Trastorno por Déficit de Atención con Hiperactividad: Ritmo Circanual en el Mes de Nacimiento / Attention Deficit Hyperactivity Disorder: Circannual Rhythm in the Month of Birth

Estudiamos la existencia de ritmo circanual en el mes de nacimiento en participantes con trastorno de déficit de atención e hiperactividad (TDAH)y analizamos la asociación entre meses de nacimiento y TDAH. La muestra incluye 10978 participantes (1778 TDAH / 9200 no TDAH), entre 3 y18 años, reclutados mediante muestreo consecutivo de primeras consultas atendidas en salud mental entre 1992 y 2021. Los participantes conTDAH presentan un ritmo circanual significativo en los meses de nacimiento, con una acrofase en octubre. Nacer en el último cuatrimestre del añoincrementa significativamente la probabilidad de ser diagnosticado TDAH, controlando el efecto de sexo y edad. Con el transcurso de los meses delaño, existe una tendencia lineal creciente significativa de ser diagnosticado de TDAH, no observada en población general, ni en casos sin TDAH.Es necesario tener precaución en el diagnóstico y tratamiento de los niños nacidos en los últimos meses del año, que, por su mayor inmadurez encomparación con los demás niños de la clase, pudieran ser diagnosticados y tratados erróneamente como TDAH. (AU)

We studied the existence of circanual rhythm in the month of birthin participants with attention deficit hyperactivity disorder (ADHD) and analyzed the association between months of birth and ADHD. We analyzed10,978 participants (1,778 ADHD/9,200 non-ADHD), aged 3 to 18 years. A consecutive sample of first visits to mental health between 1992 and2021 is used. Participants with ADHD exhibit a significant circannual rhythm in the months of birth, with an acrophase in October. Being born in thelast quarter of the year significantly increases the probability of being diagnosed with ADHD, controlling for the effect of sex and age. As the monthsof the year go by, there is a significant increasing linear trend of being diagnosed with ADHD, which is not observed neither in general populationnor in cases without ADHD. Caution is necessary in diagnosis and treatment of children born in the last months of year, who, due to their greaterimmaturity compared to the other children in class, could be misdiagnosed and treated as ADHD. (AU)

Calidad de vida en el trastorno por déficit de atención con hiperactividad: percepción de padres e hijos / Quality of life in attention deficit hyperactivity disorder: perception of parents and children

INTRODUCCIÓN: la calidad de vida relacionada con la salud (CVRS) es una dimensión relevante en la evaluación y consideración de los efectos de un tratamiento en el trastorno por déficit de atención con hiperactividad (TDAH). El objetivo del estudio es analizar las diferencias entre la percepción de padres e hijos en la CVRS en casos TDAH tratados farmacológicamente (TDAH-T), casos no tratados (TDAH-N) y controles. MATERIAL Y MÉTODOS: muestra de 228 participantes entre 8 y 14 años (114 controles, 57 TDAH-T y 57 TDAH-N). Muestreo consecutivo de TDAH según DSM-IV (ADHD RS-IV) y muestreo aleatorio de controles emparejados por sexo y edad. Evaluación de CVRS mediante las diez dimensiones del KIDSCREEN-52 versión padres y versión hijos. RESULTADOS: en los controles existen diferencias significativas entre padres e hijos en tres de las diez dimensiones del KIDSCREEN-52 (autonomía, autopercepción y recursos económicos), en cuatro dimensiones en TDAH-T (bienestar psicológico, autopercepción, entorno escolar y recursos económicos) y en seis dimensiones en TDAH-N (bienestar psicológico y físico, estado de ánimo, autopercepción, entorno escolar y recursos económicos). En todas las dimensiones donde existen diferencias significativas los hijos perciben mejor CVRS que la atribuida por los padres, excepto en la dimensión económica que sucede a la inversa. No existen diferencias significativas entre padres e hijos en controles, TDAH-N o TDAH-T en las dimensiones de aceptación social, relación con padres y amigos. CONCLUSIONES: es necesario que en la evaluación que precede a cualquier intervención clínica se deban tener en cuenta las perspectivas de padres e hijos sobre la CVRS

