Attention-deficit/hyperactivity Disorder Severity Research Articles

The possibilities of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder

Introduction. Attention defi cit hyperactivity disorder (ADHD) is diagnosed in childhood and is the most common mental disorder in children — about 5–7 % among school-age children. None of the treatment methods, as clinical observations showed, is completely effective for the treatment of ADHD. In most cases, the main method of treatment is pharmacotherapy. But despite the proven short-term effectiveness, pharmacotherapy may have limitations: partial response or no response, side effects, questionable long-term benefi ts, poor adherence to the treatment regimen, negative attitude of parents. Limitations of existing pharmacological treatment methods emphasize the need to develop effective non-pharmacological interventions that improve short- and long-term results in regard to neuropsychological defi ciency symptoms and disorders of other general activity fi elds. Currently, there are publications noting the positive clinical effect of osteopathic correction on the children′s health state in various mental sphere disorders. But only a few studies are aimed at studying the effect of osteopathic correction in ADHD. At the same time, there are no publications about the osteopathic correction use in the ADHD treatment without pharmacotherapy.The aim of the study is to investigate the possibility of osteopathic correction using for the treatment of children with attention defi cit hyperactivity disorder.Materials and methods. The study was conducted on the basis of the medical organization «Health′ Clinic» Tver from March 2021 to February 2022. Inclusion criteria: children age 7–10 years; established ADHD diagnosis; absence of diseases and conditions that are an absolute contraindication for osteopathic correction; parental consent to osteopathic examination and correction. Criteria for non-inclusion: age of children younger than 7 and older than 10 years; not confi rmation of the diagnosis according to the «ADHD Assessment Scale — ICD-10 criteria»; the presence of diseases and conditions that are an absolute contraindication for osteopathic correction. Exclusion criteria: failure to attend repeated examinations. The total number of children was 38 people. The patients were distributed by randomization envelopes into 2 groups of 19 people each. The main group: the osteopathic correction and the behavioral psychotherapy were used. The comparison group: the drug hopanthenic acid and the behavioral psychotherapy were used. Before and after the treatment, osteopathic status was assessed in both groups, and the severity of ADHD was assessed according to the ADHD assessment scale (ICD-10 criteria), and an attention test was conducted in the form of a Bourdon correction test.Results. At the beginning of the study, the patients were characterized by regional biomechanical disorders of the head region — in 100 % of participants in both groups, as well as the neck (structural component) — in 63 % of participants in both groups, and the dura mater — in 89 % of participants in the comparison group and 79 % of the main group. After the course of treatment, a signifi cant (p<0,05) positive dynamics was observed in the main group according to the three above indicators, and there was no signifi cant dynamics in the comparison group. After the treatment, the statistically signifi cant (p<0,05) positive dynamics was observed in both groups with respect to the severity of ADHD and the main characteristics of attention: the indicators of the ADHD assessment scale (ICD-10 criteria) decreased, the accuracy coeffi cients and concentration of attention increased, and the fatigue index decreased. At the same time, in the main group, the fatigue index decrease was statistically signifi cant (p<0,05) more pronounced than in the comparison group.Conclusion. The obtained results allow us to recommend osteopathic correction in the treatment of children with ADHD, especially in the cases where, for some reasons, there are restrictions on the medications use.

Examining adverse childhood experiences and attention deficit/hyperactivity disorder: A systematic review

AbstractAdverse childhood experiences (ACEs) comprise many dimensions of abuse and neglect in early development. Attention deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that often begins in childhood. In this review, we investigated the associations between ACEs and ADHD in children. Specifically, the focus is to determine the extent of the relationship between ACE type, cumulative number, and ADHD severity. Furthermore, this study explored all aspects of the bidirectional nature of this relationship including how children with ADHD may experience greater ACEs and the potential contribution of confounding and mediating variables including comorbid conditions and resilience. Selected studies were published between January 2015 and January 2023 on PsychInfo, Google Scholar, PubMed, and Scopus. Selected studies included: (1) The main age group of the study was children; (2) The children had to have been diagnosed with or have parent‐reported ADHD; and (3) The research must include ACE. Case studies and those not meeting the inclusion criteria were excluded from this review. Ultimately, 43 studies met the inclusion criteria, were included in this review, and were evaluated using the appropriate risk of bias assessment tools. These studies supported a positive association between ACEs and ADHD including cumulative quantity and select types of ACEs increasing ADHD severity. Previous literature has primarily utilized observational methodologies which prevent researchers from establishing if there are causal associations and if there is a temporal order to ACEs and ADHD development. This review also provides implications for future research.

