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1.
N C Med J ; 81(2): 122-125, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32132257

RESUMEN

At present, data suggests that attention-deficit/hyperactivity disorder may be more prevalent in North Carolina than other states, but whether we are properly identifying and treating cases, in childhood and adulthood, is murky. Much innovative work to this end is being done in North Carolina, but more is needed.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/terapia , Adulto , Niño , Predicción , Humanos , North Carolina/epidemiología , Prevalencia
2.
Rev Med Suisse ; 16(686): 543-545, 2020 Mar 18.
Artículo en Francés | MEDLINE | ID: mdl-32186800

RESUMEN

Although there is a substantial literature concerning the sexuality of people suffering from a psychiatric disorder, such as depression, anxiety disorder, schizophrenia, eating disorders or personality disorders, few studies have investigated the sexuality of attention deficit/hyperactivity disorder (ADHD) patients. The purpose of this article is therefore to show current knowledge about sexuality in people suffering from ADHD. The latter seem to have less sexual satisfaction, more sexual desire, more sexual dysfunction and more risky sexual behavior than the general population.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/psicología , Conducta Sexual , Sexualidad , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Humanos , Sexo Inseguro/estadística & datos numéricos
3.
Medicine (Baltimore) ; 99(11): e19423, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176068

RESUMEN

The purpose of this study is to evaluate the prevalence rates of externalizing symptom, ADHD, as well as internalizing symptoms, depression, anxiety, suicidal ideation, self-esteem, and alcohol problem in Korea juvenile delinquency for the first time in Korea. A case-control study design was used. It also examined the associations with ADHD, suicidal ideation, depression, anxiety, self-esteem, and alcohol problem between the Juvenile Delinquency group and the comparison group in Korea.A series of questionnaires were provided to a total of 251 participants (149 from the juvenile delinquency group and 102 from the comparison group) from October 2015 to December 2015 in Korea. All participants were evaluated using KARS, SSI, BDI, BAI, RSI, and CAGE. This study showed the relationship between ADHD, suicidal ideation, depression, anxiety, self-esteem, and alcohol problem in Korean juvenile delinquency. Also this study showed that ADHD and self-esteem were important factors in predicting juvenile delinquency. Therefore, in order to prevent juvenile delinquency, special attention, and consideration are needed for adolescents with high ADHD or low self-esteem.


Asunto(s)
Trastornos Relacionados con Alcohol/epidemiología , Ansiedad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Depresión/epidemiología , Delincuencia Juvenil/estadística & datos numéricos , Autoimagen , Ideación Suicida , Adolescente , Femenino , Humanos , Masculino , Prevalencia , República de Corea/epidemiología , Encuestas y Cuestionarios , Adulto Joven
4.
Adv Neurobiol ; 24: 481-504, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32006369

RESUMEN

Autism has been increasing dramatically since its description by Leo Kanner in 1943. The Centers for Disease Control and Prevention (CDC) in 2018 has identified 1 in 59 children (1 in 37 boys and 1 in 151 girls) has autism spectrum disorder (ASD). Autistic spectrum disorders and ADHD are complex conditions in which nutritional and environmental factors play major roles. It is important to understand how food can have an impact on their current and future health. Appealing food colors stimulate the consumption of different food products. Since 2011, it is evident that dyes are linked to harmful effects in children. Artificial dyes have neurotoxic chemicals that aggravate mental health problems. Many families with autistic children avoid food dyes in their diet in order to avoid behavioral issues. A study reported that there is a correlation between yellow dye and sleep disturbance. Food colors Blue 1 and 2, Green 3, Red 3, Yellow 5 and 6, Citrus Red 2, and Red 40 can trigger many behaviors in most kids. Artificial food color usually contains petroleum and is manufactured in a chemical process that includes formaldehyde, aniline, hydroxides, and sulfuric acids. Most impurities in the food color are in the form of salts or acids. Sometimes lead, arsenic, and mercury may be present as impurities. The U.S. FDA is yet to study the effects of synthetic dyes on behavior in children. A study conducted at Southampton University in England found a link between food dyes and hyperactive behavior in children. The research does not prove that food coloring actually causes autism spectrum disorder, but there seems to be a link. This chapter attempts to provide a broad review of the available literature on food color and the epidemiology, etiology, prevention, and treatment of autistic spectrum disorder.


