parenting Scale' before intervention, and then again, in the third and sixth months following the intervention. The interventions included 8 weekly parent management training sessions for all of the involved parents and additional pharmacologic and psychological interventions according to the subjects' needs. RESULTS: Participants included 73 children with the mean age of 6.9 ± 4.3 year, while the mean age of parents was 31.76 ± 6.52 year for the mothers and 38.07 ± 8.45 year for the fathers. General anxiety disorder (30.1%) and depression (27.4%) were the most common psychiatric disorders among mothers. In parenting scale, there were significant differences between the zero and third month in all subscales (P = 0.008), but there was no significant difference in verbosity and overreactivity after 6 months. Laxness showed significant changes over the period (P = 0.03). In viewing the 'Being a Parent Scale', there was no significant difference in satisfaction and competency subscales before and after the intervention. CONCLUSIONS: Therapeutic intervention and parent management training improves parenting skill of abusive parents, and this might lead to fewer incidents of abuse or neglect.

15.
Asian Pac J Cancer Prev ; 12(5): 1329-32, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21875291

RESUMEN

OBJECTIVE: It is well established that treatment modalities against cancer have psychosocial and serious medical side effects especially neurologic, learning, and intellectual disorders among children with cancer. The aim of this study was to evaluate the behavioral change specially the effect of chemotherapy and cranial radiotherapy on the development of attention deficit hyperactivity disorder (ADHD) in children with cancer. MATERIALS AND METHODS: The children diagnosed with cancer and referred to Mahak Hospital (a well funded charity organization helping children with cancer in Iran) participated in this study. To assess the post treatment behavior, the Conner's Rating Scales (CRS) questionnaire, which its reliability and validity has been well established was administrated by trained interviewer in a two hour sessions to mother or attending nurses of the cases. The relationship between attention deficits, hyperactivity disorder were assessed with different categories of treatment, socio-economic status, age at diagnosis, sex, as well as duration since treatment. RESULTS: During periods of six months, 30 subjects (16 male and 14 female) were studied and participated in the study. Fifteen cases had both radiotherapy as well as chemotherapy and 15 cases just had chemotherapy as their treatment regiment. The mean Conner's Rating Score (total score of ADHD) were higher among those who received both chemotherapy and radiotherapy compared with those who had just chemotherapy but it was not statistically significant (34.7∓12.6 for just chemotherapy and 39.3∓9.0 for chemo and radiotherapy together). The total Conner's Rating Score was higher among girls compared to boys (mean ∓ standard deviation was 39.8∓9.4 for girls and 33.7∓12 for boys). Duration since treatment, age diagnosis, and mother's level of education had effect in post treatment intellectual capacity and behavioral aspect of patients. CONCLUSION: In the light of dramatic improvement of survival among children with cancer the intellectual and behavioral impairment due to treatment modalities needs serious attention and proper medical management.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/etiología , Trastornos de la Conducta Infantil/etiología , Discapacidad Intelectual/etiología , Neoplasias/tratamiento farmacológico , Neoplasias/radioterapia , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Síntomas Conductuales/etiología , Sistema Nervioso Central/efectos de los fármacos , Sistema Nervioso Central/efectos de la radiación , Niño , Preescolar , Terapia Combinada/efectos adversos , Escolaridad , Femenino , Humanos , Irán , Masculino , Radioterapia/efectos adversos , Encuestas y Cuestionarios
16.
Eur Child Adolesc Psychiatry ; 18(1): 53-9, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18563471

RESUMEN

BACKGROUND AND PURPOSE: Attention deficit-hyperactivity disorder (ADHD) is a common psychiatric diagnosis among children and adolescents. This study has been conducted to evaluate the efficacy and tolerability of reboxetine in comparison with methylphenidate in treatment of children and adolescents with ADHD. METHODS: Thirty three children, 7-16 years of age, diagnosed with ADHD, participated in a 6-week, double-blind clinical trial with reboxetine (4-6 mg/d) and methylphenidate (20-50 mg/d) in two divided doses. The principal measure of the outcome was the Teacher and Parent ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline, 14, 28, and 42 days after the start of medication. RESULTS: No significant differences were observed between the two protocols on the Parent (P = 0.26) and Teacher (P = 0.97) ADHD Rating Scale scores and in treatment dropouts. A significant improvement in ADHD symptoms was observed over the 6 weeks of treatment for Parent ADHD Rating Scale (P < 0.001) and Teacher ADHD Rating Scale score in both groups (P < 0.001). The most common adverse effects reported with reboxetine were drowsiness and anorexia with mild to moderate severity. CONCLUSIONS: The study revealed that reboxetine may be beneficial in treatment of ADHD. Further studies are required to clarify the potential therapeutic effects on comorbid depression and anxiety and adverse effect profile.


Asunto(s)
Inhibidores de Captación Adrenérgica/uso terapéutico , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Metilfenidato/uso terapéutico , Morfolinas/uso terapéutico , Adolescente , Niño , Método Doble Ciego , Femenino , Humanos , Masculino , Reboxetina
17.
Artículo en Inglés | MEDLINE | ID: mdl-12921918

RESUMEN

Attention deficit hyperactivity disorder (ADHD) is a common disorder of childhood that affects 3% to 6% of school-age children. Conventional stimulant medications are recognized by both specialists and parents as useful symptomatic treatment. Nevertheless, approximately 30% of ADHD children treated with them do not respond adequately or cannot tolerate the associated adverse effects. Such difficulties highlight the need for alternative safe and effective medications in the treatment of this disorder. Selegiline is a type B monoamine oxidase inhibitor (MAOI) that is metabolized to amphetamine and methamphetamine stimulant compounds that may be useful in the treatment of ADHD. The authors undertook this study to further evaluate, under double-blind and controlled conditions, the efficacy of selegiline for ADHD in children. A total of 28 children with ADHD as defined by DSM IV were randomized to selegiline or methylphenidate dosed on an age and weight-adjusted basis at selegiline 5 mg/day (under 5 years) and 10 mg/day (over 5 years) (Group 1) and methylphenidate 1 mg/kg/day (Group 2) for a 4-week double-blind clinical trial. The principal measure of the outcome was the Teacher and Parent ADHD Rating Scale. Patients were assessed by a child psychiatrist at baseline, 14 and 28 days after the medication started. No significant differences were observed between the two protocols on the Parent and Teacher Rating Scale scores. Although the number of dropouts in the methylphenidate group was higher than in the selegiline group, there was no significant difference between the two protocols in terms of the dropouts. Decreased appetite, difficulty falling asleep and headaches were observed more in the methylphenidate group. The results of this study must be considered preliminary, but they do suggest that selegiline may be beneficial in the treatment of ADHD. In addition, a tolerable side effect profile may be considered as one of the advantages of selegiline in the treatment of ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Selegilina/uso terapéutico , Análisis de Varianza , Trastorno por Déficit de Atención con Hiperactividad/psicología , Niño , Preescolar , Método Doble Ciego , Femenino , Humanos , Masculino , Metilfenidato/uso terapéutico
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