Criteria For Attention Deficit Hyperactivity Disorder Research Articles

Low perceived social support in mothers during pregnancy and early childhood; associations with anxiety and ADHD symptoms in children at 3 and 8 years.

Low perceived social support is associated with adverse effects on maternal mental health, and often coexists with other risk factors for offspring anxiety and attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate whether low maternal social support during pregnancy and early childhood predicted anxiety and ADHD symptoms in children at ages 3.5 and 8 years. This study is part of the longitudinal, population-based Norwegian Mother, Father, and Child Cohort Study. Mothers were queried about perceived social support twice during pregnancy, and again at child ages 18 months and 3 years. They were interviewed about their children's symptoms of anxiety and ADHD at 3.5 years. At 8 years (n = 781), the Child Symptom Inventory-4 was used to identify children who fulfilled the criteria for anxiety disorders and ADHD. Logistic regression models estimated the risk of child anxiety and ADHD, depending on maternal social support. Low maternal social support predicted child anxiety symptoms at both ages 3.5 and 8 years as well as ADHD symptoms at 8 years. When including other maternal stressors and child risk factors, low maternal social support remained a significant predictor for child anxiety symptoms at 3.5 years, and there was a trend towards also predicting child anxiety and ADHD symptoms at 8 years. The associations between low maternal social support and child symptoms of anxiety and ADHD found in the present study, suggest that focusing on mothers with low social support may hold significance for child symptoms years later.

Pediatric cognitive reserve moderates the effect of brain structure in attention-deficit/hyperactivity disorder: Evidence for an optimized residual approach.

To validate a residual-based cognitive reserve (CR) index optimized for a pediatric sample with attention-deficit/hyperactivity disorder (ADHD). Participants were N = 115 children aged 9.5-13 years at baseline (Mage = 10.48 years, SDage = 0.61), and n = 43 (37.4%) met criteria for ADHD. Elastic-net regularized linear regression was used to generate baseline and longitudinal CR indices by maximally residualizing variance in fluid intelligence for demographics and brain structure. Academic and diagnostic outcomes were regressed onto CR indices, and interactions with brain integrity were assessed. Baseline CR predicted baseline math computation (estimate = 0.10, SE = 0.02, p < .001), while change in CR predicted change in word reading ability (estimate = 0.08, SE = 0.02, p < .001). Further, when grey matter volume tended to be lower, higher CR was associated with higher word reading score (estimate = -0.05, SE = 0.02, p = .019) and lower ADHD symptom severity (estimate = 0.04, SE = 0.02, p = .047) compared to lower CR, at baseline. Similarly, when longitudinal change in white matter hypointensity volume tended to be greater, higher change in CR resulted in more favorable word reading trajectory (estimate = 0.03, SE = 0.02, p = .048). A data-driven residual approach to operationalizing pediatric CR shows better evidence of construct validity over previous methods, with our index showing a novel ability to moderate the deleterious effects of lower grey matter on outcomes in ADHD. This approach may benefit future research aiming to study the early development of CR. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Effect of Levetiracetam and Valproic Acid Treatment on Anger and Attention Deficit Hyperactivity Disorder Clinical Features in Children and Adolescents with Epilepsy: A Prospective Study.

