Presence Of ADHD Research Articles

Looking beyond psychosocial adversity and sex: Clinical factors associated with ADHD and other psychiatric disorders in a non-Caucasian sample of high-risk siblings

This study examined the association of clinical factors, independent of sex and high psychosocial adversity (HPAd), with the presence of ADHD or other mental disorders, specifically within a middle-income country with a non-Caucasian population. A multi-centric cross-sectional study was conducted in three sites in Colombia. Our study recruited trios of an ADHD proband, one sibling, and one parent. We used valid instruments for assessing parents and siblings. The sample included 223 siblings, an average age of 12.3 (SD 3.9), and 51.1% Females. The ADHD recurrence risk ratio (λ) was 12. The clinical factors mainly associated with the presence of ADHD, independent of sex and HPAd, were 1) Pregnancy and childbirth complications, 2) Delayed psychomotor development, 3) Temperament, and 4) Sleep disturbances. Our research showed that, independently of HPAd and the male sex, there were other clinical factors associated with ADHD and other psychiatric disorders in this population. These findings need to be replicated in similar populations globally.

Distinctive patterns of Multiple Object-Tracking performance trajectories in youth with deficits in attention, learning, and intelligence

There is a significant overlap in symptomology between individuals with deficits in attention and learning, which is explained by the co-dependent dynamic between the two cognitive constructs. Within this dynamic, attentional resources are allocated to salient stimuli while learning mechanisms distinguish relevant from irrelevant information. Moreover, individuals with deficits in higher-order cognition (i.e., intelligence) can demonstrate difficulties in attention and learning. The Multiple Object-Tracking (MOT) task is a sensitive and versatile measure of attention that has characterized individual differences in attention as a function of higher-order cognition. Exploiting the traditional MOT task’s ability to characterize the allocation of attentional resources to task demands, the current study compared learning exhibited on an attention-based task across neurodevelopmental conditions defined by deficits in attention (attention-deficit/hyperactivity disorder; ADHD), learning (specific learning disorder; SLD), and intelligence (intellectual developmental disorder; IDD). Children and adolescents (N = 101) completed 15 sessions on a Multiple Object-Tracking (MOT) task where performance trajectories were analyzed using latent growth curve modeling and conditioned by the presence of ADHD, SLD, or IDD while controlling for performance on a separate measure of attention, age, and sex. The sample, characterized by below-average IQ and problematic levels of attention, exhibited an effect of learning on MOT. However, individuals with an IDD diagnosis demonstrated decreased baseline MOT capability while ADHD and SLD profiles exhibited decreased slopes, relative to other neurodevelopmental conditions. Taken together, the results demonstrate distinct linear performance trajectories between neurodevelopmental conditions defined by deficits in attention, learning, and intelligence. The current study provides additional evidence to repurpose the traditional MOT task as a descriptor of attention and discusses alternative uses for the paradigm. Overall, these results suggest an eclectic approach that considers attention, learning, and higher-order cognition when diagnosing ADHD, SLD, or IDD.

Characteristics prior to and at time of diagnosis in pediatric bipolar disorder

Objectives Describe symptoms before and at time of register-diagnosis in children and adolescents. Methods A random sample was selected for chart-review from a Danish nationwide cohort of patients <18 years registered with an incident ICD-10 register-diagnosis of single hypomanic/manic episode or bipolar disorder between 1995 and 2014. Patients with symptoms which adequately documented a BD diagnosis in the chart were included for analysis. Results 521 were diagnosed in the study period. A random sample of 25% were selected, and 106 charts were possible to retrieve, with 48 chart reviews resulting in confirmation of diagnosis. Time from first reported affective symptoms to diagnosis was 2.6 ± 2.7 years for depressive symptoms, 2.5 ± 2.9 years for mixed symptoms, 1.4 ± 1.6 years for hypomanic symptoms, and 0.4 ± 0.5 years for manic symptoms. A hierarchical clustering analysis revealed three patient-profiles: primarily hypomanic/manic, primarily depressive, and more rare, primarily mixed profile. Frequently reported symptoms prior to diagnosis include anhedonia (79%), irritability (71%), hyperactivity (62.5%), decreased energy (62.5%), and psychotic symptoms (52%). Symptoms of ADHD (19%), comorbid ADHD (15%), symptoms of anxiety (52%), comorbid anxiety (4%), suicidal thoughts (50%), suicide attempts (8%), cutting (23%), substance misuse (21%), and criminal activity (10%) were reported before incident BD diagnosis. Conclusion The observed patient-profiles leading to diagnosis were primarily manic or depressive, resembling presentations in adults. The presence of ADHD, anxiety, suicide attempts, cutting, and criminal activity prior to diagnosis emphasizes the need for treatment of children and adolescents with affective symptoms. The gap from appearance of the symptoms to diagnosis suggests a window for earlier treatment.