INTRODUCTION: health-related quality of life (HRQL) is a relevant dimension in the evaluation and consideration of the effects of a treatment in Attention Deficit Hyperactivity Disorder (ADHD). The objective of the study is to analyze the differences on the perception between parents and children in the HRQL in ADHD cases treated pharmacologically (ADHD-T), untreated cases (ADHD-N) and controls. MATERIAL AND METHODS: sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T and 57 ADHD-N). Consecutive sampling of ADHD according to DSM-IV (ADHD Rating Scales IV) and random sampling of controls matched by sex and age. HRQL assessment using the ten dimensions of the KIDSCREEN-52 parent version and child version. RESULTS: there are significant differences between parents/children in three out of ten dimensions of KIDSCREEN-52 (autonomy, self-perception, and financial resources), in four ADHD-T dimensions (psychological well-being, self-perception, school environment, and financial resources), and in six ADHD-N dimensions (psychological and physical well-being, mood, self-perception, school environment and financial resources) in controls. Children perceive HRQL better than parents in all dimensions with significant differences, except for economic dimension (the opposite). There are no significant differences between parents/children in controls, ADHD-N or ADHD-T in the dimensions of social acceptance, relationship with parents and friends. CONCLUSIONS: it is necessary to take into account the perspectives of parents and children regarding HRQL in the evaluation preceding any clinical intervention

Hospitalization trends and chronobiology for mental disorders in Spain from 2005 to 2015.

Rhythm research has had a long tradition in psychiatry, especially in affective disorders. The study of trends in incidence plays a central role in epidemiology and public health. The aims of this research were to describe the socio-demographic and clinical characteristics of persons admitted for psychiatric hospitalization and their trends and periodicity in cases (global and by groups) in Spain over the 11 year study span. We conducted a cross-sectional study of the hospital discharge database of Castilla y León from 2005 to 2015, selecting hospitalizations for psychiatric reasons. Trends in the rates of hospitalization were studied by joinpoint regression analysis. Time series analysis for periodicities was done by spectral analysis, fast Fourier transform, and cosinor analysis. Some 49501 hospitalizations due to psychiatric disorders, out of 2717192 hospital admissions, took place during the study span. Hospitalizations for psychosis were frequent (15949, 32.2%), while such for eating disorders were infrequent, but showed the highest average stay (28 days) and DRG relative weight (2.41). The general trend was a statistically significant 2% annual increase in psychiatric hospitalizations over the 11 year span; substance abuse was the only exception to this trend. The whole population and the subgroups of psychosis and bipolar disorders showed significant circannual (one-year) variation in admissions. The rhythm percentage of the global group was 11.4%, while the rhythm percentages of the psychosis, bipolar, and eating disorders were 17.1%, 17.5%, and 9.6%, respectively (p < .05).

Trends in Psychiatric Hospitalization of Children and Adolescents in Spain between 2005 and 2015.

Eating disorders are on top of chronic conditions in children and adolescents, and the most severe cases may require hospitalization. Inpatient psychiatric treatment is one of the most expensive ones and therefore the efforts when treating eating disorders should focus on avoiding and shortening admissions, as well as preventing readmissions. Advances in of eating disorders treatment lie in an accurate knowledge of those patients requiring admission. This study examined the Conjunto Mínimo Básico de Datos-the largest public hospitalization database in Spain-to estimate the prevalence of eating and other psychiatric disorders during childhood and adolescence. It is a cross-sectional study of the hospital discharges in Castilla y León (Spain) from 2005 to 2015, in which patients under 18 years old with a psychiatric diagnosis at discharge were selected. Trends in the rates of hospitalization/1000 hospitalizations per year were studied by joinpoint regression analysis. Conclusions: eating disorders were the only group that presented an upward and continuous trend throughout the study period. This statistically significant increase showed an annual change of 7.8%.

