Attention-deficit/hyperactivity Disorder In Taiwan Research Articles

Relationship between Bullying Victimization and Quality of Life in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) in Taiwan: Mediation of the Effects of Emotional Problems and ADHD and Oppositional Defiant Symptoms.

This cross-sectional study investigated the mediating effects of emotional problems including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms on the association between bullying victimization and quality of life (QoL) among adolescents with ADHD in Taiwan. A total of 171 adolescents diagnosed as having ADHD participated in this study. Adolescents completed the School Bullying Experience Questionnaire, the Taiwanese Quality of Life Questionnaire for Adolescents, the Taiwanese version of the Children’s Depression Inventory and the Multidimensional Anxiety Scale for Children. Caregivers completed the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale. Structural equation modeling (SEM) was used to examine the relationships among the variables. The results of SEM revealed that bullying victimization indirectly correlated with QoL through the mediation of emotional problems in adolescents with ADHD, whereas ADHD and ODD symptoms did not mediate the association between bullying victimization and QoL. Bullying victimization should be actively prevented and intervened on to ensure better QoL in adolescents with ADHD. Moreover, emotional problems should be alleviated among adolescents with ADHD with bullying victimization experience to maintain their QoL.

Affiliate Stigma in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: The Roles of Stress-Coping Orientations and Parental Child-Rearing Styles

Affiliate stigma may increase the risks of negative parenting and psychological and depressive problems in caregivers of children with attention-deficit/hyperactivity disorder (ADHD). Evaluating affiliate stigma and determining how to reduce it are crucial to promoting mental health in caregivers and their children with ADHD. The aim of this study was to examine the associations of stress-coping orientations and parental child-rearing styles with the risk of high affiliate stigma in caregivers of children with ADHD in Taiwan. Affiliate stigma, stress-coping orientations, and parental child-rearing styles were assessed. The results of univariate logistic regression analysis indicated that caregivers’ gender, depressive symptoms, four orientations of stress coping, and two parenting styles, and children’s high severities of internalizing, externalizing, and ADHD symptoms were significantly associated with high affiliate stigma. The results of multivariate logistic regression analysis indicated that after controlling for caregivers’ gender, depressive symptoms, and children’s severity of internalizing, externalizing, and ADHD symptoms, caregivers with high orientation of seeking social support were less likely to have high affiliate stigma than those with low orientation of seeking social support; the caregivers with high care and affection parenting were less likely to have high affiliate stigma than those with low care and affection parenting, whereas the caregivers with high overprotection parenting were more likely to have high affiliate stigma than those with low overprotection parenting. Intervention programs targeting caregiver affiliate stigma must consider various coping orientations and parental child-rearing styles in their approach.

Social Anxiety in Victimization and Perpetration of Cyberbullying and Traditional Bullying in Adolescents with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.

Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The aims of this study were to examine the role of social anxiety in victimization and perpetration of cyberbullying and traditional bullying in adolescents with ASD and ADHD in Taiwan. A total of 219 adolescents with ASD and 287 adolescents with ADHD aged 11–18 years and their caregivers were recruited from the child psychiatry outpatient clinics into this study. The associations of social anxiety with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results indicated that after the effects of sex, age, and autistic social impairment were controlled, social anxiety increased the risk of being a victim of cyberbullying (Odds Ratios (OR) = 1.048; 95% Confidence Interval (CI): 1.013–1.084), a victim of traditional bullying (OR = 1.066; 95% CI: 1.036–1.097), and a perpetrator of traditional bullying (OR = 1.061; 95% CI: 1.027–1.096) in adolescents with ASD. After the effects of sex, age, and ADHD symptoms were controlled for, social anxiety increased the risk of being a victim of traditional bullying in adolescents with ADHD (OR = 1.067; 95% CI: 1.039–1.096). Social anxiety was significantly associated with several forms of bullying involvement in adolescents with ASD and ADHD and warrants being considered into prevention and intervention programs for bullying involvement.