Multi-tract multi-symptom relationships in pediatric concussion.

The heterogeneity of white matter damage and symptoms in concussion has been identified as a major obstacle to therapeutic innovation. In contrast, most diffusion MRI (dMRI) studies on concussion have traditionally relied on group-comparison approaches that average out heterogeneity. To leverage, rather than average out, concussion heterogeneity, we combined dMRI and multivariate statistics to characterize multi-tract multi-symptom relationships. Using cross-sectional data from 306 previously concussed children aged 9-10 from the Adolescent Brain Cognitive Development Study, we built connectomes weighted by classical and emerging diffusion measures. These measures were combined into two informative indices, the first representing microstructural complexity, the second representing axonal density. We deployed pattern-learning algorithms to jointly decompose these connectivity features and 19 symptom measures. Early multi-tract multi-symptom pairs explained the most covariance and represented broad symptom categories, such as a general problems pair, or a pair representing all cognitive symptoms, and implicated more distributed networks of white matter tracts. Further pairs represented more specific symptom combinations, such as a pair representing attention problems exclusively, and were associated with more localized white matter abnormalities. Symptom representation was not systematically related to tract representation across pairs. Sleep problems were implicated across most pairs, but were related to different connections across these pairs. Expression of multi-tract features was not driven by sociodemographic and injury-related variables, as well as by clinical subgroups defined by the presence of ADHD. Analyses performed on a replication dataset showed consistent results. Using a double-multivariate approach, we identified clinically-informative, cross-demographic multi-tract multi-symptom relationships. These results suggest that rather than clear one-to-one symptom-connectivity disturbances, concussions may be characterized by subtypes of symptom/connectivity relationships. The symptom/connectivity relationships identified in multi-tract multi-symptom pairs were not apparent in single-tract/single-symptom analyses. Future studies aiming to better understand connectivity/symptom relationships should take into account multi-tract multi-symptom heterogeneity. Financial support for this work came from a Vanier Canada Graduate Scholarship from the Canadian Institutes of Health Research (G.I.G.), an Ontario Graduate Scholarship (S.S.), a Restracomp Research Fellowship provided by the Hospital for Sick Children (S.S.), an Institutional Research Chair in Neuroinformatics (M.D.), as well as a Natural Sciences and Engineering Research Council CREATE grant (M.D.).

Special needs of internationally adopted adolescents in 4 European receiving countries: Relation to mothers’ adoption satisfaction

IntroductionThe extent and nature of SN among international adoptees at adolescence in different receiving countries (RC) has not been completely described, nor have differences between children of Eastern Europe (EE) and non-EE origin been fully assessed. Furthermore, the impact of SN on parent adoption satisfaction has not been systematically assessed or compared between RC. AimsIn 4 European RC (1) determine the prevalence and type of SN among internationally adopted adolescents, (2) compare these for children of EE and non-EE origin, (3) relate SN to mothers’ adoption satisfaction. Methods685 mothers of internationally adopted adolescents in four different RC (France n = 246, Italy n = 322, Norway n = 60, Spain n = 57) completed on-line surveys including (a) child’s medical, behavior, psychological, or school problems, (b) Pinderhughes’ Adoption Satisfaction Questionnaire. ResultsMothers reported that 54% of the adolescents (58 %M, arrival age:53.53±40.35 months, current:14.98±1.70 years, 44% EE origin) had at least one SN. Learning disabilities were most common (40% of adolescents), followed by ADHD (30%), and medical issues (21%), but patterns differed by receiving country. Except for speech/language problems, the frequency of specific SN (developmental delay, attention deficit hyperactivity disorder [ADHD], behavior problems, learning disabilities, psychiatric issues, prenatal alcohol exposure) varied significantly between RC. The frequency of these conditions between children of EE and non-EE origin also varied by RC. Mothers’ adoption satisfaction did not differ significantly between RC; the presence of ADHD, behavior and/or psychiatric problems consistently related to mothers’ adoption satisfaction in all 4 RC. The relation to mothers’ ASQ and the presence and number of SN was assessed by hierarchical linear regression, controlling for child demographic characteristics. Both the presence and number of SN negatively predicted mothers’ adoption satisfaction. Child’s age at adoption (and to a lesser extent, current age) also negatively predicted mothers’ ASQ score. ConclusionsSN were relatively common among internationally adopted adolescents in 4 European RC, but the pattern of specific conditions and relationship to mothers’ adoption satisfaction differed among RC. However, ADHD, behavioral and/or psychiatric problems consistently related to mothers’ ASQ in all 4 RC. In regressions controlling for demographic characteristics, the presence of any SN and the number of SN related to mothers’ adoption satisfaction. SN represent an additional stress on adoptive families; further work is needed to understand how differences in RC may impact post-adoption adjustment and experiences.

