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1.
Nord J Psychiatry ; 75(1): 31-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33393425

RESUMO

AIM: Discriminant validity of the Attention Deficits/Hyperactive Disorders (ADHD) subtypes/presentations is not yet clear. The purpose of this study was to investigate joint contribution of the strongest factors of the three dimensions, namely psychopathology, neuropsychology and electrophysiology for subtyping of presentations. METHOD: A sample of 104 boys aged 7-12 years was subdivided into three groups with ADHD combined (n = 22), inattentive (n = 25) and hyperactive/impulsive subtype (n = 14), and 43 typically developing controls (TDC). Children were investigated regarding the Child Behavior Checklist (CBCL), the Integrated Visual and Auditory Test (IVA), and EEG spectral power during eyes closed resting state. Subsequently, statistical analysis included discriminant functional analysis and principle component analysis. RESULTS: Neuropsychological parameters had the highest contribution in classifying of the groups. EEG parameters had no effect on differentiation of the groups, and among the psychopathological parameters, only the oppositional behavioral disorder score contributed to correctly classify 74.3% of the groups. Furthermore, we found four factors with eigenvalues higher than 1 in the ADHD and typical groups, with one factor characterized by four CBCL scales, another one by auditory and visual vigilance, speed and beta band power, the third by auditory and visual prudence, and forth by theta band power. CONCLUSIONS: Our results demonstrated that ADHD subtypes/presentations can be differentiated from each other at different levels of investigation despite some clinical symptoms overlap. The results suggested that not only psychopathology but also the impairment of sensory processing should be assessed in children with ADHD in order to use this additional information for a jointly multilevel clinical intervention, which may improve treatment success.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos do Comportamento Infantil , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Cognição , Humanos , Comportamento Impulsivo , Masculino
2.
Nord J Psychiatry ; 75(1): 63-72, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32749193

RESUMO

OBJECTIVE: To analyze the psychometric properties of the Norwegian version of the Weiss Functional Impairment Rating Scale parent and self-reports (WFIRS-P and WFIRS-S) in adolescents with ADHD. METHODS: 102 clinically referred patients, of which 86% were enrolled in an ongoing RCT program (Clinical trials NCT02937142), were diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV). The conceptual framework of the WFIRS-P and the WFIRS-S was evaluated using confirmatory factor analysis (CFA), reliability was estimated using Cronbach's alpha, convergent and divergent validity was assessed using correlations with the Children's Global Assessment Scale (C-GAS) and the ADHD Rating Scale-IV (ADHD-RS-IV). RESULTS: CFA supported the original factor structure of the questionnaires, both a first-order and a second-order model revealed acceptable model fit. Internal consistency was satisfactory across domains. The parent-adolescent agreement was moderate. The correlations between the C-GAS and the total scores of the WFIRS-P and WFIRS-S were low to moderate (r = -0.29 to -0.38). The ADHD-RS-IV correlated moderately (r = 0.49) with WFIRS-P, the correlation with WFIRS-S was weak (r = 0.28) supporting divergent validity. In multiple regression analyses, the ADHD-RS total score was the strongest predictor of the total score in both the WFIRS questionnaires, with internalizing disorder showing an additional small contribution. Age, gender and full-scale IQ gave no additional contribution in explaining the variance. CONCLUSIONS: The findings support the use of the Norwegian version of the WFIRS-S and the WFIRS-P in the evaluation of functional impairment in adolescents with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Humanos , Pais , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes , Autorrelato
4.
Psychiatr Hung ; 35(4): 435-447, 2020.
Artigo em Húngaro | MEDLINE | ID: mdl-33263293