Antiseizure medications (ASMs) can potentially trigger psychobehavioral adverse events associated with the onset or exacerbation of psychiatric symptoms such as irritability, aggression, and hyperactivity. The objective of this study was to evaluate the effects of levetiracetam and valproic acid on changes in clinical features of anger, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). The purpose was to furnish guidance on rational drug selection in children and adolescents with epilepsy to minimize psychiatric comorbidity in the treatment of epilepsy. This was a prospective, observational, cohort study involving treatment-naïve children aged 7-18 years with newly diagnosed generalized or focal epilepsy who were prescribed levetiracetam or valproic acid as monotherapy for a 6-month period and regularly followed up. Psychiatric assessment was conducted at the time of the new epilepsy diagnosis and at the six-month follow-up. These assessments were performed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children Current and Lifetime Version (DSM-5), a structured psychiatric interview, as well as the State-Trait Anger Expression Style Inventory and Turgay DSM-IV Based Disruptive Behaviour Disorders Screening and Rating Scale. Anger subscores, ADHD symptoms, change in diagnosis, focal and generalized epilepsy groups, continuous seizures and seizure-free periods before and 6 months after treatment with valproic acid and levetiracetam were compared. A total of 50 children, 25 in the valproic acid group and 25 in the levetiracetam group, with a mean age of 11.92 ± 3.08 years, were included in the study. There was a statistically significant increase in the ADHD subscale score post-treatment among patients receiving levetiracetam (p = 0.045) and valproic acid (p = 0.034) compared with pre-treatment. The change in both anger-in and anger-out expression scores with treatment was significantly higher in patients receiving levetiracetam (p = 0.035) compared with those receiving valproic acid (p = 0.026). Statistically, there was a significant difference in the diagnostic criteria of the levetiracetam group pre- and post-treatment (p = 0.026). The proportion of patients in whom the diagnostic criteria for ADHD+ODD were fulfilled increased from 16% before treatment to 48% after treatment, a statistically significant increase (p = 0.026). This study found an increase in internalized anger features and ADHD symptom severity in children with epilepsy treated with valproic acid and levetiracetam. In those prescribed levetiracetam, there was a statistically significant rise in the proportion meeting the diagnostic criteria for ADHD + ODD. Our research is one of the first to prospectively examine the psychiatric assessment of children diagnosed with epilepsy. The remarkable results demonstrate changes in psychiatric diagnoses associated with the treatment of levetiracetam and valproic acid. Furthermore, a considerable rise in ADHD symptoms was observed in those treated with valproic acid.

Examine the Effects of Atomoxtine Alone Versus Atomoxtine Combined with Risperidone at Sample of Egyptian Children Suffering from ADHD.

Background: An estimated 7% of elementary school children suffer from Attention Deficit Hyperactivity Disorder (ADHD), a mental neuro-developmental condition marked by impulsivity, hyperactivity, and lack of attention. Atomoxetine is one of the most important medications for ADHD however Risperidone has been used as a label for the treatment of ADHD. Aim: To study the Efficacy of Atomoxetine alone vs. Atomoxtine with Antipsychotic (Risperidone) in ADHD children. Subjects and Methods: 54 Egyptian children with ADHD, ranging in age from 6 to 18. They meet the DSM-IV criteria for ADHD and have been receiving therapy at Al Hussian Hospital's psychiatry clinic. Conner's 2 scale was used to evaluate each patient for ADHD. Between January and June of 2024, a study was carried out on all children receiving therapy for all forms of ADHD using either Atomoxetine alone or in combination with an antipsychotic (Risperidone). Results: When Atomoxetine was administered to 27 children, it demonstrated a moderate level of efficacy in 12 of 27 patients (44.4%) for all children with ADHD, regardless of type, but it significantly improved the inattention type of ADHD in 4 from 4 patients (100%). Given to 27 children, the combination of Atomoxetine and Risperidone demonstrated a greater effect on 24 of 27 patients with (88.9%) for all ADHD children, and it showed a discernible improvement on 9 out of 9 with (100%) for ADHD hyperactivity type. Conclusion: Patients with Attention deficit variant responded well to Atomoxetine., Patients with attentiondeficit/hyperactivity variant responded well to Atomoxetine/Antipsychotic (Risperidone) combination., Patients with Hyperactivity variants show good responses to Antipsychotics (Risperidone)., All types of ADHD are responsive to Atomoxetine or Atomoxetine / Antipsychotic (Risperidone) combination, But the Atomoxetine effect is more on the Attention deficit variant than other variants, while Antipsychotic (Risperidone) is more effective on hyperactivity and aggression.

Attachment Styles and Parenting Attitudes in Adults With "Pseudo-Attention-Deficit/Hyperactivity Disorder".

