Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis.

BACKGROUND: The estimates of attention-deficit hyperactivity disorder (ADHD) prevalence across various studies are significantly variable, contributing to uncertainty in ADHD prevalence estimation. Previous systematic reviews and meta-analyses have attributed this variability primarily to the methodological characteristics of the studies, including the diagnostic criteria, source of information, and impairment requirement for the diagnosis. METHODS: Review identified studies reporting ADHD prevalence in representative samples of children and adults in Europe and worldwide. Studies that were conducted in the general population were included. We focused on studies that report ADHD prevalence based on clinical diagnosis (clinical diagnostic criteria based on the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases criteria, other diagnostic tools, such as various scales or interviews based on clinical diagnostic criteria). PubMed/Medline was searched to identify relevant articles published until 2024/2/01. The study was registered in PROSPERO (CRD42020200220) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic review and meta-analysis. RESULTS: In total, 117 studies were subjected to full evaluation. In the meta-analysis, 103 studies representing 159 independent datapoints were included. The overall prevalence of ADHD in register studies was 1.6%, 95% CI [0.9; 3.0], in survey studies 5.0%, 95% CI [2.9; 8.6], in one-stage clinical studies 4.2%, 95% CI [2.9; 6.0], and in two-stage clinical studies 4.8%, 95% CI [4.0; 5.8]. CONCLUSIONS: Exact comparisons among studies with different diagnostic criteria and types of sampling can impact prevalence estimates. When comparing data from methodologically different studies, these factors need to be considered.

Clinical study on the intervention effect of digital therapy on children with attention deficit hyperactivity disorder (ADHD).

To evaluate the efficacy and safety of digital therapy for children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD). From January to March 2023, 52 children aged 6 to 12 years with attention deficit hyperactivity disorder (ADHD) from Wuhan Children's Hospital, Hubei Province, China were selected for intervention using the "MindPro1" attention training software developed by Jiangsu Ruinao Qizhi Medical Technology Co., Ltd. Before the intervention, the children were in a stable treatment state, and no modifications were made to the original treatment plan during the MindPro1 intervention. Subjects with severe mental illness or other conditions that may affect the implementation and evaluation of disease treatment were excluded. Subjects completed the planned 4-week intervention, and changes in attention-related variables were assessed using the Test of Attention Variables (TOVA) and the parent version of the 18-item SNAP-IV scale (Swanson, Nolan, and Pelham, version IV scale) before and after the intervention. After 4 weeks of intervention, the lower limit of the 95% confidence interval of the response rate of the 18-item SNAP-IV-Parent scale, which was ≥ 30% improvement from baseline, was higher than 27.5% (better than similar products on the market); the SNAP-IV parent score improved (P < 0.001), with statistical significance; the TOVA-ACS score improved (P < 0.05), with statistical significance. The acceptance rate of parents of children was 100%, and the average compliance rate was 95%. There were 4 cases (7.69%) of adverse reactions that may be related to the device in this trial, which recovered spontaneously within 2 days of discontinuation, and no serious adverse events occurred. After 4 weeks of treatment with ADHD auxiliary treatment software, the objective attention assessment data and attention function assessment scale were significantly improved. Parents had a high acceptance of the software, the average compliance rate of participants was high, and the incidence of related adverse events was low and mild.

Binge, Purge, and Wander: Navigating Bulimia and Attention Deficit Hyperactivity Disorder (ADHD).

A 32-year-old woman with no prior medical conditions, but a history of anorexia nervosa (AN) diagnosed in adolescence, was referred for evaluation by an eating disorders (ED) specialist due to worsening bingeing and purging behaviors. Her clinical presentation was characterized by a body mass index (BMI) approaching the underweight range and frequent bingeing and purging episodes occurring twice daily, consistent with a diagnosis of BN. No other medical or psychiatric comorbidities were diagnosed, including mood, anxiety, and substance use disorders, which are often comorbid with ED. However, the patient reported significant difficulties in managing both personal and professional activities, attributing these challenges to impaired concentration. She had difficulty staying focused on tasks and was easily distracted by unrelated thoughts or stimuli. As a result, she often procrastinated on household and self-care tasks. She also reported problems with time management, frequently arriving late to work, struggling to complete assignments on time, and underestimating how long tasks would take. Initial treatment with fluoxetine and cognitive behavioral therapy (CBT) yielded no substantial improvement. Given the presence of symptoms suggestive of attention deficit hyperactivity disorder (ADHD), a one-month trial of lisdexamfetamine (LDX) was initiated. This intervention resulted in a marked reduction in bingeing and purging episodes and a notable improvement in the patient's concentration, thereby enhancing her overall quality of life. The importance of ADHD screening is underscored, particularly for high-functioning adult women who may not present typical symptoms. In this case, a thorough clinical assessment and detailed anamnesis raised suspicion of previously unrecognized ADHD, that may have been present since childhood. Although the literature on the comorbidity of ADHD and BN is limited, this case highlights a potential link between the two conditions. The significant improvement observed following the introduction of psychostimulants supports the hypothesis that untreated ADHD may contribute to the exacerbation of BN symptoms. Further research is essential to clarify the underlying mechanisms and establish a solid scientific basis for future clinical interventions and therapeutic strategies.

