Hyperactivity Research Articles

Involuntary Psychiatric Hospitalization of Minors Due to Court Orders: Effectiveness Assessing Through a Case Series

IntroductionInvoluntary treatments in forensic psychiatry represents a complex intersection of mental health, legal systems and ethics. Judicial authorities may compulsorily refer children to inpatient clinics for receiving necessarily treatment. Despite its importance, there is limited research on the reasons behind and effectiveness of such interventions in minors.ObjectivesThe objectives of this study were to describe the clinical characteristics of minors who have risks of harming themselves and/or others so receiving involuntary treatment due to a court order. It is aimed to assess the effectiveness of involuntary treatment.MethodsA follow-up case series was conducted on 9 minors who hospitalized by court orders in a secure inpatient child and adolescent psychiatry clinic, in the year of 2023. Data collected from medical records, including demographic information, clinical presentation, diagnosis and discharge treatment. After one, three and six month of the discharge, interviews made with the patients and their families. Current data collected on treatment regimen, compliance, behavioral outcomes and reoffending rates. All data were anonymized to maintain patient confidentiality.ResultsThe case series consisted of 3 males and 6 females, with a mean age of 16.5 years at the time of admission. The most common reason to hospitalization was homicide risk 88%, followed by substance use 66%. Conduct Disorder was the most common diagnosis with the rate of 88%, followed by Substance Use Disorder(66%) and Attention Deficit and Hiperactivity Disorder(50%). 44% of minors had a history of juvenile delinquency. School dropout rates were 100%. Treatment consisted of a combination of individual and group therapy and medication. Treatment refusal rates were 88% so in terms of treatment, 88% of the minors in this sample treated with depot form antipsychotic medications, with the most common medication being risperidone. Overall all of the sample showed a significant reduction in disruptive behaviors during their hospital stay. Follow-up data collecting is still continue and preliminary statistics show us that relapse rates are low and treatment compliance is relatively high of the sample.ConclusionsThe findings suggest that involuntary hospitalization can be effective in reducing disruptive behaviors and increasing treatment compliance in minors with conduct disorders, substance abuse disorders and a history of juvenile delinquency. These results underscore the need for comprehensive, multidisciplinary approaches that integrate psychiatric treatment, psychoeducation and social support. Given the relatively small sample size and short-term follow-up, further research is needed to determine the long-term effects of involuntary treatment and to identify factors that predict treatment response.Disclosure of InterestNone Declared

The importance of including ADHD in the differential diagnosis in adults. About a case

IntroductionADHD is a diagnosis almost always made in childhood or adolescence and oftent difficult to make it new in adults because it is not thought of in the differential diagnosis process and for the lack of experience from adult devices. -ADHD in adults is characterized by symptoms of executive dysfunction, inattention, emotional dysregulation. The symptoms of impulsivity and hyperactivity tend to be less evident.Objectives-Frequently, the adult patient with ADHD comes to the consultation with a secondary symptom and the primary pathology is hidden and often not evident at first glance.Methods-A 20-year-old woman, university student, with no relevant medical or psychiatric history, without toxic habits, who attended her first consultation referred by her primary care physician for long-standing insomnia, restless legs and anxiety.-The patient’s underlying complaint and her bigger concern is her poor academic performance. It is striking that she has just started her third year at the university, the first year she did not pass any subjects, the second year she changed majors and only passed two, now she is repeating the course.-The examination did not reveal overt affective symptoms, nor psychotic symptoms or other notable psychopathology. The patient’s speech tended towards superficiality, inconcretion, it was salty, it was difficult for her to express herself, even suggesting a certain intellectual disability.-In the first consultation sleep study is requested. And referral to clinical psychology consultation for psychometric study.Results-She is administered Clinical interview and WAIS IV (Adult Intelligence Scale), Trail Making Test, d2 and Stroop, Diagnostic Interview for ADHD in adults (inattention items).-The WAIS-IV demonstrated global cognitive abilities within normality, although with significantly lower scores in the IMT and IVP indices which involve the functions of attention, concentration, mental control and short-term visual memory). Trail Making Test, d2, Stroop and Diagnostic Interview of ADHD in adults (inattention items) yielded profile results highly suggestive of Attention Deficit Disorder without Hyperactivity.-The insomnia subsided with a regimen of 7.5 mg of mirtazapine per day. Subsequently, after starting treatment with low-dose methylphenidate (20 mg/day), the patient improved very significantly, both academic performance and social functioning and mood, self-esteem and subjective well-being.Conclusions-We must always include ADHD in the differential diagnosis of a young adult patient when faced with a wide variety of consultation symptoms, especially if they report some type of deterioration or dysfunction in their social, family or academic life.-An adequate clinical evaluation supported, if possible, by psychometric tests is essential to reach the diagnosis, which allows establishing an effective treatment that modifies the patient’s overall prognosis.Disclosure of InterestNone Declared

