Deficit Hyperactivity Disorder Research Articles

Transtorno do Déficit de Atenção com Hiperatividade (TDAH): desafios e possibilidades frente a sala de aula

O presente estudo aborda o Transtorno de Déficit de Atenção e Hiperatividade (TDAH) transtorno este, característico por influenciar diretamente no comportamento dos alunos e, consequentemente no processo ensino-aprendizagem, podendo gerar conflitos pessoais, familiares e escolares. Esta pesquisa teve como justificativa a busca por conhecimentos sobre o TDAH. O objetivo geral deste estudo foi conhecer e caracterizar TDAH, compreendendo os principais desafios e as possibilidades de atuação pedagógica. A metodologia utilizada foi à revisão bibliográfica. Discutimos neste estudo que este transtorno vem sendo cada vez mais frequente em alunos nas séries iniciais, que inicialmente apresentam características como falta de atenção e concentração, inquietação, comportamentos, estes, que refletem na vida escolar e social do aluno. Vimos que o trabalho do professor, junto à família, outros profissionais, e, em alguns casos associado à medicação prescrita por um profissional especializado é essencial à aprendizagem do aluno, a fim de que, o mesmo possa ter melhor desempenho nas atividades acadêmicas e em sua vida pessoal. Concluímos que a atuação pedagógica especializada frente as crianças que apresentam o TDAH se torna essencial, mas para isso é necessário que o professor adquira conhecimentos sobre este transtorno e saiba da importância de sua mediação no processo de ensino e aprendizagem deste aluno, proporcionando um atendimento educacional diferenciado e um trabalho voltado para atender as suas especificidades, visando minimizar as suas dificuldades.

Predictors Of Concussive Recovery In Adolescents

Concussions in adolescents are a public health concern with the growing popularity of high school sports. State legislation mandates that athletes who are suspected of having a concussion be cleared by a clinician to return-to-play. More research is needed to identify populations at risk for protracted recovery. PURPOSE: The aim of this study was to identify clinical (e.g., concussion history, migraine history, learning disabilities/attention deficit hyperactivity disorders [ADHD]) and demographic factors (e.g., age, sex, race/ethnicity, health insurance status, mechanism of injury/sport, education) that predict concussion recovery times. METHODS: In a retrospective cohort study of adolescents, 13 to 19 years old, evaluated for an acute concussion (≤ 10 days from injury) at a university-based concussion clinic, recovery times were calculated from the date of concussive injury to the date of clearance to return-to-play and/or normal activities. The healthcare provider determined recovery based on physical examination, symptom reporting by the patient, parent, and/or athletic trainer, ImPACT computerized battery performance compared with norms and/or baseline scores (when available), and academic performance. A Cox proportional hazards model was used to identify predictors of concussion recovery times. RESULTS: There were 227 charts that met inclusion criteria. There were no differences in distributions of age and sex. The sample (N = 227) was primarily male (75%), and the median age was 15 years. Ethnic minorities (blacks and Hispanics) constituted 46% of the sample. The median time to recovery was 16 days in white males and 11 days in minority males. The median time to recovery was 26 days in females and 13 days in males. White females had the longest recovery time (median 27.5 days). Predictors of protracted recovery included ADHD (HR = .449, 95% CI = .272 - .741, p = .002) and prior concussion (HR = .574, 95% CI = .397 - .828, p = .003) in all sex and ethnic groups, while shorter recovery times were predicted by male minority status (HR = 2.12, 95% CI = 1.30 - 3.46, p = .003). CONCLUSION: This study found significantly shorter recovery times in adolescent minority males compared to white females and identified ADHD and prior concussions as risk factors for protracted recovery.

Clinical and genetic aspects of the 15q11.2 BP1-BP2 microdeletion disorder.

