Lisdexamphetamine versus methylphenidate for paediatric patients with attention-deficit hyperactivity disorder and type 1 diabetes (LAMAinDiab): protocol for a multicentre, randomised cross-over clinical trial in an outpatient telemedicine-supported setting.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) affects 5%-10% of paediatric population and is reportedly more common in children with type 1 diabetes (T1D), exacerbating its clinical course. Proper treatment of ADHD in such patients may thus provide neurological and metabolic benefits. To test this, we designed a non-commercial second phase clinical trial comparing the impact of different pharmacological interventions for ADHD in children with T1D. METHODS AND ANALYSIS: This is a multicentre, randomised, open-label, cross-over clinical trial in children and adolescents with ADHD and T1D. The trial will be conducted in four reference paediatric diabetes centres in Poland. Over 36 months, eligible patients with both T1D and ADHD (aged 8-16.5 years, T1D duration >1 year) will be offered participation. Patients' guardians will undergo online once-weekly training sessions behaviour management for 10 weeks. Afterward, children will be randomised to methylphenidate (long-release capsule, doses 18-36-54 mg) versus lisdexamphetamine (LDX, 30-50-70 mg). Pharmacotherapy will continue for 6 months before switching to alternative medication. Throughout the trial, the participants will be evaluated every 3 months by their diabetologist and online psychological assessments. The primary endpoint (ADHD symptom severity, Conners 3.0 questionnaire) will be assessed by a blinded investigator. Secondary endpoints will include HbA1c, continuous glucose monitoring indices and quality-of-life (PedsQL). ETHICS AND DISSEMINATION: The trial is approved by Bioethical Committee at Medical University of Lodz and Polish regulatory agency (RNN/142/22/KE, UR/DBL/D/263/2022). The results will be communicated to the research and clinical community, and Polish agencies responsible for healthcare policy. Patient organisations focused on paediatric T1D will be notified by a consortium member. We hope to use the trial's results to promote collaboration between mental health professionals and diabetes teams, evaluate the economic feasibility of using LDX in patients with both diseases and the long run improve ADHD treatment in children with T1D. TRIAL REGISTRATION NUMBERS: EU Clinical Trials Register (EU-CTR, 2022-001906-24) and NCT05957055.

Cultural contributions to adults' self-rated mental health problems and strengths: 7 culture clusters, 28 societies, 16 906 adults.

BACKGROUND: It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals. METHODS: To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects. RESULTS: Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects. CONCLUSIONS: Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.

Genome-wide Association Study Points to Novel Locus for Gilles de la Tourette Syndrome.

BACKGROUND: Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder of complex genetic architecture and is characterized by multiple motor tics and at least one vocal tic persisting for more than 1 year. METHODS: We performed a genome-wide meta-analysis integrating a novel TS cohort with previously published data, resulting in a sample size of 6133 individuals with TS and 13,565 ancestry-matched control participants. RESULTS: We identified a genome-wide significant locus on chromosome 5q15. Integration of expression quantitative trait locus, Hi-C (high-throughput chromosome conformation capture), and genome-wide association study data implicated the NR2F1 gene and associated long noncoding RNAs within the 5q15 locus. Heritability partitioning identified statistically significant enrichment in brain tissue histone marks, while polygenic risk scoring of brain volume data identified statistically significant associations with right and left thalamus volumes and right putamen volume. CONCLUSIONS: Our work presents novel insights into the neurobiology of TS, thereby opening up new directions for future studies.

Polygenic risk score-based phenome-wide association study identifies novel associations for Tourette syndrome.

