Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment ...Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.展开更多
Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child ...Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.展开更多
The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via...The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.展开更多
To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionate...To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.展开更多
BACKGROUND Attention-deficit hyperactivity disorder(ADHD)and its pharmacological treatments may influence growth in children and adolescents.This meta-analysis aimed to clarify their effects on the physical developmen...BACKGROUND Attention-deficit hyperactivity disorder(ADHD)and its pharmacological treatments may influence growth in children and adolescents.This meta-analysis aimed to clarify their effects on the physical development,especially weight and height.AIM To investigate the effects of ADHD and its treatment on growth in children and adolescents.METHODS Researchers reviewed 18 studies published up to September 2023 from databases such as PubMed,EMBASE,Cochrane,and Web of Science.They analyzed changes in body weight,height,and body mass index(BMI)before and after ADHD treatment,along with the risks of overweight and obesity.RESULTS Children with ADHD undergoing long-term medication therapy showed decreased actual weight[weighted mean difference(WMD)=-9.50]and height(WMD=-0.15),along with a slight increase in weight standard deviation scores(WMD=0.23)and height z scores(WMD=0.10).BMI showed a non-significant downward trend(WMD=-1.72).Regarding overweight and obesity risks,the pooled odds ratios were 1.37 and 1.16,respectively,but these were not statistically significant.CONCLUSION Overall,the study suggests that long-term pharmacological treatment for ADHD may be associated with reduced growth in weight and height among young patients.However,no clear link was found between ADHD and increased risk of overweight or obesity.These findings highlight the importance of monitoring growth in children receiving medication for ADHD.展开更多
BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ...BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.展开更多
The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stoppi...The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stopping task paradigm,with 66 children with ADHD tendencies as the research subjects.A mixed design of 2(reward and punishment type:reward,punishment)×2(stimulus type:monetary stimulus,social stimulus)was used.The analysis applied a between intervention group(with reward and punishment type variables)and within type of reward approach(by stimulus type as intra subject variables).The results showed that monetary punishment better promotes behavioral inhibition in children with an ADHD tendency than does reward.In addition,this study showed that monetary punishment and social rewards affected the speed–accuracy trade-off of inhibited behavior in children with an ADHD tendency.Thesefindings suggest that withdrawal of a material token resulted in more behavioural compliance in children with an ADHD tendency.展开更多
BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emoti...BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emotional functioning.Resting-state functional magnetic resonance imaging(rs-fMRI)provides critical insights into the functional architecture of the brain in ADHD.Despite extensive research,specific brain regions consistently affected in ADHD patients during these formative years have not been comprehensively delineated.AIM To identify consistent vulnerable brain regions in adolescent ADHD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We conducted a comprehensive literature search up to August 31,2024,to identify studies investigating functional brain alterations in adolescents with ADHD.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF),dynamic ALFF(dALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with ADHD with those in healthy controls(HCs)using ALE.RESULTS Fifteen studies(468 adolescent ADHD patients and 466 HCs)were included.Combining the ReHo and ALFF/fALFF/dALFF data,the results revealed increased activity in the right lingual gyrus[LING,Brodmann Area(BA)18],left LING(BA 18),and right cuneus(CUN,BA 23)in adolescent ADHD patients compared with HCs(voxel size:592-32 mm³,P<0.05).Decreased activity was observed in the left medial frontal gyrus(MFG,BA 9)and left precuneus(PCUN,BA 31)in adolescent ADHD patients compared with HCs(voxel size:960-456 mm³,P<0.05).Jackknife sensitivity analyses demonstrated robust reproducibility in 11 of the 13 tests for the right LING,left LING,and right CUN and in 11 of the 14 tests for the left MFG and left PCUN.CONCLUSION We identified specific brain regions with both increased and decreased activity in adolescent ADHD patients,enhancing our understanding of the neural alterations that occur during this pivotal stage of development.展开更多