Reduced levels of plasma strong antioxidant uric acid in children with Autism Spectrum Disorder and Attention deficit-hyperactivity disorder

Objective: Uric acid (UA) is one of the most powerful antioxidants in human body fluids, as well as being the end product of purine metabolism. UA alone constitutes half of the scavenging effect of oxidant substances in the plasma.It has proinflammatory and metal chelation effects. In this study, UA levels and UA situation according to the normal range were investigated in patients with Autism Spectrum Disorder (ASD), and Attention deficit-hyperactivity disorder (ADHD). Methods: Eighty-two ASD, 28 ADHD patients and 66 healthy control subjects were compared and serum UA levels were measured. ASD and ADHD severity were determined by CARS and Atilla Turgay ADHD scale. K-SADS-PL was administered to all subjects over the age of 6 years. Results: UA levels were found to be significantly lower in the ASD and ADHD groups. UA levels were found to be lower than the normal range in nearly half of the ASD and ADHD groups. This rate was found to be 18.2% in the control group. Conclusion: it was determined that UA levels were low in ASD and ADHD patients. It can be suggested that it may play a role in the pathophysiology of ASD and ADHD. UA may be a potential treatment target.

Childhood Comorbidity Severity Impacts Adolescent Substance Consumption in Patients With Tourette Syndrome

BackgroundThis study explores the longitudinal impact of severity of Tourette Syndrome (TS), diagnosis and severity of Attention-Deficit/Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Disorder (OCD), and guardian socioeconomic status on the level of substance use of pediatric patients with TS. MethodsA total of 314 pediatric patients with TS participated at time 1 (T1). During these visits, the severity of the patients' TS, ADHD, and OCD symptoms were assessed, along with their guardians' socioeconomic status. At time 2 (T2), between four and eight years later (median 5.6 years), 227 patients returned for a follow-up. Here, the patients answered questions about their intake of alcohol, cigarettes, and illegal substances. The relationship between the patients’ diagnoses, symptom severity, and socioeconomic status at T1 and reported substance use at T2 was then analyzed using binary logistic regression. ResultsIncreased severity of ADHD and lower guardian socioeconomic status at T1 significantly increased the odds of later high cigarette consumption. Furthermore, both presence and increased severity of ADHD at T1 increased the odds of illegal substance consumption at T2. Conversely, increased severity of OCD at T1 significantly decreased cigarette and illegal substance consumption at T2, whereas both presence and increased severity of OCD decreased alcohol consumption. ConclusionsPediatric patients with TS with increased ADHD severity have increased risk of consuming illegal substances and high amounts of cigarettes as adolescents, whereas increased OCD severity may act as a protective factor. Having preventative conversations about substance consumption with patients with TS with high ADHD severity is important.

Psychostimulants: An Overview

Treatment of narcolepsy is based on the need to regulate life rhythms. Psychostimulants such as modafinil, methylphenidate-immediate release, and pemoline are used to treat hypersomnia. A psychosocial approach is considered the mainstay of treatment for attention-deficit/hyperactivity disorder (ADHD), and medication is used to treat moderate or severe ADHD symptoms. Two of the four drugs approved in Japan for ADHD therapy (osmotic-release oral system methylphenidate and lisdexamfetamine dimesylate) are psychostimulants, which are administered via the ADHD proper distribution management system.

Mental Health and Psychosocial Status in Mothers of Children with Attention Deficit Hyperactivity Disorder (ADHD): Differences by Maternal ADHD Tendencies : Mental Health and Psychosocial Status in Mothers of ADHD Children.