RESUMO

Among patients with substance use disorders (SUD), adult attention deficit hyperactivity disorder (ADHD) is one of the most frequently co-occuring disorder. Those SUD patients with comorbid ADHD show earlier onset of substance use, more severe SUD and poor treatment outcomes. Therefore, early recognition of ADHD is highly rele - vant within this patient population. The results of available screening instruments may lay the foundation of timely ADHD diagnosis. Considering the integrated treatment of patients with a dual ADHD+SUD diagnosis, the applica tion of combined pharmaco- and psychotherapy is recommended. Based on the evidence-and consensus-based suggestions, prescription of long-acting methylphenidate, extended-release amphetamines and atomoxetine with up-titration might be the best choice in the treatment of patients who are either unresponsive to standard dose or characterized by therapy resistance. The main purpose of this manuscript is to establish a standing-ground for the effective screening, diagnosis and treatment of ADHD+SUD patients.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Programas de Rastreamento , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Comorbidade , Humanos , Psicoterapia , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
5.
Psychiatry Res ; 293: 113477, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33198048

RESUMO

The aim of the present study was to examine the relationship between sensory processing sensitivity (SPS) and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in adults. The Highly Sensitive Person Scale (HSPS) scale and the Adult ADHD Self-Report Scale (ASRS) were administered to a non-clinical group of 274 participants recruited from a university volunteers list. We found a highly significant positive correlation between number of self-reported ADHD traits and sensory sensitivity. Furthermore, ADHD traits and age were predictors of SPS and exploratory factor analysis revealed a factor that combined ADHD traits and items from the HSPS. The psychometric properties of the HSPS were also examined supporting the unidimensional nature of the concept. To our knowledge, this is the first study to identify a positive relationship between HSPS and ADHD traits in the general population. Our results further support recent findings suggesting abnormal sensory processing in ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Percepção/fisiologia , Transtornos das Sensações/diagnóstico , Transtornos das Sensações/epidemiologia , Sensação/fisiologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Análise Fatorial , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Fenótipo , Vigilância da População/métodos , Escalas de Graduação Psiquiátrica , Psicometria/estatística & dados numéricos , Autorrelato , Transtornos das Sensações/psicologia , Inquéritos e Questionários , Universidades , Adulto Jovem
6.
Am Fam Physician ; 102(10): 592-602, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-33179887

RESUMO

Attention-deficit/hyperactivity disorder (ADHD) is a multidimensional chronic neurodevelopmental condition that affects 8.4% of U.S. children between two and 17 years of age and may pose long-term morbidity if untreated. The evaluation for ADHD begins when parents or caregivers present to primary care physicians with concerns about behavior problems or poor school or social function. A comprehensive history and physical examination should assess for comorbid or other conditions that can mimic ADHD. The combination of Diagnostic and Statistical Manual of Mental Disorders, 5th ed., criteria and validated screening tools completed by parents, teachers, or other adults can aid in establishing the diagnosis. The goals of treatment include symptom reduction and improved social and cognitive function. Psychosocial interventions are the recommended first-line treatment for preschool children (four to five years) and can improve overall function when used as an adjunct therapy in elementary school children (six to 11 years of age) and adolescents (12 to 17 years of age). Stimulant medications are well-established as an effective treatment for reducing symptoms of ADHD in elementary school children and adolescents. Nonstimulant medications are less effective but reasonable as adjunct or alternative therapy when stimulants are ineffective or not tolerated. Regular follow-up is key in the management of ADHD and should assess symptoms, overall function, presence of comorbidities, adverse effects of treatment, and medication use.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Escala de Avaliação Comportamental , Estimulantes do Sistema Nervoso Central/uso terapêutico , Comportamento Infantil , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Lista de Checagem , Criança , Pré-Escolar , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Pais , Professores Escolares
7.
PLoS One ; 15(11): e0242566, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33201920

