A randomized controlled trial of effects of sleep hygiene training and progressive muscle relaxation training in children with ADHD.

OBJECT: Sleep problems often accompany ADHD and negatively affect ADHD symptoms, however, there are not enough intervention studies on sleep interventions in children with ADHD. The present study investigated the effects of sleep hygiene training (SH) and progressive muscle relaxation exercises (PMR) in children with ADHD. METHOD: 57 children aged 6-12 years with ADHD were randomly assigned to the SH and SH + PMR groups and completed the intervention consisting of group training and eight weeks of telephone interviews. The effects of both intervenitons were evaluated via parent, child and clinician report scales and neuropsychological tests. RESULTS: Both interventions resulted in significant positive changes in child sleep, ADHD symptoms, functioning, neuropsychological tests and parental sleep quality. Significant differences were found between the interventions in selective attention, peer problems and anxiety scores in favor of the SH + PMR group. CONCLUSION: SH may have positive effects on various clinical parameters as well as sleep problems in children with ADHD. Addition of PMR to SH may lead to further improvements in anxiety, peer problems and selective attention. SH and PMR may be a useful tool in the clinical management of children with ADHD with sleep problems.

The Effects of Methylphenidate on Ventricular Repolarization Parameters in Children with Attention-Deficit Hyperactivity Disorder.

Background: Long-acting methylphenidate (MPH), a psychostimulant agent, is widely used in the treatment of attention-deficit hyperactivity disorder (ADHD). Methylphenidate might cause an increment in the risk of lethal arrhythmias by deteriorating ventricular repolarization. QT intervals, the corrected QT (QTc), QT dispersion, T-peak to T-end (TpTe), and the TpTe/QTc ratio are the most utilized indicators of ventricular repolarization in electrocardiogram (ECG). The present study was conducted to examine the effects of long-term MPH use on the ECG in pediatric patients. Methods: A total of 52 children with ADHD and 51 age- and gender-matched controls were enrolled in the study. The children had been using MPH regularly for at least 6 months. Comparisons were made regarding ECG parameters, including the mean intervals of QT, QTc, QTc dispersion interval duration, TpTe intervals, TpTe/QT, and TpTe/QTc ratio. Results: The median duration of treatment with MPH was 30 months (minimum-maximum: 6-120), and the median MPH dose was 30 mg/day (minimum-maximum: 18-54). The main findings showed significantly prolonged P-wave dispersion, TpTe interval, TpTe dispersion, and TpTe/QT and TpTe/QTc ratios in the ADHD group compared to the healthy controls (P < .001). These parameters were not associated with MPH dose or treatment duration. Additionally, nearly half of the patients had QTc values of 460 ms or higher, but there were no significant differences in treatment duration and dose compared to the remaining group (P = .792 and P = .126). Conclusion: Methylphenidate may have proarrhythmogenic effects in children with ADHD, which may not be adversely affected by long-term use and treatment dose. Considering the extensive use of MPH, cardiac monitoring of these children is important.

Peer Victimization in Preadolescent Children With ADHD: A Controlled Follow-up Study.

INTRODUCTION: The present study examines bullying and its psychological consequences in school age children with and without attention deficit hyperactivity disorder (ADHD). METHOD: The sample consisted of 34 children with ADHD and 36 children without ADHD. Continuity of bullying and victimization and their relationship with psychological problems and quality of life (QoL) were examined at two time points (T1 and T2) with one-year interval. RESULTS: Children with ADHD experienced significantly more bullying and victimization than controls at both times. There was a marginally significant positive relationship between victimization scores at T1 and internalizing problems at T2 for the total sample. For both groups separately, victimization scores at T2 was significantly related with QoL and internalizing problems at T2. DISCUSSION: School-age children with ADHD are at risk for bullying and victimization and their short-term negative effects. Timely interventions should be used to overcome the possible negative effects of peer victimization.