Asunto(s)
Trastorno del Espectro Autista/inducido químicamente , Trastorno del Espectro Autista/epidemiología , Dieta/efectos adversos , Colorantes de Alimentos/efectos adversos , Trastorno por Déficit de Atención con Hiperactividad/inducido químicamente , Trastorno por Déficit de Atención con Hiperactividad/dietoterapia , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Trastorno del Espectro Autista/dietoterapia , Trastorno del Espectro Autista/psicología , Niño , Dieta/estadística & datos numéricos , Femenino , Humanos , Masculino
5.
Med Care ; 58(3): 273-279, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32049948

RESUMEN

BACKGROUND: The prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) have increased substantially among children and adolescents over the past decade; however, little is known regarding trends in adult populations. OBJECTIVE: The objective of this study was to explore trends in the prevalence, incidence, and correlates of adult ADHD in a national sample of veterans receiving care at Veteran Affairs (VA) hospitals and clinics. RESEARCH DESIGN: A retrospective design was used to examine ADHD diagnosed in all VA primary care (PC) and mental health clinics (MHCs) from fiscal years (FYs) 2009 to 2016. Age-adjusted prevalence and incidence were calculated using direct standardization, and Poisson regressions modeled differences in trends between demographic groups. SUBJECTS: All veterans with VA PC or MHC visits during the observation period. MEASURES: ADHD incidence and prevalence, psychiatric comorbidity, neuropsychological evaluation. RESULTS: An annual average of 5.09 million (range: 4.63-5.42 million) VA patients attended a PC or MHC appointment between FY09 and FY16. During this period, age-adjusted annual prevalence increased 258% from 0.23% to 0.84% and incidence increased 240% from 0.14% to 0.48%. Black veterans and older veterans had the lowest prevalence and incidence across all years. Increases in prevalence and incidence occurred across all demographic subgroups. The proportion of patients who had a neuropsychological evaluation within 6 months before or after a new ADHD diagnosis decreased from 12.6% to 10.8% [χ(1)=16.59, P<0.001]. CONCLUSION: Overall increases and demographic differences in adult veterans diagnosed with ADHD suggest a growing need to establish the reliability of diagnostic practices to ensure appropriate and equitable care.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Comorbilidad , Hospitales de Veteranos , Veteranos/estadística & datos numéricos , Adulto , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Prevalencia , Atención Primaria de Salud , Estudios Retrospectivos , Estados Unidos/epidemiología
6.
BMJ ; 368: m331, 2020 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-32075790

RESUMEN

OBJECTIVE: To assess the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children. DESIGN: Population based cohort study. SETTING: The UK Clinical Practice Research Datalink. PARTICIPANTS: The study cohort included 104 605 children born from 1990 to 2016 whose mothers were prescribed one macrolide monotherapy (erythromycin, clarithromycin, or azithromycin) or one penicillin monotherapy from the fourth gestational week to delivery. Two negative control cohorts consisted of 82 314 children whose mothers were prescribed macrolides or penicillins before conception, and 53 735 children who were siblings of the children in the study cohort. MAIN OUTCOME MEASURES: Risks of any major malformations and system specific major malformations (nervous, cardiovascular, gastrointestinal, genital, and urinary) after macrolide or penicillin prescribing during the first trimester (four to 13 gestational weeks), second to third trimester (14 gestational weeks to birth), or any trimester of pregnancy. Additionally, risks of cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder. RESULTS: Major malformations were recorded in 186 of 8632 children (21.55 per 1000) whose mothers were prescribed macrolides and 1666 of 95 973 children (17.36 per 1000) whose mothers were prescribed penicillins during pregnancy. Macrolide prescribing during the first trimester was associated with an increased risk of any major malformation compared with penicillin (27.65 v 17.65 per 1000, adjusted risk ratio 1.55, 95% confidence interval 1.19 to 2.03) and specifically cardiovascular malformations (10.60 v 6.61 per 1000, 1.62, 1.05 to 2.51). Macrolide prescribing in any trimester was associated with an increased risk of genital malformations (4.75 v 3.07 per 1000, 1.58, 1.14 to 2.19, mainly hypospadias). Erythromycin in the first trimester was associated with an increased risk of any major malformation (27.39 v 17.65 per 1000, 1.50, 1.13 to 1.99). No statistically significant associations were found for other system specific malformations or for neurodevelopmental disorders. Findings were robust to sensitivity analyses. CONCLUSIONS: Prescribing macrolide antibiotics during the first trimester of pregnancy was associated with an increased risk of any major malformation and specifically cardiovascular malformations compared with penicillin antibiotics. Macrolide prescribing in any trimester was associated with an increased risk of genital malformations. These findings show that macrolides should be used with caution during pregnancy and if feasible alternative antibiotics should be prescribed until further research is available. TRIAL REGISTRATION: ClinicalTrials.gov NCT03948620.