Tourette Syndrome (TS) is a complex neurodevelopmental disorder characterized by vocal and motor tics lasting more than a year. It is highly polygenic in nature with both rare and common previously associated variants. Epidemiological studies have shown TS to be correlated with other phenotypes, but large-scale phenome wide analyses in biobank level data have not been performed to date. In this study, we used the summary statistics from the latest meta-analysis of TS to calculate the polygenic risk score (PRS) of individuals in the UK Biobank data and applied a Phenome Wide Association Study (PheWAS) approach to determine the association of disease risk with a wide range of phenotypes. A total of 57 traits were found to be significantly associated with TS polygenic risk, including multiple psychosocial factors and mental health conditions such as anxiety disorder and depression. Additional associations were observed with complex non-psychiatric disorders such as Type 2 diabetes, heart palpitations, and respiratory conditions. Cross-disorder comparisons of phenotypic associations with genetic risk for other childhood-onset disorders (e.g.: attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and obsessive-compulsive disorder [OCD]) indicated an overlap in associations between TS and these disorders. ADHD and ASD had a similar direction of effect with TS while OCD had an opposite direction of effect for all traits except mental health factors. Sex-specific PheWAS analysis identified differences in the associations with TS genetic risk between males and females. Type 2 diabetes and heart palpitations were significantly associated with TS risk in males but not in females, whereas diseases of the respiratory system were associated with TS risk in females but not in males. This analysis provides further evidence of shared genetic and phenotypic architecture of different complex disorders.

Attachment in adolescents with attention deficit hyperactivity disorder and oppositional defiant disorder. / Przywiazanie u nastolatków z zespolem nadpobudliwosci psychoruchowej i opozycyjno-buntowniczymi zaburzeniami zachowania.

OBJECTIVES: To assess attachment styles among adolescents (13-16 years) with ADHD or ADHD and oppositional defiant disorders (ODD). METHODS: The Parents and Peers Attachment (IPPA) and the Parent Bonding Questionnaire (PBI) were used in three groups of teenagers raised in biological families: (1) ADHD/ODD group (n = 40), (2) ADHD group (n = 40) and (3) K (control) group of teenagers (n = 40) who have not benefited from psychological or psychiatric care in the past or at present. RESULTS: Parental attachment styles in the area of "Trust", "Communication" and "Alienation" (IPPA), and "Care" and "Control" (PBI) in the ADHD/ODD group differ significantly compared to the control group. Teens from the ADHD/ODD group report to have experienced significantly less "Trust" and "Communication" (IPPA), and "Care" (PBI) in relationships with parents and more "Alienation" (IPPA) and "Control" (PBI) than adolescents in the ADHD group. Attachment patterns with peers in both clinical and control groups differ significantly. The ADHD/ODD group is dominated by the anxious-avoidant style of attachment to the mother and father, in the ADHD group, a secure style in relation to the mother and anxious-avoidant in relation to the father. In relations with peers in the ADHD/ODD group and the ADHD group, the anxious-avoidant style dominates. CONCLUSIONS: The attachment style is significantly different in adolescents diagnosed with ADHD and ODD than in adolescents with only ADHD. In the ADHD/ODD group and the ADHD group, unlike in the group of adolescents without a psychiatric diagnosis, insecure attachment styles for parents and peers dominate (mainly anxious-avoidant style).

Enhancing neuroimaging genetics through meta-analysis for Tourette syndrome (ENIGMA-TS): A worldwide platform for collaboration.

Tourette syndrome (TS) is characterized by multiple motor and vocal tics, and high-comorbidity rates with other neuropsychiatric disorders. Obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), major depressive disorder (MDD), and anxiety disorders (AXDs) are among the most prevalent TS comorbidities. To date, studies on TS brain structure and function have been limited in size with efforts mostly fragmented. This leads to low-statistical power, discordant results due to differences in approaches, and hinders the ability to stratify patients according to clinical parameters and investigate comorbidity patterns. Here, we present the scientific premise, perspectives, and key goals that have motivated the establishment of the Enhancing Neuroimaging Genetics through Meta-Analysis for TS (ENIGMA-TS) working group. The ENIGMA-TS working group is an international collaborative effort bringing together a large network of investigators who aim to understand brain structure and function in TS and dissect the underlying neurobiology that leads to observed comorbidity patterns and clinical heterogeneity. Previously collected TS neuroimaging data will be analyzed jointly and integrated with TS genomic data, as well as equivalently large and already existing studies of highly comorbid OCD, ADHD, ASD, MDD, and AXD. Our work highlights the power of collaborative efforts and transdiagnostic approaches, and points to the existence of different TS subtypes. ENIGMA-TS will offer large-scale, high-powered studies that will lead to important insights toward understanding brain structure and function and genetic effects in TS and related disorders, and the identification of biomarkers that could help inform improved clinical practice.

