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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(8): 791-796, 2021 Aug 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34511167

RESUMO

OBJECTIVES: To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone. METHODS: A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups. RESULTS: Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (P<0.05). Compared with the BECT group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, WMI, PSI, FSIQ, and FRCQ (P<0.05). Compared with the ADHD group, the BECT+ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of VCI, PRI, FSIQ, ARCQ, FRCQ, and AAQ (P<0.05). CONCLUSIONS: Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Disfunção Cognitiva , Epilepsia , Criança , Disfunção Cognitiva/etiologia , Humanos , Estudos Prospectivos , Escalas de Wechsler
2.
Prax Kinderpsychol Kinderpsychiatr ; 70(6): 499-519, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34519617

RESUMO

The controlled, prospective intervention study without randomization with a non-inferiority study design investigates the effectiveness of psychoanalytic treatments without medication in comparison to behavioral therapy treatments with and without medication in children aged 6 to 11 years with a diagnosis of ADHD and/or conduct disorder. 73 children (58 boys and 15 girls) were included in the study. Diagnostics before treatment, at end of treatment and at follow-up after 38 months included a standardized clinical interview (DISYPS-KJ), questionnaires for parents, teachers and children (DISYPS-KJ, CBCL, TRF, CPRS, CTRS, ILK), intelligence test and behavioral observation of the child. Primary outcome criterion was disorder-specific symptom reduction at end of treatment and follow-up. Both treatment groups showed significant symptom reductions at end of treatment and at follow-up. There were no significant differences between treatment groups. Parent and teacher ratings showed significant improvements in both groups at end of treatment and at follow-up on the ADHD index, oppositional behavior, and hyperactivity/impulsivity scales, as well as on the externalizing and internalizing behavior problems scales. Quality of life improved for children in both treatment groups.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno da Conduta , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Terapia Comportamental , Criança , Transtorno da Conduta/diagnóstico , Transtorno da Conduta/terapia , Feminino , Humanos , Masculino , Pais , Estudos Prospectivos , Qualidade de Vida
3.
Prax Kinderpsychol Kinderpsychiatr ; 70(6): 520-540, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34519618

RESUMO

The Attention deficit/hyperactivity disorder (ADHD) is a common mental disorder in childhood and adolescence. However, it is a very heterogeneous disorder with subgroups of patients with mild symptoms and others with severe and complex impairments. Patients suffering from complex ADHD are usually characterized by multiple developmental disorders and impaired personality development. Due to the multimodal origin of the disorder, multimodal treatment approaches aimed at reducing the various deficits are usually indicated. The current study evaluated a multimodal inpatient psychodynamic treatment (PDT) for children and adolescents suffering from ADHD. 47 patients (age 9-17 years) were included in the study. Next to complex impairments (comorbid mental disorders, deficits regarding psychic structure, learning disorders and sensorimotor integration disorders), a high number of adverse childhood experiences (M = 11.71) was particularly remarkable in the sample. The PDT led to significant improvements regarding ADHD symptoms and general level of functioning. However, first symptom improvements were already evident at the end of the waiting period. For ten patients who participated in the follow-up assessment effects remained stable six months after treatment. Due to the high drop-out rate, however, the study results have to be regarded as preliminary.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Terapia Combinada , Humanos , Pacientes Internados
4.
Tijdschr Psychiatr ; 63(7): 550-556, 2021.
Artigo em Holandês | MEDLINE | ID: mdl-34523707

RESUMO

BACKGROUND: Treatment options for attention deficit hyperactivity disorder (ADHD) in adults consist of psycho-education, cognitive behavioral therapy (CBT), pharmacotherapy or a combination thereof. AIM: To investigate the effect of CBT combined with pharmacotherapy on the quality of life in adults with ADHD compared to medication alone. METHOD: In this multicenter prospective cohort study a total of 627 patients were included, 305 where included in the medication only group and 322 in de combination group (CBT and medication). The Adult ADHD Quality-of-Life scale (AAQoL) was conducted at baseline and at the end of treatment. RESULTS: The quality of life as measured by the AAQoL increased significantly in both groups but was not significantly different between the two groups (p = 0.33). CONCLUSION: To our knowledge, this is the first study to describe the effect of CBT as an addition to ADHD drug therapy on the quality of life in adults. Contrary to our expectations, there was no significant effect of CBT as an addition to drug therapy on the quality of life.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Terapia Cognitivo-Comportamental , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Humanos , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
6.
Behav Ther ; 52(5): 1198-1212, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34452673