This study clarified differences in mental health, psychosocial status, and mental health-related factors among mothers of ADHD children between those with and without maternal ADHD tendencies from data of 149 mothers of children with ADHD through an online survey. Mothers with ADHD tendencies had poorer mental health, lower education, more ADHD children, and more parenting stressor of "inadequate understanding of the child's disorder from others" than mothers without ADHD tendencies. Their mental health was poorer especially in younger and in those who had more parenting stressors of "difficulties in understanding the child and coping with the child's needs" and "inadequate understanding of the child's disorder from others." Mental health in mothers without ADHD tendencies was related to a variety of parenting stressors and severe ADHD symptoms in the child. Therefore, assessing maternal ADHD tendencies may be necessary to consider effective individualized support measures for mothers of ADHD children.

Comparison of brief group behavioural parent training with individual parent training for preschool children with attention deficit hyperactivity disorder: A randomized feasibility study.

Behaviour parent training (BPT) is first-line treatment for preschool attention deficit hyperactivity disorder (ADHD). BPT in a group format can be a cost- and time-effective alternative in low and middle-income countries (LMIC) settings with limited resources. We conducted a randomized controlled trial to compare the feasibility and efficacy of group BPT with individual BPT in improving ADHD severity in the preschool age group over 12 weeks. After approval by the ethical committee, the study was conducted in the child guidance clinic, JIPMER. Fifty-six children aged 2.5 to 6 years diagnosed with ADHD according to DSM5 were recruited. Children with autism spectrum disorder and a social quotient less than 50 were excluded. Block randomization parallel design was done. Group interventions were delivered with 4-8 parents per group, focusing on psychoeducation, structuring of routine, attention enhancing tasks, behavioural parenting techniques, and TAU. ADHD severity was assessed using Conner's abbreviated behaviour rating scale at baseline, 4, 8, and 12 weeks. Parental stress was estimated by FISC-MR adapted for ADHD. Statistical analysis included repeated measures ANOVA. Significant improvement was noticed for both groups (F = 20.261, p < .001, ES (η2 ) = 0.539). Group intervention was not inferior to individual BPT in reducing ADHD severity (F = 0.860, p = .468, ES (η2 ) = 0.047). There was a statistically significant difference from baseline to 12 weeks of intervention in the reduction of parental stress (F = 20.80, p < .001, ES (η2 ) = 0.278) and enhancement of the coping strategies (F = 64.4, (p < .001), ES (η2 ) = 0.78). The intervention had high attendance and fidelity rates. Group BPT was promising in treating ADHD in low-resource settings.

Health-related quality of life and perceived stress of informal caregivers of children and adolescents with intellectual disabilities and ADHD

IntroductionInformal caregivers of children and adolescents with intellectual disabilities and attention deficit/hyperactivity disorder (ADHD) face numerous challenges. However, no study has yet compared the HRQoL of the caregivers of children and adolescents with these two conditions. We aimed to compare the HRQoL and perceived stress of caregivers of children and adolescents with intellectual disabilities and ADHD. MethodsThe HRQoL and perceived stress of informal caregivers of children and adolescents with intellectual disabilities and ADHD (40 in each group) were compared using the perceived stress scale and the Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form, respectively. ResultsHRQoL was significantly worse in most dimensions in caregivers of children and adolescents with severe ADHD than in caregivers of children and adolescents with severe intellectual disabilities. However, perceived stress was similar. ConclusionDifferences in the impact of intellectual disability and ADHD on family members' HRQoL should be considered while developing educational programs for patients and their families.

Longitudinal effects of environmental noise and air pollution exposure on autism spectrum disorder and attention-deficit/hyperactivity disorder during adolescence and early adulthood: The TRAILS study