The impact of the COVID-19 pandemic on the mental health of children with psychiatric diagnoses - multidimensional CCPCA Model.

BACKGROUND: The study aimed to assess the severity of symptoms of anxiety and depression in children with previously diagnosed psychiatric disorders during the COVID-19 pandemic in Poland. METHODS: Online questionnaires were used to investigate three groups of subjects: patients with a psychiatric diagnosis, primary school pupils, and children from children's homes. A total of 167 children with their parents or guardians participated in the study. In addition to basic statistics, a multidimensional Centroid Class Principal Component Analysis (CCPCA) model was used. RESULTS: It was found that the strongest fear of the coronavirus was experienced by children from children's homes, while the most severe depressive symptoms and state anxiety were observed among patients diagnosed with psychiatric disorders. Parental care by assisting with school education and lack of close contact with other people (less than two metres) at parents/guardians' work had the most potent protective effect in reducing the fear of COVID-19. CONCLUSIONS: There is a need for further research in children and adolescents to develop effective strategies for protecting their mental well-being when faced with social isolation or disease.

Practical guidelines for management of patients with suspected or confirmed COVID-19 hospitalized in a child and adolescent psychiatric ward. / Wytyczne postepowania z pacjentami hospitalizowanymi w oddziale psychiatrii dla dzieci i mlodziezy z podejrzeniem zachorowania lub z potwierdzonym zachorowaniem na COVID-19.

The novel coronavirus disease (COVID-19) epidemic - in addition to its many widely described negative consequences - has created achallenge for the mental health care system in every country, including Poland to safely manage psychiatric disorders in addition to preventing and treating COVID-19. In Poland, online mental health services are provided for the outpatients. Still there are patients with severe psychiatric disorders who have suspected or confirmed COVID-19 and need to be treated in a psychiatric hospital. The Department of Child and Adolescent Psychiatry of the Medical University of Warsaw was appointed by local authorities to hospitalize childrenwith mental disorders and with confirmed or suspected COVID-19. This created an urgent need to adapt our department for treating COVID-19 infected patients. As far as we know no guidelines for psychiatric hospitals management during the COVID-19 pandemic are available in English. In this manuscript, we present our guidelines regarding safe management of patients with suspected or confirmed COVID-19 in the Department of Child and Adolescent Psychiatry of the Medical University of Warsaw.

Psychiatric Comorbidities in Pediatric Monogenic Diabetes due to GCK Mutation: Impact on Diabetes-Related Quality of Life.

BACKGROUND: Monogenic diabetes caused by mutation in the glucokinase gene (GCK-MD) is a rare disorder manifesting in childhood as mild, prevalent hyperglycemia. By consensus, it is managed by dietary supervision and infrequent consultations. However, its impact on the mental health of the affected children is largely unknown. OBJECTIVE: To estimate the prevalence of psychiatric comorbidities in children with monogenic glucokinase-related diabetes (GCK-MD) and evaluate their association with quality of life (QoL). METHODS: The study invited children with GCK-MD aged 5-18 years identified in the Central National Registry and treated in 3 pediatric diabetes centers in Poland. The control group comprised children with type 1 diabetes (T1D, the most common diabetes type in youth) matched for age and family history of diabetes. Participants underwent a semistructured clinical interview diagnostic for psychiatric comorbidities, questionnaires assessing behavioral problems, depressive symptoms, parental stress, and measuring general and diabetes-related QoL (PedsQl). RESULTS: We included 35 patients with GCK-MDMD and 199 with T1D. Eight (22.9%) GCK-MD patients were diagnosed with psychiatric disorder in their lifetime, compared with 16 (8.1%) in the T1D group (odds ratio 3.4 [95% confidence interval: 1.3-8.7]). Patients with GCK-MD showed better parent-reported general QoL (87.1 ± 11.9 vs 82.0 ± 14.0, P = 0.0060) and higher diabetes-related QoL in both parental (84.5 ± 13.8 vs 74.1 ± 15.2, P < 0.0001) and child's perspective (87.6 ± 10.9 vs 77.3 ± 13.9, P < 0.0001). Psychiatric disorders (+P) were associated with worse child-reported diabetes QoL (T1D+P 66.6 ± 16.7, T1D-P 78.2 ± 13.3, GCK-MD+P 79.6 ± 16.3, GCK-MD-P 90.1 ± 7.5, P = 0.0002). CONCLUSIONS: High prevalence of psychiatric disorders in children with GCK-MD and lower QoL emphasizes the need for psychologic surveillance in those otherwise mildly-treated patients.