Background Attention-deficit/hyperactivity disorder(ADHD)is a common neurodevelopmental disorder with behavioural symptoms and grey matter volume(GMV)changes.However,previous studies have not fully elucidated the prog...Background Attention-deficit/hyperactivity disorder(ADHD)is a common neurodevelopmental disorder with behavioural symptoms and grey matter volume(GMV)changes.However,previous studies have not fully elucidated the progressive and causal GMV changes associated with behavioural symptoms in ADHD.Aims This study aimed to explore the causal relationship between GMV alterations and behavioural symptoms in children and adolescents with ADHD using behaviourcausal structural covariance network(BCaSCN)analysis.Methods Structural magnetic resonance imaging(sMRI)data from 135 children and adolescents with ADHD and182 neurotypical controls(NCs)were analysed.ADHD subtypes were identified based on GMV using a clustering algorithm to address the neuroanatomical heterogeneity.To investigate the causal relationships of GMV changes related to behavioural symptoms,sMRI data were sequentially ordered by ADHD index,inattentive index and hyperactive/impulsive index values to generate pseudotime series data.These data were then analysed using region-of-interest-based BCaSCN analysis to explore potential progressive patterns of GMV change.Results Neuroanatomical subtyping revealed two ADHD subtypes with distinct GMV patterns compared with NCs.BCaSCN analysis showed that ADHD subtype 1 was closely associated with inattentiveness,involving prominent nodes in the frontal regions and cerebellum.In contrast,ADHD subtype 2 was more strongly linked to overall disease severity,with the cerebellum and hippocampus as primary hubs.Conclusions ADHD is associated with heterogeneous changes in GMV corresponding to distinct behavioural domains,highlighting the need for subtype-specific diagnostic and therapeutic strategies.展开更多
The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（A...The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.展开更多
Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperacti...Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.展开更多
Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have re...Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have reported the association between the serotonin receptor family （5-HTR） gene polymorphisms and ADHD, but the results are still controversial. In this study, we conducted a meta-analysis of the association between 5-HTRIB, 5-HTR2A, and 5-HTR2C genetic variants and ADHD. The results showed that the 861G allele of 5-HTRIB SNP rs6296 could significantly increase the risk of ADHD （OR= 1.09, 95% CI： 1.01-1.18）; the 5-HTR2C gene rs518147 （OR=1.69, 95% CI： 1.38-2.07） and rs3813929 （OR = 1.57, 95% CI： 1.25-1.97） were all associated with the risk of ADHD. In addition, we also carried on a case- control study to explore the relevance between potential candidate genes 5-HTR1A, 5-HTRIE, 5-HTR3A and ADHD. The results indicated that 5-HTRIA rs6295 genotype （CC＋CG vs. GG OR=Z00, 95% CI： 1.23-3.27） and allele （OR=1.77, 95% CI： 1.16-2.72） models were statistically significantly different between case group and control group. This study is the first comprehensive exploration and summary of the association between serotonin receptor family genetic variations and ADHD, and it also provides more evidence for the etiology of ADHD.展开更多
Attention deficit hyperactivity disorder(ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperact...Attention deficit hyperactivity disorder(ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function.展开更多
OBJECTIVE:To investigate the mechanism underlying the effects of Shichangpu(Rhizoma Acori Tatarinowii)on attention deficit hyperactivity disorder(ADHD).METHODS:A network pharmacology approach integrating ingredients o...OBJECTIVE:To investigate the mechanism underlying the effects of Shichangpu(Rhizoma Acori Tatarinowii)on attention deficit hyperactivity disorder(ADHD).METHODS:A network pharmacology approach integrating ingredients of Shichangpu(Rhizoma Acori Tatarinowii)and target with ADHD,network construction,molecular function interactions and pathway analysis was used.RESULTS:This approach successfully helped to identify 7 active ingredients of CN,interacting with21 key targets(ADRA1 A,ADRA1 B,ADRA2 A,ADRA2 B,ADRA2 C,ADRB1,ADRB2,CHRM1,CHRM2,CHRM3,PTGS1,SLC6 A2,SLC6 A3,SLC6 A4,DRD1,DRD5,HTR2 A,ADRA1 D,MAOB,GRIA2,HTR1 A).The molecular function interactions among candidate targets mainly consisted of four groups:G-protein coupled amine receptor activity,catecholamine binding,monoamine transmembrane transporter activity and neurotransmitter receptor activity.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis indicated that Shichangpu(Rhizoma Acori Tatarinowii)-regulated pathways were mainly classified into signal transduction and monoamine neurotransmitters.CONCLUSION:Our investigation revealed that Shichangpu(Rhizoma Acori Tatarinowii)could improve the symptoms of ADHD by regulating neurotransmitter,in multiple types of compounds-target-pathway,which may be implicated in the major pathological processes of ADHD.展开更多
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset in early childhood.It is a clinically heterogenous condition with comorbidity posing a distinct challenge to diagnosin...Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset in early childhood.It is a clinically heterogenous condition with comorbidity posing a distinct challenge to diagnosing and managing these children and adolescents.This review aims to provide an overview of comorbidity with ADHD including other neurodevelopmental disorders,learning disorders,externalising and internalising disorders.Challenges in screening for,diagnosing and managing comorbidity with ADHD are summarised.Also,methodological challenges and future directions in research in this interesting field are highlighted.展开更多
Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are c...Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.展开更多