The 15q11.2 BP1-BP2 microdeletion (Burnside-Butler susceptibility locus) is an emerging condition with over 200 individuals reported in the literature. TUBGCP5, CFYIP1, NIPA1 and NIPA2 genes are located in this chromosome 15 region and when disturbed individually are known to cause neurological, cognitive or behavioural problems as well as playing a role in both Prader-Willi and Angelman syndromes. These syndromes were the first examples in humans of genomic imprinting and typically caused by a deletion but involving the distal chromosome 15q11-q13 breakpoint BP3 and proximally placed breakpoints BP1 or BP2 of different parental origin. The typical 15q11-q13 deletion involves BP1 and BP3 and the typical type II deletion at BP2 and BP3. Several studies have shown that individuals with the larger type I deletion found in both Prader-Willi and Angelman syndromes are reported with more severe neurodevelopmental symptoms compared to those individuals with the smaller type II deletion. The literature was reviewed and clinical and cytogenetic findings summarised in 200 individuals with this microdeletion along with the role of deleted genes in diagnosis, medical care and counseling of those affected and their family members. Reported findings in this condition include developmental delays (73% of cases) and language impairment (67%) followed by motor delay (42%), attention deficit disorder/attention deficit hyperactivity disorder (35%) and autism spectrum disorder (27%). The de novo deletion frequency has been estimated at 5 to 22% with low penetrance possibly related to subclinical manifestation or incomplete clinical information on family members. A prevalence of 0.6 to 1.3% has been identified in one study for patients with neurological or behavioural problems presenting for genetic services and chromosomal microarray analysis. The summarised results indicate that chromosome 15q11.2 BP1-BP2 microdeletion is emerging as one of the most common cytogenetic abnormalities seen in individuals with intellectual impairment, autism spectrum disorder and other related behavioural or clinical findings, but more research is needed.

Potential factors influencing recovery from concussion in collegiate student-athletes

Background Factors including sex, previous diagnosis of migraines, previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder, and a history of concussion may influence the length of recovery from concussion in collegiate student-athletes. Purpose To better understand factors that may influence recovery from concussion in collegiate-student athletes. Methods A total of 91 student-athletes from a Division I NCAA University who sustained concussions from the fall of 2011 to the spring of 2015 were evaluated. They were considered recovered from their concussion when neurocognitive and symptom scores returned to baseline and they were cleared by their physician. Analyses of variance were conducted to determine if potential factors influenced concussion recovery ( p < .0125). Results No significant differences were found for sex (males = 7.4 ± 5.9; females = 8.3 ± 4.8 days; p = 0.417), previous diagnosis of migraines (diagnosis = 8.0 ± 5.7; no diagnosis = 7.8 ± 5.4 days; p = 0.926), or history of concussion (history = 8.3 ± 5.7; no history = 5.6 ± 3.4 days; p = 0.088). However, a significant difference in the length of recovery was found between those with a previous diagnosis of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and those without (diagnosis = 13.3 ± 7.3; no diagnosis = 7.3 ± 4.9 days; p = 0.002). Conclusion Student-athletes with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder show significantly longer recovery from concussions than those without. Further investigation of this and other factors that influence recovery from concussion may help in concussion recovery and return-to-play guidelines that improve student-athlete well-being.

Vibrational and NMR Investigation on Pharmaceutical Activity of 2,5- Dimethoxy-4-Ethylamphetamine by Theoretical and Experimental Support

The Detailed physical, chemical, thermal and circular vibrational investigations have been made on FT-IR, FTRaman, NMR and UV-Visible spectra of 2,5-Dimethoxy-4-ethylamphetamine. The modification of the basic property (deficit hyperactivity disorder) of the base compound (Amphetamine) is favoured by the insertion of two methoxy and ethyl-methyl groups have been discussed in detail. The transitional pattern among NBO emphasized the inducement of the psychedelic activity in the compound. The strong interpretation made on the physical and chemical properties by intense observation using excitations between the electronic energy levels within the molecule have been carried out. The arrangement of the dipole moment of the bonds and the change of resultant magnetic moment were observed from the average Polarizability first order diagonal hyperpolarizability. The receptor and inhibition property of the molecule were interpreted by the identification of reactive sites from molecular electrostatic potential contour map. The chemical reaction continuity is keenly observed from thermodynamical analysis.

Examination of the Neuroplastic Biomarker Levels in Attention Deficit Hyperactivity Disorder

Examination of the Neuroplastic Biomarker Levels in Attention Deficit Hyperactivity Disorder

Childhood Fish Consumption and Learning and Behavioral Disorders.

Fish is a major source of nutrients critical for brain development during early life. The importance of childhood fish consumption is supported by several studies reporting associations of n-3 polyunsaturated fatty acid (n-3 PUFA) supplementation with better behavior and school performance. However, fish may have a different effect than n-3 PUFA alone due to the neurotoxic effects of methylmercury, a frequent contaminant. We investigated associations of childhood fish consumption with learning and behavioral disorders in birth cohort study of the neurotoxic effects of early life exposure to solvent-contaminated drinking water. Childhood (age 7–12 years) fish consumption and learning and behavioral problems were reported in self-administered questionnaires (age 23–41 at questionnaire completion). Fish consumption was not meaningfully associated with repeating a grade, tutoring, attending summer school, special class placement, or low educational attainment. However, participants who ate fish several times a week had an elevated odds of Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (odds ratio: 5.2; 95% confidence interval: 1.5–18) compared to participants who did not eat fish. While these findings generally support the safety of the observed level of fish consumption, the absence of a beneficial effect may be attributed to insufficient fish intake or the choice of relatively low n-3 PUFA fish.