Effects of individual differences, society, and culture on youth-rated problems and strengths in 38 societies.

BACKGROUND: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11-17 year olds in 38 societies. METHODS: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. RESULTS: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. CONCLUSIONS: Like parents' ratings, youths' self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self-reports should thus not be minimized by societal/cultural differences, which-while important-can be taken into account with appropriate norms, as can gender and age differences.

Behavioral and Emotional Problems of Prisoners' Children Based on the Children's Self-Report.

The aim of the analyses was to investigate the relations between parental incarceration and the levels of behavioral and emotional problems in children of fathers serving prison sentences, based on the children's self-report. We tested a criterion group and two control groups. The criterion group consisted of children whose fathers were in prison. The children in control group I were from complete families; the level of problem behaviors in these families and the level of psychological resiliency in these children were similar to the respective levels in the criterion group. Finally, control group II consisted of children whose fathers were not in prison; problem behaviors in their families were basically absent or slight, and their level of resiliency was significantly higher compared to prisoners' children and control group I. Prisoners' children exhibited a higher level of emotional and behavioral problems than children from families in which the father was not serving a prison sentence and in which the level of dysfunctions was low. As regards prisoners' children compared to their peers with a similar level of resiliency and a similar level of problem behavior in the family, statistically significant differences were found only in a few categories of emotional and behavioral problems. Parental incarceration proved to be an additional factor increasing the level of behavioral and emotional problems in children and adolescents-particularly girls-whose fathers were imprisoned.

Behavioral and emotional problems of prisoners' children in the family environment. / Zaburzenia behawioralne i emocjonalne dzieci wiezniów w srodowisku rodzinnym.

OBJECTIVES: The aim of the present study was to investigate the links between parental incarceration and the level of behavioral and emotional problems in children of incarcerated fathers, based on the information provided by parents. METHODS: The subjects were a group of prisoners' children and two control groups. The criterion group consisted of prisoners' children (N = 72) brought up in families with an increased level of dysfunction and problem behaviors. The first control group (I) was composed of children (N = 76) brought up in complete families; the level of problem behavior in these families and the level of these children's resiliency was similar to that of prisoners' children (i.e., the criterion group). The second control group (II) was composed of children from complete families (N = 98). In these families, problem behaviors were not present at all or their level was very low, and the children's level of resiliency was significantly higher compared to prisoners' children and children from control group I. To measure behavioral and emotional problems, the version of Thomas Achenbach's questionnaire that is meant to be completed by parents: namely, the Child Behavior Checklist (CBCL) was used. RESULTS: The level of behavioral and emotional problems in prisoners' children turned out to be significantly higher in all categories of problems compared to their peers from complete families. CONCLUSIONS: The results of the study indicate that parental incarceration is an additional factor increasing behavioral and emotional problems. The results of our study make it reasonable to suspect that parental incarceration affects girls more strongly than it affects boys.

The functioning of families of teens with attention deficit hyperactivity disorder and oppositional defiant disorder. / Funkcjonowanie rodzin nastolatków z zespolem nadpobudliwosci psychoruchowej i opozycyjno-buntowniczymi zaburzeniami zachowania.