Visual attention and inhibitory control in children, teenagers and adults with autism without intellectual disability: results of oculomotor tasks from a 2-year longitudinal follow-up study (InFoR)

BackgroundInhibitory control and attention processing atypicalities are implicated in various diseases, including autism spectrum disorders (ASD). These cognitive functions can be tested by using visually guided saccade-based paradigms in children, adolescents and adults to determine the time course of such disorders.MethodsIn this study, using Gap, Step, Overlap and Antisaccade tasks, we analyzed the oculomotor behavior of 82 children, teenagers and adults with high functioning ASD and their peer typically developing (TD) controls in a two-year follow-up study under the auspices of the InFoR-Autism project. Analysis of correlations between oculomotors task measurements and diagnostic assessment of attentional (ADHD-RS and ADHD comorbidity indices) and executive functioning (BRIEF scales) were conducted in order to evaluate their relationship with the oculomotor performance of participants with ASD.ResultsAs indicated by the presence of a Gap and Overlap effects in all age groups, the oculomotor performances of ASD participants showed a preserved capability in overt attention switching. In contrast, the difference in performances of ASD participants in the Antisaccade task, compared to their TD peers, indicated an atypical development of inhibition and executive functions. From correlation analysis between our oculomotor data and ADHD comorbidity index, and scores of attention and executive function difficulties, our findings support the hypothesis that a specific dysfunction of inhibition skills occurs in ASD participants that is independent of the presence of ADHD comorbidity.LimitationsThese include the relatively small sample size of the ASD group over the study’s two-year period, the absence of an ADHD-only control group and the evaluation of a TD control group solely at the study’s inception.ConclusionsChildren and teenagers with ASD have greater difficulty in attention switching and inhibiting prepotent stimuli. Adults with ASD can overcome these difficulties, but, similar to teenagers and children with ASD, they make more erroneous and anticipatory saccades and display a greater trial-to-trial variability in all oculomotor tasks compared to their peers. Our results are indicative of a developmental delay in the maturation of executive and attentional functioning in ASD and of a specific impairment in inhibitory control.

A-141 Vindicated by Awareness: Acting with Awareness May Compensate for Inhibitory Deficits in ADHD Symptom Burden

Abstract Objective To understand the role of trait mindfulness acting-with-awareness in the relationship between inhibitory control and ADHD symptom burden. Method We conducted a cross-sectional study with 103 adults, aged 18 to 86, mean age = 46, mean education = 15 years, 46% male. Participants were recruited in North Western Oregon counties. Eligible individuals were aged &amp;gt;18, fluent in English, and with normal global cognition (Montreal Cognitive Assessment, MoCA&amp;gt;22). The presence of ADHD diagnoses/symptoms was not required. Participants were administered the Adult Investigator Symptom Rating Scale (AISRS), the Five Facet Mindfulness Questionnaire (FFMQ) Acting with Awareness, and the DKEFS Color-Word Interference Test (CWIT). We examined the contribution of CWIT (time/sec), acting-with-awareness (AA), and their interaction in age-adjusted multiple regression predicting AISRS total score. Results Descriptives for the measures of interest were AISRS (M = 19.21, SD = 12.72), CWIT (M = 55.66, SD = 15.27), and FFMQ-AA (M = 25.10, SD = 7.17). Both CWIT and FFMQ-AA predicted AISRS when analyzed independently (B = 0.274, p = 0.14, R2 = 0.13 and B = -0.633, p &amp;lt; 0.001, R2 = 0.45). In the combined model, FFMQ-AA (B = -1.06, p = 0.000) but not CWIT predicted AISRS, R2 = 0.47. The interaction was not significant, p = 0.55. Conclusion AA is a powerful predictor of ADHD symptom burden: it accounts for almost half of the variance, and removes any contribution from inhibitory control. Our finding suggests that trait mindfulness has a more important role in shaping ADHD than cognition.