RESUMO

College students with attention-deficit/hyperactivity disorder (ADHD) are at risk for alcohol-related problems and disorders relative to their typically developing peers. Despite risk, the optimal therapeutic approach for reducing problem alcohol use in students with ADHD, and mechanisms of change underlying treatment effects in this population, are largely unknown. The current study evaluated putative mechanisms of change in a randomized controlled trial of two harm reduction interventions for college student drinkers with ADHD (N = 113; 49% male): brief motivational intervention plus supportive counseling (BMI + SC) versus brief motivational intervention plus behavioral activation (BMI + BA). Results showed that participants in the BMI + BA condition engaged in more goal-directed activation and less avoidant behavior over the course of treatment compared to those in the BMI + SC condition, in turn predicting reductions in alcohol-related negative consequences. Effects were more robust 1 month following intervention, and diminished by 3 months. Sensitivity analyses revealed a significant indirect effect of treatment condition on alcohol-related negative consequence via reductions in avoidance over treatment. Post hoc moderated mediations showed that BMI + BA engaged target mechanisms more robustly for students with more severe ADHD and depressive symptoms compared to BMI + SC. These findings support the application of BMI + BA intervention, particularly in targeting goal-directed activation and avoidance/rumination in at-risk student drinkers with ADHD.


Assuntos
Consumo de Álcool na Faculdade , Transtorno do Deficit de Atenção com Hiperatividade , Feminino , Objetivos , Humanos , Masculino , Motivação , Estudantes
7.
S D Med ; 74(8): 372-375, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34461003

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is a commonly encountered diagnosis in the child and adolescent populations, and stimulant medications are often prescribed for their treatment. There are numerous available options in this category, including immediate and extended release formulations. There have been many case reports in the literature involving purposeful overdose on immediate release stimulants, but a relative paucity involving extended release forms. Additionally, they often involve Caucasian and Asian populations. We treated a Native American adolescent who took an overdose of extended-release methylphenidate with the intention of suicide. He developed transient orofacial dyskinesia and upper extremity choreoathetosis as a result which did not abate during his time in the emergency department. Once transferred to our care, he was given a one-time benzodiazepine dose with some benefit. This case report describes objective sequelae of a long-acting methylphenidate overdose as well as treatment for the benefit of treating clinicians with similar patient populations and situations.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Discinesias , Metilfenidato , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/efeitos adversos , Criança , Discinesias/tratamento farmacológico , Humanos , Masculino , Metilfenidato/efeitos adversos , Extremidade Superior
8.
Sci Rep ; 11(1): 16144, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34373540

RESUMO

COVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17-87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.


Assuntos
Alopecia/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , COVID-19/complicações , Dispneia/diagnóstico , Fadiga/diagnóstico , Cefaleia/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Alopecia/complicações , Transtorno do Deficit de Atenção com Hiperatividade/complicações , COVID-19/virologia , Dispneia/complicações , Fadiga/complicações , Cefaleia/complicações , Humanos , Pessoa de Meia-Idade , SARS-CoV-2/fisiologia , Adulto Jovem
9.
BMC Psychiatry ; 21(1): 405, 2021 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-34391396

RESUMO

BACKGROUND: The study aim was to examine the secular trends and regional variations in pharmacotherapy of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Germany. METHODS: We used nationwide drug prescription data of outpatient care (2009 to 2016). The study population comprised patients aged between 5 and 14 years with the diagnoses "hyperkinetic disorders" (ICD-10 code F90) (e.g. n = 262,766 in 2016). The examined drugs were methylphenidate, amphetamines, atomoxetine and guanfacine. RESULTS: Overall, the proportion of patients received any prescription showed a decreasing trend over years (2010, 51%; 2016, 44%). The proportion of methylphenidate prescription was higher in Western than Eastern federal states. However, atomoxetine was more often prescribed in Eastern than Western federal states. The proportion of methylphenidate prescriptions issued by pediatric psychiatrists increased from 28% (2009) to 41% (2016). CONCLUSION: A decreasing trend in use of pharmacotherapy may be explained by prescription restrictions issued by the Federal Joint Committee in recent years.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Metilfenidato , Adolescente , Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Pré-Escolar , Alemanha , Humanos , Metilfenidato/uso terapêutico
10.
BMC Psychiatry ; 21(1): 411, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412609