Background The number of individuals who experience the onset of attention-deficit/hyperactivity disorder (ADHD)-like symptoms after the age of 12 years has been growing, which does not meet the diagnostic criteria for adult ADHD. We designated this condition as "pseudo-ADHD" and investigated its psychological implications by comparing the parenting attitudes in childhood and attachment styles among individuals with "pseudo-ADHD," those with adult ADHD, and healthy controls. Methods We conducted an online cross-sectional survey of adults aged 18 years. Participants in the analysis included individuals with "pseudo-ADHD" (n = 46), adults with ADHD (n = 23), and healthy controls (n = 758). The Parental Bonding Instrument (PBI) was used to evaluate parenting attitudes, and the Experiences in Close Relationships Inventory for the Generalized Other (ECR-GO) was used to evaluate attachment styles. One-way analysis of variance was performed to compare the PBI and ECR-GO scores among the three groups. Results Regarding the PBI scores, a significant main effect of group was found for the paternal care scores (p = 0.002), and the "pseudo-ADHD" group did not differ significantly from the adult ADHD group or healthy control group (p = 0.378, p = 0.228, respectively). A significant main effect of the group was found for the maternal care scores (p < 0.001). The "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p = 0.005), whereas there was no significant difference compared to the healthy control group (p = 1.000). A significant main effect of the group was also found for the paternal overprotection scores (p < 0.001). The "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p = 0.002), whereas there was no significant difference compared to the healthy control group (p = 0.571). A significant main effect of group was found for the maternal overprotection scores (p < 0.001), and the "pseudo-ADHD" group did not differ significantly from either the adult ADHD group or the healthy control group (p = 0.060, p = 0.161, respectively). Regarding ECR-GO scores, a significant main effect of group was found for the fear of abandonment score (p < 0.001), and the "pseudo-ADHD" group scored significantly lower than the adult ADHD group (p < 0.001) and significantly higher than the healthy control group (p = 0.005). Conclusion This study suggested that the parenting attitudes of parents of individuals with "pseudo-ADHD" were not different from those of the healthy controls. For attachment styles, the fear of abandonment was higher in individuals with "pseudo-ADHD" than in healthy controls, but not as high as in patients with adult ADHD. This study highlights, for the first time, the importance of considering attachment styles in the diagnosis and treatment of individuals with ADHD symptoms in adulthood.

O PARADOXO DO SOBREDIAGNÓSTICO DO TDAH E SUAS CONSEQUÊNCIAS

Attention Deficit Hyperactivity Disorder (ADHD) is defined as a psychomotor developmental disorder that is characterized by a persistent pattern of inattention and/or hyperactivity and/or impulsivity. Currently, it is observed that discrete signs of psychological distress tend to be classified as pathological, initiating the early use of psychotropic drugs. In this sense, given that the increase in medicalization becomes alarming in adults, the scenario becomes even more serious in the children’s situation, in view of the child’s motor and neuropsychic immaturity. The present study aims to analyze and discuss the increase in the diagnosis of ADHD in the last decade and the consequent hypermedicalization of children. The methodology used was a literature review of a quantitative nature, through searches in PubMed, Scielo and Google Scholar, with publication date from 2010. Regarding the results, it was observed: increase in overdiagnosis and overmedicalization in around 25% of the evaluated studies; approximately 40% of the articles highlighted the importance of carrying out training projects for health professionals to make more accurate diagnoses and more effective treatments; around 25% of the articles concluded that methylphenidate, from the amphetamine group, has benefits and that it increases quality of life, even though it has side effects. Finally, it is concluded that it is necessary to analyze and propose training strategies for health professionals, in addition to implementing a more efficient multidisciplinary work together with family educators, in order to assess the real need for the diagnosis, performing it in a more efficient way. efficient and avoid unnecessary medicalization of children and adolescents who do not fit the ideal diagnostic criteria for ADHD.

Retrospective assessment of ICD-10/DSM-5 criteria of childhood ADHD from descriptions of academic and social behaviors in German primary school reports.