Putting mindfulness-based cognitive therapy to the test in routine clinical practice: A transdiagnostic panacea or a disorder specific intervention?

BackgroundOver the past two decades there has been a growing number of randomized clinical trials supporting the efficacy of mindfulness-based cognitive therapy (MBCT) in the treatment of several psychiatric disorders. Since evidence for its effectiveness in routine clinical practice is lagging behind, we aimed to examine adherence, outcome and predictors of MBCT in a well-characterized, heterogeneous outpatient population in routine clinical practice. MethodsData were collected from a naturalistic uncontrolled cohort of 998 patients formally diagnosed with mainly depression, anxiety disorders, personality disorders, somatoform disorders and/or ADHD. Patients received protocolized MBCT and completed self-report questionnaires pre- and post-treatment on overall functioning (Outcome Questionnaire, primary outcome), depressive symptoms, worry, mindfulness skills and self-compassion. Pre-to post-treatment changes were analysed for the overall sample and each diagnostic category separately with paired sample t-tests, reliable change indices (only overall sample) and repeated measures ANOVA for groups with and without comorbidity. Multiple linear regression was carried out to assess possible predictors of adherence and change in overall functioning. ResultsAdherence was high (94%) but negatively affected by lower levels of education, more comorbidity and presence of ADHD. Outcome in terms of improvement in overall functioning was good in the overall sample (Cohen's d = 0.50, 30% showed reliable improvement vs. 3.5% reliable deterioration) and within each diagnostic category (Cohen's d range = 0.37–0.61). Worse overall functioning at baseline was the only predictor for a larger treatment effect. ConclusionsAfter MBCT, overall functioning improved in a large heterogeneous psychiatric outpatient population independent of diagnosis or comorbidity.

Influence of the month of birth on persistence of ADHD in prospective studies: protocol for an individual patient data meta-analysis

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with symptoms, especially the hyperactive ones, that tend to decrease in severity with age. Interestingly, children born just before the school-entry cut-off date...

Adult attention deficit hyperactivity disorder in patients with fibromyalgia syndrome: Assessment and disabilities

In the broader list of cognitive concerns, neuropsychological testing has shown that attentional impairment may have a specific burden in Fibromyalgia Syndrome (FMS).Preliminary observations have reported a subset of FMS patient screened for attention disorders fulfilling the actual diagnosis of ADHD, a neurodevelopmental disorder characterized by developmentally inadequate levels of inattention, hyperactivity and impulsivity that might persist in adulthood. Yet, no study to date has systematically examined the history and the specific contribution of ADHD to FMS in terms of clinical impact and related specific disabilities.In this study, 106 individuals with a FMS diagnosis based on the 2010 criteria of the American College of Rheumatology have been assessed for (a) the presence of ADHD; (b) the burden of disability caused by ADHD versus FMS; (c) the presence of other psychiatric disorders. Results indicated that ADHD was present in 24.5% of FMS individuals, it was associated with higher FMS symptoms severity and a greater functional impairment, particularly in the work/school domain. Moreover, patients with both FMS and ADHD had higher frequency of substance use disorders than those with FMS only (38.5% versus 3.8%) and mainly opioids. Overall, results suggest that ADHD can increase burden adding specific disability in work and social activities, and it is associated with a trend for the excessive use of opioid painkillers. Detection of neurodevelopmental and actual symptoms of ADHD is highly recommended especially in patient prone to increase the dose of anti-pain medication.