OBJECTIVES: Comparison of the functioning of families of teens (13-16 years) with the diagnosis of attention deficit hyperactivity disorder (ADHD) or ADHD and oppositional defiant disorder (ODD). METHODS: Assessment using the Family Assessment Questionnaire in three groups of adolescents growing up in biological families: (1) ADHD/ODD group (n = 40), (2) ADHD group (n = 40) and (3) group C (control group) adolescents (n = 40) who have not used psychological or psychiatric care in the past or at present. RESULTS: Mothers, fathers and adolescents from the ADHD/ODD group scored significantly lower in all important aspects of family functioning compared to the control group. In the ADHD group, less favorable mother's and father's assessment was shown for all areas of family functioning compared with the control group. Adolescents' assessment in the dimension of "Role performance", "Emotionality", "Affective involvement", and "Control" was also lower. The ADHD/ODD group participants and their parents rated the functioning of the family lower compared with the ADHD group: mothers - in all described areas, teenagers - in most of the described areas except the dimension of "Control", and fathers - in most areas except the dimension of "Emotionality". CONCLUSIONS: The functioning of families of patients with ADHD and ODD, and families of patients with ADHD significantly differs in all or most of the examined dimensions compared with families of people without diagnosis, while the functioning of families of patients with ADHD and oppositional defiant patients can be described as more abnormal than that of families of ADHD patients.

Cognitive impairments in Polish children and adolescents with perinatal HIV infection. / Zaburzenia poznawcze u dzieci i mlodziezy z wrodzonym zakazeniem HIV w Polsce.

OBJECTIVES: The aim of the study was to assess the presence of cognitive impairments in children and adolescents with vertically transmitted HIV infection and to determine possible relationships with clinical and socio-demographic variables. METHODS: Fifty children with perinatal HIV infection aged 6-18 years were included in the experimental group (PHIV+). Two sex- and age-matched groups were recruited as reference groups: (1) a PHEU group that included 24 healthy children perinatally HIV-exposed but uninfected, and (2) an HIV-nA group that included 43 healthy children of uninfected parents. CANTAB Research Suite was used to assess cognitive functioning. RESULTS: In comparison with the HIV-nA group, the PHIV+ group scored worse in movement execution, shifting and flexibility of attention, reversal learning and working memory. In comparison with the PHEU group, the PHIV+ group had significantly longer planning time in the memory task. The analysis of results for the 12-18 year-old age group revealed deterioration of cognitive functions in all tests of the PHIV+ children in comparison with the HIV-nA group. A higher logarithm of viral load at the start of the ARV treatment was associated with worse results in the use of feedback, shifting of attention, cognitive flexibility and worse information processing. CONCLUSIONS: Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment.

Morphometric evaluations based on Voxel Based Morphometry on adolescents with autism spectrum disorders. / Badania morfometryczne oparte o pomiar voksela (Voxel Based Morphometry) u nastolatków z zaburzeniami ze spektrum autyzmu.

OBJECTIVES: Goal: to evaluate changes in the grey matter volume using the VBM method in a group of adolescents with ASD, who met the criteria for Asperger's Syndrome. METHODS: Material and methods: Morphometric evaluations based on Voxel Based Morphometry (VBM) were performed on 37 male adolescents aged 12 to 19 (M = 14.3 ± 2.0), with autism spectrum disorders, who met the DSM-IV-TR criteria for Asperger's Syndrome and 15 neurotypical adolescents matched by age. Significance was set at p<0.007 without FWE correction and p<0.05 with FWE correction. RESULTS: Results: the decrease in the volume of the grey matter was observed in ASD group including the pre- and postcentral gyrus, the superior and middle frontal gyrus, the inferior and superior parietal lobule, the praecuneus, the anterior and posterior cingulate cortex, the fusiform gyrus, the parahippocampal gyrus, the lingual gyrus, the middle occipital region, the cuneus and the angular gyrus, the regions of calcarine sulcus and the cerebellum. The majority of changes was localized bilaterally. CONCLUSIONS: Conclusions: the decrease in the volume of grey matter observed in ASD group can be related functionally with the characteristics of deficits observed in autism spectrum disorders which highlights the role of abnormal organization of numerous CNS structures in the genesis of symptoms observed in cognitive and behavioural domains.