Stimulant exposure in utero not linked to child neurodevelopmental disorders

A cohort study involving both publicly and commercially insured patients has found in adjusted analyses that exposure to stimulant medications during pregnancy did not significantly increase risk of childhood neurodevelopmental disorders. The investigators focused largely on children's risk of autism spectrum disorder (ASD) and attention‐deficit hyperactivity disorder (ADHD). Study results were published online Jan. 24, 2024, in JAMA Psychiatry.

Turner Syndrome and Attention-Deficit with Hyperactivity Disorder in a Pediatric Population

Turner Syndrome and Attention-Deficit with Hyperactivity Disorder in a Pediatric Population

A Follow-Up Study of Children Diagnosed with Delayed Speech and Language

Objective: The aim of our study was to examine the current health status of children with normal peripheral hearing who were referred to the audiology clinic with complaints of speech and language delay in early childhood.
 Methods: The data of a retrospective file review in which the information of 105 children with normal hearing ages 12-60 months referred to the Audiology Clinic with complaints of speech and language delay were used in the study. After the initial diagnosis of delayed speech and language (approximately two years), their medical condition was assessed through semi-structured telephone interviews. The obtained data are presented with descriptive statistics.
 Results: Out of 105 children, 54 (51.4%) were diagnosed with other additional diagnoses including; autism spectrum disorder:21 (20%), general developmental delay: 13 (12.3%), attention deficit and hyperactivity disorder: 9 (8.5%), epilepsy: 4 (3.8%).7 (6.6%) of children followed from endocrine, neurology, genetics, cardiology, nephrology and ophthalmology departments. 51 children (48.57%) have achieved the average level of speech and language development with interventions such as speech and language therapy and/or social support in the following period, and they do not currently have any medical follow-up. 
 Conclusion: The results indicated that cases where children who apply with the complaint of speech and language delay may have additional diagnoses in the future, or they can achieve the average level of speech and language development with specialist interventions. Long-term follow-up of this delay is important in terms of providing effective communication skills and the probability of being a diagnostic marker.

The Evaluation of Parenting Styles of Children with Attention Deficit/ Hyperactivity Disorder

Background: Parenting has an important role in improving the performance of children with ADHD and in their families, this study will create awareness about parenting styles among parents addressing differences in parenting styles and improving the quality of child mental health.
 Objective: This study was intended to evaluate the different parenting styles of parents having children with ADHD and healthy children. It also aimed to find out any relationship between the socio-demographic variables of children and parents with the parenting style of the diseased child. 
 Methodology: This was a case-control study. The study was conducted in the Department of Psychiatry, Sylhet MAG Osmani Medical College, Sylhet during the period from September 2020 to August 2022. ADHD was diagnosed using DSM-5 and confirmed by a consultant psychiatrist. A total of 60 parents of children (ADHD=30, Healthy=30) were interviewed who fulfilled the enrollment criteria. Semi-structured questionnaire for socio-demographic variables and a Bangla Parenting Style and Dimension Questionnaire (PSDQ) were used for assessing parenting style. The data analysis was conducted utilizing the one-way analysis of variance (ANOVA) method, followed by post-hoc comparisons using the Bonferroni correction.
 Results: The predominant parenting style found to be applied to children with ADHD was authoritative (56.67%), followed by 26.67% authoritarian parenting and 16.33% permissive parenting style. Among the parents of healthy children, 53.33% were authoritative, 23.33% were authoritarian and permissive. There was a statistically significant association of parenting styles with education level and occupation. ADHD children's parents who studied up to the primary level had a significantly higher authoritarian score and (authoritarian p = 0.005) and the normal children's parents who studied up to the secondary level had a significantly higher authoritarian score (authoritarian p = 0.007. A significant association was found in the authoritarian domain in parents who were housewives (p = 0.032). Individuals within 6-9 years age range exhibit significantly higher scores in the authoritative domain (p=.001). Both boys and girls groups exhibit a considerably higher score in the authoritative domain (p=.003, p=.001). 
 Conclusion: The fact that parenting styles influence ADHD may appear to be a burden, but it can also be an opportunity to change one's life. Solutions like parent training programs can provide skills and strategies as well as help build resilience in parents to manage the challenging behavior of children with ADHD.