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adolescence and adulthood is particularly challenging because retrospective confirmation of previous childhood ADHD is mandatory. Therefore, collecting valid diagnostic information about behavior at school is important. Primary school reports often contain descriptions of academic performance and social behaviors associated with ADHD criteria. Yet, there is no systematic approach available how to assess such reports quantitatively, and therefore, there is also no study on how valid such an approach could predict an ADHD diagnosis. We examined primary school reports from Germany (ADHD: n = 1197, typically developing controls: n = 656) for semantic references to ICD-10/DSM-5 main and sub-criteria of ADHD. Descriptions were assessed on a quantitative scale (blinded clinical expert rating) for disorder-associated behaviors (symptoms scale) as well as for desired, adaptive behaviors (competencies scale) according to these criteria. The scores of these developed scales have been summarized to summary scores. Scores were analyzed using linear mixed models, and sensitivity and specificity were estimated using receiver operating characteristics (ROC). Ratings showed highly significant differences between school reports of children with and without ADHD. For the summary scores, both symptoms and competencies scales showed high diagnostic accuracy (ROC area under the curve at least 0.96) with best discrimination when combining both into an integrated index (sensitivity and specificity > 0.97). Our findings suggest that systematic quantitative analysis of primary school reports should be further explored to construct a valid instrument for retrospective assessment of childhood ADHD criteria to aid the diagnostic process in adolescents and adults.

Comorbid ADHD and Pediatric Sickle Cell Disease: Prevalence and Risk Factors.

Sickle cell disease (SCD) is a genetic blood condition that places youth at increased risk for deficits in complex attention suggestive of increased risk for Attention-Deficit/Hyperactivity Disorder (ADHD). We used systematic screening to assess the prevalence of ADHD in a clinic-based sample of youth with SCD and explored factors related to ADHD. Caregivers of 107 children with SCD (ages 7-11years) completed routine psychosocial screening which included inattentive symptoms of ADHD. Follow-up diagnostic procedures were completed for patients with elevated inattentive symptoms to assess for ADHD diagnoses. Biomedical and social-environmental variables were examined from the screening and medical records. Twenty-six percent of patients showed elevated inattentive symptoms with 13% meeting diagnostic criteria for ADHD diagnoses. Most children (75%) who met criteria for ADHD had not been previously diagnosed. Disease severity did not predict inattentive symptoms or ADHD diagnoses, though a measure of chronic inflammation was associated with ADHD. Family functioning was related to elevated inattentive symptoms but not ADHD diagnoses. Children with SCD show relatively high rates of ADHD with many cases not detected through routine care. Screening for ADHD as part of hematology care may be a feasible strategy to improve identification and access to intervention.

Distinct attentional and executive profiles in neurofibromatosis type 1: Is there difference with primary attention deficit-hyperactivity disorder?

PurposeAttentional and executive dysfunctions are the most frequent cognitive disorders in neurofibromatosis type 1 (NF1), with a high prevalence of attention deficit-hyperactivity disorder (ADHD). We (i) compared attentional profiles between NF1 children with and without ADHD and children with primary ADHD criteria and (ii) investigated the possible relationship between attentional disorders and “unidentified bright objects” (UBOs) in NF1. MethodsThis retrospective study included 47 NF1 children, 25 with ADHD criteria (NF1+adhd group), matched for age, sex, and cognitive level with 47 children with primary ADHD (ADHD group). We collected computer task (sustained-attention, visuomotor-decision, inhibition, and cognitive-flexibility tasks) scores normalized for age and sex, and brain magnetic resonance imaging data. Results(i) Working memory was impaired in all groups. (ii) Omissions (p < 0.002) and response-time variability (p < 0.05) in sustained-attention and visuomotor-decision tasks and errors (p < 0.02) in the cognitive-flexibility task were lower for the NFI+adhd and ADHD groups than for the NF1-no-adhd group. (iii) The NF1+adhd group had slower response times (p ≤ 0.02) for inhibition and visuomotor-decision tasks than the other groups. (iv) We found no relevant association between cognitive performance and UBOs. ConclusionsNF1 children with ADHD have an attentional and executive functions deficit profile similar to that of children with primary ADHD, but with a slower response-time, increasing learning difficulties. The atypical connectivity of fronto-striatal pathways, poorer dopamine homeostasis, and increased GABA inhibition observed in NF1 renders vulnerable the development of the widely distributed neural networks that support attentional, working-memory, and executive functions.