AIM: To determine the prevalence of bipolar disorder(BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder(ADHD) through 14 years' follow-up, when participants were between 21-24...AIM: To determine the prevalence of bipolar disorder(BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder(ADHD) through 14 years' follow-up, when participants were between 21-24 years old.METHODS: First, we examined rates of BD type Ⅰ?and Ⅱ diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD(MTA). We used the diagnostic interview schedule for children(DISC), administered to both parents(DISC-P) and youth(DISCY). We compared the MTA study subjects with ADHD(n = 579) to a local normative comparison group(LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts(TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic(PM) and non-specific manic(NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD(1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time(df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability(BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG(χ2 = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM(df 3, 2538; F = 43.2; P < 0.0001).CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2(A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.展开更多
AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS...AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.展开更多
Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive deve...Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive development in childhood, and may lead to chronic under-achievement, academic failure, problematic peer relationships, and low self-esteem. There are at least three challenges for the treatment of ADHD. First, the neurobiological bases of its symptoms are still not clear. Second, the commonly prescribed medications, most showing short-term therapeutic efficacy but with a high risk of serious side-effects, are mainly based on a dopamine mechanism. Third, more novel and efficient animal models, especially in nonhuman primates, are required to accelerate the development of new medications. In this article, we review research progress in the related fields, focusing on our previous studies showing that blockade of prefrontal cortical a2A-adrenoceptors in monkeys produces almost all the typical behavioral symptoms of ADHD.展开更多
Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either...Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either isolated or administered with lead acetate to establish an animal model of attention deficit hyperactivity disorder.Atomoxetine served as the reference standard.Animals’behaviours were assessed through Y-maze,novel object preference,fear conditioning and residentintruder aggression tests.Oxidative stress parameters,bioamine concentration(dopamine,noradrenaline and 5-hydroxytryptamine),nerve growth factor,interleukin-6,nuclear factor-κB,and tumour necrosis factor(TNF)-αwere estimated.Synaptophysin immunohistochemical assay was performed.Results:Celastrus paniculatus oil significantly improved behavioural parameters in Y maze,novel object preference,discrimination index,fear conditioning and resident intruder aggressive tests.The treatment groups showed a decrease in malondialdehyde level.Changes in the levels of dopamine,noradrenaline,and serotonin were restored by Celastrus paniculatus oil.Celastrus paniculatus oil increased nerve growth factor and decreased interleukin-6,nuclear factor-κB,and TNF-α.Synaptophysin immunoreactivity was also improved by Celastrus paniculatus oil with alleviated reactive gliosis,degeneration,and vascular proliferation.Conclusions:This research shows the therapeutic potential of Celastrus paniculatus oil for the treatment of attention deficit hyperactivity disorder.展开更多
基金Supported by the Central Guiding Local Science and Technology Development Fund Project,No.YDZX2022091。
文摘Attention deficit hyperactivity disorder(ADHD)turns into a common neuro progressional disorder.Although gender identity has obtained increasing attention in ADHD researches,its role in ADHD presentation and treatment response remains underexplored.Our review seeks to mainly delve into the effect of gender identity on ADHD,exploring the unique needs of individuals with various gender identities in the context of ADHD symptoms,diagnostic assessment,and treatment,with the goal of supplying theoretical support and practical recommendations for future research and clinical practice.The primary content includes,specifically:(1)Symptom expression differences:Gender identity significantly affects ADHD symptoms;male-identified individuals commonly perform worse in task orientation and attention stability,while female-identified individuals may demonstrate more variability in attention control and executive functions;(2)Diagnosis and treatment:Clinical practice generally neglects the impact of gender identity on ADHD management,with personalized needs of gender-identified individuals frequently not adequately addressed,potentially,affecting treatment outcomes;and(3)Future research directions:Future studies should further assess how gender identity affects the specific mechanisms of ADHD,conduct researches in multicultural contexts,and engage in long-term follow-up studies to evaluate the long-term impact of gender identity on ADHD progression.Besides,enhanced funding and public education on the relationship between gender identity and ADHD are needed to advance the field.