Impact of quarantine on the experience and management of children with learning disabilities or attention deficit disorders with or without hyperactivity: A retrospective observational study

BackgroundDuring the COVID-19 pandemic, France faced a 2-month lockdown in 2020, marked by numerous restrictions. This study aimed to examine the experience and management of children aged 6–17 years with learning and/or attention disorders during the first lockdown. MethodsWe conducted an observational, retrospective study, with data collection from March 1 to May 31, 2021, by means of an anonymous digital qualitative questionnaire completed by parents. The experience of confinement as well as the children's behavior, schooling, and level of progress during rehabilitation were assessed by parents through a Likert scale. Data were compared according to two groups: negative experience and positive or neutral experience of the child's confinement. ResultsA total of 251 questionnaires were collected and 217 were analyzed. Overall, 47 children (21.7 %) reported a negative experience of the confinement period. In total, 164 (75.6 %) of the children had their schooling monitored throughout the period; half of the parents reported a course format unsuited to their child's disorders and a lack of motivation, and 46.5 % a refusal by their child to study. Only 16.8 % of parents reported a regression in their child's rehabilitation. These last three results were significantly associated with a poor experience of confinement (p < 0.05). ConclusionThe period of confinement was experienced relatively well by the children, and the rehabilitative management seemed to have been minimally impacted during this period. The therapeutic education of children, their parents, and also teachers is a major axis of improvement for better care and support of children with these disorders.

Aperiodic components and aperiodic-adjusted alpha-band oscillations in children with ADHD

This study aimed to investigate the aperiodic properties and aperiodic-adjusted alpha-band oscillations in children with ADHD, focusing on the influence of different scalp regions and lateralization on these neural correlates. Sixty-two ADHD children and 52 typical developing children aged 6–12 years were enrolled. EEG recordings were made with eyes closed for a minimum of 6 min. The ‘FOOOF’ was used to compute aperiodic parameters (exponent and offset), and aperiodic-adjusted alpha-band features including center frequency (CF), adjusted power (AP), and bandwidth (BW). Mixed-design ANOVAs were conducted with two between-subjects levels (ADHD and control groups) and two within-subjects’ factors (lateralization and scalp region). ANCOVAs were conducted after accounting for sex and age. The ADHD group showed a significantly lower exponent compared to the control group, and this difference was not influenced significantly by factors like lateralization, scalp region, or sex. There were no notable distinctions between the groups for other measures. We noticed alpha-band CF tends to increase with age, while only frontal AP shows a significant positive correlation with age. Significant main effects of sex and lateralization were observed for offset, along with an interaction effect between sex and lateralization for CF. Our findings indicate that children aged 6–12 with ADHD have a markedly lower exponent, suggesting that this measure could potentially serve as a biomarker for ADHD. Future studies should consider factors such as age, sex, lateralization, and scalp region when investigating aperiodic and aperiodic-adjusted features.

Commentary: Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use.

Commentary: Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use.

Heavy Metal and Thiol/Disulfide in Children with Attention-Deficit and Hyperactivity Disorder.