Exploring causal associations of antioxidants from supplements and diet with attention deficit/hyperactivity disorder in European populations: a Mendelian randomization analysis.

Background: Antioxidants from both supplements and diet have been suggested to potentially reduce oxidative stress in individuals with ADHD. However, there is a lack of studies utilizing the Mendelian randomization (MR) method to explore the relationship between dietary and supplemental antioxidants with ADHD. Methods: This study employed two-sample mendelian randomization. Various specific antioxidant dietary supplements (such as coffee, green tea, herbal tea, standard tea, and red wine intake per week), along with diet-derived circulating antioxidants including Vitamin C (ascorbate), Vitamin E (α-tocopherol), Vitamin E (γ-tocopherol), carotene, Vitamin A (retinol), zinc, and selenium (N = 2,603-428,860), were linked to independent single nucleotide polymorphisms (SNPs). Data on ADHD was gathered from six sources, comprising 246,888 participants. The primary analytical method utilized was inverse variance weighting (IVW), with sensitivity analysis conducted to assess the robustness of the main findings. Results: In different diagnostic periods for ADHD, we found that only green tea intake among the antioxidants was significantly associated with a reduced risk of ADHD in males (OR: 0.977, CI: 0.963-0.990, p < 0.001, FDR = 0.065), with no evidence of pleiotropy or heterogeneity observed in the results. Additionally, a nominal causal association was found between green tea intake and childhood ADHD (OR: 0.989, 95% CI: 0.979-0.998, p = 0.023, FDR = 0.843). No causal relationships were detected between the intake of other antioxidant-rich diets and ADHD. Conclusion: Our study found a significant inverse association between green tea intake and male ADHD, suggesting that higher green tea consumption may reduce ADHD risk in males. Further research is needed to explore optimal doses and underlying mechanisms.

Loss of Control Eating in Adults With Impulsive and/or Inattentive Tendencies.

OBJECTIVE: Previous research has tended to consider impulsive, inattentive, and loss of control eating (LOC) tendencies as symptoms of greater pathologies in treatment-seeking samples. However, inattentive and impulsive tendencies and LOC often co-occur. Although LOC is an important diagnostic component of disordered eating (ED), it has recently been argued to be a dysregulated eating behavior in its own right. The purpose of the current self-report study was, therefore, to investigate the association between impulsive and inattentive tendencies and LOC in adults after accounting for ED. METHOD: A community sample of 516 adults was surveyed online about their inattentive and impulsive tendencies, LOC, and ED behaviors. RESULTS: A hierarchical multiple linear regression revealed ED, inattentive, and impulsive symptoms to be independent, significant, positive predictors of LOC. DISCUSSION: These findings suggest that the levels of inattentive and, to a lesser extent, impulsive tendencies are significantly associated with LOC in adults, even after ED is accounted for. Moreover, inattentive tendencies were found to be more significantly associated with LOC than impulsive tendencies. These are novel and important findings that can be used to inform both clinicians and individuals with inattentive and impulsive tendencies alike of this association. Considering the well-documented adverse health and wellbeing outcomes associated with LOC, future feasibility trials are needed aimed at treating this co-occurrence.

Relationships between screen time and childhood attention deficit hyperactivity disorder: a Mendelian randomization study.