RESUMO

This study investigated quantitative electroencephalography (QEEG) subtypes as auxiliary tools to assess Attention Deficit Hyperactivity Disorder (ADHD). A total of 74 subjects (58 male and 16 female) were assessed using the Korean version of the Diagnostic Interview Schedule for Children Version IV and were assigned to one of three groups: ADHD, ADHD-Not Otherwise specified (NOS), and Neurotypical (NT). We measured absolute and relative EEG power in 19 channels and conducted an auditory continuous performance test. We analyzed QEEG according to the frequency range: delta (1-4 Hz), theta (4-8 Hz), slow alpha (8-10 Hz), fast alpha (10-13.5 Hz), and beta (13.5-30 Hz). The subjects were then grouped by Ward's method of cluster analysis using the squared Euclidian distance to measure dissimilarities. We discovered four QEEG clusters, which were characterized by: (a) elevated delta power with less theta activity, (b) elevated slow alpha relative power, (c) elevated theta with deficiencies of alpha and beta relative power, and (d) elevated fast alpha and beta absolute power. The largest proportion of participants in clusters (a) and (c) were from the ADHD group (48% and 47%, respectively). Conversely, group (b) mostly consisted of the participants from the NOS group (59%), while group (d) had the largest proportion of participants from the NT group (62%). These results indicate that children with ADHD does not neurophysiologically constitute a homogenous group. We also identified a new subtype with increased alpha power in addition to those commonly reported in ADHD. Given the QEEG characteristics with increased alpha power, we should consider the possibility that this subtype may be caused by childhood depression. In conclusion, we believe that these QEEG subtypes of ADHD are expected to provide valuable information for accurately diagnosing ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Eletroencefalografia/métodos , Ritmo beta/fisiologia , Encéfalo/fisiologia , Mapeamento Encefálico/métodos , Criança , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Masculino , República da Coreia , Ritmo Teta/fisiologia
8.
Dev Neuropsychol ; 45(6): 396-413, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33043703

RESUMO

Symptoms of inattention and hyperactivity/impulsivity, arranged along a continuum, are commonly associated with neuropsychological and academic deficits, even in the general population. The aim of this study is to analyze how Attention Deficit Hyperactivity Disorder (ADHD) symptoms are associated with the performance in neuropsychological and academic abilities (phonological processing, processing speed/automatic attention, executive functions, reading, and spelling) in school-age children. The sample consisted of 216 children from 3rd and 4th grades (M = 8.94 years old, SD =.71) from public elementary schools of two Brazilian capitals. Pearson correlation and Multiple Linear Regression analysis were performed. Inattention symptoms were the only predictors of performance in phonological processing (phoneme suppression and rapid automatized naming of letters), processing speed/automatic attention, executive functions, such as inhibitory control and cognitive flexibility, and reading fluency. Beta values ranged from .14 to .27, and the largest value was related to an inhibitory control task. Inattention, and not hyperactivity/impulsivity symptoms, seems to affect neuropsychological functions even in non-clinical diagnosed children. Contributions and future directions are discussed.


Assuntos
Atenção/fisiologia , Função Executiva/fisiologia , Testes Neuropsicológicos/normas , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Feminino , Humanos , Masculino
10.
Sci Rep ; 10(1): 18285, 2020 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-33106555

RESUMO

The relation between thyroid function biomarkers and attention deficit hyperactivity disorder (ADHD) in children and adolescents is currently unclear. Cross-sectional data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Baseline) was analyzed to assess the association between thyroid function biomarkers and ADHD in a population-based, nationally representative sample. The study cohort included 11,588 children and adolescents with 572 and 559 having an ADHD diagnosis or symptoms, respectively. ADHD symptoms were assessed through the Inattention/Hyperactivity subscale of the Strength and Difficulties Questionnaire. ADHD diagnosis was determined by a physician or psychologist. Serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) concentrations were determined enzymatically. Adjusted regression models were used to relate serum TSH, fT3, and fT4 with risk for ADHD diagnosis or symptoms. In children, a 1 mIU/l higher TSH was related to a 10% lower risk (odds ratio [OR] 0.90; 95% confidence interval [CI] 0.81-1.00) of ADHD diagnosis. We found a significant positive association between fT3 and continuously assessed ADHD symptoms in children (ß 0.08; 95% CI 0.03-0.14). Our results suggest that physical maturity may influence the association between thyroid function biomarkers and risk for ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/sangue , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Testes de Função Tireóidea
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 2829-2832, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018595