In the etiology of attention-deficit and hyperactivity disorder (ADHD), oxidative stress and heavy metal exposure are still controversial topics. In this study, our goal was to examine heavy metal levels and oxidative balance in newly diagnosed patients with ADHD and reveal whether heavy metal levels have an effect on the oxidation balance. The study included 35 patients with newly diagnosed ADHD and 31 healthy control groups of similar age and gender. Participants' parents or caregivers completed a semi-structured questionnaire regarding their children's breastfeeding and prenatal and postnatal smoking exposures. The levels of heavy metals lead (Pb), mercury (Hg), and cadmium were measured with inductively coupled plasma optical emission spectroscopy, and a unique automated spectrophotometric approach was used to quantify serum total thiol, native thiol, and disulfide quantities and ratios. The rate of smoking during pregnancy was significantly higher in the ADHD group than in the control group (P = .030). Compared to the control group, the native and total thiol levels of children with ADHD were significantly higher (P < .001). Likewise, the ADHD group had significantly higher Hg levels compared to the control group (P = .002). Cadmium levels were substantially greater in the control group compared to the ADHD group (P < .001). However, there was no significant difference between Pb levels in the ADHD and the control group (P = .844). Exposure to Hg and prenatal smoking may contribute to the development of ADHD in childhood. In response to oxidative stress, the young brains of children with ADHD may enhance their antioxidant levels.

UNDERSTANDING THE EMOTIONAL IMPACT OF ADHD IN PRIMARY SCHOOL STUDENTS

Today, a remarkable place in society is occupied by children who need special conditions of education and their inclusion in schools, which determines the peculiarities of the organization of education. In all historical eras, the development system of special education has been connected with the socio-economic structure of the country, the state's value system and society, and the state's policy towards children who have developmental problems.&#x0D; The article highlights children with special educational needs, especially children with attention deficit and hyperactive behavior syndrome. Children with attention deficit and hyperactivity disorder are included in the inclusive education system, and the organization of their educational activities, their inclusion in schools is considered an important and primary issue. To organize the effective teaching of hyperactive children, it is necessary to study the features of the emotional sphere of these children, which will make it possible to identify their strengths, highlight their problems, and accordingly organize their education more effectively, as well as interpersonal interactions with classmates in public schools. At present, the syndrome of attention deficit and hyperactivity is the subject of study of many psychologists, because the features of the emotional sphere of these children are not so well studied.

Reducing symptoms of attention deficit/hyperactivity disorder (ADHD) in elementary students: the effectiveness of neurofeedback.

This research was conducted to investigate the effectiveness of neurofeedback on the symptoms of hyperactivity and attention deficit in primary school students with attention deficit/hyperactivity disorder (ADHD) disorder. The present study utilized a randomized clinical trial with pre-test and post-test measurements and included a control group. The research population included all primary school students with ADHD in 2023; 50 of these children were selected as the experimental group based on the accessible sampling method, and 50 were also included in the control group. Neurofeedback treatment sessions for the experimental group were 30 sessions. Research data were collected in three stages: pre-test and post-test, using a questionnaire based on the Conners rating scale from parents. SPSS-25 analyzed the data. The results showed that neurofeedback is associated with significant effectiveness in the symptoms of attention deficit disorder and hyperactivity of students (P<0.05). Based on the findings of this research, it can be said that neurofeedback treatment is effective in reducing attention deficit and hyperactivity symptoms of students with ADHD disorder. It is suggested to widely use neurofeedback to reduce the symptoms of attention deficit and hyperactivity disorder.

The Beginnings of Attention Deficit in a Dutch 18th Century Medical Treatise

Objective: An early description, possibly the earliest, of attention deficit disorder in a 1753 Dutch medical book by Cornelius Kloekhof is presented. Method: The author of this text is briefly introduced and contextualized. The text is translated from Latin and afterwards, its impact on later scientific literature is discussed. Results and Conclusions: Kloekhofs description of attention deficit was one of the first and thoroughly inspired the subsequent literature, such as Adam Weikard, making this text an important moment in the rich history of ADHD.

Research progress on the roles of dopamine and dopamine receptors in digestive system diseases.