Are the concepts of "chronic mania" in German-speaking psychiatry around 1900 early contributions to the disorder of the adult form of attention deficit hyperactivity disorder (ADHD)?

The adult form of attention deficit hyperactivity disorder (ADHD) has increasingly become afocus of adult psychiatry. Despite long-established diagnostic criteria and specific therapeutic approaches for the disorder, the common misconception that ADHD is a"fad" has persisted. Examining the history of psychiatry can make an educational contribution by showing that the adult form of ADHD is a continuously existing illness phenomenon. The present study examines the discussion of sometimes prominent authors about "chronic mania" in German-speaking psychiatry around 1900. The individual concepts were analyzed for their content and compared with each other and with modern diagnostic manuals for adult ADHD. The aim of this work is to question and discuss whether these "chronic-manic concepts" are part of the conceptual history of adult ADHD and whether agap in the history of this disorder can be filled with their help. It is concluded that in the early twentieth century neurologists reported and discussed about patients who nowadays would almost certainly receive the diagnosis of ADHD. The psychiatrists had difficulty in classifying this disorder into their nosological schemes but their "chronic-manic concepts" show clear parallels to the current diagnostic criteria for adult ADHD and its symptoms.

A Digital Cognitive-Physical Intervention for Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Pharmacotherapy has been the primary treatment for ADHD, supplemented by behavioral interventions. Digital and exercise interventions are promising nonpharmacologic approaches for enhancing the physical and psychological health of children with ADHD. However, the combined impact of digital and exercise therapies remains unclear. The aim of this study was to determine whether BrainFit, a novel digital intervention combining gamified cognitive and exercise training, is efficacious in reducing ADHD symptoms and executive function (EF) among school-aged children with ADHD. This 4-week prospective randomized controlled trial included 90 children (6-12 years old) who visited the ADHD outpatient clinic and met the diagnostic criteria for ADHD. The participants were randomized (1:1) to the BrainFit intervention (n=44) or a waitlist control (n=46) between March and August 2022. The intervention consisted of 12 30-minute sessions delivered on an iPad over 4 weeks with 3 sessions per week (Monday, Wednesday, and Friday after school) under the supervision of trained staff. The primary outcomes were parent-rated symptoms of attention and hyperactivity assessed according to the Swanson, Nolan, and Pelham questionnaire (SNAP-IV) rating scale and EF skills assessed by the Behavior Rating Inventory of Executive Function (BRIEF) scale, evaluated pre and post intervention. Intention-to-treat analysis was performed on 80 children after attrition. A nonparametric resampling-based permutation test was used for hypothesis testing of intervention effects. Among the 145 children who met the inclusion criteria, 90 consented and were randomized; ultimately, 80 (88.9%) children completed the study and were included in the analysis. The participants' average age was 8.4 (SD 1.3) years, including 63 (78.8%) male participants. The most common ADHD subtype was hyperactive/impulsive (54/80, 68%) and 23 (29%) children had severe symptoms. At the endpoint of the study, the BrainFit intervention group had a significantly larger improvement in total ADHD symptoms (SNAP-IV total score) as compared to those in the control group (β=-12.203, 95% CI -17.882 to -6.523; P<.001), owing to lower scores on the subscales Inattention (β=-3.966, 95% CI -6.285 to -1.647; P<.001), Hyperactivity/Impulsivity (β=-5.735, 95% CI -8.334 to -3.137; P<.001), and Oppositional Defiant Disorder (β=-2.995, 95% CI -4.857 to -1.132; P=.002). The intervention was associated with significant reduction in the Metacognition Index (β=-6.312, 95% CI -10.973 to -1.650; P=.006) and Global Executive Composite (β=-5.952, 95% CI -10.214 to -1.690; P=.003) on the BRIEF. No severe intervention-related adverse events were reported. This novel digital cognitive-physical intervention was efficacious in school-age children with ADHD. A larger multicenter effectiveness trial with longer follow-up is warranted to confirm these findings and to assess the durability of treatment effects. Chinese Clinical Trial Register ChiCTR2300070521; https://www.chictr.org.cn/showproj.html?proj=177806.