Background: In previous observational studies and meta-analyses, childhood attention deficit hyperactivity disorder (ADHD) is found to have a significant association with screen time. However, the causal associations between them remain unclear. Method: This study performed a bidirectional two-sample Mendelian randomization (MR) analysis to confirm the causality between screen time and childhood ADHD. Large-scale genome-wide association studies (GWAS) datasets derived from the Psychiatric Genomics Consortium (PGC) and the UK Biobank were used to identify single nucleotide polymorphisms (SNPs) associated with exposure and outcome. Four categories of datasets were selected to represent screen time. The SNPs that are significantly associated with exposure data (P < 5e-08) and have a strong correlation with the exposure in the F-statistic (F > 10) were selected as instrumental variables. This study also used the PhenoScanner V2 database and the LDlink webtool to exclude confounding factors, and the MR-PRESSO method (p < 0.05) was employed to eliminate outliers with bias. Five commonly used methods were employed to assess the interaction and the Inverse Variance Weighted (IVW) method was utilized as the primary basis for determining the MR estimates in this study. Results: The MR analysis revealed that the length of mobile phone use (OR, 1.848; 95% CI, 1.3360-2.5558; p=2.07e-4) and the time spent watching television (OR, 2.104; 95% CI, 1.3958-3.1703; p=3.8e-4) increased the risk of childhood ADHD. Although the causal relationships were exclusively identified through the IVW and weighted median methods, the results retained their statistical significance following correction. In the reverse analysis, no evidence was found to support an effect of childhood ADHD on screen time. The sensitivity analysis conducted on the significant findings revealed no evidence of horizontal pleiotropy or heterogeneity. Conclusion: This study provides some evidence for the causality of screen time and childhood ADHD. Given the limitations of our study, further research is required to comprehensively investigate this relationship.

Contrasting Deficits in the Function of the Phonological Loop Between Children With Attention Deficit Hyperactivity Disorder and Reading Disability.

Attention Deficit Hyperactivity Disorder (ADHD) and reading disability (RD) often co-occur. Impairments in the phonological loop of working memory are central to RD, but it is unclear whether this is linked to ADHD, especially in Chinese reading. Two experiments were conducted with Chinese children aged 7 to 12 (Experiment 1, n = 65; Experiment 2, n = 60). Immediate and delayed recognition paradigms were used to assess phonological encoding and rehearsal. Both the RD-only and comorbid (ADHD + RD) groups performed worse than the control and ADHD-only groups in response time and accuracy. Notably, the comorbid group performed similarly to the RD-only group, indicating that phonological loop deficits in comorbid children are likely due to RD, not ADHD. This highlights phonological loop function as the key to distinguishing between ADHD and RD.

Does Temperament Constitute a Risk Factor for Adult Attention Deficit Hyperactivity Disorder?

OBJECTIVE: The aim of this study was to examine the temperament characteristics of adults with attention deficit hyperactivity disorder (ADHD) and the relationship between ADHD subtypes and temperament. Additionally, the study aimed to investigate the relationship between childhood ADHD symptoms and temperament. METHODS: The study included 59 ADHD patients aged between 18 and 60 years and 44 healthy controls. All participants completed the Wender-Utah Rating Scale (WURS) and the Adult Attention Deficit Hyperactivity Disorder Diagnosis and Rating Scale. Temperament characteristics were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire scale (TEMPS-A). RESULTS: The ADHD group had significantly higher scores for cyclothymic, irritable, and anxious temperament compared to the control group (p<0.001). The number of individuals with cyclothymic, irritable, and anxious temperament was also significantly higher in the ADHD group (p=0.007, p=0.018, p=0.029, respectively). Positive correlations were found between cyclothymic and depressive temperament scores and WURS scores (r=0.278, p=0.033; r=0.326, p=0.012, respectively), between hyperthymic temperament scores and hyperactivity scores (r=0.399, p=0.002), and between depressive temperament scores and attention deficit scores (r=0.303, p=0.020). There was no relationship between ADHD subtypes and dominant temperament (p>0.05). CONCLUSION: The most common dominant temperament in the ADHD group was cyclothymic, irritable, and anxious. The positive correlation between WURS scores and cyclothymic temperament suggests that cyclothymic temperament may be a risk factor for adult ADHD.

Scheduling of methylphenidate: Preventing misuse or impeding ADHD treatment adherence?