Questionário de qualidade de vida em adultos com transtorno do déficit de atenção com hiperatividade (AAQOL): revisão sistemática

OBJETIVO: Analisar sistematicamente o uso de medicamentos que melhorem a qualidade de vida em adultos com transtorno do déficit de atenção com hiperatividade (TDAH) mensurada por meio de um instrumento específico (AAQoL).MÉTODOS: O presente estudo de revisão sistemática foi seccionado nas seguintes etapas: elaboração da pergunta de pesquisa, busca na literatura, seleção dos artigos, extração dos dados, síntese dos dados, avaliação da qualidade das evidências e redação, e publicação dos resultados.RESULTADOS: Os estudos selecionados para a composição da revisão sistemática, demonstraram o comprometimento associado à presença do TDAH na vida adulta, tendo como intervenção a medicação em estudos caracterizados de qualidade. Com base na avaliação proposta pela ferramenta Cochrane de colaboração, é possível evidenciar que a qualidade de vida foi melhorada com a utilização de fármacos que controlam os sintomas em adultos com TDAH.CONCLUSÕES: Estudos clínicos comprovam melhora significativa da qualidade de vida dos pacientes com o uso de medicações específicas para TDAH, como Atomoxetina, Metilfenidato de ação prolongada e Metadoxina de liberação prolongada.

Empathy, social relationship and co-occurrence in young adults with DCD

Empathy is defined as an emotional or cognitive response to another’s emotional state. It is considered essential for navigating meaningful social interactions and is closely linked to prosocial behavior. Developmental coordination disorder (DCD) is characterized by an impairment of motor coordination that has a marked impact on both academic and day-to-day living activities. Children and adolescents with DCD have been shown to have less developed social support and friendships. The research linking empathy and DCD is scarce. The aims of this study are to gain an understanding of the relationship between DCD and empathy in young adults with DCD only, and with DCD coupled with other neurodevelopmental disorders, in comparison with typically developing adults. MethodsThe study included 212 young adults aged 18–40 years. The subjects in this study were from mainstream populations in the UK. The study groups included: (a) “DCD only” with 42 individuals; (b) “DCD + ASD” with 21 individuals; (c) “DCD + ADHD” with 45 individuals; (d) “DCD + ASD + ADHD” with 29 individuals; and (e) the control group of 75 individuals. ResultsANOVA on the Empathy Questionnaire (EQ) showed a statistically significant difference between groups (F [4,257] = 35.63; p < 0.001; ηp2 = 0.409). No significant differences were found between the DCD-only and the control. MANOVA was performed to assess differences in the Socialising and Friendship Questionnaire (SAF-Q) scores. The results showed a statistically significant difference between groups (F [8,257] = 9.98; p < 0.001; η = 0.162). Pearson correlation coefficients were performed, revealing significant high correlations between the EQ and the two parts of the SAF-Q (“past” and “currently”). ConclusionThe results of this study indicate that social difficulties in the DCD-only group are not due to lack of empathy, but may be driven by an accumulation of external factors. In this study we also concluded that DCD does not appear to be the factor that reduces the ability to empathize, but rather the presence of ADHD and/or ASD.

Comorbidity &amp; socioeconomic status associated with attention deficit hyperactive disorder

Aims &amp; Objectives: (1) To find out the prevalence of ADHD in urban primary school children (2)To find out the presence of any co-morbid disorders associated with ADHD. Settings and design: This is a cross sectional study of school children selected from 15 different Govt. Schools nearby Govt. Royapettah Hospital, attached to Govt. Kilpauk medical college, Chennai. Material &amp; Methods: 1000 children aged between 5 and 11 years were randomly selected from 15 different schools in Chennai. The presence of ADHD was then assessed by using Vanderbilt assessment scale Teacher’s version by their class teachers. Those children screened positive were verified and reassessed for the presence of any comorbid factors by using Child Behavioural Checklist (CBCL) scale. All children screened positive were subjected to psychiatrist evaluation. Results: The prevalence of ADHD among urban primary school children in Chennai, Tamilnadu was found to be 9.67%. Poor academic performance was the most common associated comorbid condition (18.75%), followed by poor social behaviour (17.7%). Conclusion: The present study shows Poor academic performance was the most common associated comorbid conditions, followed by poor social behaviour.

The Prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) Among Adolescents in Stationary Rehabilitation

ADHD in adulthood is assumed to be a positive predictor for many comorbid diseases and impairments affecting all domains of life, particularly career performance. Participation in social and professional life is limited for populations which qualify for rehabilitation programs, and thus the prevalence of ADHD is presumably also higher in these populations. To estimate the prevalence of ADHD in a population undergoing rehabilitation, 1010 people aged 18 to 75 years were screened for the presence of ADHD in adulthood. Additional impairments were measured and compared to a group of non ADHD participants. As expected a higher prevalence of ADHD was found in the population undergoing rehabilitation than in the general population (10.5%) Participants with ADHD who had recently begun rehabilitation seemed to have more impairments than non ADHD-participants. Participants with ADHD who were near the end of rehabilitation were more severely impaired in their capacity to reintegrate into their previous occupation, but not for the general employment market. Adult ADHD should be more closely investigated, especially in rehabilitation programs. Affected clients not only had more severe impairments, but more often had a profession that did not fit their capability.