Two-year prospective study of characteristics and outcome of adolescents referred to an adolescent urgent psychiatric clinic.

(a) To describe the clinical characteristics and outcome of adolescents referred for urgent psychiatric consultation, and (b) compare suicidal with non-suicidal referrals. This was a 2-year prospective study. Data was gathered on demographic, historical and clinical variables. Comparison of suicidal and non-suicidal patients was conducted using χ2. A hospital database was used for referral and wait times. Of 805 assessments, 55% were referred by emergency physicians and 28% by primary care physicians. Sixty-four percent of referrals were referred for suicidal behavior and depression and 19.6% for aggression. Eighty percent had a positive family psychiatric history and 59% were bullied. The most frequent psychiatrist assigned diagnosis was attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). Almost a quarter did not require psychiatric follow-up. Referrals to an outpatient clinic and admission were reduced significantly. Greater suicidality was associated with being female, presence of bullying-victimization and substance abuse [χ2(1)=9.33, p=0.002]. Suicidal behavior is the most common reason for urgent psychiatric consults. ADHD was the most frequent psychiatrist assigned diagnosis. Urgent psychiatric services can reduce admissions, referrals and wait times for hospital based clinics for low lethality, low intent suicidal behaviors and facilitate triage to community services.

ADHD and bipolar disorder challenge in diagnosis in children and adolescents

IntroductionThe professionals in charge of children and adolescents with attention deficit disorder and hyperactivity disorder (ADHD) should be prepared to treat a wide variety of psychiatric symptoms, as most have at least one comorbid psychiatric disorder.Sometimes the differential diagnosis between ADHD and bipolar disease is difficult because of overlapping symptoms between the two disorders (Geller et al., 1997; Biederman et al., 2000; Singh et al., 2006).MethodologyA literature review about the comorbidity between ADHD and bipolar disorder in children and adolescents was performed.ResultsAccording to different studies, between 60 and 90% of children and adolescents with ADHD have comorbid bipolar disorder. However, the percentage of children and adolescents with ADHD that has comorbid bipolar disorder varied from 10 to 22% (puedes poner from 60 to 90% si no quieres repetir el and).ConclusionsThe prevalence of bipolar disease, particularly among adolescents, is between 1 and 7%. This percentage is higher if all forms of bipolar spectrum are included. Some personal and family factors increase the probability of a patient having ADHD present bipolar disease: decreased IQ, delayed development, family history of ADHD or bipolar disease, and the combined subtype.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Associations between serotonin transporter gene (SLC6A4) methylation and clinical characteristics and cortical thickness in children with ADHD.

Attention deficit hyperactivity disorder (ADHD) is a common, highly heritable psychiatric disorder. Additionally, environmental factors such as perinatal stress and early adversities contribute to the occurrence and severity of ADHD. Recently, DNA methylation has emerged as a mechanism that potentially mediates gene-environmental interaction effects in the aetiology and phenomenology of psychiatric disorders. Here, we investigated whether serotonin transporter gene (SLC6A4) methylation patterns were associated with clinical characteristics and regional cortical thickness in children with ADHD. In 102 children with ADHD (age 6-15 years), the methylation status of the SLC6A4 promoter was measured. Brain magnetic resonance imaging was obtained and ADHD symptoms were evaluated. A higher methylation status of the SLC6A4 promoter was significantly associated with worse clinical presentations (more hyperactive-impulsive symptoms and more commission errors). Additionally, a negative correlation was observed between SLC6A4 methylation levels and cortical thickness values in the right occipito-temporal regions. Our results suggest that the SLC6A4 methylation status may be associated with certain symptoms of ADHD, such as behavioural disinhibition, and related brain changes. Future studies that use a larger sample size and a control group are required to corroborate these results.

English

English

Effectiveness of Family-Based Behavioral Treatment Based on Medication Behavior Barkley Compared with Drug Therapy in Reducing the Symptoms of Children with Attention Deficit Disorder-Hyperactivity

Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency, and also when they become adults, they have problems in social relationships that these problems can increase or decrease in dealing with family. Hence, this study was performed in order to examine the impact of family-based behavioral treatment compared with Barkley behavior therapy in reducing symptoms of children with attention deficit disorder—ADHD. To meet the aim, 20 of children with age range of 7 to 12 years old with attention deficit disorder—hyperactivity were selected in both experimental and control groups, and exposed to the treatment of behavioral family therapy groups and changes in behavior Barkley. Before and after the treatment, they were evaluated according to the scale of the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R: S). Results of multivariate analysis of covariance indicated that there were significant differences between the experimental group who had received family-based behavioral treatments based on changes in behavior Barkley and a control group who had received drug treatment in variables, including conduct problems, learning problems, psychosomatic symptoms, and signs of impulsive hyperactivity, anxiety and hyperactivity (p < 0.01). These results could be guidance for counsel or sand therapists for children with attention deficit disorder—ADHD.

Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study

Little is known about the epidemiology of severe acne in the U.S. We sought to study the U.S. prevalence, determinants and comorbidities of severe acne in adolescence. We analysed data from the 2007 National Health Interview Survey, a cross-sectional questionnaire-based study of 9417 children ages 0-17years. Prevalence of severe acne, demographics and comorbid disorders were determined. The U.S. prevalence of severe acne was virtually nil in the first decade of life, but increased in a linear fashion from 11years [1·7% (95% confidence interval (CI) 0·4-3·0%)] to 17years of age [12·1% (95% CI 7·8-16·5%)] (Rao-Scott Chi-square, P<0·0001). Severe acne was more common in Whites compared with other racial groups at age 14-15years (P=0·0004) and girls at age 11-13 (P=0·02). Severe acne was associated with a number of comorbid disorders. Sinopulmonary disease included sinus infection (P=0·0003), sore throat other than strep infection (P=0·0003), asthma (P=0·03) and nonasthmatic lung disease (P=0·03). Upper gastrointestinal comorbidities included reflux/heartburn (P=0·0003), abdominal pain (P=0·03), nausea/vomiting (P=0·0001) and food/digestive allergy (P=0·01). Psychological comorbidities included depression (P=0·02), anxiety (P<0·0001), attention deficit disorder/attention deficit hyperactivity disorder (P=0·01) and insomnia (P=0·02). In conclusion, severe acne was more prevalent in older age, Whites, female sex and higher socioeconomic status. Future studies are needed to confirm the associations with sinopulmonary, upper gastrointestinal and psychological disorders in adolescents.

TDA/H : intérêt de l’association entre pharmacothérapie et psychothérapie analytique ?

Interest in attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) is growing, as evidenced by the number of scientific publications on the topic, as well as by the number of requests for child psychiatric consultations to diagnose ADD. The current clinical consensus is the result of the long evolution of a historical dichotomy between advocates for an organogenetic or psychopathological etiology of the disorder. Today, we question whether a “double reading” is possible taking into consideration both neuro-developmental factors as well as psychopathological elements? The contribution of complexity theorists and developmental phenomenology could help to conceptualize the ADD/ADHD as a complex and multifactorial disorder, which would support a “transversal” therapeutic approach involving psychoanalytical and psychopharmacology. However, questions remain regarding the effectiveness of psychoanalytical therapy and its association with pharmacotherapy in treating ADHD – and there appears to be little evidence of its effectiveness in existing literature. Thus, the possibility of a future therapeutic consensus for ADHD could be expected.

Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse

Attention deficit disorder and attention deficit/hyperactivity disorders (ADD/ADHD) are found in approximately 5% to 10% of school-aged children. This study examined whether childhood physical abuse was associated with ADD/ADHD. Data were derived from a population-based sample of 13,054 adults from the 2005 Canadian Community Health Survey. We used logistical regression analysis in 2 models, both of which had ADD/ADHD as the criterion variable. There were 7 times higher odds of ADD/ADHD among those who reported they had been abused after controlling for several potential mediating factors, including age, race, gender, and 3 other types of adverse childhood experiences (parental divorce, parental addictions, and long-term parental unemployment) in comparison to those who were not abused. The results of this analysis show a strong link between childhood abuse and ADD/ADHD, an association that requires further study.