Background: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with a chronic, and potentially debilitating course if untreated. Medication adherence is poor - negatively affecting emotional, social, educational and employment outcomes. The current Schedule 6 status of methylphenidate (MPH) drives healthcare resource utilisation and costs - a potential barrier to care. Aim: This study explored stakeholders' understanding and perceptions of the potential impact of a regulatory shift in the scheduling of MPH on treatment accessibility and adherence for ADHD. Setting: Participants from multiple stakeholder groups, involved in ADHD management in South Africa, were recruited via professional networks. Methods: A qualitative analysis of semi-structured interviews with 23 stakeholders was conducted to explore their views on the utility, benefits and risks associated with rescheduling MPH. Results: Six key themes emerged from the interviews: 'adherence', 'accessibility', 'affordability', 'stigma', 'rescheduling of MPH' and 'risk mitigation'. Core to these themes is the role of the scheduling of MPH - which can have a protective societal role, but also acts as a barrier to care for individuals with ADHD. Conclusion: The current Schedule 6 status of MPH is not an effective strategy to prevent misuse and diversion but negatively impacts on treatment adherence. The positive outlook from stakeholders on rescheduling MPH holds significant implications for the ADHD landscape in South Africa. Contribution: It is crucial to address stigma, facilitate fundamental change in service delivery and remove structural and practical barriers to care to improve outcomes for individuals with ADHD. A framework for ADHD treatment adherence is provided.

Subclinical attention-deficit hyperactivity disorder symptoms and unhealthy lifestyle behaviours.

BACKGROUND: Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations. AIMS: The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored. METHOD: This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors. RESULTS: The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms. CONCLUSIONS: Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.

A Boy With KIF11-Associated Disorder Along With ADHD and ASD: Collaboration Between Paediatrics and Child Psychiatry.

Kinesin family member 11 (KIF11)-associated disorder, a rare condition caused by autosomal dominant mutations in the KIF11 gene, presents with microcephaly, chorioretinal dysplasia, lymphoedema, and varying degrees of intellectual disability. While intellectual disability is often described in the literature on KIF11 mutations, autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are only mentioned by a few authors but not thoroughly investigated. We present a case report of an 8-year-old boy with KIF11-associated disorder alongside ADHD and ASD but without intellectual disability. Genetic testing confirmed a KIF11 mutation. Cognitive, language, and motor assessments revealed delays in fine motor skills and attention deficits. The diagnosis of ADHD was confirmed by a child neurologist through multidisciplinary investigations, while the ASD diagnosis was established by a child psychiatrist. Despite the challenges of delayed psychiatric assessment, interventions including physiotherapy and medication management were initiated with positive results. We designed a parent support group survey that showed a higher prevalence of neurodevelopmental disorders in children with KIF11 mutations compared to the general population. Therefore, low-threshold referrals to a child psychiatrist have to be made when the potential presence of developmental problems is suspected. Collaboration between ophthalmologists, paediatricians, and child psychiatrists is crucial for early detection and intervention. Addressing developmental disorders promptly improves long-term outcomes and enhances quality of life. Moreover, gaining a deeper understanding of the higher prevalence of ASD and ADHD in individuals with KIF11 mutations could offer valuable insights into the genetic mechanisms underlying neurodevelopmental disorders.

Comparison of Brain Function Between Medication-Naïve ADHD with and without Comorbidity in Chinese Children Using Resting-State fNIRS.

Background: This study used functional near-infrared spectroscopy (fNIRS) to investigate brain activation patterns in children with attention deficit hyperactivity disorder (ADHD) with and without additional comorbidities to identify disease-related biomarkers by the neuroimaging that will facilitate to make a diagnosis decision. Methods: In this study, 165 medication-naive children aged 7 to 15 years were recruited and categorized into four groups: ADHD, ADHD with learning disabilities (ADHD&LD), ADHD with oppositional defiant disorder (ADHD&ODD), and healthy controls. A multichannel fNIRS system was used to monitor hemodynamic changes at rest state in the prefrontal and temporal lobes of the brain. The amplitude of a low-frequency fluctuation (ALFF) matrix was calculated by summation and averaging of the square root of the signal power spectrum. One-way analysis of variance was used to identify statistical differences between channels. Results: All ADHD children presented significantly higher ALFF values in different brain regions when compared with the healthy controls. Patients with ADHD&LD exhibited higher ALFF values in the medial prefrontal cortex (P Ch38 = .01, P Ch48 = .01), temporal cortex (P Ch22 = .04, P Ch41 = .002, P Ch51 = .001), and the left ventrolateral prefrontal cortex (P Ch39 = .0009, P Ch50 = .001), whereas ADHD&ODD children were not significantly different to those diagnosed with ADHD. Conclusions: ADHD with learning disabilities (LD) possessed a different pathogenesis from ADHD, manifested as lower functional brain activity in the medial prefrontal cortex, temporal cortex, and the left ventrolateral prefrontal cortex, while ADHD&ODD did not present significant changes compared with ADHD. ODD-related symptoms may be part of ADHD symptoms rather than being an independent disorder.