Asunto(s)
Anomalías Inducidas por Medicamentos/etiología , Antibacterianos/efectos adversos , Macrólidos/efectos adversos , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Anomalías Inducidas por Medicamentos/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/inducido químicamente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno del Espectro Autista/inducido químicamente , Trastorno del Espectro Autista/epidemiología , Anomalías Cardiovasculares/inducido químicamente , Anomalías Cardiovasculares/epidemiología , Parálisis Cerebral/inducido químicamente , Parálisis Cerebral/epidemiología , Estudios de Cohortes , Bases de Datos Factuales , Prescripciones de Medicamentos/estadística & datos numéricos , Epilepsia/inducido químicamente , Epilepsia/epidemiología , Femenino , Humanos , Recién Nacido , Embarazo , Primer Trimestre del Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Estudios Retrospectivos , Sensibilidad y Especificidad , Reino Unido/epidemiología
7.
Sci Total Environ ; 699: 134053, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31678884

RESUMEN

Temperamental tendencies may form the basis of personality development, and specific personality constellations are associated with increased incidences of behavioural problems. Phthalic acid ester (PAE) has been associated with symptoms of attention deficit hyperactivity disorder (ADHD) in cross-sectional studies. We hypothesised that early-life exposure to PAE affects the temperaments of children, particularly ADHD traits. In this study, we analysed the temperament evaluations completed at least once by maternal-infant pairs (n = 208) when the child was aged 2, 5, and/or 11 years between 2000 and 2012. We measured seven PAE metabolites in the urine of the mothers during pregnancy and their children using liquid chromatography-electrospray ionisation-tandem mass spectrometry. These metabolites included mono-methyl phthalate, mono-ethyl phthalate, mono-butyl phthalate (MBP), mono-benzyl phthalate (MBzP), and three metabolites of di (2-ethylhexyl) phthalate. The phthalate metabolite levels in pregnant women were significantly associated with a decreased threshold of responsiveness (coefficients from -0.21 to -0.46) and increased distractibility (coefficients from 0.23 to 0.46) in pre-school children. After adjustment for maternal exposure, the phthalate metabolite concentrations of the children exhibited significantly increased odds ratios (ORs) with respect to the ADHD symptom traits. Specifically, mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), the sum of the DEHP metabolites, and MBzP yielded ORs and 95% confidence intervals of 2.98 (1.05-8.48), 3.28 (1.15-9.35), and 9.12 (1.07-78.06), respectively, for every log10 creatinine unit (g/g creatinine) increase. Thus, early-life phthalate exposure was found to be associated with the behavioural characteristics of children, particularly temperamental traits associated with ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Contaminantes Ambientales/metabolismo , Exposición Materna/estadística & datos numéricos , Ácidos Ftálicos/metabolismo , Adulto , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Embarazo
8.
Indoor Air ; 30(1): 126-136, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31797459

RESUMEN

Cooking is one of the main sources of indoor air pollution in China. Given emerging evidence of a link between air pollutants and neurodevelopmental delays, we examined whether maternal experiences with cooking during gestation might increase their child's hyperactivity at 3 years of age. The participants involved 45 518 mothers of children who were newly enrolled at kindergarten in the Longhua District of Shenzhen from 2015 to 2017. The results show that maternal exposure to cooking fumes during pregnancy was related to an increased risk of their offspring having hyperactivity behaviors at the age of 3 years. Compared with pregnant mothers who never cooked, pregnant mothers who cooked sometimes, often, or always had children who showed a significantly higher hyperactivity risk. Households using cooking fuels such as coal, gas during the mothers' pregnancy, exhibited more hyperactivity behaviors in the young child when compared to those using electricity for cooking. In addition, poor ventilation during cooking, while mothers were pregnant, was found to be a significant risk factor for clinical levels of the offspring's hyperactive behaviors. Furthermore, the positive association with maternal cooking during pregnancy and their offsprings' hyperactivity was relatively consistent across strata defined by social class, education, and other covariates.