Stimulant Use in Patients With Sturge-Weber Syndrome: Safety and Efficacy

BackgroundSturge-Weber syndrome is characterized by a facial port-wine birthmark, vascular eye abnormalities, and a leptomeningeal angioma. Attention and behavioral issues are common in Sturge-Weber syndrome. However, literature evidence for stimulant treatment is minimal. This study evaluates stimulant medication safety and efficacy in individuals with Sturge-Weber syndrome. MethodsThe research database of the Hunter Nelson Sturge-Weber Center (n = 210 subjects in the database) was reviewed for stimulant use. Twelve patients (mean age 10.5 years, age range 4 to 21 years) on stimulants were seen between 2003 and 2012. A retrospective chart review obtained comorbid diagnoses, stimulant type and dosage, medication side effects, vital signs, and medication efficacy. ResultsAll 12 patients had brain involvement (unilateral, nine; bilateral, three). Additional comorbidities included epilepsy (twelve), hemiparesis (eight), headaches (eight), and vision deficits (six). Eight patients reported side effects, primarily appetite suppression (four) and headaches (three). There were no statistically significant changes in weight or blood pressure 6 months after medication initiation. Medication efficacy was subjectively reported in 11 patients. Seven patients remained on stimulants at their most recent follow-up visit. ConclusionsThis study preliminarily evaluates stimulant medication use in a small group of Sturge-Weber syndrome patients. Stimulants were tolerated and effective in most subjects. Side effects were mostly minor and medication did not negatively affect growth or vital signs. Stimulant medication may be a safe and effective intervention for Sturge-Weber syndrome children with attention issues/attention deficit hyperactivity disorder. Further studies with larger sample sizes are needed.

Health, chronic conditions, and behavioral risk disparities among U.S. immigrant children and adolescents.

We examined differentials in the prevalence of 23 parent-reported health, chronic condition, and behavioral indicators among 91,532 children of immigrant and U.S.-born parents. We used the 2007 National Survey of Children's Health to estimate health differentials among 10 ethnic-nativity groups. Logistic regression yielded adjusted differentials. Immigrant children in each racial/ethnic group had a lower prevalence of depression and behavioral problems than native-born children. The prevalence of autism varied from 0.3% among immigrant Asian children to 1.3%-1.4% among native-born non-Hispanic white and Hispanic children. Immigrant children had a lower prevalence of asthma, attention deficit disorder/attention deficit hyperactivity disorder; developmental delay; learning disability; speech, hearing, and sleep problems; school absence; and ≥ 1 chronic condition than native-born children, with health risks increasing markedly in relation to mother's duration of residence in the U.S. Immigrant children had a substantially lower exposure to environmental tobacco smoke, with the odds of exposure being 60%-95% lower among immigrant non-Hispanic black, Asian, and Hispanic children compared with native non-Hispanic white children. Obesity prevalence ranged from 7.7% for native-born Asian children to 24.9%-25.1% for immigrant Hispanic and native-born non-Hispanic black children. Immigrant children had higher physical inactivity levels than native-born children; however, inactivity rates declined with each successive generation of immigrants. Immigrant Hispanic children were at increased risk of obesity and sedentary behaviors. Ethnic-nativity differentials in health and behavioral indicators remained marked after covariate adjustment. Immigrant patterns in child health and health-risk behaviors vary substantially by ethnicity, generational status, and length of time since immigration. Public health programs must target at-risk children of both immigrant and U.S.-born parents.

G.4. Workshop: Children and adolescents with neurodevelopmental disorders: challenges and opportunities

Reasons for the workshop Developmental disorders, including intellectual disability, autism and attention deficit (hyperactivity) disorder (AD(H)D) are neurodevelopmental disorders that manifest themselves in early childhood as deviations from normal development. The prevalence of neurodevelopmental disorders in children and adolescents, its associated problems, and related costs are high. The prevalence estimates of children with developmental disabilities have increased over time. In addition, this group of children is a very vulnerable population, given their great burden from emotional and mental disorders and …

The abnormal brain blood perfusion and impaired functions in adolescents with attention- deficit hyperactivity disorder co morbid bipolar disorder

The abnormal brain blood perfusion and impaired functions in adolescents with attention- deficit hyperactivity disorder co morbid bipolar disorder

El TDAH en preescolares: validez, diagnóstico, prevención y tratamiento

The scientific literature supports the construct validity and clinical utility of attention- deficit hyperactivity disorder (ADHD) in preschoolers. These children exhibit high rates of comorbid psychopathology and significant levels of cognitive, pre-academic and social difficulties. They are also at high risk for presenting this disorder and a range of difficulties over time that could affect adaptive functioning in multiple areas and settings. Parent training programs have demonstrated a high level of effectiveness. Pharmacotherapy can be effective but the treatment effect size is not as high as that found in older children and its side effects are greater. It is important to eliminate or reduce non-genetic risk factors that may contribute to the development of ADHD. Behavioral and cognitive training programs, as well as activities and games aimed at developingexecutive functions, could be effective for prevention and treatment of this condition and its associated difficulties. CITE AS:Bauermeister Baldrich, J.J. &amp; Matos Román, M. (2011). El TDAH en preescolares: validez, diagnóstico, prevención y tratamiento. Apuntes de Psicología, 29, 205-225.