The neurodivergent perinatal experience - A systematic literature review on autism and attention deficit hyperactivity disorder.

BACKGROUND: Neurodivergent individuals often face unique challenges during the perinatal period, which can significantly impact their experiences of pregnancy, childbirth, and early parenting. Despite growing awareness of neurodiversity, there remains a gap in perinatal care that fully addresses the lived experiences and needs of those with neurodivergent conditions such as Autism (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). OBJECTIVE: To compile and analyse recent literature on the perinatal experiences of neurodivergent parturients. To provide an overview of current knowledge, identify prevalent challenges, and suggest opportunities for improving perinatal services. Additionally, we aim to highlight research gaps that guide future studies and enhance care quality for neurodivergent individuals during the perinatal period. METHODS: The Systematic Reviews methodological process was utilised to search relevant scientific databases to gather current research articles on neurodivergent perinatal experiences. Eleven studies met the inclusion criteria and were appraised using a rigorous quality checklist. Thematic analysis identified recurring themes across the selected papers. RESULTS: Three major themes emerged: Care provider support, Perinatal mental health needs, and Resilience and growth of neurodivergent parturients. These themes highlight significant differences in perinatal experiences between neurodivergent and neurotypical individuals, underscoring the need for tailored care approaches. CONCLUSION: The findings reveal that current perinatal care practices do not adequately address the specific challenges faced by perinatal neurodivergent individuals. There is a critical need for perinatal care systems to integrate neurodiversity-affirming practices. Future research should consider intersectionality to include marginalised and underrepresented neurodivergent voices.

Comparative analysis of electroencephalogram (EEG) data gathered from the frontal region with other brain regions affected by attention deficit hyperactivity disorder (ADHD) through multiresolution analysis and machine learning techniques.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by repeated patterns of hyperactivity, impulsivity, and inattention that limit daily functioning and development. Electroencephalography (EEG) anomalies correspond to changes in brain connection and activity. The authors propose utilizing empirical mode decomposition (EMD) and discrete wavelet transform (DWT) for feature extraction and machine learning (ML) algorithms to categorize ADHD and control subjects. For this study, the authors considered freely accessible ADHD data obtained from the IEEE data site. Studies have demonstrated a range of EEG anomalies in ADHD patients, such as variations in power spectra, coherence patterns, and event-related potentials (ERPs). Some of the studies claimed that the brain's prefrontal cortex and frontal regions collaborate in intricate networks, and disorders in either of them exacerbate the symptoms of ADHD. , Based on the research that claimed the brain's prefrontal cortex and frontal regions collaborate in intricate networks, and disorders in either of them exacerbate the symptoms of ADHD, the proposed study examines the optimal position of EEG electrode for identifying ADHD and in addition to monitoring accuracy on frontal/ prefrontal and other regions of brain our study also investigates the position groupings that have the highest effect on accurateness in identification of ADHD. The results demonstrate that the dataset classified with AdaBoost provided values for accuracy, precision, specificity, sensitivity, and F1-score as 1.00, 0.70, 0.70, 0.75, and 0.71, respectively, whereas using random forest (RF) it is 0.98, 0.64, 0.60, 0.81, and 0.71, respectively, in detecting ADHD. After detailed analysis, it is observed that the most accurate results included all electrodes. The authors believe the processes can detect various neurodevelopmental problems in children utilizing EEG signals.

Bidirectional association between allergic rhinitis and attention-deficit/hyperactivity disorder: A systematic review and meta-analysis.