RESUMO

Accurate detection of neuro-psychological disorders such as Attention Deficit Hyperactivity Disorder (ADHD) using resting state functional Magnetic Resonance Imaging (rs-fMRI) is challenging due to high dimensionality of input features, low inter-class separability, small sample size and high intra-class variability. For automatic diagnosis of ADHD and autism, spatial transformation methods have gained significance and have achieved improved classification performance. However, they are not reliable due to lack of generalization in dataset like ADHD with high variance and small sample size. Therefore, in this paper, we present a Metaheuristic Spatial Transformation (MST) approach to convert the spatial filter design problem into a constraint optimization problem, and obtain the solution using a hybrid genetic algorithm. Highly separable features obtained from the MST along with meta-cognitive radial basis function based classifier are utilized to accurately classify ADHD. The performance was evaluated using the ADHD200 consortium dataset using a ten fold cross validation. The results indicate that the MST based classifier produces state of the art classification accuracy of 72.10% (1.71% improvement over previous transformation based methods). Moreover, using MST based classifier the training and testing specificity increased significantly over previous methods in literature. These results clearly indicate that MST enables the determination of the highly discriminant transformation in dataset with high variability, small sample size and large number of features. Further, the performance on the ADHD200 dataset shows that MST based classifier can be reliably used for the accurate diagnosis of ADHD using rs-fMRI.Clinical relevance- Metaheuristic Spatial Transformation (MST) enables reliable and accurate detection of neuropsychological disorders like ADHD from rs-fMRI data characterized by high variability, small sample size and large number of features.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Autístico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Humanos , Imagem por Ressonância Magnética
12.
Eur J Epidemiol ; 35(9): 795-805, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32968938

RESUMO

Although maternal use of hormones has been suspected of increasing the risk for childhood attention-deficit/hyperactivity disorder (ADHD), no study has examined hormonal contraception use in this context. We examined the association between maternal hormonal contraception use before or during pregnancy and ADHD risk in children. This nationwide population-based cohort study included 1,056,846 children born in Denmark between 1998 and 2014. Prescriptions for hormonal contraceptives redeemed by the mother was categorized as: no use, previous use (> 3 months before pregnancy), and recent use (≤ 3 months before or during pregnancy). Children were followed for ADHD, from birth until 31 December 2015. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). During 9,819,565 person-years of follow-up (median: 9.2), ADHD was diagnosed or a prescription for ADHD medication redeemed for 23,380 children (2.2%). The adjusted HR for ADHD was higher in children of mothers who had previously (HR 1.23; 95% CI 1.18-1.28) or recently (HR 1.30; 95% CI 1.24-1.37) used hormonal contraception than in those of mothers with no use. The highest estimates were seen for use of non-oral progestin products with HRs of 1.90 (95% CI 1.59-2.26) for previous use, 2.23 (95% CI 1.96-2.54) for recent use, and 3.10 (95% CI 1.62-5.91) for use during pregnancy. Maternal use of hormonal contraception was associated with an increased risk for ADHD in the offspring; more pronounced for non-oral progestin-only than other products.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Contracepção Hormonal/efeitos adversos , Exposição Materna/efeitos adversos , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Mães , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Modelos de Riscos Proporcionais , Sistema de Registros , Medição de Risco , Fatores de Risco
13.
BMC Med Inform Decis Mak ; 20(1): 232, 2020 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943029