Asunto(s)
Contaminación del Aire Interior/estadística & datos numéricos , Trastornos de la Conducta Infantil/epidemiología , Culinaria/métodos , Exposición Materna/estadística & datos numéricos , Adulto , Contaminantes Atmosféricos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Niño , Preescolar , China/epidemiología , Carbón Mineral , Culinaria/instrumentación , Composición Familiar , Femenino , Humanos , Masculino , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología
9.
Disabil Health J ; 13(1): 100841, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31542364

RESUMEN

BACKGROUND: Unintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries. OBJECTIVE: To study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex. METHOD: Cross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models. RESULTS: We found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08-2.97) and 1.79 (95% CI 1.10-1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR = 0.43, CI 0.2-0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime. CONCLUSIONS: There was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.


Asunto(s)
Lesiones Accidentales/epidemiología , Personas con Discapacidad/estadística & datos numéricos , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno del Espectro Autista/epidemiología , Comorbilidad , Estudios Transversales , Epilepsia/epidemiología , Femenino , Pérdida Auditiva/epidemiología , Humanos , Masculino , Limitación de la Movilidad , Oportunidad Relativa , Factores de Riesgo , Instituciones Académicas , Índice de Severidad de la Enfermedad , Factores Sexuales , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Suecia/epidemiología , Trastornos de la Visión/epidemiología
10.
Int J Hyg Environ Health ; 223(1): 80-92, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31653559

RESUMEN

BACKGROUND: Perfluoroalkyl substances (PFASs) are persistent organic pollutants that are suspected to be neurodevelopmental toxicants, but epidemiological evidence on neurodevelopmental effects of PFAS exposure is inconsistent. We investigated the associations between prenatal exposure to PFASs and symptoms of attention-deficit/hyperactivity disorder (ADHD) and cognitive functioning (language skills, estimated IQ and working memory) in preschool children, as well as effect modification by child sex. MATERIAL AND METHODS: This study included 944 mother-child pairs enrolled in a longitudinal prospective study of ADHD symptoms (the ADHD Study), with participants recruited from The Norwegian Mother, Father and Child Cohort Study (MoBa). Boys and girls aged three and a half years, participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview, Child Development Inventory and Stanford-Binet (5th revision). Prenatal levels of 19 PFASs were measured in maternal blood at week 17 of gestation. Multivariable adjusted regression models were used to examine exposure-outcome associations with two principal components extracted from the seven detected PFASs. Based on these results, we performed regression analyses of individual PFASs categorized into quintiles. RESULTS: PFAS component 1 was mainly explained by perfluoroheptane sulfonate (PFHpS), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS) and perfluorooctanoic acid (PFOA). PFAS component 2 was mainly explained by perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA) and perfluorononanoic acid (PFNA). Regression models showed a negative association between PFAS component 1 and nonverbal working memory [ß = -0.08 (CI: -0.12, -0.03)] and a positive association between PFAS component 2 and verbal working memory [ß = 0.07 (CI: 0.01, 0.12)]. There were no associations with ADHD symptoms, language skills or IQ. For verbal working memory and PFAS component 2, we found evidence for effect modification by child sex, with associations only for boys. The results of quintile models with individual PFASs, showed the same pattern for working memory as the results in the component regression analyses. There were negative associations between nonverbal working memory and quintiles of PFOA, PFNA, PFHxS, PFHpS and PFOS and positive associations between verbal working memory and quintiles of PFOA, PFNA, PFDA and PFUnDA, with significant relationships mainly in the highest concentration groups. CONCLUSIONS: Based on our results, we did not find consistent evidence to conclude that prenatal exposure to PFASs are associated with ADHD symptoms or cognitive dysfunctions in preschool children aged three and a half years, which is in line with the majority of studies in this area. Our results showed some associations between PFASs and working memory, particularly negative relationships with nonverbal working memory, but also positive relationships with verbal working memory. The relationships were weak, as well as both positive and negative, which suggest no clear association - and need for replication.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Cognición/efectos de los fármacos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/sangre , Fluorocarburos/sangre , Efectos Tardíos de la Exposición Prenatal/epidemiología , Ácidos Alcanesulfónicos/sangre , Caprilatos/sangre , Preescolar , Ácidos Decanoicos/sangre , Contaminantes Ambientales/toxicidad , Ácidos Grasos/sangre , Femenino , Fluorocarburos/toxicidad , Humanos , Masculino , Memoria a Corto Plazo , Noruega/epidemiología , Embarazo
11.
Environ Health Prev Med ; 24(1): 74, 2019 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-31812162