Semantic decisions in adolescents with autism spectrum disorders - functional magnetic resonance imaging study. / Decyzje semantyczne u nastolatków z zaburzeniami ze spektrum autyzmu - badanie czynnosciowym rezonansem magnetycznym.

OBJECTIVES: Goal: to assess fMRI activation during semantic tasks in adolescents with ASD. METHODS: Material: 44 right-handed male adolescents aged 12-19 (mean 14.3 ± 2.0) - 31 with autism spectrum disorders who met DSM-IV-TR criteria for Asperger's syndrome and 13 neurotypical adolescents matched according to age and handiness. Method: Functional testing (fMRI) was performed during semantic decisions tasks and phonological decisions in three categories of tasks: concrete nouns, verbs with plural meanings, words describing states of mind, as a control condition. Statistical analyzes were performed at the level of p <0.05 with FWE (family-wise error) correction and p <0.001. RESULTS: Results: lower BOLD signal was demonstrated in many brain areas including precuneus, posterior cingulate gyrus, angular gyrus, parahippocampal gyrus, regardless of task category and processing method in the ASD group. The smallest differences in semantic processing were found for concrete nouns and the greatest ones for words describing states of mind. CONCLUSIONS: Conclusions: the presence of different activation patterns in the ASD group suggests that far more than just the areas traditionally attributed to language processing, are involved in semantic deficits in ASD.

The role of factors associated with the course of pregnancy and childbirth in attention deficit hyperactivity disorder (ADHD). / Rola czynników zwiazanych z przebiegiem ciazy i porodu w zespole nadpobudliwosci psychoruchowej z deficytem uwagi.

OBJECTIVES: Assessment of the prevalence of risk factors associated with the course of pregnancy and childbirth and the condition of the child after birth in agroup of children and adolescents with ADHD and a control group. METHODS: 205 unrelated children and adolescents diagnosed with ADHD and 106 primary and secondary school students aged 7-17. Method. Mothers of children and adolescents diagnosed with ADHD, and those from the control group, were asked to provide a medical history in order to obtain data to supplement the Pregnancy and perinatal history questionnaire. RESULTS: Statistically significant differences (p < 0.05) were demonstrated for the incidence rates of factors related to the course of pregnancy and childbirth such as: the occurrence of maternal diseases during pregnancy, especially in the I/II trimester, and other problems during pregnancy; exposure to stress and taking medication during pregnancy; smoking during pregnancy; mother's age at childbirth, i.e., < 25 years or > 35 years; use of pain reducing substances during labor and problems with the child during the delivery;an APGAR score in the range of 5-7 points; the occurrence of neonatal jaundice necessitating treatment, especially replacement transfusion; physical anomalies or other congenital problems in the newborn, as well as adaptive problems necessitating neonatal oxygen administration or placement in an incubator. CONCLUSIONS: Significantly more frequent occurrence of risk factors related to the course of pregnancy, childbirth and the child's condition after birth in the ADHD group may indicate their potential role in the etiology of ADHD.

Depression and smoking - widespread health problems among 14-year-old adolescents in Poland. The results of the SOPKARD-Junior survey. / Depresja i palenie papierosów ­ powszechne problemy zdrowotne wsród polskich 14-latków. Wyniki badania SOPKARD-Junior.