BackgroundExposure to ambient noise and air pollution may affect the manifestation and severity of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). However, evidence is limited, and most studies solely assessed environmental exposures during pregnancy and early childhood. ObjectiveTo examine the longitudinal effects of ambient noise and air pollutants on ASD and ADHD symptom severity during adolescence and early adulthood. MethodsUsing a longitudinal design, we included 2750 children between 10 and 12 years old from the TRacking Adolescents' Individual Lives Survey (TRAILS) in the Netherlands, who were assessed in 6 waves from 2001 to 2017. ASD was measured by the Children's Social Behavior Questionnaire and the Adult Social Behavior Questionnaire. ADHD was measured by Child Behavior Checklist and the Adult Behavior Checklist. Ambient noise and air pollution exposures, including Ozone (O3), soot, sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter 2.5 (PM2.5), and PM10 were modeled at the residential level according to standardized protocols. The longitudinal associations between exposures and symptom outcomes were examined using linear mixed models. ResultsWe found evidence that higher levels of exposure to PM were associated with more severe ASD and ADHD symptoms. This association decreased over time. We did not observe any other consistent associations of noise or other air pollutants with ASD and ADHD severity. ConclusionThe current study provides evidence for the negative impact of PM on ASD and ADHD symptoms. We did not find evidence of the negative health impact of other air pollutants and noise exposures on ASD or ADHD symptoms. Our study adds more evidence on the presence of associations between PM air pollution and neurodevelopmental diseases among adolescents and young adults.

Family Functioning Style as a Predictor of the Quality of Cognitive Functioning of Primary School Students With ADHD

Objective: This study aimed to specify whether family communication and satisfaction are predictors of a child’s executive functions and whether attention deficit hyperactivity disorder (ADHD) severity lies in the pathway between these variables. Method: Two hundred Polish children with ADHD, aged 10 to 13, were tested using Conners 3, the PU1 Battery of Cognitive Tests and Stanford-Binet Intelligence Scale, Fifth Edition (SB5). Parents filled out the FACES IV-SOR questionnaire. Structural equation modeling (SEM) was used to test the hypotheses. Results: The quality of family communication and satisfaction did not predict executive functioning in children with ADHD, and ADHD severity did not play a mediating role neither in boys or in girls. Intelligent quotient was the only predictor of executive functioning in the group of boys. Conclusion: These results contrast with those of previous studies that have shown the existence of similar associations in other cultural contexts.

Motor Function and Physiology in Youth With Neurofibromatosis Type 1

BackgroundNeurofibromatosis type 1 (NF1) is a genetic neurocutaneous disorder commonly associated with motor and cognitive symptoms that greatly impact quality of life. Transcranial magnetic stimulation (TMS) can quantify motor cortex physiology, reflecting the basis for impaired motor function as well as, possibly, clues for mechanisms of effective treatment. We hypothesized that children with NF1 have impaired motor function and altered motor cortex physiology compared to typically developing (TD) control children and children with attention-deficit/hyperactivity disorder (ADHD). MethodsChildren aged 8-17 years with NF1 (n = 21) were compared to children aged 8-12 years with ADHD (n = 59) and TD controls (n = 88). Motor development was assessed using the Physical and Neurological Examination for Subtle Signs (PANESS) scale. The balance of inhibition and excitation in motor cortex was assessed using the TMS measures short-interval cortical inhibition (SICI) and intracortical facilitation (ICF). Measures were compared by diagnosis and tested using bivariate correlations and regression for association with clinical characteristics. ResultsIn NF1, ADHD severity scores were intermediate between the ADHD and TD cohorts, but total PANESS scores were markedly elevated (worse) compared to both (P < 0.001). Motor cortex ICF (excitatory) was significantly lower in NF1 than in TD and ADHD (P < 0.001), but SICI (inhibitory) did not differ. However, in NF1, better PANESS scores correlated with lower SICI ratios (more inhibition; ρ = 0.62, P = 0.003) and lower ICF ratios (less excitation; ρ = 0.38, P = 0.06). ConclusionsTMS-evoked SICI and ICF may reflect processes underlying abnormal motor function in children with NF1.

The impact of ADHD symptom severity on reinforcement and punishment learning among adults

ABSTRACT Introduction: Aberrations in feedback learning are hypothesised to contribute to the behavioural disruptions and impairment of attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated the relation of reward/punishment feedback and ADHD symptom severity on learning. The current study evaluates the differential effects of reward and punishment feedback on learning among adults with elevated ADHD. Methods: One hundred five participants self-reported their level of current ADHD symptoms and completed an innovative instrumental learning task. Results: Consistent with predictions, participants with low self-reported ADHD symptom severity benefitted equally from reward and punishment feedback during the learning task, whereas participants with high self-reported symptom severity performed better (indexed by accuracy on learning task) from reward than punishment feedback trials. Conclusions: Overall, adults with high self-reported symptom severity of ADHD learned more from reward-based feedback, which provides critical implications for motivational theories about ADHD, as well as for treatment protocols. Future work should examine the translatability of results within a treatment setting.