Autism and attention-deficit/hyperactivity disorder in children with Dravet syndrome: A population-based study.

To identify on a population basis the prevalence of autism and attention-deficit/hyperactivity disorder (ADHD) in children with Dravet syndrome and factors associated with symptoms of autism and ADHD. Forty-one of 48 children with Dravet syndrome living in Sweden, born between 1st January 2000 and 31st December 2018 underwent assessment including measures of autism and ADHD. Diagnoses of autism and ADHD were made with respect to DSM-5 criteria. Factors associated with features of autism and ADHD were analysed via regression. Twenty-five of the 41 children fulfilled DSM-5 criteria for autism spectrum disorder and 12 of 37 children considered for an ADHD diagnosis fulfilled DSM-5 criteria for ADHD. Severe intellectual disability was significantly associated with a greater degree of autistic features (p < 0.001) and a DSM-5 diagnosis of autism spectrum disorder (p = 0.029). Younger children had significantly more features of ADHD (p = 0.004) and features of inattention were significantly more common than features of hyperactivity/impulsivity (p < 0.001). Children with Dravet syndrome often have significant features of autism and ADHD, primarily inattentive type. Screening for autism and ADHD should be routine in children with Dravet syndrome. In total, 25 of 41 assessed children with Dravet syndrome fulfilled DSM-5 criteria for autism. Twelve of 37 assessed children with Dravet Syndrome met DSM-5 criteria for attention-deficit/hyperactivity disorder (ADHD). Severe intellectual disability was significantly associated with a greater degree of autism spectrum disorder features. Younger children had significantly more features of ADHD.

Identifying Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD): a Public Health Concern and Opportunity.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. inJournal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23,2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitskoet al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.

Intersectionality in Neurodevelopmental Disorders: A Literature Review on Co-Occurrence of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder – Examining Therapeutic Approaches and Interventions

Purpose: To examine the intersectionality between autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), focusing on the latest research into their co-occurrence, potential shared mechanisms, and implications for diagnosis and treatment.&#x0D; Methodology: A comprehensive literature search was conducted, focusing on studies published within the last 3-4 years on the comorbidity and intersection of traits between ASD and ADHD.&#x0D; Findings: Results reveal high rates of co-occurrence, with 30-80% of individuals with ASD also meeting criteria for ADHD. There appear to be shared genetic, environmental, cognitive, and neural mechanisms contributing to both disorders, potentially explaining this overlap. Despite the frequent co-occurrence, ASD and ADHD present distinct symptom profiles and behavioural challenges.&#x0D; Unique Contribution to Theory, Practice, and Policy: Cognitive-behavioural therapy, social skills training, parental training programs, and stimulant medications are supported as evidence-based approaches for treating both ASD and ADHD. Targeting common mechanisms through combined treatment plans shows promise for improving outcomes. However, more research is needed to develop integrated, personalized treatment models tailored to the specific needs of this substantial subgroup of patients with neurodevelopmental disorders. The intersection between ASD and ADHD traits warrants deeper investigation to better characterize overlapping and disorder-specific phenotypes, guiding targeted treatments.

The Impact of Integrating a Low-Lectin Diet with Traditional ADHD Treatments on Gut Microbiota Composition and Symptom Improvement in Children - A Cohort Study.

This study aimed to investigate the impact of implementing a low-lectin diet on gut microbiota composition and symptom amelioration in pediatric patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). A total of 58 children (ages 7-15 years), meeting the criteria for ADHD were recruited. In addition to standard medication treatment, participants in the experimental group with a low-lectin diet, while those in the control group received standard medication treatment alone. Clinical outcomes were assessed through evaluations conducted by physicians and teachers, implementation of the Conners Parent Rating Scales, and analysis of gut microbiota composition. The results revealed significant improvements in symptom reduction and attention allocation rate within the experimental group, surpassing those observed in the control group. Specifically, the experimental group exhibited lower physician ratings, teacher ratings, and attention allocation rate compared to the control group. Moreover, analysis of gut microbiota composition identified notable distinctions between the two groups. These findings provide compelling evidence and valuable guidance supporting the integration of a low-lectin diet as an adjunctive intervention for managing ADHD.