Percepción de niños y adolescentes sobre la calidad de vida en casos de trastorno por déficit de atención/hiperactividad con y sin tratamiento farmacológico y en controles / Children's and adolescents' perception of their quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment and in controls

Introducción. La calidad de vida relacionada con la salud percibida por niños y adolescentes es un factor importante para valorar los efectos de una intervención terapéutica. Objetivo. Analizar la calidad de vida comparando casos con trastorno por déficit de atención/hiperactividad (TDAH) tratados farmacológicamente con metilfenidato, casos no tratados y controles. Sujetos y métodos. Muestra de 228 participantes de 8-14 años. Muestreo consecutivo de casos de TDAH según los criterios del Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición, y muestreo aleatorio de controles emparejados por sexo, edad y zona sociodemográfica. Evaluación de la calidad de vida mediante el KIDSCREEN-52 (versión niños y adolescentes). Para responder al objetivo se utilizó ANOVA con corrección de Bonferroni. Resultados. Observamos una correlación significativa moderada entre mayor intensidad de síntomas de TDAH y peor calidad de vida, excepto en el bienestar físico. Los casos de TDAH no tratados tienen significativamente peor calidad de vida que los controles en bienestar psíquico, autonomía, estado de ánimo, entorno escolar y aceptación social. Los casos de TDAH tratados observan similares resultados excepto en el entorno escolar y el bienestar psíquico, que no presentan diferencias significativas con los controles. Los casos de TDAH tratados por comparación con los de TDAH no tratados sólo presentan significativamente mejor calidad de vida en el entorno escolar. Conclusión. Los casos de TDAH presentan dimensiones del KIDSCREEN-52 con peor calidad de vida que los controles y los casos de TDAH tratados con metilfenidato sólo se diferencian significativamente de los no tratados porque presentan mejores resultados en el entorno escolar

Introduction. Health-related quality of life perceived by children and teenagers is important to assess the effects of therapeutic intervention. Aim: To analyze quality of life, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate, untreated cases and controls. Subjects and methods: Sampling of 228 participants between 8 and 14 years-old. Consecutive sampling in ADHD according to DSM-IV criteria (ADHD Rating Scales IV) and random sampling of matched controls by sex and age. Evaluation of quality of life using KIDSCREEN-52 (children version). ANOVA with Bonferroni correction was used. Results: There is a moderate significant correlation between greater intensity of ADHD symptoms and worse quality of life, except in the dimension of physical well-being. Cases of untreated ADHD have significantly worse quality of life than controls on psychic well-being, mood, autonomy school environment and social acceptance. Cases of treated ADHD present similar results, except in the school environment and psychological well-being. The cases of ADHD treated only differ significantly from ADHD not treated in having a better school environment. Conclusions: The cases of ADHD present dimensions of KIDSCREEN-52 with worse quality of life than controls and the cases of ADHD treated with methylphenidate only differ significantly from those not treated in presenting better results in the school environment

Trends in Hospitalization and Mortality Rates Due to Acute Cardiovascular Disease in Castile and León, 2001 to 2015.