Home Indoor Environmental Quality and Attention Deficit Hyperactivity Disorder

Indoor environmental quality (IEQ) has been found to influence children’s health and behaviour, particularly conditions, such as attention deficit hyperactivity disorder (ADHD). This research aimed to ascertain whether housing IEQ impacted the symptoms of ADHD and its related behaviours. This study involved 435 parents of children and adolescents (aged 5–17) with ADHD residing in Australia. We utilised an online survey tool comprising the home version of the ADHD Rating Scale for Children and Adolescents and the Housing Environmental Quality Assessment Tool. The findings revealed that all the housing IEQ factors were associated with both the diagnosis and the severity of the symptoms. The results indicated that, for over one in ten children with ADHD (13.3%), the diagnosis was impacted by a collective contribution of air quality, acoustic quality, lighting quality, and the thermal comfort within their home. The air quality and the thermal comfort predicted a 4% variance in the severity of inattention. Additionally, air and lighting qualities predicted a 9.7% variance in the severity of hyperactivity-impulsivity, and all the factors of air quality, acoustic quality, lighting quality, and thermal comfort predicted a 10.9% variance in the severity of combined ADHD. In conclusion, this research provided insights into the importance of housing features and suggests that improving the housing indoor environmental quality, mainly thermal comfort, air, and lighting quality, could positively correlate with alleviating ADHD symptoms and severity among children and adolescents. Therefore, ensuring an appropriate indoor environmental quality should be prioritised in housing design, modification, and building, especially for those with ADHD.

Exploring telediagnostic procedures in child neuropsychiatry: addressing ADHD diagnosis and autism symptoms through supervised machine learning.

Recently, there has been an increase in telemedicine applied to child neuropsychiatry, such as the use of online platforms to collect remotely case histories and demographic and behavioral information. In the present proof-of-concept study, we aimed to understand to what extent information parents and teachers provide through online questionnaires overlaps with clinicians' diagnostic conclusions on attention-deficit/hyperactivity disorder (ADHD). Moreover, we intended to explore a possible role that autism spectrum disorders (ASD) symptoms played in this process. We examined parent- and teacher-rated questionnaires collected remotely and an on-site evaluation of intelligence quotients from 342 subjects (18% females), aged 3-16years, and referred for suspected ADHD. An easily interpretable machine learning model-decision tree (DT)-was built to simulate the clinical process of classifying ADHD/non-ADHD based on collected data. Then, we tested the DT model's predictive accuracy through a cross-validation approach. The DT classifier's performance was compared with those that other machine learning models achieved, such as random forest and support vector machines. Differences in ASD symptoms in the DT-identified classes were tested to address their role in performing a diagnostic error using the DT model. The DT identified the decision rules clinicians adopt to classify an ADHD diagnosis with an 82% accuracy rate. Regarding the cross-validation experiment, our DT model reached a predictive accuracy of 74% that was similar to those of other classification algorithms. The caregiver-reported ADHD core symptom severity proved the most discriminative information for clinicians during the diagnostic decision process. However, ASD symptoms were a confounding factor when ADHD severity had to be established. Telehealth procedures proved effective in obtaining an automated output regarding a diagnostic risk, reducing the time delay between symptom detection and diagnosis. However, this should not be considered an alternative to on-site procedures but rather as automated support for clinical practice, enabling clinicians to allocate further resources to the most complex cases.