Dopamine (DA) is a neurotransmitter synthesized in the human body that acts on multiple organs throughout the body, reaching them through the blood circulation. Neurotransmitters are special molecules that act as messengers by binding to receptors at chemical synapses between neurons. As ligands, they mainly bind to corresponding receptors on central or peripheral tissue cells. Signalling through chemical synapses is involved in regulating the activities of various body systems. Lack of DA or a decrease in DA levels in the brain can lead to serious diseases such as Parkinson's disease, schizophrenia, addiction and attention deficit disorder. It is widely recognized that DA is closely related to neurological diseases. As research on the roles of brain-gut peptides in human physiology and pathology has deepened in recent years, the regulatory role of neurotransmitters in digestive system diseases has gradually attracted researchers' attention, and research on DA has expanded to the field of digestive system diseases. This review mainly elaborates on the research progress on the roles of DA and DRs related to digestive system diseases. Starting from the biochemical and pharmacological properties of DA and DRs, it discusses the therapeutic value of DA- and DR-related drugs for digestive system diseases.

A randomized controlled trial of effects of sleep hygiene training and progressive muscle relaxation training in children with ADHD

ObjectSleep problems often accompany ADHD and negatively affect ADHD symptoms, however, there are not enough intervention studies on sleep interventions in children with ADHD. The present study investigated the effects of sleep hygiene training (SH) and progressive muscle relaxation exercises (PMR) in children with ADHD. Method: 57 children aged 6–12 years with ADHD were randomly assigned to the SH and SH + PMR groups and completed the intervention consisting of group training and eight weeks of telephone interviews. The effects of both intervenitons were evaluated via parent, child and clinician report scales and neuropsychological tests. Results: Both interventions resulted in significant positive changes in child sleep, ADHD symptoms, functioning, neuropsychological tests and parental sleep quality. Significant differences were found between the interventions in selective attention, peer problems and anxiety scores in favor of the SH + PMR group. Conclusion: SH may have positive effects on various clinical parameters as well as sleep problems in children with ADHD. Addition of PMR to SH may lead to further improvements in anxiety, peer problems and selective attention. SH and PMR may be a useful tool in the clinical management of children with ADHD with sleep problems.

ADHD medications for young children

Attention‐deficit hyperactivity disorder, also known as ADHD, is a condition that often begins between ages 3 and 6, according to the National Institute of Mental Health. And it's not just a childhood disease. ADHD may continue through the teenage years and into adulthood.

Long-term low-dose lamotrigine for paroxysmal kinesigenic dyskinesia: a two-year investigation of cognitive function in children.

While low-dose lamotrigine has shown effectiveness in managing paroxysmal kinesigenic dyskinesia (PKD) in pediatric populations, the cognitive consequences of extended use are yet to be fully elucidated. This study seeks to assess the evolution of cognitive functions and the amelioration of attention deficit and hyperactivity disorder (ADHD) symptoms following a two-year lamotrigine treatment in children. This investigation employed an open-label, uncontrolled trial design. Between January 2008 and December 2021, thirty-one participants, ranging in age from 6.5 to 14.1 years, were enrolled upon receiving a new diagnosis of PKD, as defined by the clinical diagnostic criteria set by Bruno in 2004. Comprehensive evaluation of PRRT2 variants and 16p11.2 microdeletion was achieved using whole-exome sequencing (WES) and bioinformatics analysis of copy number variant (CNV) for all subjects. Immediately after diagnosis, participants commenced treatment with low-dose lamotrigine. Cognitive function was assessed using the Wechsler Intelligence Scale for Children-Chinese Revised (WISC-CR) at baseline and after 2 years, with ADHD diagnoses and symptom severity simultaneously assessed by experts in accordance with the DSM-IV diagnostic criteria for ADHD and the ADHD Rating Scale-IV (ADHD-RS-IV). Initially, twelve out of 31 patients (38.7%) presented with comorbid ADHD. The latency to treatment initiation was notably longer in PKD patients with ADHD (30.75 ± 12.88 months) than in those without ADHD (11.66 ± 9.08 months), t = 4.856, p<0.001. Notably, patients with a latency exceeding 2 years exhibited a heightened risk for comorbid ADHD (OR = 4.671, P=0.015) in comparison to those with shorter latency. Out of the cohort, twenty-five patients saw the clinical trial to its completion. These individuals demonstrated a marked elevation in WISC-CR scores at the 2-year mark relative to the outset across FSIQ (baseline mean: 108.72 ± 10.45 vs 24 months: 110.56 ± 10.03, p=0.001), VIQ (baseline mean: 109.44 ± 11.15 vs 24 months: 110.80 ± 10.44, p=0.028), and PIQ domains (baseline mean: 106.52 ± 9.74 vs 24 months: 108.24 ± 9.38, p=0.012). Concurrently, a substantial mitigation was observed in ADHD inattention at 2 years compared to baseline (p<0.001), with an average total subscale scores decrement from 9.04 ± 4.99 to 6.24 ± 4.05. Prolonged duration of untreated PKD in children may elevate the risk of ADHD comorbidity. Notably, following a 2-year lamotrigine regimen, enhancements were observed in both cognitive test outcomes and ADHD symptomatology.