BACKGROUND: This meta-epidemiological study seeks to further investigate the reciprocal relationship between allergic rhinitis (AR) and attention-deficit/hyperactivity disorder (ADHD). METHODS: A comprehensive search of the databases was conducted up to March 3, 2024. We performed a synthesis and meta-analysis of odds ratios and their corresponding 95 % confidence intervals using Stata 14.0. Funnel plot analysis and Egger's regression test were utilized to assess potential publication bias. RESULTS: Eighteen articles involving 4,289,444 participants were included. AR patients had an increased risk of developing ADHD (OR: 1.83; 95 % CI: 1.37-2.43), while ADHD patients were also more likely to have AR (OR: 1.38; 95 % CI: 1.11-1.72). Subgroup analysis indicated a predisposition of AR patients to autism spectrum disorder (OR: 1.34; 95 % CI: 0.86-1.0) and a higher risk of ADHD in cohort studies (OR: 1.90; 95 % CI: 1.26-2.88). Female AR patients were more likely to develop ADHD than males (OR: 1.86; 95 % CI: 1.43-2.43), and children aged ≤8 years with AR were at greater risk for ADHD compared to older children (OR: 1.75; 95 % CI: 1.14-2.69). CONCLUSIONS: This meta-analysis confirms a bidirectional association between AR and ADHD, indicating that they are mutually independent risk factors.

Investigating Attention Deficit Hyperactivity Disorder Symptoms, Emotional Dysregulation and Family Functioning in Children: A Community-Based Study in Elementary Schools in Surabaya, Indonesia.

Objectives: Research on emotional dysregulation related to attention deficit hyperactivity disorder (ADHD) symptoms and its effects on family functioning in children is scarce. This is the first study conducted in Indonesia to examine the intricate relationships between ADHD symptoms, emotional regulation, and family functioning in children. Methods: A cross-sectional survey was conducted involving primary caregivers of children aged 9-13 years old across three elementary schools in Surabaya, using validated questionnaires comprising the Indonesian ADHD Rating Scale, Emotion Regulation Checklist, and Family APGAR scale. Results: The findings revealed a positive association between ADHD features and the emotional lability/negativity subscale (ERLN) (r=0.528; p<0.001), but not the emotion regulation subscale (EREG). Moreover, family functioning positively correlated with ERLN (r= -0.269; p=0.003) and negatively correlated with EREG (r=0.331; p<0.001). Parental education emerged as a significant demographic factor, with higher education levels linked to better emotion regulation (r=0.297; p=0.001). Conclusion: These findings underscore the importance of addressing ADHD symptoms and emotional dysregulation in children in order to enhance family functioning and overall well-being. Implications for future research and interventions targeting emotion regulation, especially in children with ADHD and their families, are also discussed.

Analysis of the therapeutic effect of pestle needle & EEG biofeedback and methylphenidate in the treatment of attention deficit and hyperactivity disorder.

OBJECTIVE: This research aimed to analyze the therapeutic effect of pestle needle combined with electroencephalogram (EEG) biofeedback and methylphenidate in the treatment of attention deficit and hyperactivity disorder (ADHD) in children. METHODS: Seventy-eight children with ADHD were selected and randomized into a control group and an observation group (n = 39). The control group received EEG biofeedback and methylphenidate treatment, while the observation group received pestle needle therapy on this basis. Both groups received continuous treatment for 3 months. The clinical efficacy, scores of Conners Parents Symptom Questionnaire (PSQ), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Pittsburgh Sleep Quality Index (PSQI), EEG θ/ß changes in values, serum indicators such as adrenocorticotropic hormone (ACTH) and cortisol (CORT), and incidence of adverse reactions were compared in two groups. RESULTS: The total effective rate of the observation group was 92.31% (36/39), which was higher than the control group's 69.23% (27/39) (P < 0.05). After treatment, reduced PSQ scores, PSQI scores, EEG θ/ß values, and ACTH levels while elevated IVA-CPT and CORT levels were observed in both groups; the observation group had the best improvement effect after treatment (P < 0.05). CONCLUSION: Pestle needle combined with EEG biofeedback and methylphenidate in the treatment of ADHD children can elevate the IVA-CPT score, improve EEG waves, sleep quality, regulate serum indicators such as ACTH and CORT, reduce behavioral problem scores, and have high efficacy and safety.

Role of vesicular monoamine transporter-2 for treating attention deficit hyperactivity disorder: a review.