文摘Background Raising a child with attention deficit hyperactivity disorder(ADHD)is a key challenge for the primary caregiver.This systematic review aims to identify major burdens facing the primary caregiver of a child with ADHD.Methods The electronic databases CINAHL,PubMed,and Google Scholar were searched for studies published in English from 2017 to 2022 assessing the challenges facing caregivers of a child with ADHD.The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess quality and risk of bias of studies identified for inclusion.Articles were synthesized by evaluating principal themes of burden to caregivers,stress of caregivers,and effectiveness of intervention programs.Results Eleven articles were included in this review and included a total of 2426 participants.Findings revealed that caregivers of children with ADHD have a poor quality of life and high stress levels.Supportive parenting programs can be effective for improved coping and adaptation mechanisms with children with ADHD.However,few interventional studies were identified,increasing potential for bias.No meta-analysis was conducted.Conclusion Caregivers of children with ADHD can benefit from strategies to improve their quality of life and reduce their stress levels.Targeted parenting programs can make a positive difference in the well-being of caregivers and children with ADHD.Additional research is needed to address the evidence-based effectiveness of parenting support programs.
文摘The prevalence of autism and attention deficit/hyperactivity disorders is increasing worldwide.Recent studies suggest the excessive intake of ultra-processed food plays a role in the inheritance of these disorders via heavy metal exposures and nutritional deficits that impact the expression of genes.In the case of the metallothionein(MT)gene,biomarker studies show dietary zinc(Zn)deficits impact MT protein levels in children with autism and are associated with the bioaccumulation of lead and/or mercury in children exhibiting autism/attention deficit/hyperactivity disorders symptomology.The impact of dietary changes on lead and mercury exposures and MT gene behavior could be determined using a randomized test and control group design.Pregnant women serving in the testgroup would participate in a nutritional epigenetics education intervention/course designed to reduce ultra-processed food intake and heavy metal levels in blood while increasing whole food intake and MT and Zn levels.Changes in maternal diet would be measured using data derived from an online diet survey administered to the test and control groups pre-post intervention.Changes in maternal lead,mercury,Zn,and MT levels would be measured via blood sample analyses prior to the intervention and after childbirth via cord blood analyses to determine infant risk factors.
基金supported by National Natural Science Foundation Youth Project (81901386)the Fundamental Research Funds for the Central Universities (YG2025ZD07)+5 种基金the National Science and Technology Innovation 2030 Major Project of China (2021ZD0203900)National Natural Science Foundation of China (NSFC) grant (82422029)the Science and Technology Commission of Shanghai Municipality (24Y22800200, 22QA1407900)NSFC grant (82271530)Innovation teams of high-level universities in Shanghaithe Scientific Research and Innovation Team of Liaoning Normal University (24TD004).
文摘To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.
基金Supported by First-class Undergraduate Course Construction Project of Henan Province(Online and Offline Hybrid Course),No.[2021]21548and 2021 Pingdingshan Smart Nursing Key Laboratory.
文摘BACKGROUND Attention-deficit hyperactivity disorder(ADHD)and its pharmacological treatments may influence growth in children and adolescents.This meta-analysis aimed to clarify their effects on the physical development,especially weight and height.AIM To investigate the effects of ADHD and its treatment on growth in children and adolescents.METHODS Researchers reviewed 18 studies published up to September 2023 from databases such as PubMed,EMBASE,Cochrane,and Web of Science.They analyzed changes in body weight,height,and body mass index(BMI)before and after ADHD treatment,along with the risks of overweight and obesity.RESULTS Children with ADHD undergoing long-term medication therapy showed decreased actual weight[weighted mean difference(WMD)=-9.50]and height(WMD=-0.15),along with a slight increase in weight standard deviation scores(WMD=0.23)and height z scores(WMD=0.10).BMI showed a non-significant downward trend(WMD=-1.72).Regarding overweight and obesity risks,the pooled odds ratios were 1.37 and 1.16,respectively,but these were not statistically significant.CONCLUSION Overall,the study suggests that long-term pharmacological treatment for ADHD may be associated with reduced growth in weight and height among young patients.However,no clear link was found between ADHD and increased risk of overweight or obesity.These findings highlight the importance of monitoring growth in children receiving medication for ADHD.