RESUMO

BACKGROUND: Nearly half of all mental health disorders develop prior to the age of 15. Early assessments, diagnosis, and treatment are critical to shortening single episodes of care, reducing possible comorbidity and long-term disability. In Norway, approximately 20% of all children and adolescents are experiencing mental health problems. To address this, health officials in Norway have called for the integration of innovative approaches. A clinical decision support system (CDSS) is an innovative, computer-based program that provides health professionals with clinical decision support as they care for patients. CDSS use standardized clinical guidelines and big data to provide guidance and recommendations to clinicians in real-time. IDDEAS (Individualised Digital DEcision Assist System) is a CDSS for diagnosis and treatment of child and adolescent mental health disorders. The aim of IDDEAS is to enhance quality, competency, and efficiency in child and adolescent mental health services (CAMHS). METHODS/DESIGN: IDDEAS is a mixed-methods innovation and research project, which consists of four stages: 1) Assessment of Needs and Preparation of IDDEAS; 2) The Development of IDDEAS CDSS Model; 3) The Evaluation of the IDDEAS CDSS; and, 4) Implementation & Dissemination. Both qualitative and quantitative methods will be used for the evaluation of IDDEAS CDSS model. Child and adolescent psychologists and psychiatrists (n = 30) will evaluate the IDDEAS` usability, acceptability and relevance for diagnosis and treatment of attention-deficit/hyperactivity disorder. DISCUSSION: The IDDEAS CDSS model is the first guidelines and data-driven CDSS to improve efficiency of diagnosis and treatment of child and adolescent mental health disorders in Norway. Ultimately, IDDEAS will help to improve patient health outcomes and prevent long-term adverse outcomes by providing each patient with evidence-based, customized clinical care. TRIAL REGISTRATION: ISRCTN, ISRCTN12094788. Ongoing study, registered prospectively 8 April 2020 https://doi.org/10.1186/ISRCTN12094788.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Sistemas de Apoio a Decisões Clínicas , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Comorbidade , Testes Diagnósticos de Rotina , Humanos , Noruega
14.
BMC Psychiatry ; 20(1): 444, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912205

RESUMO

BACKGROUND: The aim of this study was to investigate the association between adult ADHD screening scores and hospitalization due to pedestrian injuries in a sample of Iranian pedestrians. METHODS: Through a case-control study, a case population of 177 pedestrians injured by the vehicles in road traffic crashes were compared with 177 controls who lacked a record of intentional or unintentional injuries enrolled from various wards of Imam Reza University Hospital which is a specialty teaching hospital located in the same city with similar referral level. The cases and controls had an age range of 18-65 years and were matched on gender and age. ADHD symptom profile was assessed using the Persian Self-report Screening Version of the Conner's Adult ADHD Rating Scales (CAARS-S:SV). The association of ADHD screening score and pedestrian injuries was investigated using multiple binary logistic regression to investigate the independent effect of ADHD index score on belonging to case group. Both crude and adjusted odds ratios were reported. RESULTS: Men comprised 86.4% of the study subjects. The crude odds ratios for all the four ADHD subscales to be associated with pedestrian injuries were 1.05, 1.08, and 1.04 for the subscales A (attention deficit), B (hyperactivity/impulsiveness) and ADHD index respectively. However, the association for subscale A was not statistically significant with a borderline p-value. The final multivariate analysis showed that variables associated with pedestrian injuries in the road traffic crashes were ADHD Index score (OR = 1.06, 95% CI: 1.01-1.12); economic status (including household income and expenditure capacity); educational level and total walking time per 24 h. CONCLUSIONS: Adult ADHD screening score can predict pedestrian injuries leading to hospitalization independently from sex, age, economic status, educational level and pedestrian exposure to traffic environment (average walking time).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Pedestres , Ferimentos e Lesões , Acidentes de Trânsito , Adolescente , Adulto , Idoso , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos de Casos e Controles , Cidades , Hospitalização , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Caminhada , Ferimentos e Lesões/epidemiologia , Adulto Jovem
15.
Arch. argent. pediatr ; 118(4): e405-e409, agosto 2020. tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1118592

RESUMO

El trastorno por déficit de atención e hiperactividad afecta al 5 % de los niños en edad escolar. Se presenta una serie de 82 niños con este trastorno no asociado a enfermedades neurológicas ni a discapacidad intelectual o trastorno del espectro autista, atendidos durante un período de 8 meses en Neuropediatría: 57 casos de tipo combinado, 23 de tipo inatento y 2 de predominio hiperactivo. Tiempo medio de seguimiento: 7 ± 2,8 años (rango: 4-14,6). Compartían seguimiento con Psiquiatría 16 pacientes. Nunca recibieron tratamiento por decisión parental 12 pacientes. De los 70 que recibieron, en 20, hubo demora en el inicio del tratamiento. Tiempo medio de demora: 20 meses ± 1,6 años (rango: 1 mes y 6 años). Tiempo medio de tratamiento: 44 meses ± 2,6 años (rango: 1 mes y 10,5 años). El 90 % de los pacientes (63) que iniciaron tratamiento continuaban tomándolo en la última revisión