Injury among adolescents with intellectual disability: A prospective cohort study

IntroductionInjury is the leading cause of mortality and morbidity in adolescents worldwide, and injury rates have been shown to be higher among youth with intellectual disability. Despite this, injury among adolescents with intellectual disability remains poorly investigated. This study aimed to identify characteristics associated with injury among adolescents with intellectual disability living in the community. MethodsA cohort of adolescents with intellectual disability living in southern Queensland, Australia was investigated prospectively between January 2006 and June 2010. Personal characteristics were collected via postal questionnaire. Injury information, including mechanism and location of injury, was extracted from general practitioner records. The association between demographic, social and clinical characteristics of participants and episodes of injury was investigated using negative binomial regression. ResultsA total of 289 injuries were recorded from 432 participants over 1627.3 years of study-time. The overall annual injury incidence was 17.5 (95%CI 14.7, 20.9) per 100 person years. Presence of ADHD and less severe disability was associated with increased risk of injury. Down syndrome and reduced verbal communication capacity were associated with decreased risk of injury. Falls accounted for the highest single mechanism of injury (19.0%) with the majority (73.2%) of injuries involving either upper or lower limbs. ConclusionsADHD is a co-morbidity that increases risk of injury among adolescents with intellectual disability. A critical component of injury prevention is avoidance of the great variety of environmental risk factors for injury relevant to this population.

Relation between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD.

The current study explored the concurrent and longitudinal association between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD. Eighty children (42 ADHD, 38 non-ADHD) ages 8-12 participated in the present study conducted over a 6-month period. During the baseline session, parents completed a structured diagnostic interview and the Vanderbilt ADHD Parent Rating Scale to determine whether their child met criteria for ADHD, and the Child Behavior Checklist (CBCL) to assess their child's internalizing and externalizing behaviors; children completed the Perception of Peer Support Scale (PPSS) to assess experiences of peer victimization. At the 6-month follow-up session, parents completed the CBCL and children completed the PPSS. Concurrently, internalizing behaviors were associated with peer victimization among children with and without ADHD; ADHD moderated this relation, such that internalizing behaviors were more strongly related to peer victimization among children with ADHD. Longitudinally, internalizing behaviors at baseline predicted peer victimization at 6-month follow-up; however, further analyses demonstrated there was a covarying change in internalizing behaviors and peer victimization. These findings suggest internalizing behaviors are related to peer victimization concurrently, and over time, and are associated with increased risk for peer victimization in the presence of ADHD. Additionally, internalizing behaviors and peer victimization appear to share a dynamic relationship; that is, decreases in internalizing behaviors predict similar decreases in peer victimization. No significant relations were observed between externalizing behaviors and peer victimization. Implications and limitations are discussed.

Utilisation de stimulants du système nerveux central chez les élèves du primaire suivis à l’école pour des troubles du comportement

Objectives Elementary school-aged children referred to school-based mental health services for conduct problems are commonly also prescribed central nervous system stimulants (CNSS), since many also suffer from comorbid ADHD. Nevertheless, there exists little information in the extant literature to determine to what degree the prescription of CNSS is associated with the presence of ADHD in these students or if other characteristics contribute to increasing the likelihood of CNSS use.Methods The current study was carried out on a sample of 341 students receiving school-based mental health services for conduct problems (27.8% girls, mean age of 9.9 years). ADHD and conduct problem symptomatology was assessed using a structured diagnostic instrument administered to parents and teachers.Results Results show that 39.9% of students were medicated using CNSS and that, among those who do not present ADHD symptomatology, approximately a third used CNSS. Age (6-8 years), socio-economic status (medium or high), placement in a special class for children with conduct problems, and symptoms of hyperactivity/impulsivity and oppositional defiant disorder all contributed unique variance in the prediction of utilisation of CNSS in this sample.Conclusion These results suggest that there may be several characteristics other than the presence of ADHD that can contribute to the medical decision to treat child problems with CNSS. These findings also underscore the importance of more rigorous assessment of ADHD in these children as well as longitudinal follow-up studies to determine the long-term effects of CNSS on their educational performance and eventual educational attainment.