RESUMEN

BACKGROUND: There have been inconsistent findings reported on maternal passive smoking during pregnancy and child risk of ADHD. In this study, ADHD symptoms at pre-school age children in association with prenatal passive and active tobacco smoke exposure determined by maternal plasma cotinine levels in the third trimester were investigated. METHODS: This was a follow-up study of the birth cohort: the Hokkaido Study on Environment and Children's Health. Children whose parents answered Strengths and Difficulties Questionnaire (SDQ) to identify child ADHD symptoms (hyperactivity/inattention and conduct problems) and total difficulties at age 5 years with available maternal plasma cotinine level at the third trimester were included (n = 3216). Cotinine levels were categorized into 4 groups; ≦ 0.21 ng/ml (non-smoker), 0.22-0.51 ng/ml (low-passive smoker), 0.52-11.48 ng/ml (high-passive smoker), and ≧ 11.49 ng/ml (active smoker). RESULTS: Maternal cotinine levels of active smokers were significantly associated with an increased risk of total difficulties (OR = 1.67) and maternal low- and high-passive smoking also increased the risk (OR = 1.11, 1.25, respectively) without statistical significance. Similarly, maternal cotinine levels of active smokers were associated with an increased risk of hyperactivity/inattention (OR = 1.49). Maternal low- and high-passive smoking and active smoking increased the risk of hyperactivity/inattention (OR = 1.45, 1.43, and OR = 1.59, respectively) only in boys. CONCLUSION: Our findings suggested that maternal active smoking during pregnancy may contribute to the increased risk of child total difficulties and hyperactivity/inattention at pre-school age. Pregnant women should be encouraged to quit smoking and avoid exposure to tobacco smoke.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/etiología , Exposición Materna/efectos adversos , Efectos Tardíos de la Exposición Prenatal/etiología , Fumar Tabaco/efectos adversos , Adulto , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Preescolar , Cotinina/sangre , Femenino , Estudios de Seguimiento , Humanos , Japón/epidemiología , Masculino , Madres , Embarazo , Tercer Trimestre del Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Riesgo , Factores Sexuales , Fumar Tabaco/epidemiología
12.
Rev. neurol. (Ed. impr.) ; 69(11): 461-469, 1 dic., 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-187114

RESUMEN

Introducción: Actualmente, en el Manual diagnóstico y estadístico de los trastornos mentales (DSM-5) se incluye una nueva categoría diagnóstica referida a trastornos del neurodesarrollo. Son diversos los trastornos del neurodesarrollo que, aun siendo entidades diagnósticas independientes, comparten manifestaciones comunes a las que presentan personas con daño cerebral o disfunción en la corteza prefrontal, es decir, presentan diferentes alteraciones de las funciones ejecutivas. Desarrollo: El propósito de este estudio es ofrecer una visión de los hallazgos actuales sobre el funcionamiento ejecutivo en niños y jóvenes con diferentes trastornos del neurodesarrollo: trastorno del espectro autista, trastorno por déficit de atención/hiperactividad y trastorno específico del aprendizaje. Con este objetivo se revisaron 27 artículos. Los resultados de los análisis indican una asociación estadísticamente significativa entre dimensión de flexibilidad y trastorno por déficit de atención/hiperactividad (W de Wilcoxon = 123; p = 0,011) y dimensión de flexibilidad y trastorno del espectro autista (W de Wilcoxon = 101,5; p = 0,003), y ausencia de asociación estadísticamente significativa entre las diferentes dimensiones evaluadas y trastorno específico del aprendizaje. Conclusiones: Las dimensiones ejecutivas se encuentran afectadas en los diferentes trastornos del neurodesarrollo en grado variable. Podemos hipotetizar la existencia de un continuo en las dimensiones que se encuentran afectadas en los diferentes trastornos del neurodesarrollo; en ocasiones, es complejo establecer límites categoriales cuando se comparan distintos trastornos