RATIONALE: The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) classifies attention deficit hyperactivity disorder (ADHD) as a neurodevelopmental disorder that interferes with human functioning and development. As the clinical presentation of ADHD involves a deficiency in executive function, neurocognitive deficits involving distinctive neuropathological changes must be present for clinical diagnosis. OBJECTIVES: The vesicular monoamine transporter (VMAT), specifically VMAT-2, plays a role in ADHD pathogenesis. In addition, experimental data show that the stimulants (amphetamines and methylphenidate) are first-line treatments for the condition because of their extensive interaction with VMAT-2. The interactions of peptides, bupropion, and nutritional supplements with VMAT-2 receptors have been researched, but more evidence is needed to elucidate their pharmacodynamic properties. Therefore, this literature review evaluated the current pharmacological treatment modalities, peptides, and nutritional supplements for ADHD that target the VMAT-2 system. METHODS, RESULTS, AND CONCLUSIONS: We obtained relevant studies from several platforms, including the National Center for Biotechnology, Clinical Key, Access Medicine, and PubMed. From the results of these studies, we observed that stimulants interact highly with the VMAT-2 transporter, with omega-3 fatty acids, peptides, and bupropion exerting some modulatory activity on VMAT-2. These agents should be considered for the future treatment of ADHD, although clinical-level research involving human participants is necessary.

Exploring the quantity and quality of symptoms of attention deficit hyperactivity disorder and intelligence in children with cerebral palsy: a case-control study.

To evaluate whether attention deficit hyperactivity disorder (ADHD) symptoms differ across cerebral palsy (CP) and the relationship of these symptoms to CP disease data. Each of the three groups (CP, ADHD, and control) included 22 volunteers, aged 6-18. The CP group was divided into two groups, with and without ADHD (CP + ADHD and CP-ADHD). The groups were compared in terms of clinical data, ADHD symptoms, and intelligence levels. ADHD was reported in 36.4% of the CP group and 9.1% of the control group (p = 0.031). The rate of moderate/severe motor disability was higher (p = 0.052), and the Wechsler Intelligence Scale for Children-Revised (WISC-R) (total, performance, verbal) scores were lower in the CP + ADHD group compared to the CP-ADHD group (p = 0.005, p = 0.005, p = 0.002). Cognitive problems/inattention scores were higher in the CP group compared to the control group (p = 0.015). WISC-R (total, performance, verbal) scores were lower in the CP group compared to the ADHD group (p = 0.008, p = 0.001, p = 0.047) and the control group (p < 0.001, p < 0.001, p = 0.001). CONCLUSION: ADHD is more common in CP and may be seen in a predominantly inattentive presentation. It is related to a worse motor disability and intelligence level in CP. WHAT IS KNOWN: • Compared to the general population, ADHD is reported to be more common in children with CP. WHAT IS NEW: • ADHD may be seen in a predominantly inattentive presentation rather than the other presentations in children with CP. • ADHD is related to a worse motor disability and intelligence level in CP.

Association of Parental Prenatal Mental Health on Offspring Neurodevelopmental Disorders: A Systematic Review and Meta-Analysis.

Objective: Parental prenatal mood and anxiety disorders (PMAD) are linked to child neurodevelopmental disorders (NDDs), but evaluations of the magnitude and mechanisms of this association are limited. This study estimates the strength of the association and whether it is impacted by genetic and environmental factors. Method: A systematic search of PubMed, CENTRAL, PsycINFO, OVID, and Google Scholar was performed for articles published from January 1988 to January 2024. Of 2,170 articles screened, 64 met the inclusion criteria. Meta-analyses were conducted on 20 studies, and 44 were included in the narrative synthesis. We conducted random-effects meta-analyses, along with tests for heterogeneity (I2) and publication bias (Egger's test). The review followed PRISMA and MOOSE guidelines. Results: Maternal PMADs were associated with a significantly increased risk of ADHD (OR 1.91, 95% CI 1.45-2.52) and ASD (OR 1.57, 95% CI 1.37-1.81) in children. Paternal PMADs were also associated with the risk of NDDs, with combined odds for ASD and ADHD (OR 1.24, 95% CI 1.15-1.34). Several studies suggested that the link between parental PMADs and offspring NDDs might be impacted by both genetic and environmental factors, including the impact of ongoing parental depression on child behavior. Conclusions and Relevance: Parental PMADs are significantly associated with an increased risk of NDDs in children. These associations may be influenced by both genetic predispositions and environmental factors. Understanding these pathways is important for informing interventions aimed at mitigating mental health risks in families and supporting child development.