Correlations of Internet Addiction Severity With Reinforcement Sensitivity and Frustration Intolerance in Adolescents With Attention-Deficit/Hyperactivity Disorder: The Moderating Effect of Medications.

Background: Deviations in reinforcement sensitivity and frustration-related reactions have been proposed as components of the biopsychosocial mechanisms, which explained the high vulnerability to internet addiction (IA) among individuals with attention-deficit/hyperactivity disorder (ADHD). There is currently limited knowledge on the relationship of IA symptoms with reinforcement sensitivity and frustration intolerance, as well as factors moderating those correlations in this population. Objective: The aims of this study were (1) to examine the associations of IA symptoms severity with reinforcement sensitivity and frustration intolerance and (2) identify the moderators of these associations among adolescents diagnosed with ADHD in Taiwan. Methods: A total of 300 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their levels of IA severity, reinforcement sensitivity, and frustration intolerance were assessed using the Chen Internet Addiction Scale, behavioral inhibition system (BIS) and behavioral approach system (BAS), and Frustration Discomfort Scale, respectively. The associations of IA severity with reinforcement sensitivity and frustration intolerance were examined using multiple regression analysis. Possible moderators, including medications for ADHD, were tested using the standard criteria. Results: Higher fun seeking on the BAS (p = .003) and higher frustration intolerance (p = .003) were associated with more severe IA symptoms. Receiving medication for treating ADHD moderated the association between fun seeking on the BAS and severity of IA symptoms. Conclusion: Fun seeking on the BAS and frustration intolerance should be considered as targets in prevention and intervention programs for IA among adolescents with ADHD.

Risk of Traumatic Brain Injury Among Children, Adolescents, and Young Adults With Attention-Deficit Hyperactivity Disorder in Taiwan

PurposePrevious studies suggested that patients with attention-deficit hyperactivity disorder (ADHD) were prone to health-risk behaviors and accidents. However, the relationship of ADHD with the risk of traumatic brain injury (TBI) remained uncertain. MethodsUsing the Taiwan National Health Insurance Research Database, 72,181 children (aged 3–11 years), adolescents (12–17 years), and young adults (18–29 years) with ADHD and 72,181 age-/sex-matched controls were enrolled between 2001 and 2009, and followed up to the end of 2011 in our study. Those who developed any TBI during the follow-up period were identified. ResultsChildren, adolescents, and young adults with ADHD had a higher incidence of developing any TBI (9.8% vs. 2.2%, p < .001), such as skull fracture (.2% vs. .1%, p < .001) and concussion (4.3% vs. 1.0%, p < .001), than the controls did. Cox regression analysis with the adjustment of demographic data, psychiatric comorbidities, and ADHD medications showed that ADHD was related to an increased risk of subsequent TBI (hazard ratio: 4.57, 95% confidence interval: 4.31–4.85), and indicated that long-term use of ADHD medication was associated with a reduced likelihood of subsequent TBI (hazard ratio: .93, 95% confidence interval: .87–.99). ConclusionsPatients with ADHD had an increased risk of developing any TBI compared with the controls. Long-term use of ADHD medications would reduce this risk. Our findings suggested that the public health government and clinicians should pay more attention to the TBI risk among patients with ADHD, and further indicated the importance of the optimal treatment for ADHD.