Introduction: Currently, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has new criteria that include a diagnostic reference to neurodevelopmental disorders. Neurodevelopmental disorders are diverse, and even though they are independent diagnostic entities they share common manifestations in people with brain damage or dysfunction of the prefrontal cortex; that is, neurodevelopmental disorders present different alterations in executive functions. Development: The aim of the present study was to offer an overview of the recent findings on executive functioning in children, adolescents and young adults with different neurodevelopmental disorders: autistic spectrum disorder, attention-deficit/hyperactivity disorder and specific learning disorder. Hence, with this objective, 27 studies from the literature were reviewed. The results indicate a statistically significant association between the dimension of flexibility and attention deficit/hyperactivity disorder (W of Wilcoxon = 123.0; p = 0.011), and flexibility with autistic spectrum disorder (W of Wilcoxon = 101.5; p = 0.003); and absence of a statistically significant association between the different assessed dimensions and specific learning disorder. Conclusions: The dimensions of executive functioning are affected to a variable degree in different neurodevelopmental disorders. We can hypothesis that the dimensions that are affected in the different neurodevelopmental disorders can be characterized in terms of the existence of a continuum, and occasionally those dimensions are too complex to establish categorical limits when comparing different neurodevelopmental disorders


Asunto(s)
Humanos , Niño , Adolescente , Trastornos del Neurodesarrollo/epidemiología , Trastorno del Espectro Autista/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Discapacidades para el Aprendizaje/epidemiología , Función Ejecutiva , Trastornos del Neurodesarrollo/clasificación , Trastornos del Neurodesarrollo/fisiopatología , Solución de Problemas
13.
East Asian Arch Psychiatry ; 29(124): 124-128, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31871309

RESUMEN

OBJECTIVE: To survey the prevalence of retrospectively recalled clinically significant symptoms of attention deficit hyperactivity disorder (ADHD) in childhood and determine the association of ADHD symptoms in childhood with current academic achievement and psychopathological outcomes among college students in the state of Kerala, India. METHODS: A self-administered questionnaire was distributed to 5784 students from 58 colleges selected by cluster random sampling. The Barkley Adult ADHD Rating Scale-IV was used for recollection of childhood ADHD symptoms; a total score of ≥60 (indicating the 99 percentile) was taken as the cut-off for clinically significant ADHD symptoms in childhood. The Alcohol, Smoking and Substance Involvement Screening Test was used to assess lifetime use of alcohol and tobacco. The Kessler Psychological Distress Scale was used to assess non-specific psychological distress. Lifetime suicidality and exposure to sexual abuse were assessed by asking relevant questions. Students who recalled having clinically significant ADHD symptoms in childhood were compared with those who did not. RESULTS: Of 5784 students, 639 (11.5%) did not complete the questionnaire. Of the remaining 5145 students, 1750 (34.8%) were men and 3395 (65.2%) were women, with a mean age of 19.4 years. 143 (2.8%) students reported clinically significant ADHD symptoms in childhood. Childhood ADHD symptoms were significantly more common in men and in those living in urban areas. In the bivariate analysis, those with clinically significant ADHD symptoms in childhood had significantly higher odds of poorer academic performance, alcohol use, tobacco use, psychological distress, suicidal thoughts, suicidal attempts, and contact and non-contact sexual abuse, after adjusting for sex and residence. CONCLUSIONS: Clinical evaluation and appropriate management may be warranted for adults who retrospectively recall clinically significant ADHD symptoms in childhood.


Asunto(s)
Éxito Académico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Estudiantes/psicología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Trastorno por Déficit de Atención con Hiperactividad/psicología , Femenino , Humanos , India/epidemiología , Masculino , Prevalencia , Estudios Retrospectivos , Encuestas y Cuestionarios , Universidades , Adulto Joven
14.
East Asian Arch Psychiatry ; 29(4): 118-123, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31871308

RESUMEN

OBJECTIVE: To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital. METHODS: All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected. RESULTS: Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021). CONCLUSIONS: Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Psiquiatría Forense , Hospitales Psiquiátricos , Pacientes Internos/psicología , Pacientes Internos/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Malasia/epidemiología , Masculino , Prevalencia , Escalas de Valoración Psiquiátrica
15.
BMC Public Health ; 19(1): 1706, 2019 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-31856776

RESUMEN

BACKGROUND: Adverse childhood experience (ACE), attention deficit hyperactivity disorder (ADHD), and resilience can all contribute to depressive symptoms. However, little is known regarding the complex relationships between these factors and their joint effects on depressive symptoms. This study aimed to explore the underlying mechanism of ACE, ADHD, and resilience on depressive symptoms among men have sex with men (MSM) in China. METHODS: A total of 714 MSM were recruited from gay/bisexual men-serving venues in Wuhan, Changsha, and Nanchang of China. The data was collected using computer-assisted self-interview. The mediated and moderated mediation models were employed to explore the underlying mechanisms between ACE, ADHD, resilience, and depressive symptoms. RESULTS: Among 714 MSM, 51.4% reported at least one ACE and 13.0% reported three or more. ACE had a direct (ß = 1.01, 95% CI: 0.45-1.57) effect on depressive symptoms. ADHD partially mediated the correlation between ACE and depressive symptoms (indirect effect: 0.55; 95% CI: 0.34-0.79). Additionally, the effect of ACE on depressive symptoms was moderated and buffered by resilience (ß = -0.09, 95% CI: -0.15 - -0.03). CONCLUSION: The findings suggested that, programs and policies that promote resilience and address ADHD might protect Chinese MSM exposed to ACE from depressive symptoms.