Mitochondrial Dysfunction in Attention Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder is a neurodevelopmental disorder with primary symptoms of inattention, hyperactivity, and impulsivity, beginning in early childhood. Attention deficit hyperactivity disorder has a complex etiology based on neurobiological foundations, involving genetic, environmental, and biological factors in the early development process. The etiology of attention deficit hyperactivity disorder has not been completely clarified yet, but it has been suggested that increased oxidative stress is one of the possible common etiologies in attention deficit hyperactivity disorder. Oxidative stress can cause cellular damage, DNA repair system malfunction, and mitochondrial dysfunction. Mitochondrial dysfunction is thought to be a susceptibility factor in the development of psychiatric diseases. This article aims to review the research conducted to evaluate the possible relationship between attention deficit hyperactivity disorder and mitochondrial dysfunction and systematically examine the data obtained from these studies. Although studies considering the relationship between attention deficit hyperactivity disorder and mitochondrial dysfunction are less than those of autism spectrum disorder, schizophrenia, and mood disorders, studies on attention deficit hyperactivity disorder are increasing. A compensating system against mitochondrial dysfunction caused by hereditary and environmental factors may be generated by an increase in mitochondrial DNA copy number. Mitochondrial DNA copies may decrease with the reduction of attention deficit hyperactivity disorder severity and attention deficit in patients receiving treatment and may positively affect mitochondrial functions. The literature data of this review show that mitochondrial dysfunction could be a crucial factor in the pathophysiology of attention deficit hyperactivity disorder. Understanding mitochondrial contributions in the pathogenesis of attention deficit hyperactivity disorder may result in new diagnostic tools and the development of new therapeutic strategies for attention deficit hyperactivity disorder treatment.

Youth Polygenic Scores, Youth ADHD Symptoms, and Parenting Dimensions: An Evocative Gene-Environment Correlation Study.

Parenting practices and parental symptoms of attention-deficit/hyperactivity disorder (ADHD) have been linked to severity and course of youth ADHD. However, genetically influenced behaviors related to ADHD in youth may also influence parenting behaviors. Polygenic scores (PGS) have been widely used to quantify genetic vulnerability for ADHD but has rarely been used to examine gene-environment correlation effects. The current study examined the direct effects of youth ADHD PGS and its evocative effects on parenting behaviors via youth ADHD symptoms. 803 youth aged 6-18years (58.5% male) completed a multistage, multi-informant assessment that included measures of parenting practices and youth and parental ADHD symptoms. A mediation model was used to evaluate direct and evocative effects. Furthermore, we examined if these evocative effects remain after controlling for parental ADHD symptoms. Sensitivity analyses across age, sex, and socioeconomic status (SES) as well as restricting ancestry groups to European only ancestry were also conducted. Results indicated that youth ADHD PGS reliably predicted youth ADHD symptoms across all models (βs ranging from 0.18 to 0.26), including across age, sex, and SES and held even with ancestry restricted to the largest group (northern European). Evocative effects emerged such that higher youth PGS significantly predicted more youth ADHD symptoms, which in turn, significantly predicted lower levels of parental involvement and higher levels of poor supervision/monitoring and inconsistent discipline. These effects remained after controlling for parent ADHD symptoms.

Is Problematic Media Use a Marker for Aggression in Children with Attention Deficit/Hyperactivity Disorder?

Background: Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a series of problems, including aggressive behavior and problematic media use (PMU). However, the literature concerning the relationship between PMU and aggressive behavior patterns in children diagnosed with ADHD is limited. This study examines the relationships between PMU and aggression in children with ADHD. Methods: One hundred sixty-two children aged 6-12 years diagnosed with ADHD were included in the study. All participants were assessed with DSM-5-based psychiatric evaluations. Aggressive behaviors in children were evaluated using the Children’s Aggression Scale Parent Version (CAS-P). The children’s screen use was scored using the Problematic Media Use Measure Short Form (PMUM-SF). The data obtained were compared using statistical methods. Results: A significant correlation at the p&lt;.05 level was determined between PMU and the severity of ADHD (mild-moderate and severe). PMU was positively and statistically significantly correlated with verbal aggression (r = 0.422, p &lt; 0.001), aggression against objects and animals (r = 0.367, p &lt; 0.001), provoked physical aggression (r = 0.365, p &lt; 0.001) and unprovoked physical aggression (r = 0.283, p &lt; 0.001). In addition, PMU significantly (p &lt;0.001) predicted verbal aggression, aggression against objects and animals, and provoked and unprovoked physical aggression. Conclusions: A positive correlation was observed between PMU in children and the risk of aggression in this group, and PMU predicted aggression. These findings may contribute to the formation of guidelines for intervention when problematic behaviors emerge in children diagnosed with ADHD.