Serum levels of glucose, thyroid stimulating hormone, and free thyroxine in boys diagnosed with attention deficit hyperactivity disorder: a cross-sectional pilot study

BackgroundAlthough attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, its aetiology remains unclear. We aimed to establish a relationship between ADHD diagnosis and serum levels of glucose, free thyroxine (FT4), and thyroid stimulating hormone (TSH) in primary school aged boys.MethodsIn a cross-sectional study, we enrolled 133 participants aged 6.5–12.5 years, 67 of whom met DSM-5 criteria for ADHD and 66 healthy age-matched boys. The ADHDT test (ADHDT) was used to assess ADHD symptoms and the Wechsler Intelligence Scale for Children – Revised was used to exclude participants with cognitive deficits. The ADHD participants were tested using the Iowa Conners’ Teacher Rating Scale.ResultsThe ADHD participants had lower glucose levels, higher TSH values, and significantly lower FT4 values than the control group. The multiple logistic regression analysis showed that TSH is a parameter that is 2.7% more likely to occur in the ADHD group. We found a significant correlation between the TSH level and the symptoms of hyperactivity (r = 0.318, p = 0.009) and impulsivity (r = 0.275, p = 0.024) as well as between the glucose level and the symptoms of hyperactivity (r = 0.312, p = 0.010).ConclusionsCertain ADHD symptoms may correlate with certain hormonal patterns. Our results suggest that the likelihood of suffering from ADHD was lower when FT4 levels were elevated. One biochemical parameter that was significantly and independently associated with the diagnosis of ADHD was the serum TSH level.Trial registrationOn June 26, 2018, at its VI session in 2018, the Ethics Committee of the Institute for Mental Health in Belgrade, Serbia, has considered and unanimously approved the conduct of the research, under the number 1704/1.

Increased risk of attention-deficit/hyperactivity disorder in adolescents with high salivary levels of copper, manganese, and zinc

Exposure to toxic heavy metals has been associated with the development of attention-deficit/hyperactivity disorder (ADHD). However, fewer studies have examined the associations between abnormal levels of essential trace metals and ADHD, and none have done so using saliva. We investigated whether salivary metals were associated with ADHD in adolescents aged 12 from the Family Life Project (FLP) using a nested case–control study design that included 110 adolescents who met diagnostic criteria for inattentive (ADHD-I), hyperactive-impulsive (ADHD-H), or combined type ADHD (ADHD-C) (cases) and 173 children who did not (controls). We used inductively coupled plasma optical emission spectrophotometry to measure chromium, copper, manganese, and zinc in saliva samples. We employed logistic regression models to examine associations between quartile levels of individual metals and ADHD outcomes by subtype. Salivary copper levels were significantly associated with increased odds of any ADHD diagnosis (OR = 3.31, 95% CI: 1.08–10.12; p = 0.04) and with increased odds of ADHD-C diagnosis (OR = 8.44, 95% CI: 1.58–45.12; p = 0.01). Salivary zinc levels were significantly associated with increased odds of ADHD-C diagnosis (OR = 4.06, 95% CI: 1.21–13.69; p = 0.02). Salivary manganese levels were also significantly associated with increased odds of ADHD-C diagnosis (OR = 5.43, 95% CI: 1.08–27.27, p = 0.04). This is the first study using saliva to assess metal exposure and provide a potential link between salivary levels of copper, manganese, and zinc and ADHD diagnoses in adolescents. Public health interventions focused on metal exposures might reduce ADHD incidence in low-income, minority communities.