INTRODUCTION AND OBJECTIVES: To analyze hospitalization and mortality rates due to acute cardiovascular disease (ACVD). METHODS: We conducted a cross-sectional study of the hospital discharge database of Castile and León from 2001 to 2015, selecting patients with a principal discharge diagnosis of acute myocardial infarction (AMI), unstable angina, heart failure, or acute ischemic stroke (AIS). Trends in the rates of hospitalization/100 000 inhabitants/y and hospital mortality/1000 hospitalizations/y, overall and by sex, were studied by joinpoint regression analysis. RESULTS: A total of 239 586 ACVD cases (AMI 55 004; unstable angina 15 406; heart failure 111 647; AIS 57 529) were studied. The following statistically significant trends were observed: hospitalization: ACVD, upward from 2001 to 2007 (5.14; 95%CI, 3.5-6.8; P < .005), downward from 2011 to 2015 (3.7; 95%CI, 1.0-6.4; P < .05); unstable angina, downward from 2001 to 2010 (-12.73; 95%CI, -14.8 to -10.6; P < .05); AMI, upward from 2001 to 2003 (15.6; 95%CI, 3.8-28.9; P < .05), downward from 2003 to 2015 (-1.20; 95%CI, -1.8 to -0.6; P < .05); heart failure, upward from 2001 to 2007 (10.70; 95%CI, 8.7-12.8; P < .05), upward from 2007 to 2015 (1.10; 95%CI, 0.1-2.1; P < .05); AIS, upward from 2001 to 2007 (4.44; 95%CI, 2.9-6.0; P < .05). Mortality rates: downward from 2001 to 2015 in ACVD (-1.16; 95%CI, -2.1 to -0.2; P < .05), AMI (-3.37, 95%CI, -4.4 to -2, 3, P < .05), heart failure (-1.25; 95%CI, -2.3 to -0.1; P < .05) and AIS (-1.78; 95%CI, -2.9 to -0.6; P < .05); unstable angina, upward from 2001 to 2007 (24.73; 95%CI, 14.2-36.2; P < .05). CONCLUSIONS: The ACVD analyzed showed a rising trend in hospitalization rates from 2001 to 2015, which was especially marked for heart failure, and a decreasing trend in hospital mortality rates, which were similar in men and women. These data point to a stabilization and a decline in hospital mortality, attributable to established prevention measures.

Prevalence of Oppositional Defiant Disorder in a sample of Spanish children between six and sixteen years: teacher’s report.

INTRODUCTION: Our main objective is to study the prevalence of Oppositional Defiant Disorder (ODD) in school children aged 6-16 years of an autonomous region of Spain (Castile and Leon), according to reports from the teachers and to analyze the impact of the disorder on academic performance and school behavior. METHODS: Population study with stratified multistage, proportional and cluster design sample. Sample analyzed: 1,049. Cases were defined according to DSM-IV-TR criteria. RESULTS: An overall prevalence rate of 4.2% was found, this being significantly higher in males (5.7%) compared to females (2.6%) and in rural (6.8%) than in urban areas (3%). No significant differences by grade or type of school were found. ODD prevalence without considering functional impairment would increase to 5.1%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, math and writing) and entail worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks and disruption of the class). CONCLUSIONS: Based on the prevalence, early onset, persistence of symptoms and social and academic dysfunction of ODD, early diagnosis and preventive intervention are necessary.

Prevalencia del Trastorno Negativista Desafiante en una muestra de niños españoles entre seis y dieciséis años: informe del profesor / Prevalence of Oppositional Defiant Disorder in a sample of Spanish children between six and sixteen years: teacher’s report

Introducción. Nuestro objetivo principal es estudiar la prevalencia del Trastorno Negativista Desafiante (TND) en escolares de 6 a 16 años de una Comunidad Autónoma de España (Castilla y León) según informes del profesorado y analizar la repercusión del trastorno en resultados académicos y conducta escolar. Metodología. Estudio poblacional con diseño muestral polietápico estratificado, proporcional y por conglomerados. Muestra analizada: 1.049. Casos definidos según criterios DSM-IV-TR. Resultados. La prevalencia de TND es 4,2%. La prevalencia es significativamente superior en sexo masculino (5,7%), respecto al femenino (2,6%) y en zona rural (6,8%) respecto a urbana (3%). No existen diferencias significativas en función del curso o colegio público/privado. La prevalencia de TND sin considerar deterioro funcional aumentaría al 5,1%. Los casos de TND según informes de profesores presentan significativamente peores resultados académicos (resultados globales, lectura, matemáticas y expresión escrita) y peor conducta en clase (relación con compañeros, respeto a normas, destrezas organizativas, realización de tareas académicas e interrupciones de clase). Conclusiones. En función de la prevalencia, inicio precoz, persistencia de síntomas y disfunción social y escolar del TND, es necesario un diagnóstico temprano e intervención preventiva