Burden and Epidemiology of Mental Disorders in the Middle East and North Africa from 1990 to 2019: Findings from the Global Burden of Disease Study

Previous studies have mainly focused on individual mental disorders, and there is no study addressing the total burden of mental disorders in the Middle East and North Africa (MENA). To evaluate the burden of mental disorders in the MENA region from 1990 to 2019. A cross-sectional study. We utilized global burden of disease data to examine the burden of 12 mental disorders from 1990 to 2019 across age groups, genders, and the 21 MENA countries. We collected data on prevalence, incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALY), including both crude and age-standardized rates per 100,000 people. The DALY rate of mental disorders in MENA countries increased by 13.88% from 1,747.92 per 100,000 people in 1990 to 1990.5 per 100,000 people in 2019. The highest percentage increases in the DALY rates of mental disorders were observed for bulimia nervosa (35.69%), other mental health disorders (34.58%), and schizophrenia (33.02%) from 1990 to 2019. However, the DALY rates for idiopathic developmental intellectual disability (-26.48%), conduct disorder (-23.91%), attentiondeficit/ hyperactivity disorder (-16.46%), and autism spectrum disorders (-4.12%) decreased in the MENA region from 1990 to 2019. In 2019, the highest DALY rates for idiopathic developmental intellectual disability, anxiety disorders, and major depressive disorder were observed in age groups ≤ 4 years, 5-19 years, and ≥ 20 years, respectively. The age-standardized DALY rate of mental disorders was the highest in Palestine (2,396.9 per 100,000), Iran (2,295.8 per 100,000), and Lebanon (2,126.0 per 100,000) compared with other MENA countries in 2019. There has been a slight increase in the burden of mental disorders in the MENA region between 1990 and 2019. National policies should prioritize evidence-based preventive measures and ensure accessible treatment options for mental health disorders in the population, especially in the MENA region.

İlk Gençlik Çağı Romanlarında Özel Gereksinimli Karakterlerin İncelenmesi

Introduction: Juvenile books are useful tools to increase young people's knowledge and sensitivity about individuals with special needs. In particular, the books that are structured in a qualified way and that appeal to the world of young people will be useful in establishing healthy communication bridges between individuals with typical development and individuals with special needs. For this reason, it is important to identify qualified books on individuals with special needs. In this research, we examined the books that include individuals with special needs as characters in terms of their structure, depiction, and developmental characteristics. Method: The study utilized document analysis model, one of the qualitative research methods, in which we examined the characters with special needs according to various criteria. We evaluated thirty-eight books in the study. While identifying the books, we sought that they appealed to juvenile and included at least one character with special needs. We analyzed the books with the content analysis technique. Results: Results showed eleven different disability types in the 38 books. Of these, 10 were visual impairment, 11 were physical disabilities, six were hearing impairment, six were intellectual disability, six were autism spectrum disorder (ASD), five were cerebral palsy, three were speech and language disorders, three were gifted, one was specific learning disability, one was attention deficiency and hyperactivity disorder, one was a physical disorder. In 33 books, characters had positive depictions; 33 characters had dynamic characteristics, and all of the books had realistic fiction except two. Discussion: The results of the study differ from the studies in the literature in terms of the variety of special needs of the characters. In terms of the reality of the fictions, the results overlap with the studies in the literature. The rate of dynamic characters in the books that are the subject of this research is higher than past studies. The results regarding the relationship between the characters with special needs and their peers are also consistent with the results of the studies on the topic.

Prevalence and comorbidity of anxiety disorder in school-attending children and adolescents aged 6–16 years in China

BackgroundThe reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey of childhood anxiety disorder in China. This...