RESUMO

BACKGROUND: We aimed to examine symptom load in a clinical adolescent population at three-year follow-up and explore associations with standard care treatment procedures and resilience factors upon first presenting at Child and Adolescent Mental Health Services. METHODS: This study is part of a prospective longitudinal cohort study: The Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. A clinical population of 717 (43.5% of eligible) adolescents aged 13-18 years participated in the first study visit (T1, 2009-2011). Of these, 447 adolescents with psychiatric disorders, with treatment history from medical records and self-reported resilience factors (Resilience Scale for Adolescents; READ) at T1, reported symptom load (Achenbach System of Empirically Based Assessment - Youth Self Report; YSR) three years later aged 16-21 years (T2). RESULT: At T1, 93.0% received individual treatment. The frequency of psychotherapy and medication varied by disorder group and between genders. Overall, psychotherapy was more frequent among girls, whereas medication was more common among boys. Total READ mean value (overall 3.5, SD 0.8), ranged from patients with mood disorders (3.0, SD 0.7) to patients with Attention Deficit Hyperactivity disorder (3.7, SD 0.7), and was lower for girls than boys in all diagnostic groups. At T2, the YSR Total Problem mean T-score ranged across the diagnostic groups (48.7, SD 24.0 to 62.7, SD 30.2), with highest symptom scores for those with mood disorders at T1, of whom 48.6% had T-scores in the borderline/clinical range (≥60) three years later. Number of psychotherapy sessions was positively associated and Total READ score was negatively associated with the YSR Total Problems T-score (regression coefficient ß = 0.5, CI (0.3 to 0.7), p < 0.001 and ß = - 15.7, CI (- 19.2 to - 12.1), p < 0.001, respectively). The subscale Personal Competence was associated with the lowest Total Problem score for both genders. CONCLUSIONS: Self-reported symptom load was substantial after three years, despite comprehensive treatment procedures. Higher self-reported resilience characteristics were associated with lower symptom load after three years. These results highlight the burden of adolescent psychiatric disorders, the need for extensive interventions and the importance of resilience factors for a positive outcome.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos do Humor , Pacientes , Estudos Prospectivos
11.
Neurosci Biobehav Rev ; 129: 261-268, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34364945

RESUMO

Tourette Disorder (TD) is a male predominant neurodevelopmental disorder characterized by tics and frequent psychiatric comorbidities. Girls with TD have later peak symptoms, less remission with age, and worse impairment from tics, particularly in adulthood. Female TD patients are less likely to have Attention Deficit Hyperactivity Disorder and more likely to have anxiety and mood disorders. Hyperandrogenism is associated with TD in both sexes, and neuroanatomic sexual dimorphism is reduced in adult TD patients. Some women report catamenial tics, which may relate to estrogen withdrawal or rises in allopregnanolone. Limited data suggest that several neuroanatomic alterations present in boys with TD are not present in girls with TD. Female sex predicts better response to haloperidol. Further research into female tic pathophysiology may influence sex-specific treatment development.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Obsessivo-Compulsivo , Transtornos de Tique , Tiques , Síndrome de Tourette , Adulto , Feminino , Humanos , Masculino , Caracteres Sexuais
13.
BMC Pediatr ; 21(1): 354, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412606