Introduction. Our main objective is to study the prevalence of Oppositional Defiant Disorder (ODD) in school children aged 6-16 years of an autonomous region of Spain (Castile and Leon), according to reports from the teachers and to analyze the impact of the disorder on academic performance and school behavior. Methods. Population study with stratified multistage, proportional and cluster design sample. Sample analyzed: 1,049. Cases were defined according to DSM-IV-TR criteria. Results. An overall prevalence rate of 4.2% was found, this being significantly higher in males (5.7%) compared to females (2.6%) and in rural (6.8%) than in urban areas (3%). No significant differences by grade or type of school were found. ODD prevalence without considering functional impairment would increase to 5.1%. ODD cases have significantly worse academic outcomes (overall academic performance, reading, math and writing) and entail worse classroom behavior (relationship with peers, respect for rules, organizational skills, academic tasks and disruption of the class). Conclusions. Based on the prevalence, early onset, persistence of symptoms and social and academic dysfunction of ODD, early diagnosis and preventive intervention are necessary

Hipotermia terapéutica tras parada cardiaca / No disponible

No disponible

Melatonin rhythm in children with enuresis.

OBJECTIVE: To study the circadian rhythm of melatonin in children with enuresis. PATIENTS AND METHODS: Twenty-five children, divided into two groups (enuretic patients and controls) were assessed; salivary samples were collected to measure melatonin by radioimmunoassay using commercial kits. Friedman two-way anova and Wilcoxon tests were used to assess the circadian rhythm of melatonin, and anova with between-patient factors and Mann-Whitney tests to compare melatonin values and groups. RESULTS: Both groups had statistically significant differences in melatonin concentration during the 24-h period (both P < 0.001), with a circadian rhythm; the highest values were always at approximately 04.00 hours. There were no significant differences overall in melatonin values between cases and controls, but patients had lower peak values than controls at 04.00 hours, and higher melatonin levels at 24.00 hours, but with no significant differences. CONCLUSION: There was some evidence for minor disturbances in the circadian rhythm of melatonin as a cause of enuresis, but the rhythm was not grossly disrupted.

[Cardiovascular risk factors in the circadian rhythm of acute myocardial infarction]. / Factores de riesgo cardiovascular en el ritmo circadiano del infarto agudo de miocardio.

INTRODUCTION AND OBJECTIVES: The aim of this study was to analyze the influence of modifiable cardiovascular risk factors on the circadian rhythm of acute myocardial infarction. PATIENTS AND METHOD: We analyzed a retrospective cohort of 54,249 patients from a multicenter study of acute myocardial infarction (the Spanish ARIAM study). The variables were time of onset of symptoms, age, sex, previous ischemic heart disease, coronary unit discharge status, previous stroke, familial antecedents of ischemic heart disease, hypertension, diabetes, dyslipidemia, smoking, and reinfarction. To verify the presence of circadian rhythm, we developed a simple test of equality of time series based on cosinor analysis of multiple sinusoid curves. Three sinusoids (24, 12 and 8 hour periods) were used. RESULTS: The time of onset of pain showed a circadian rhythm (P< .01), with a peak at 10:07 am and a trough at 4:46 am. All subgroups categorized according to the presence of the variables analyzed here showed a circadian rhythm, with a sinusoid curve after adjustment. In patients with diabetes or reinfarction or who were smokers, the sinusoid curve was bimodal. CONCLUSIONS: Time of onset of symptoms in patients with acute myocardial infarction follows a circadian rhythm. Diabetes, smoking and reinfarction can modify the standard circadian rhythm of onset of myocardial infarction.