Classification of ADHD and Non-ADHD Subjects Using a Universal Background Model.

ADHD affects a major portion of our children, predominantly boys. Upon diagnosis treatment can be offered that is usually quite effective. Diagnosis is generally based on subjective observation and interview. As a result, an objective test for the detection or presence of ADHD is considered very desirable. Based on EEG, across multiple channels, using autoregressive model parameters as features, ADHD detection is approached here in analogy with the imposter problem known from speaker verification. Gaussian mixture models are used to define ADHD and universal background models so that a likelihood ratio detector can be designed. The efficacy of this approach is reflected in the traditional detector performance measures of the area-under-the-curve and equal-error-probability. The results - based on a limited database of males, approximately 6 years of age - indicate that high probability of detection and low equal error rate can be achieved simultaneously with the proposed approach, when using EEG collected during an attention network task. The effect of using contaminated data is investigated as well.

Maternal obesity and attention-related symptoms in the preterm offspring

BackgroundMaternal pre-pregnancy obesity, in term-born children, is associated with an increased risk of attention problems, however this relationship has not been explored among children born extremely preterm. AimTo estimate the risk of attention problems at age 10years in children born very preterm to overweight (i.e., body mass index (BMI) 25–29kg/m2) and obese (i.e., BMI≥30kg/m2) women relative to the risk among children born to women who were neither overweight nor obese (i.e. BMI<25kg/m2). Study designMulti-center prospective cohort study. MethodsA total of 764 children born before the 28th week of gestation and whose mother's pre-pregnancy height and pre-pregnancy weight were obtained at birth had an IQ≥70 at age 10years when parents and teachers completed Child Symptom Inventory-4 questionnaires that included items about the presence of ADHD. ResultsCompared to children whose mother's pre-pregnancy weight was in the normal range (BMI<25kg/m2), children were at increased risk of parent-identified ADHD behaviors if their mother was overweight (odds ratio (OR)=1.9; 95% confidence interval (CI): 1.1, 3.3), or obese (OR=2.3; 95% CI: 1.4, 3.9). They were not at increased risk of teacher-identified ADHD characteristics if their mother was overweight before her pregnancy (OR=1.0; 95% CI: 0.6, 1.8), or obese (OR=1.0; 95% CI: 0.6, 1.6). ConclusionMaternal overweight and obesity are associated with increased risk of parent-identified ADHD characteristics at 10years of age in children born extremely preterm.

Genome-wide analysis of attention deficit hyperactivity disorder in Norway.

BackgroundAttention deficit hyperactivity disorder (ADHD) is a highly heritable neuropsychiatric condition, but it has been difficult to identify genes underlying this disorder. This study aimed to explore genetics of ADHD in an ethnically homogeneous Norwegian population by means of a genome-wide association (GWA) analysis followed by examination of candidate loci.Materials and MethodsParticipants were recruited through Norwegian medical and birth registries as well as the general population. Presence of ADHD was defined according to DSM-IV criteria. Genotyping was performed using Illumina Human OmniExpress-12v1 microarrays. Statistical analyses were divided into several steps: (1) genome-wide association in the form of logistic regression in PLINK and follow-up pathway analyses performed in DAPPLE and INRICH softwares, (2) SNP-heritability calculated using genome-wide complex trait analysis (GCTA) tool, (3) gene-based association tests carried out in JAG software, and (4) evaluation of previously reported genome-wide signals and candidate genes of ADHD.ResultsIn total, 1.358 individuals (478 cases and 880 controls) and 598.384 autosomal SNPs were subjected to GWA analysis. No single polymorphism reached genome-wide significance. The strongest signal was observed at rs9949006 in the ENSG00000263745 gene (OR=1.51, 95% CI 1.28–1.79, p=1.38E-06). Pathway analyses of the top SNPs implicated genes involved in the regulation of gene expression, cell adhesion and inflammation. Among previously identified ADHD candidate genes, prominent association signals were observed for SLC9A9 (rs1393072, OR=1.46, 95% CI = 1.21–1.77, p=9.95E-05) and TPH2 (rs17110690, OR = 1.38, 95% CI = 1.14–1.66, p=8.31E-04).ConclusionThis study confirms the complexity and heterogeneity of ADHD etiology. Taken together with previous findings, our results point to a spectrum of biological mechanisms underlying the symptoms of ADHD, providing targets for further genetic exploration of this complex disorder.