文摘BACKGROUND Speech and language therapy(ST)might moderate the prognosis in children with attention deficit and hyperactivity disorder(ADHD)comorbid with speech delay.This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.AIM To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.METHODS The population-based National Health Insurance Research Database in Taiwan was used.Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.RESULTS Of 11987 children with ADHD identified from the dataset,2911(24%)had received ST.The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72(95%confidence interval:0.63-0.82)in children who received ST compared to the matched counterparts.This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.CONCLUSION ST can moderate the effects of integrated early interventions in ADHD children with speech delay.
基金supported by the National General Projects in 2020 of the 13th Five Year Plan of National Education Science in China:A Study on Attention Training Interventions for ADHD Children in Regular Classes from the Perspective of Educational Neuroscience(BHA200123).
文摘The study investigated the effects of monetary rewards and punishments on the behavioral inhibition in children with attention deficit hyperactivity disorder(ADHD)tendencies.The present study adopted the signal stopping task paradigm,with 66 children with ADHD tendencies as the research subjects.A mixed design of 2(reward and punishment type:reward,punishment)×2(stimulus type:monetary stimulus,social stimulus)was used.The analysis applied a between intervention group(with reward and punishment type variables)and within type of reward approach(by stimulus type as intra subject variables).The results showed that monetary punishment better promotes behavioral inhibition in children with an ADHD tendency than does reward.In addition,this study showed that monetary punishment and social rewards affected the speed–accuracy trade-off of inhibited behavior in children with an ADHD tendency.Thesefindings suggest that withdrawal of a material token resulted in more behavioural compliance in children with an ADHD tendency.
基金Supported by National Natural Science Foundation of China,No.82460282Guizhou Province Science and Technology Plan Project,No.ZK-2023-195+1 种基金Guizhou High-Level Innovative Talent Project,No.gzwjrs2022-013Health Commission of Guizhou Province Project,No.gzwkj2024-475 and No.gzwkj2021-150.
文摘BACKGROUND Attention deficit hyperactivity disorder(ADHD)is a prevalent neurodevelopmental disorder in adolescents characterized by inattention,hyperactivity,and impulsivity,which impact cognitive,behavioral,and emotional functioning.Resting-state functional magnetic resonance imaging(rs-fMRI)provides critical insights into the functional architecture of the brain in ADHD.Despite extensive research,specific brain regions consistently affected in ADHD patients during these formative years have not been comprehensively delineated.AIM To identify consistent vulnerable brain regions in adolescent ADHD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We conducted a comprehensive literature search up to August 31,2024,to identify studies investigating functional brain alterations in adolescents with ADHD.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF),dynamic ALFF(dALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with ADHD with those in healthy controls(HCs)using ALE.RESULTS Fifteen studies(468 adolescent ADHD patients and 466 HCs)were included.Combining the ReHo and ALFF/fALFF/dALFF data,the results revealed increased activity in the right lingual gyrus[LING,Brodmann Area(BA)18],left LING(BA 18),and right cuneus(CUN,BA 23)in adolescent ADHD patients compared with HCs(voxel size:592-32 mm³,P<0.05).Decreased activity was observed in the left medial frontal gyrus(MFG,BA 9)and left precuneus(PCUN,BA 31)in adolescent ADHD patients compared with HCs(voxel size:960-456 mm³,P<0.05).Jackknife sensitivity analyses demonstrated robust reproducibility in 11 of the 13 tests for the right LING,left LING,and right CUN and in 11 of the 14 tests for the left MFG and left PCUN.CONCLUSION We identified specific brain regions with both increased and decreased activity in adolescent ADHD patients,enhancing our understanding of the neural alterations that occur during this pivotal stage of development.
基金funded by the Department of Science and Technology of Shandong ProvinceNatural Science Foundation of Shandong Province(ZR2023QH109)Taishan Scholars Program of Shandong Province(TS201712065)。
文摘Background Attention-deficit/hyperactivity disorder(ADHD)is a common neurodevelopmental disorder with behavioural symptoms and grey matter volume(GMV)changes.However,previous studies have not fully elucidated the progressive and causal GMV changes associated with behavioural symptoms in ADHD.Aims This study aimed to explore the causal relationship between GMV alterations and behavioural symptoms in children and adolescents with ADHD using behaviourcausal structural covariance network(BCaSCN)analysis.Methods Structural magnetic resonance imaging(sMRI)data from 135 children and adolescents with ADHD and182 neurotypical controls(NCs)were analysed.ADHD subtypes were identified based on GMV using a clustering algorithm to address the neuroanatomical heterogeneity.To investigate the causal relationships of GMV changes related to behavioural symptoms,sMRI data were sequentially ordered by ADHD index,inattentive index and hyperactive/impulsive index values to generate pseudotime series data.These data were then analysed using region-of-interest-based BCaSCN analysis to explore potential progressive patterns of GMV change.Results Neuroanatomical subtyping revealed two ADHD subtypes with distinct GMV patterns compared with NCs.BCaSCN analysis showed that ADHD subtype 1 was closely associated with inattentiveness,involving prominent nodes in the frontal regions and cerebellum.In contrast,ADHD subtype 2 was more strongly linked to overall disease severity,with the cerebellum and hippocampus as primary hubs.Conclusions ADHD is associated with heterogeneous changes in GMV corresponding to distinct behavioural domains,highlighting the need for subtype-specific diagnostic and therapeutic strategies.