OBJECTIVES: Assessment of prevalence and co-prevalence of depression and substance abuse among Sopot youth. METHODS: In the years 2006-2007, 316 subjects participated in a psychological examination as part of the SOPKARD-Junior program. The assessment was made using the Beck Depression Inventory, the Krakow Depression Inventory and a proprietary questionnaire evaluating the frequency of psychoactive substance use. Adolescents with depressive symptoms in the questionnaire study underwent a psychiatric examination. The SOPKARD-Junior program is a multidisciplinary epidemiologic study that comprehensively assesses the health of the population of 14-year-old junior secondary school students in Sopot. RESULTS: Symptoms of depression were detected in 29.4% of subjects: 37.4% of girls (G) and 20.9% of boys (B) (p < 0.05). In the psychiatric examination, an episode of depression was diagnosed in 4.1% of students (G: 5.5%; B: 2.6%). The rates of substance use (occasional or regular) were: cigarettes - 20.2 % of students (G: 24% and B: 16.4%; p < 0.05), alcohol - 45.9% (G: 50.9% and B: 40.5%; p < 0.05), and illicit drugs - 6.3% (G: 6.2% and B: 6.6%; n.s.). Teenagers with depressive symptoms smoke cigarettes and drink alcohol significantly more often than those without depressive symptoms (smoking rates:30.1% vs. 16.1%; p <0.05; alcohol drinking rates: 61.3% vs. 39.5%; p < 0.05). CONCLUSIONS: (1) Significant prevalence of depressive symptoms was detected among the adolescents in the study. (2) Girls smoke cigarettes and drink alcohol significantly more frequently than boys. (3) The occurrence of depressive symptoms in adolescents almost doubles the risk of tobacco and alcohol use.

Gut microbiota and probiotic therapy in ADHD: A review of current knowledge.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, impulsivity and hyperactivity. The etiology of the disorder is multi-factorial, with a main focus on genetic factors. However, emerging research shows the involvement of changes and imbalances in the intestinal microbiota. Evidence for the influence of gut microbiota on brain development and neurogenesis is clear. We present a review of emerging research on the microbiota in the ADHD population. The aim of this study was to summarize the current state of knowledge on ADHD, to identify gaps in knowledge, as well as to indicate the directions of new research. Thanks to the researchers that would be possible to better understand the complexity of ADHD etiology, especially the role of the intestinal microbiota in the pathogenesis of the disorder. Pubmed, Scopus and Google Scholar databases were used while writing the review. Numerous studies show that probiotic supplementation can have a positive effect on the course of neurodevelopmental disorders, including ADHD. Unfortunately, clinical studies that were identified are mostly inconclusive, and more high-quality research is needed to produce robust evidence for therapy based on interventions targeting microbiota.

The Occurrence of Overweight and Obesity in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder According to Three Different Diagnostic Criteria for Obesity.

Objective: This study aimed to assess the prevalence of overweight and obesity in the group of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) according to three different diagnostic criteria for obesity. The effect of ADHD treatment on the risk of obesity was controlled. Materials and Methods: The study group consisted of 58 subjects aged from 8 to 17 years with ADHD. Control group consisted of 62 healthy age- and sex-matched children and adolescents. Overweight and obesity were assessed according to International Obesity Task-Force (IOTF), World Health Organization (WHO) and European Childhood Obesity Group (ECOG) criteria. Results: There was a significantly higher incidence of obesity in ADHD group according to WHO (ADHD vs. Control: 17.2% vs. 3.2%, p = 0.01) and IOTF criteria (ADHD vs. Control: 10.3% vs. 1.6%, p = 0.04), but no significant difference according to ECOG criteria. There was significantly higher occurrence of overweight (20.7% vs. 12.8%, p < 0.001), obesity (10.3% vs. 3.5%, p < 0.001), and overweight and obesity (31.0% vs. 16.3%, p < 0.001) in the ADHD group compared to the Polish population. The analysis did not show a statistically significant relationship between the amount of taken psychostimulant and the occurrence of overweight and obesity. Conclusions: The prevalence of overweight and obesity in the group of ADHD children and adolescents varies depending on the choice of diagnostic criteria. At the same time, it is significantly more frequent than in the general population. We suggest that future studies should give a clear rationale for the selection of cutoff points to minimize errors that could confound data analysis and interpretation.