Outpatient rehabilitation resources and medical expenditure in children with attention-deficit hyperactivity disorder in Taiwan.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children. This study investigated the use of rehabilitation treatment in Taiwan. We selected children aged 3–12 years from the National Health Insurance Research Database from 2008 to 2012 and included them in the analysis. The children who received a diagnosis according to the International Classification of Diseases, Ninth Revision, Clinical Modification were divided into two groups: ADHD and non-ADHD. We used the chi-squared test, independent sample t test, and multiple regression analysis to conduct the analysis. The utilisation of rehabilitation resources was higher in the ADHD group than in the non-ADHD group. The number of school-aged children with ADHD was higher than the number of preschool-aged children (p < 0.001). The highest utilisation of rehabilitation resources was observed in clinics (p < 0.001). In terms of region, Taipei exhibited the highest utilisation of rehabilitation resources, and the East exhibited the lowest resource utilisation (p < 0.001). Prediction of the use of rehabilitation resources, average cost, average frequency of visits, and total annual cost was affected by factors such as the average frequency of rehabilitation use, demographic characteristics, and the hospital characteristics and location (p < 0.001). The number of children with ADHD and rehabilitation use are increasing yearly; however, limitations in payment restrict the growth of rehabilitation resource use in hospitals. Supplementation of rehabilitation resources at clinics accounts for more than 60%, however, the total annual cost is less than what is observed for hospitals (p < 0.001). Policies should be established to aid in the early detection and treatment of children with ADHD to improve treatment outcomes and reduce the family burden and treatment expenditure in the future.

One-year trajectory analysis for ADHD symptoms and its associated factors in community-based children and adolescents in Taiwan

BackgroundSeveral longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples. However, little is known about the patterns and trajectories of ADHD symptoms in community-based populations.MethodsTo differentiate developmental trajectories of ADHD symptoms over 1 year, with a four-wave quarterly follow-up in children and adolescents in the community of Taiwan, we conducted this prospective study in 1281 students in grade 3, 5, and 8. All the students in the regular classes rather than special educational classes were eligible and recruited to the study. Inattention, hyperactivity–impulsivity, and opposition-defiance were rated by parent reports on the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV). Group-based trajectory modeling and multivariable regression analyses were used to explore the individual, family and social factors associated with differential trajectories.ResultsTrajectories were classified as Low (29.9–40.6%), Intermediate (52.5–58.5%) and High (6.9–12.5%) based on the symptom severity of ADHD symptoms assessed by the SNAP-IV. The proportion of children in the high ADHD trajectory might approximately reflect the prevalence of ADHD in Taiwan. The following factors differentiated High from Low trajectories: male gender, more externalizing problems, fewer prosocial behaviors, school dysfunction, more home behavioral problems, and less perceived family support.ConclusionsOur findings that the concurrent conditions of emotional or externalizing problems, as well as impaired school and home function at baseline, might differentiate the high ADHD symptoms trajectory from others could help developing the specific measures for managing high ADHD symptoms over time in a school setting.

Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011.

Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan. Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year. The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16). The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.

Neonatal jaundice and increased risk of attention-deficit hyperactivity disorder: a population-based cohort study.

Previous studies have posited conflicting results regarding the relationship between neonatal jaundice and the subsequent risk of attention-deficit hyperactivity disorder (ADHD). We therefore performed a large population study with a defined neonatal jaundice cohort to investigate the incidence and risk of physician-diagnosed ADHD in Taiwan. From 2000 to 2004, 24,950 neonatal jaundice cases and 69,964 matched nonjaundice controls were identified. At the end of 2008, the incidence rate and hazard ratios (HRs) of physician-diagnosed ADHD were calculated. The incidence of ADHD was 2.48-fold greater in the jaundice cohort than in the nonjaundice cohort (3.84 vs. 1.51 per 100,000 person-years) in the study period. The HR of ADHD was substantially greater for male, preterm, and low-birth-weight infants with neonatal jaundice. The risk of developing ADHD in the jaundice cohort was greater after a diagnosis of neonatal jaundice for more than 6 years (HR: 2.64; 95% confidence interval: 2.13-3.28). The risk of ADHD increased for neonates with higher serum bilirubin levels requiring phototherapy and with longer admission days. Neonates with jaundice are at high risk for developing physician-diagnosed ADHD during their growth period. A risk alert regarding neurologic consequences is urgently required after a neonatal jaundice diagnosis. Additional studies should be conducted to clarify the pathogenesis of these relationships.

The written language performance of children with Attention Deficit Hyperactivity Disorder in Taiwan.