Gray matter correlates of attention-deficit hyperactivity disorder in boys versus girls with sensory processing dysfunction

Abstract Neuroimaging shows volumetric alterations of gray matter in attention-deficit hyperactivity disorder (ADHD); however, results are conflicting. This may be due to heterogeneous phenotypic sampling and limited sensitivity of volumetric analysis. Creating more homogenous cohorts and investigating gray matter microstructure may yield meaningful biomarkers for scientific and clinical applications. Children with sensory processing dysfunction (SPD) have differences in white matter microstructure, but not gray matter volumetric differences. Approximately 40% of SPD children meet research criteria for ADHD. We apply deep learning segmentation of MRI to measure gray matter volume (GMV) and density (GMD) in SPD children with (SPD+ADHD) and without co-morbid ADHD (SPD-ADHD). We hypothesize GMV and GMD are linked to ADHD but with sex-specific regional patterns. We find boys with SPD+ADHD have widespread reduction of GMD in neocortex, limbic cortex, and cerebellum versus boys with SPD-ADHD. The greatest differences are in sensory cortex with less involvement of prefrontal regions associated with attention networks and impulse control. In contrast, changes of ADHD in girls with SPD are in brainstem nuclei responsible for dopaminergic, noradrenergic, and serotonergic neurotransmission. Hence, neural correlates of ADHD in SPD are sexually dimorphic. In boys, ADHD may result from downstream effects of abnormal sensory cortical development.

Arousal dysregulation and executive dysfunction in attention deficit hyperactivity disorder (ADHD).

Attention deficit/hyperactivity disorder (ADHD) is a heterogeneous neurodevelopmental condition, that continues to have an elusive etiological background. A number of extant models and theories have historically intended to explain the many factors contributing to ADHD behaviors. One of the most accepted hypotheses has been the executive dysfunction theory associating reduction in executive control to abnormalities in structure and operational dysfunction of dopaminergic signaling networks. Nevertheless, executive functions are not always impaired in ADHD, and the literature describes other symptoms commonly reported suggesting individuals with ADHD would appear to suffer from a more general deficit. Another existing line of research, that has gained much attention recently, establishes that ADHD would have dysregulated states of brain arousal that would account for its commonly observed cognitive deficits and behavioral symptoms, described as the state regulation theory, which has now included measures of autonomic function. This article describes some important aspects that compose and challenge these two most influential theoretical constructs, executive dysfunction and state-regulation, based on their empirical evidence, implying the need to reevaluate the norms used to classify individuals and establish ADHD diagnosis. Large number of controversial results continue to exist within the study of ADHD biological and/or performance markers, possibly due to such heterogeneity and variability within the same diagnosis. The need to resolve these issues and establish newly revised diagnostic criteria for ADHD is critical, as therapeutic success depends on having accurately identified underlying neurophysiological factors in order to appropriately address them in treatment.

Network structure of symptomatology of adult attention-deficit hyperactivity disorder in patients with mood disorders.

Patients with mood disorders commonly manifest comorbid psychiatric disorders, including attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated ADHD symptoms in this population. The current study aimed to explore the network structure of ADHD symptomology and identify central symptoms in patients with mood disorders. The Korean version of the Adult ADHD Self-Report Scale was used to assess the overall ADHD symptoms in 1,086 individuals diagnosed with mood disorders (major depressive disorder [n = 373], bipolar I disorder [n = 314], and bipolar II disorder [n = 399]). We used exploratory graph analysisto detect the number ofcommunities, and the network structure was analyzed using regularized partial correlation models. We identified the central ADHD symptom using centrality indices. Network comparison tests were conducted with different subgroups of patients with mood disorders, including three mood diagnosis groups, between the patients who met the diagnostic criteria for ADHD [ADHD-suspected, n = 259] in their self-report and the others [ADHD-non-suspected, n = 827], and groups with high [n = 503] versus low [n = 252] levels of depressive state. The network analysis detected four communities: disorganization, agitation/restlessness, hyperactivity/impulsivity, and inattention. The centrality indices indicated that "feeling restless" was the core ADHD symptom. The result was replicated in the subgroup analyses within our clinically diverse population of mood disorders, encompassing three presentations: Patients with suspected ADHD, patients without suspected ADHD, and patients with a high depressive state. Our findings reveal that "feeling restless" is the central ADHD symptom. The treatment intervention for "feeling restless" may thus play a pivotal role in tackling ADHD symptoms in adult patients with mood disorders.