Elevated Serum Galectin-1 and Galectin-3 Levels in Children With Specific Learning Disorder: A Case Control Study.

OBJECTIVE: Specific learning disorder (SLD) is a neurodevelopmental disorder in which underlying pathogenesis and etiological factors are not fully understood. Neuroinflammatory response (measured with serum levels of galectin-1 and galectin-3), which is associated with learning and memory, may play an important role in the etiopathogenesis of SLD. Aim of the present study is to examine whether serum galectin-1 and galectin-3 levels are related to SLD. METHODS: The current study consisted of 42 treatment-naive children with SLD and 42 control subjects. All of the subjects were assessed using semi-structured psychiatric examination to diagnose SLD and exclude attention-deficit hyperactivity disorder. Serum galectin-1 and galectin-3 levels were measured via venous blood samples. RESULTS: The SLD and control group did not differ significantly in terms of age, sex, and body mass index (BMI). The SLD group had significantly higher serum levels of galectin-1 (8.78±2.97 vs. 7.40±2.03, p=0.019) and galectin-3 (1.86±0.93 vs. 1.32±0.69, p=0.003) than the control group when controlled for age, sex, and BMI. CONCLUSION: Higher serum levels of galectin-1 and galectin-3 in children with SLD may indicate the role of neuroinflammatory response in the pathogenesis of SLD. Other mechanisms involving galectin-1 and galectin-3 related to learning may play a part in the etiology of SLD.

Peer Victimization in Preadolescent Children With ADHD in Turkey.

The present study aims to investigate peer victimization and its relationship with comorbid psychiatric diagnoses and quality of life (QoL) among children with attention deficit hyperactivity disorder (ADHD). Study sample consisted of 66 children with ADHD (mean age = 8.6 ± 1.1 years) and age- and gender-matched 66 controls (mean age = 8.5 ± 1.3 years). In self-reports, the ADHD group reported significantly higher rates of victimization and bullying than the non-ADHD group. Verbal and physical forms of victimization and bullying were the most prevalent forms in both groups; however, exclusion from peer groups, which is named as relational bullying, was the most significantly differing type between two groups. QoL parameters did not significantly differ between the children involved in bullying and those not involved, except for the lower physical QoL in victimized children in the control group. In conclusion, peer victimization was significantly more prevalent in the ADHD group than the non-ADHD group. Preventive measures are needed for peer victimization, especially for children with ADHD.

Coping and psychopathology in children with malignancy and bronchiectasis.

AIM: We aimed to evaluate the coping styles and social support perceived by the children with two different chronic diseases (cancer and bronchiectasis), their mothers' coping styles and compare them with a control group without any chronic physical or psychiatric disorder. METHODS: Our sample consisted of 114 children and adolescents, with an age range from 9 to 15 years. The data were collected by using schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, kid-coping orientation to problems experienced (Kid-COPE), social support appraisals scale (SSAS), and COPE. RESULTS: All three groups were similar with respect to age and sex distribution. Around 50% to 60% of the children in both patient groups had a psychiatric diagnosis. Remarkably, 30% of the children had an internalizing disorder. The most commonly used coping style by the mothers was religious coping in all groups. Kid-COPE scores did not significantly differ between groups. The scores on Family and Friend subscales of SSAS in the bronchiectasis group were significantly lower when compared with those of participants in hematology-oncology and control groups. CONCLUSION: Chronic medical illnesses may have a similar psychological impact on children regardless of disease-specific clinical presentations and outcomes. Future studies need to focus on identifying protective and risk factors that potentially mediate psychosocial well-being.

Duration of Breastfeeding, Bottle-Feeding, and Parafunctional Oral Habits in Relation to Anxiety Disorders Among Children.

OBJECTIVE: The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders. MATERIALS AND METHODS: The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study. RESULTS: The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p < 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p < 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (ß = 0.88, p = 0.006) and bottle-feeding (ß = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder. CONCLUSION: Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.