Poor writing is common in children with Attention Deficit Hyperactivity Disorder (ADHD). However, the writing performance of children with ADHD has been rarely formally explored in Taiwan, so the purpose of this study was to investigate writing features of children with ADHD in Taiwan. There were 25 children with ADHD and 25 normal children involved in a standardization writing assessment - Written Language Test for Children, to assess their performance at the dictation, sentence combination, adding/deducting redical, cloze and sentence making subtests. The results showed that except for the score of the sentence combining subtest, the score of children with ADHD was lower than the normal student in the rest of the subtests. Almost 60% of ADHD children's scores were below the 25th percentile numbers, but only 20% for normal children. Thus, writing problems were common for children with ADHD in Taiwan, too. First, children with ADHD performed worse than normal children on the dictation and cloze subtests, showing the weaker abilities of retrieving correct characters from their mental lexicon. Second, children with ADHD performed worse on the adding/deducting redical subtest than normal children did. Finally, at the language level, the score of children with ADHD on the sentence combination subtest was not lower than normal children, implicating their normal grammatic competence. It is worth mentioning that Taiwanese children with ADHD ignore the details of characters when they are writing, a finding that is common across languages.

Father's parenting and father–child relationship among children and adolescents with attention-deficit/hyperactivity disorder

ObjectiveWestern literature documents impaired father–child interactions in addition to strong evidence of impaired mother–child interactions in children with attention-deficit/hyperactivity disorder (ADHD). However, the parenting process of fathers and their engagement in the Asian family with children with ADHD remain unexplored. The authors compared fathering and father–child relationships between children with ADHD and those without ADHD and identified the correlates of these paternal measures. MethodsFathering and father–child relationships were compared between 296 children with attention-deficit/hyperactivity disorder (ADHD) and 229 children without ADHD in Taiwan. All child participants and their parents received psychiatric interviews for the diagnosis of ADHD and other psychiatric disorders of the children, and their fathers were assessed for ADHD, anxiety and depressive symptoms. Both the fathers and children reported on the father's parenting style, father–child interactions, behavioral problems at home, and perceived family support. ResultsThe results showed that children with ADHD received less affection/care and more overprotection and authoritarian control from their fathers. They had less active interactions with their fathers, more severe behavioral problems at home; and perceived less family support than children without ADHD. Correlates for impaired father–child interactions included childhood ADHD symptoms, any comorbidity, age at assessment, and the father's neurotic personality and depressive symptoms. In addition, the children reported more negatively on fathering and father–child interactions than the fathers. ConclusionsOur findings suggest the negative impacts of ADHD on the father's parenting style and father–child interactions. Clinical interventions aimed at improving father–child interactions warrant more attention.

Prevalence, incidence, and stimulant use of attention-deficit hyperactivity disorder in Taiwan, 1996–2005: a national population-based study

We used National Health Insurance (NHI) database to examine the prevalence, incidence, and stimulant use of attention-deficit hyperactivity disorder (ADHD) diagnosis in Taiwan. The National Health Research Institute provided a database of 10,00,000 random subjects for study. A population-based random sample of 372,642 patients aged younger than 18 was obtained as a dynamic cohort. Those study subjects who had at least one service claim from 1996 to 2005, with a principal diagnosis of ADHD, were identified. The cumulative prevalence of ADHD diagnosis increased from 0.06 to 1.64 % from 1996 to 2005. The annual incidence of ADHD diagnosis increased from 0.02 to 0.34 % from 1997 to 2005. The highest incidence rates of ADHD diagnosis for both males and females were in the 6- to 11-year age group. Higher incidence was detected in males (HR 3.76, 95 % CI 3.48-4.07), those who lived in northern region (HR 1.35, 95 % CI 1.07-1.71) and urban area (HR 1.53, 95 % CI 1.40-1.66). The percentage of stimulant use in children with ADHD diagnosis increased from 39.6 to 54.0 % from 1997 to 2005. Our findings suggest increases in the prevalence and incidence rates of ADHD diagnosis in Taiwan, which was in line with those studies of Western countries. However, the prevalence of ADHD diagnosis in the NHI program was still much lower than in the community studies. The percentage of stimulant use in children with ADHD diagnosis also has an increasing trend, which warrants further study.