Attention deficit disorder with hyperactivity has a high prevalence affecting 5 % of school-age children. We present a case series of 82 children with said disorder not associated with neurological diseases or intellectual disability or autism spectrum disorder, treated during a period of 8 months in a neuropediatrics clinic: 57 cases of combined type, 23 of inattentive type and 2 of overactive predominance. Average follow-up time: 7 ± 2.8 years (range: 4-14.6); 16 patients shared follow-up with Psychiatry; 12 patients never received treatment by parental decision. Of the 70 who received it, in 20 there was a delay in the start of treatment. Average delay time: 20 months ± 1.6 years (range: 1 month and 6 years). Average treatment time: 44 months ± 2.6 years (range: 1 month and 10.5 years); 90 % of the patients (63) who started treatment were under treatment at the last control


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Pediatria , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Epidemiologia Descritiva , Estudos Retrospectivos , Tiques , Deficiências da Aprendizagem , Neurologia
16.
Chronobiol Int ; 37(8): 1214-1222, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32856947

RESUMO

This study aimed to investigate the relationship between chronotype preference/sleep problems and symptom severity of children with Attention Deficit Hyperactivity Disorder (ADHD) during the COVID-19 outbreak and to assess the chronotype preference/sleep problems that may play a mediating role in the relationship between the reactions to trauma and severity of ADHD symptoms. The sample of this single-center cross-sectional study consisted of 76 children with ADHD and their parents. Trauma symptoms were evaluated with the Children's Impact of Event Scale (CRIES-8); sleep habits were assessed using the Children's Sleep Habits Questionnaire (CSHQ); and chronotype was assessed using the Children's Chronotype Questionnaire (CCQ). There were significant differences in CRIES-8 and CSHQ scores between the eveningness type group and the non-eveningness type group. The CRIES-8 scores of children with ADHD were related to the CCQ and CSHQ scores and severity of ADHD symptoms. In mediation analyses, sleep problems were found to be the full mediating factor in the relationship between CRIES-8 scores and severity of ADHD symptoms and the relationship between CCQ scores and the severity of ADHD symptoms. Our findings indicate that chronotype plays an important role on the negative effects of home confinement of ADHD children during the COVID-19 outbreak. The role of the full mediator of sleep problems in the path from cognition to the behavior of young ADHD and non-ADHD children confined to the home environment during the pandemic period requires further assessment.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Betacoronavirus , Ritmo Circadiano/fisiologia , Infecções por Coronavirus/virologia , Pneumonia Viral/virologia , Transtornos do Sono-Vigília/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Infecções por Coronavirus/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Pandemias , Pneumonia Viral/fisiopatologia , Transtornos do Sono-Vigília/diagnóstico
17.
Artigo em Inglês | MEDLINE | ID: mdl-32756485

RESUMO

BACKGROUND: Adequately knowledgeable schoolteachers can play an essential role in early detection and proper treatment of children with attention-deficit/hyperactivity disorder (ADHD) at school. OBJECTIVES: To assess the schoolteachers' knowledge of ADHD and to evaluate the effectiveness of the ADHD knowledge improvement program. METHODS: A randomized controlled trial study design was followed on 100 primary school teachers from Abha City, Saudi Arabia. Teachers were randomly selected and allocated into trial and control groups. A self-administered questionnaire was used to evaluate teachers' knowledge about ADHD. After the baseline assessment, participants in the trial group received a two-day ADHD knowledge improvement program. Teachers' knowledge about ADHD was reassessed using the same questionnaire immediately after finishing the intervention program and after three months in both groups. RESULTS: Only 16% and 22% of trial and control groups, respectively, showed adequate baseline knowledge about ADHD. Teachers' main sources of information about ADHD were the internet (67%), friends (47%), TV (34%), and reading books (23%). Knowledge of teachers in the trial group significantly improved immediately after the intervention. After three months, these knowledge benefits slightly declined but remained more adequate than those of teachers in the control group. The logistic regression model revealed that being a participant in the trial group and of higher qualification were associated with significant improvement in teachers' retained knowledge on ADHD (p < 0.001 and p = 0.050, respectively). CONCLUSIONS: The majority of male primary school teachers in Abha City, Saudi Arabia, have inadequate knowledge about ADHD. Applying a knowledge improvement program can substantially improve their knowledge of ADHD. Consideration should be given to the integration of ADHD knowledge improvement program into teachers' educational programs.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Conhecimentos, Atitudes e Prática em Saúde , Professores Escolares , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Humanos , Masculino , Arábia Saudita , Instituições Acadêmicas
18.
Artigo em Inglês | MEDLINE | ID: mdl-32759840