Comparison of serum vitamin D levels between healthy and ADHD children.

The most common psychiatric disorder in childhood is Attention-deficit/hyperactivity disorder (ADHD). Researchers have studied the effects of micronutrients on ADHD in recent years, but vitamin D (vit D) deficiency has received less attention. In this study, serum vit D levels were compared between healthy and ADHD children. This case-control study was carried out, in 2020, on 6-to-12-years-old children. There were 45 children with ADHD in the case group and 45 healthy children in the control group. Intravenous blood samples were taken from each child to measure serum vitamin D levels. A p-value < 0.05 was considered as significant. Mean serum vit D levels in children with ADHD (17.34±8.37 ng / ml) were significantly lower than those in the control group (23.02±10.97 ng / ml) (P= 0.007). There were no significant differences in mean serum levels of vit D due to ADHD subtypes. Mean serum vit D levels were not significantly associated with the gender of children with ADHD. There was an inverse correlation between vit D levels and the severity of ADHD, but it was not statistically significant. The present study showed that children with ADHD had significantly lower serum vit D levels than healthy controls.

Comparison of Leptin, Leptin Receptor, Vitamin D and Brain-Derived Neurotrophic Factor Levels in Major Depressive Disorder and Attention Deficit and Hyperactivity Disorder in Children and Adolescents

Objective: Data on effects of vitamins, hormones and neurotrophic factors on the etiology of attention deficit hyperactivity disorder (ADHD) and major depressive disorder (MDD) in children is limited. We hypothesized that serum vitamin D, brain-derived neurotrophic factor (BDNF), leptin, and leptin receptor levels are different in these patients, and that aforementioned biomarkers may affect symptom severity and risk of suicide. Methods: This study included 33 ADHD, 29 MDD patients and 35 healthy controls. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was used to assess the severity of ADHD, while Children Depression Inventory (CDI) and the Suicide Probability Scale (SPS) were used to measure the severity of depression and suicide risk in the MDD group. Serum vitamin D, BDNF, leptin, and leptin receptor levels were measured from participants’ venous blood samples. Results: Vitamin D and leptin receptor levels were significantly higher in the control group than in the patient groups, and leptin levels were significantly higher in the ADHD group than in the MDD and control groups. There was no difference between the groups in terms of BDNF levels. No significant correlations between ADHD duration, subtype, severity, depression severity, suicide risk, and vitamin D, BDNF, leptin, and leptin receptor levels were found. Conclusion: Although current research supports that BDNF, vitamin D, leptin, and leptin receptor levels may be involved in the etiopathogenesis of MDD and ADHD, large-scale studies are needed to better evaluate the effects of these factors.

Attention-deficit hyperactivity symptoms and risk of alcohol use relapse.

Alcohol use disorder (AUD) is frequently accompanied by comorbid attention-deficit hyperactivity disorder (ADHD). Comorbid ADHD has been reported to increase the severity of AUD. We investigated whether ADHD severity also influences AUD relapse risk at baseline and after inpatient treatment. In this study, 187 AUD patients admitted to Narimasu Kosei Hospital from October 2019 to March 2021 were included in the analysis. According to the Adult ADHD Self-Report Scale (ASRS), participants were divided into two groups: ASRS+ with ADHD characteristics (n=43) and ASRS- with low/no ADHD characteristics (n=144). Groups were compared for AUD relapse risk at the start of treatment (baseline) and before hospital discharge using the multidimensional Alcohol Relapse Risk Scale (ARRS). The change in relapse risk during hospitalization was also compared by assessment of the interaction between groups (ASRS+ vs. ASRS-) and time (at discharge vs. baseline). The total ARRS score and dimension subscores for stimulus-induced vulnerability and emotionality problems were significantly higher in the ASRS+ group at baseline and before discharge compared to the ASRS- group. There was a significant group × time interaction indicating less improvement of stimulus-induced vulnerability during inpatient treatment among the ASRS+ group compared to the ASRS- group. Our findings suggest that AUD patients with ADHD characteristics have a higher risk of relapse both at baseline and after inpatient treatment. Stimulus-induced vulnerability to relapse is less likely to improve with treatment in patients with ADHD characteristics.