The experiences of primary caregivers raising school‐aged children with attention‐deficit hyperactivity disorder

To understand the experiences of primary caregivers who are bringing up school-aged children with attention-deficit hyperactivity disorder. The research findings will help address the problems related to caring for school-aged children with attention-deficit hyperactivity disorder. In Taiwan, the rate of school-aged children diagnosed with attention-deficit hyperactivity disorder ranges from 7.9-11.7%. This study is the first, which tries to understand the experiences of primary caregivers who are bringing up school-aged children with attention-deficit hyperactivity disorder in Taiwan. The study used a qualitative phenomenological approach to explore the experiences of caregivers raising school-aged children with attention-deficit hyperactivity disorder. Purposive sampling and in-depth, face-to-face interviews were used to collect data. The unstructured interview guide allowed the major caregivers to express their experiences of raising school-aged children with attention-deficit hyperactivity disorder. When data saturation was reached, the sample size comprised 12 major caregivers. Narratives were analysed according to Colaizzi's seven-step method. Three themes and seven sub-themes emerged from this study: the burdens of caring (parenting burdens, emotional burdens and family conflicts), the lack of adequate support systems (lack of support from professionals, spouses and other family members) and the mechanisms of coping (cognitive coping strategies and social coping strategies). Furthermore, several other factors that affected the caregivers of children with attention-deficit hyperactivity disorder are also revealed in the study. The findings of the study demonstrate the importance of understanding the experiences of primary caregivers, bringing up school-aged children with attention-deficit hyperactivity disorder. Improving professional services in family care should be a major concern for all healthcare professionals. The recommendations that have been made based on the findings of this research can be used as a guide to improve the delivery of caring by people who have school-aged children with attention-deficit hyperactivity disorder and by the wider family.

Validation of Attention-Deficit–Hyperactivity Disorder Subtypes Among Taiwanese Children Using Neuropsychological Functioning

The findings regarding the validity of attention-deficit-hyperactivity disorder (ADHD) subtypes using neuropsychological functioning have been inconsistent; and no such study has been conducted in an ethnic Chinese population. The aim of the present paper was therefore to examine the validity of attention tasks in distinguishing the ADHD-combined type (ADHD-C) from the ADHD-inattention type (ADHD-I), as compared to children without ADHD in Taiwan. Participants included 52 children with ADHD-C, 17 with ADHD-I, and 52 controls, aged 7-10 years. The clinical diagnosis of DSM-IV ADHD was further confirmed by a standardized psychiatric interview. Four attention components were examined: sensory selection, response selection, capacity/focus, and sustained attention, using the Cancellation Test, Digit Span, Trail-Making Test (TMT), Continuous Performance Test (CPT), and Circle-Tracing Test. Behaviour symptoms were rated by the parents, teachers, and investigators. Compared to children without ADHD, children with ADHD scored significantly higher in parent-reported and investigator-rated behavioural symptoms, and performed worse in the four domains of attention. Multiple comparisons indicated that children with ADHD-C had a worse performance on most tests than children with ADHD-I, except that children with ADHD-I had more off-target errors on the TMT with alphanumeric sequencing than children with ADHD-C. Attention tests can distinguish Taiwanese children with ADHD from those without ADHD, and these tests also demonstrate different profiles between the ADHD-C and ADHD-I groups. Further investigation on this topic should include the ADHD-hyperactivity-impulsivity subtype (ADHD-HI) and increase sample sizes of the children with ADHD-I and ADHD-HI.