RESUMO

The term Attention Deficit Hyperactivity Disorder (ADHD) has a long history of problems behind it. The origin of all these problems lies in the lack of agreement in the assessment procedures and evaluation instruments. The diagnosis is clinical and is determined by the observation and information provided by parents and teachers. So, this is highly subjective and leads to disparate results. Therefore, on the one hand the inaccuracy of the diagnosis of ADHD, which has been based on subjective criteria, together with the fact that hyperactivity is one of the main symptoms of this disorder, implies that several studies (with limitations) have been carried out to record objective measures of movement in subjects in at least the last ten years. In order to solve some of this derived problems and limitations of previous studies, a computer program has been developed to objectively record the amount of movement of subjects. The main objective of this study is threefold: first to register the amount of movement of both experimental group and control group, then to compare them with the movement registered by observers and finally to determine the validity of the software developed as a tool to support the diagnosis of ADHD. Results show that there are significant differences in the amount of objective movement between a clinical group of subjects with ADHD and a control group, obtaining a higher average of movement the experimental group. In addition, results also demonstrate that the developed software is a valid tool for the evaluation of movement that solves the limitations of previous studies. The proposed tool is developed from different aspects to give it a multidisciplinary character.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Objetivos , Humanos , Estudantes
19.
BMC Psychiatry ; 20(1): 404, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787804

RESUMO

BACKGROUND: There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS: The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS: A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS: This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Atenção , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Consenso , Feminino , Humanos , Longevidade , Masculino , Reino Unido
20.
BMC Psychiatry ; 20(1): 423, 2020 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847520

RESUMO

BACKGROUND: Co-occurring psychiatric disorders in adults with Attention Deficit Hyperactivity Disorder (ADHD) and/or Autism Spectrum Disorder (ASD) contribute to the burden of the healthcare and possibly to the delay of diagnosis. Aim of the study was to clinically assess the prevalence and compare lifetime co-occurring psychopathology in a sample of newly diagnosed ADHD and/or ASD adults and discuss the diagnostic challenges they pose. METHODS: The lifetime prevalence rates of ten of the most frequently co-occurring psychiatric diagnoses was registered in 336 adults of normal intelligence who underwent a thorough clinical evaluation for the diagnosis of ADHD and/or ASD for the first time in their lives. Four study groups were formed: the ADHD (n = 151), the ASD (n = 58), the ADHD+ASD (n = 28) and the nonADHD/nonASD (NN) (n = 88) group. RESULTS: At least one co-occurring psychopathology was found in 72.8% of the ADHD group, in 50% of the ASD group, in 72.4% of the ADHD+ASD group and in 76.1% of the NN group (p = 0.004). In all groups the most frequent psychiatric disorder was depressive disorder. The only significant difference regarding the patterns of psychiatric co-occurrence between the ADHD and the nonADHD groups (ASD and NN groups) was found for SUD (p = 0.001). Also, the proportion of subjects with Bipolar Disorder was significantly greater in the NN group as compared to those with ASD (p = 0.025). CONCLUSIONS: Our results support the high prevalence of co-occurring psychiatric disorders in adults with ADHD and/or ASD with the ASD group presenting the lowest rate. The most marked difference between the ADHD and the nonADHD groups was found for SUD. Moreover, our findings highlight the need for a thorough clinical assessment of all referred patients both in the presence and absence of ADHD and/or ASD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Humanos , Prevalência
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