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a significant neurodevelopment disorder among children and adolescents, with 5 % prevalence. Bone fractures account for 25 % of accidents and injuries among all children and adolescents. Considering the characteristics of inattention, hyperactivity, and impulsivity in children with ADHD, it is critical to examine bone fractures among these children. The objective of our meta-analysis was to determine the prevalence of bone fractures among children and adolescents with ADHD. METHODS: We completed a systematic review and meta-analysis using an electronic search of the following databases: CINAHL, EMBASE, PsycINFO, PubMed, and Scopus. The search terms used were: "attention deficit hyperactivity disorder OR attention deficit disorder" and "bone fracture*." We included studies examining patients 18 years or younger who were diagnosed with ADHD and tracked (prospectively or retrospectively) for five or more years. Effect size (es), using a random effects model, was calculated. We registered the review protocol with PROSPERO (CRD42019119527). RESULTS: From 445 records retrieved, 31 full text articles were reviewed and 5 articles met inclusion criteria for meta-analysis. The summary es revealed the prevalence of bone fractures among children and adolescents with ADHD to be 4.83 % (95 % CI: 3.07-6.58 %). The location of bone fractures, using a subset of data, showed a distribution of 69.62 %, 22.85 %, and 7.53 % in the upper limbs, lower limbs, and other anatomical regions, respectively. Another subset of studies revealed a 2.55-fold increase in the prevalence of fractures among the children with ADHD compared to their counterparts. CONCLUSIONS: Awareness of these findings is critical to physicians, parents, and policy makers to create safe environments and provide supports in order to optimize the health and safety of children and adolescents with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Fraturas Ósseas , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Humanos , Pais , Prevalência , Estudos Retrospectivos
14.
Artigo em Inglês | MEDLINE | ID: mdl-34360120

RESUMO

This study examined the relationships of cyberbullying and traditional bullying victimization and perpetration, perceived family function, frustration discomfort, and hostility with self-reported depressive symptoms and suicidality in adolescents diagnosed as having attention-deficit/hyperactivity disorder (ADHD). Both the self-reported severity of depressive symptoms on the Center for Epidemiological Studies Depression Scale and the occurrence of suicidal ideation or a suicide attempt on the suicidality module of the Kiddie Schedule for Affective Disorders and Schizophrenia were assessed in 195 adolescents with ADHD. The adolescents completed the Cyberbullying Experiences Questionnaire, Chinese version of the School Bullying Experience Questionnaire, Frustration-Discomfort Scale, Buss-Durkee Hostility Inventory, and Family APGAR Index. Caregivers completed the ADHD problems component of the Child Behavior Checklist for Ages 6-18. Multiple regression analyses were used to examine the correlates for each of self-reported depressive symptoms and suicidality. The results showed that after the effects of gender, age, ADHD symptoms, and family function were controlled, greater frustration discomfort and bullying perpetration significantly predicted self-reported depressive symptoms. Being cyberbullying victims and displaying hostility significantly predicted the risk of suicidality. Various types of bullying involvement, frustration intolerance, and hostility significantly predicted self-reported depressive symptoms and suicidality in adolescents with ADHD. By monitoring and intervening in these factors, we can reduce the risk of depression-related problems and suicidality in adolescents with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Bullying , Vítimas de Crime , Suicídio , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Depressão/epidemiologia , Frustração , Hostilidade , Humanos , Autorrelato
15.
Acta Psychol (Amst) ; 219: 103386, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34365275

RESUMO

BACKGROUND: The relationships between cognitive and personality profile in teenagers with and without ADHD were assessed. METHOD: Two groups of teenagers, one with ADHD (N = 135; mean age = 13.93) and another group without ADHD (N = 199, mean age = 14.29) were evaluated using the K-BIT and 16PF-APQ tests. RESULTS: In cognitive variables, the results revealed that the ADHD group returned higher scores in the Matrices subtest and the IQ test. In personality variables, the group with ADHD exhibited higher scores in Tough-Mindedness and lower scores in Self-Control than the group without the disorder. The canonical correlation analysis applied to each group revealed a differing pattern of interrelationships between the cognitive-personality variables in the two groups. In adolescents with ADHD, we observed that higher scores in cognitive variables were associated with a more extroverted personality and less self-control, while in adolescents without ADHD, higher scores in cognitive variables were associated with less tough-mindedness and lower levels of self-control. CONCLUSIONS: The cognitive and personality variables of adolescents with and without ADHD differ. These results will be useful for establishing a cognitive and personality profile for this section of the population. The educational implications of the study are under discussion.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Cognição , Humanos , Testes de Inteligência , Personalidade
16.
BMJ Open ; 11(8): e048528, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34389573