Asunto(s)
Experiencias Adversas de la Infancia/estadística & datos numéricos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Depresión/epidemiología , Homosexualidad Masculina/psicología , Adolescente , Adulto , Trastorno por Déficit de Atención con Hiperactividad/psicología , China/epidemiología , Estudios de Cohortes , Depresión/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Resiliencia Psicológica , Encuestas y Cuestionarios , Adulto Joven
16.
BMC Oral Health ; 19(1): 258, 2019 11 25.
Artículo en Inglés | MEDLINE | ID: mdl-31766996

RESUMEN

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is defined as childhood neurobehavioural disorder. Due to short attention span, oral hygiene and dental treatment of such individuals can be challenging. Aim of this study was to evaluate the oral health of children and adolescents with and without ADHD living in residential care in rural Rhineland-Palatinate, Germany. METHODS: Included in the study were 79 participants (male/female:58/21, age 9-15 years) living in residential care: 34 participants with ADHD and 45 participants without ADHD (control). Oral examination included the following parameters decayed, missing, filled teeth in the primary dentition (dmft), decayed, missing, filled surfaces/teeth in the secondary dentition (DMFS/DMFT), approximal plaque index (API), bruxism and orthodontic treatment. Additionally, oral hygiene, last dental visit and treatment performed, and dietary habits were assessed by questionnaire. RESULTS: There were no significant differences in dmft, API, bruxism and oral hygiene habits between groups. However, participants with ADHD tended to have higher DMFS/DMFT values than the control group. Ongoing orthodontic treatment was found more often in the control group. The ADHD group tended to consume acidic/sugary beverages and sweet snacks more often than the controls. Different treatments (control visit/prophylaxis, dental therapy, orthodontic treatment) were performed at the last dental visit in the two groups. CONCLUSIONS: Within the limitations of this study, oral health was similar in children and adolescents with or without ADHD from the same residential care setting. Parents/guardians need instructions for better supervision of oral hygiene and dietary habits to improve the poor oral health of children with or without ADHD.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Caries Dental/complicaciones , Salud Bucal , Higiene Bucal/estadística & datos numéricos , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Estudios de Casos y Controles , Niño , Índice CPO , Caries Dental/epidemiología , Índice de Placa Dental , Conducta Alimentaria , Femenino , Alemania/epidemiología , Humanos , Masculino , Instituciones Residenciales , Población Rural , Cepillado Dental/estadística & datos numéricos
17.
Nurs Clin North Am ; 54(4): 517-532, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31703777

RESUMEN

Management of attention-deficit/hyperactivity disorders require provider skill, rapport, and referral acumen to treat patients across the life span. Incidence and prevalence have increased in the United States and globally. There are innovative models of evidence-informed screening techniques, treatment strategies to help providers work with patients and their families. Diplomatic management of highly charged treatment controversies, drug diversion, and risk factor reduction helps to ethically address this growing public health phenomenon. This article examines risk factors and treatment considerations in the United States for evidence-informed care, with a focus on affordable and readily accessible treatment in primary care settings.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/genética , Predisposición Genética a la Enfermedad , Farmacogenética , Atención Primaria de Salud , Trastorno por Déficit de Atención con Hiperactividad/terapia , Humanos , Prevalencia , Factores de Riesgo , Estados Unidos
18.
Lakartidningen ; 1162019 Oct 07.
Artículo en Sueco | MEDLINE | ID: mdl-31593288

RESUMEN

Late and moderately preterm infants, born between 32+0/7 and 36+6/7 gestational weeks, comprise more than 80 % of all preterm infants and account for almost 40 % of all days of neonatal care. While their total number of days of care has not changed, an increasing part of their neonatal stay (from 29 % in 2011 to 41 % in 2017) is now within home care programmes. Late and moderate preterm birth is often complicated by respiratory disorders, hyperbilirubinemia, hypothermia and feeding difficulties. These infants also have an increased risk of perinatal death and neurologic complications. In the long run, they have higher risks of cognitive impairment, neuropsychiatric diagnoses and need for asthma medication. As young adults, they have a lower educational level and a lower average salary than their full-term counterparts. They also have an increased risk of long-term sick leave, disability pension and need for economic assistance from society.