Parental and Family Factors for Attention-deficit Hyperactivity Disorder in Taiwanese Children

The present study aimed to examine the association between attention-deficit-hyperactivity disorder (ADHD) and maternal psychological distress, parenting style and perceived family support, and the child's interaction with parents and behavioural problems at home in Taiwan. The sample included 375 medicated pediatric patients with DSM-IV ADHD, and 750 school controls selected based on the age and gender structures of the ADHD group. Mothers reported on the Chinese Health Questionnaire, the Chinese versions of the Parental Bonding Instrument, the Family Adaptation, Partnership, Growth, Affection, and Resolve, and the Home Behaviours of the Social Adjustment Inventory for Children and Adolescents. Mothers of children with ADHD reported greater psychological distress and perceived less support from their families than did mothers of controls. Moreover, mothers of children with ADHD were less affectionate and more overprotective and controlling toward their children than were mothers of controls. This difference was more apparent in boys than in girls. Children with ADHD were less likely to interact with their parents, yet demonstrated more severe behavioural problems at home. Although the Taiwanese children with ADHD were under treatment with methylphenidate, they and their families still encountered a variety of difficulties in interaction, support, and communication with each other. Therefore, the parental approach should be integrated into the medication treatment for ADHD in Taiwan.

A Randomized, Double-Blind, Placebo-Controlled Clinical Trial on Once-Daily Atomoxetine Hydrochloride in Taiwanese Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

The aim of this study was to assess the efficacy and safety of the once-daily atomoxetine compared with placebo in pediatric patients with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. The study sample included 106 patients aged 6-16 years who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria of ADHD randomly assigned to atomoxetine once daily (n = 72) and placebo once daily (n = 34) in a double-blind, 6-week treatment study. The primary efficacy measure was the total score of the ADHD Rating Scale-IV Parents Version: Investigator Administered and Scored. The secondary efficacy measures included the Clinical Global Impressions--ADHD--Severity and Chinese Conner's Parent and Teacher Rating Scale--Revised: Short Form. Data were analyzed on an intent-to-treat basis and a last-observation-carried-forward approach. The two treatment groups did not differ in demographics and baseline measures. Compared to the placebo group, the atomoxetine group showed significantly greater reductions in ADHD-related symptoms according to the ratings of investigators, parents, and teachers. The treatment effect size of the primary efficacy measure was 0.70 at the end of study. Adverse events reported significantly more frequently with atomoxetine were decreased appetite (36.1%) and nausea (16.6%). No drug-related serious adverse event was observed. Once-daily atomoxetine is an effective, well-tolerable, and safe treatment for children and adolescents with ADHD in Taiwan.

Dietary patterns and blood fatty acid composition in children with attention-deficit hyperactivity disorder in Taiwan

Nutritional factors may be relative to attention-deficit hyperactive disorder (ADHD), although the pathogenic mechanism is still unknown. Based on the work of others, we hypothesized that children with ADHD have altered dietary patterns and fatty acid metabolism. Therefore, the aim of this study was to evaluate dietary patterns and the blood fatty acid composition in children with ADHD in the Taipei area of Taiwan. The present study found that 58 subjects with ADHD (average age 8.5 years) had significantly higher intakes of iron and vitamin C compared to those of 52 control subjects (average age 7.9 years) ( P < 0.05). The blood total protein content in subjects with ADHD was significantly lower than that in control subjects ( P < 0.05). On the other hand, children with ADHD had significantly higher blood iron levels compared to the control children ( P < 0.05). Additionally, plasma γ-linolenic acid (18:3 n-6) in children with ADHD was higher than that in control children ( P < 0.05). Concerning the composition of other fatty acids in the phospholipid isolated from red blood cell (RBC) membranes, oleic acid (18:1n-9) was significantly higher, whereas nervonic acid (24:1n-9), linoleic acid (18:2n-6), arachidonic acid (20:4n-6), and docosahexaenoic acid (22:6n-3) were significantly lower in subjects with ADHD ( P < 0.05). Our results suggest that there were no differences in dietary patterns of these children with ADHD except for the intake of iron and vitamin C; however, the fatty acid composition of phospholipid from RBC membranes in the ADHD children differed from that of the normal children.