RESUMO

OBJECTIVE: To assess the 5-year changes in the adult medical use of central nervous system (CNS) stimulants with higher risk of dependence and evaluate the population characteristics of users and their medical and/or neurological conditions. DESIGN: Cross-sectional study. SETTING: Annual US Medical Expenditure Panel Survey, a stratified random sample of approximately 30 000 persons designed to produce national population estimates. It focuses on reported medical spending, medical services used, health status and prescription medications. PARTICIPANTS: Adults age 19 years and older who reported obtaining one or more prescriptions for amphetamine or methylphenidate products during two survey years, 2013 and 2018. MAIN OUTCOMES MEASURES: Prescriptions obtained, the specific stimulant product and annual treatment days of drug supplied. RESULTS: In 2018, an estimated 4.1 million US adults (95% CI 3.4 million to 4.8 million) reported prescriptions for CNS stimulants, having filled a mean of 7.3 (95% CI 6.8 to 7.8) prescriptions with a mean of 226 (95% CI 210 to 242) days' supply. Compared with 2013, the estimated number of adults reporting using CNS stimulants in 2018 increased by 1.8 million (95% CI 1.0 million to 2.7 million) or 79.8%. Most 2018 adult stimulant users reported taking psychoactive medication for one or more mental, behavioural or neurodevelopment disorders. Overall, 77.8% (95% CI 72.6% to 83.0%) reported some medication for adult attention deficit disorder, 26.8% (95% CI 22.2% to 31.5%) took medication for anxiety, 25.1% (95% CI 19.9% to 30.3%) for depression and 15.3% (95% CI 9.8% to 20.8%) indicated drug treatment for other mental or neurological disorders. Adult CNS stimulant use was higher in females, in younger age cohorts and among individuals of white race/ethnicity. CONCLUSIONS: Adult medical use of prescription stimulants increased markedly in 5 years and occurred in a population often reporting multiple mental or neurological disorders. Further action is needed to understand and manage this new resurgence in drugs with high risks of dependence.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Metilfenidato , Transtornos Relacionados ao Uso de Substâncias , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Estudos Transversais , Prescrições de Medicamentos , Feminino , Humanos , Metilfenidato/uso terapêutico , Adulto Jovem
17.
Medicine (Baltimore) ; 100(34): e27033, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34449482

RESUMO

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder in childhood. Acupuncture treatment of ADHD has formed a relatively systematic theoretical and clinical treatment system which achieved satisfactory results. However, there has been no systematic evaluation of its effectiveness and safety. The purpose of this study was to evaluate the efficacy and safety of acupuncture in the treatment of ADHD. METHODS: A systematic search of literature will be conducted in PubMed, Cochrane Library, the Web of Science, Excerpt Medica Database, Chinese Biomedical Literature Database, VIP, Wanfang database, China National Knowledge Infrastructure database for articles published up to September, 2019. The searching terms include "attention deficit", "hyperactivity", "mild brain dysfunction", "acupuncture", "electroacupuncture". The search is limited to studies published in Chinese and English. Two reviewers will extract and evaluate the information independently. Cochrane Collaboration tool and Jadad scale will be used to evaluate the quality of the studies. Review Manager Version 5.3 (Cochrane Collaboration's software) will be used to carry out the meta-analysis. RESULTS: High-quality synthesis and/or descriptive analysis of current evidence will be provided from effective rate, total score of traditional Chinese medicines syndromes, conners child hyperactivity-diagnosis rating scale, conners index of hyperactivity, the recurrence rate, and adverse events. CONCLUSION: This study will provide the evidence of whether acupuncture is an effective and safe intervention to ADHD. INPLASY REGISTRATION NUMBER: INPLASY202140022.


Assuntos
Terapia por Acupuntura/métodos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Ensaios Clínicos como Assunto , Humanos , Projetos de Pesquisa
18.
BMJ Open ; 11(8): e045443, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344674