Asunto(s)
Nacimiento Prematuro , Corticoesteroides/administración & dosificación , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastornos del Conocimiento/epidemiología , Educación Especial/estadística & datos numéricos , Femenino , Humanos , Lactante , Mortalidad Infantil , Fenómenos Fisiológicos Nutricionales del Lactante , Recien Nacido Prematuro , Tiempo de Internación , Enfermedades Pulmonares/epidemiología , Masculino , Trastornos Mentales/epidemiología , Embarazo , Nacimiento Prematuro/economía , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/mortalidad , Nacimiento Prematuro/prevención & control , Síndrome de Dificultad Respiratoria del Recién Nacido/diagnóstico , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Factores de Riesgo , Tiempo
19.
Pediatrics ; 144(4)2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31570648

RESUMEN

Attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common neurobehavioral disorders of childhood and can profoundly affect children's academic achievement, well-being, and social interactions. The American Academy of Pediatrics first published clinical recommendations for evaluation and diagnosis of pediatric ADHD in 2000; recommendations for treatment followed in 2001. The guidelines were revised in 2011 and published with an accompanying process of care algorithm (PoCA) providing discrete and manageable steps by which clinicians could fulfill the clinical guideline's recommendations. Since the release of the 2011 guideline, the Diagnostic and Statistical Manual of Mental Disorders has been revised to the fifth edition, and new ADHD-related research has been published. These publications do not support dramatic changes to the previous recommendations. Therefore, only incremental updates have been made in this guideline revision, including the addition of a key action statement related to diagnosis and treatment of comorbid conditions in children and adolescents with ADHD. The accompanying process of care algorithm has also been updated to assist in implementing the guideline recommendations. Throughout the process of revising the guideline and algorithm, numerous systemic barriers were identified that restrict and/or hamper pediatric clinicians' ability to adopt their recommendations. Therefore, the subcommittee created a companion article (available in the Supplemental Information) on systemic barriers to the care of children and adolescents with ADHD, which identifies the major systemic-level barriers and presents recommendations to address those barriers; in this article, we support the recommendations of the clinical practice guideline and accompanying process of care algorithm.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/terapia , Adolescente , Factores de Edad , Algoritmos , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Estimulantes del Sistema Nervioso Central/efectos adversos , Estimulantes del Sistema Nervioso Central/uso terapéutico , Niño , Preescolar , Terapia Combinada/métodos , Accesibilidad a los Servicios de Salud , Humanos , Pediatría , Psicoterapia/métodos , Sociedades Médicas , Estados Unidos
20.
Artículo en Inglés | MEDLINE | ID: mdl-31618876

RESUMEN

Background: Cocaine use disorder (CUD) is a growing public health concern, but so far no effective pharmacotherapies have been demonstrated. Stimulant medications have proved to be promising in CUD treatment. The self-medication hypothesis (SMH) can help to explain this phenomenon better, especially in cases where CUD co-occurs with adult attention deficit hyperactivity disorder (A-ADHD). Methods: In the present retrospective study, a sample of 20 consecutive patients (aged from 18 to 65 years) with dual disorder (A-ADHD/CUD), under treatment with methylphenidate (MPH) or atomoxetine (ATM) medications, was followed to study the effects of A-ADHD treatment on cocaine use. Patients were followed for a mean period of 7 months (minimum 1, maximum 30 months). All individuals were assessed with standardized questionnaires to evaluate diagnosis, treatment efficacy, and clinical improvement. Results: the results showed that behaviors reflecting cocaine addiction were sharply reduced during the stimulant treatment of A-ADHD, and were not correlated with age, gender, familiarity, length of treatment, or medication used. CUD improvement was closely correlated with the A-ADHD improvement. This study supports the validity of the SMH in ADHD patients with co-occurring CUD.


Asunto(s)
Clorhidrato de Atomoxetina/uso terapéutico , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Trastornos Relacionados con Cocaína/tratamiento farmacológico , Cocaína/administración & dosificación , Metilfenidato/uso terapéutico , Adolescente , Adulto , Anciano , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastornos Relacionados con Cocaína/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
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