RESUMO

INTRODUCTION: High schoolers with attention-deficit/hyperactivity disorder (ADHD) experience substantial impairments, particularly in the school setting. However, very few high school students with ADHD receive evidence-based interventions for their difficulties. We aim to improve access to care by adapting evidence-based psychosocial intervention components to a low-resource and novel school-based intervention model, Summer STRIPES (Students Taking Responsibility and Initiative through Peer Enhanced Support). Summer STRIPES is a brief peer-delivered summer orientation to high school with continued peer-delivered sessions during ninth grade. METHODS AND ANALYSIS: Participants will be 72 rising ninth grade students with ADHD who are randomised to receive either Summer STRIPES or school services as usual. Summer STRIPES will be delivered by 12 peer interventionists in a school setting. Outcomes will be measured at baseline, start of ninth grade, mid-ninth grade and end-of-ninth grade. At each assessment, self, parent and teacher measures will be obtained. We will test the effect of Summer STRIPES (compared with school services as usual) on ADHD symptoms and key mechanisms (intrinsic motivation, extrinsic motivation, executive functions) as well as key academic outcomes during the ninth-grade year (Grade Point Average (GPA), class attendance). ETHICS AND DISSEMINATION: Findings will contribute to our understanding of how to improve access and utilisation of care for adolescents with ADHD. The protocol is approved by the institutional review board at Seattle Children's Research Institute. The study results will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences. TRIALS REGISTRATION NUMBER: NCT04571320; pre-results.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Função Executiva , Humanos , Pais , Ensaios Clínicos Controlados Aleatórios como Assunto , Instituições Acadêmicas , Estudantes
19.
Medicine (Baltimore) ; 100(33): e27018, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414995

RESUMO

ABSTRACT: Breast cancer is the leading type of cancer among women worldwide, and a high number of breast cancer patients are suffering from psychological and cognitive disorders. This cross-sectional study used resting-state functional magnetic resonance imaging (rs-fMRI) and clinical neuropsychological tests to evaluate the possible underlying mechanisms.We enrolled 32 breast cancer patients without chemotherapy (BC), 32 breast cancer patients within 6 to 12 months after the completion of chemotherapy (BC_CTx) and 46 healthy controls. Participants underwent neuropsychological tests and rs-fMRI with mean fractional amplitude of low-frequency fluctuation and mean regional homogeneity analyses. Between groups whole-brain voxel-wise rs-fMRI comparisons were calculated using two-sample t test. rs-fMRI and neuropsychological tests correlation analyses were calculated using multiple regression. Age and years of education were used as covariates. A false discovery rate-corrected P-value of less than .05 was considered statistically significant.We found significantly alteration of mean fractional amplitude of low-frequency fluctuation and mean regional homogeneity in the frontoparietal lobe and occipital lobe in the BC group compared with the other 2 groups, indicating alteration of functional dorsal attention network (DAN). Furthermore, we found the DAN alteration was correlated with neuropsychological impairment.The majority of potential underlying mechanisms of DAN alteration in BC patients may due to insufficient frontoparietal lobe neural activity to drive DAN and may be related to the effects of neuropsychological distress. Further longitudinal studies with comprehensive images and neuropsychological tests correlations are recommended.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Neoplasias da Mama/tratamento farmacológico , Tratamento Farmacológico/estatística & dados numéricos , Sobreviventes/estatística & dados numéricos , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Neoplasias da Mama/complicações , Estudos Transversais , Depressão/etiologia , Depressão/psicologia , Tratamento Farmacológico/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Taiwan
20.
Artigo em Inglês | MEDLINE | ID: mdl-34444584

RESUMO

This 1-year follow-up study examined the predictive values of the demographics, depressive symptoms, stress-coping orientations, and perceived family support of caregivers as well as the internalizing, externalizing and ADHD symptoms of children with attention-deficit/hyperactivity disorder (ADHD) at baseline on the depressive symptoms of the caregivers after 1 year. A total of four hundred caregivers of children with ADHD were recruited. The baseline levels of the caregivers' depressive symptoms, stress-coping orientations, and perceived family support and the internalizing and externalizing problems of the children were assessed using the Center for Epidemiological Studies Depression Scale, the Coping Orientation to Problems Experienced, Family Adaptation, Partnership, Growth, Affection, Resolve Index, and the Child Behavior Checklist For Ages 6-18, respectively. Their predictions for the caregiver's depressive symptoms 1 year after the baseline were examined using linear regression analysis. In total, 382 caregivers of children with ADHD underwent the follow-up assessment 1 year from the baseline. A marital status of being separated or divorced, less effective coping and depressive symptoms orientation, and children with internalizing problems and ADHD symptoms at baseline were positively associated with the caregivers' depressive symptoms at follow-up, whereas the caregivers' perceived family support and an emotion-focused coping orientation at baseline were negatively associated with depressive symptoms at follow-up. Multiple characteristics of the caregivers and children with ADHD at baseline predicted the caregivers' depressive symptoms 1 year later.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adaptação Psicológica , Adolescente , Cuidadores , Criança , Depressão/epidemiologia , Seguimentos , Humanos
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