基金supported by a Project of Shanghai Municipal Health and Family Planning Commission (201540114)a Key Specialty Project of Shanghai Municipal Health and Family Planning Commission grant for Child Psychiatry (ZK2015B01)a Research Project of the Shanghai Changning Health and Family Planning Commission grant (20164Y013)
文摘The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.
文摘Tourette syndrome(TS) is a neurodevelopmental disorder characterized by multiple chronic motor and vocal tics beginning in childhood. Several studies describe the association between TS and attention deficit hyperactivity disorder(ADHD). Fifty percent of children diagnosed with ADHD have comorbid tic disorder. ADHD related symptoms have been reported in 35% to 90% of children with TS. Since ADHD is the most prevalent comorbid condition with TS and those with concomitant TS and ADHD present with considerable psychosocial and behavioral impairments, it is essential for clinicians to be familiar with these diagnoses and their management. This paper highlights the association between treating ADHD with stimulants and the development of tic disorders. The two cases discussed underscore the fact that children with TS may present with ADHD symptomatology prior to the appearance of any TS related symptoms. Appropriate management of TS in a patient diagnosed with ADHD can lead to quality of life improvements and a reduction in psychosocial impairments.
文摘Attention deficit hyperactivity disorder （ADHD） is one of the most common mental disorders in childhood, with a high heritability about 60% to 90%. Serotonin is a monoamine neurotransmitter. Numerous studies have reported the association between the serotonin receptor family （5-HTR） gene polymorphisms and ADHD, but the results are still controversial. In this study, we conducted a meta-analysis of the association between 5-HTRIB, 5-HTR2A, and 5-HTR2C genetic variants and ADHD. The results showed that the 861G allele of 5-HTRIB SNP rs6296 could significantly increase the risk of ADHD （OR= 1.09, 95% CI： 1.01-1.18）; the 5-HTR2C gene rs518147 （OR=1.69, 95% CI： 1.38-2.07） and rs3813929 （OR = 1.57, 95% CI： 1.25-1.97） were all associated with the risk of ADHD. In addition, we also carried on a case- control study to explore the relevance between potential candidate genes 5-HTR1A, 5-HTRIE, 5-HTR3A and ADHD. The results indicated that 5-HTRIA rs6295 genotype （CC＋CG vs. GG OR=Z00, 95% CI： 1.23-3.27） and allele （OR=1.77, 95% CI： 1.16-2.72） models were statistically significantly different between case group and control group. This study is the first comprehensive exploration and summary of the association between serotonin receptor family genetic variations and ADHD, and it also provides more evidence for the etiology of ADHD.
文摘Attention deficit hyperactivity disorder(ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function.
基金Supported by the National Natural Science Foundation of China(No.81774366)National Major New Drug Creation Project(No.2014ZX09304-306-002).
文摘OBJECTIVE:To investigate the mechanism underlying the effects of Shichangpu(Rhizoma Acori Tatarinowii)on attention deficit hyperactivity disorder(ADHD).METHODS:A network pharmacology approach integrating ingredients of Shichangpu(Rhizoma Acori Tatarinowii)and target with ADHD,network construction,molecular function interactions and pathway analysis was used.RESULTS:This approach successfully helped to identify 7 active ingredients of CN,interacting with21 key targets(ADRA1 A,ADRA1 B,ADRA2 A,ADRA2 B,ADRA2 C,ADRB1,ADRB2,CHRM1,CHRM2,CHRM3,PTGS1,SLC6 A2,SLC6 A3,SLC6 A4,DRD1,DRD5,HTR2 A,ADRA1 D,MAOB,GRIA2,HTR1 A).The molecular function interactions among candidate targets mainly consisted of four groups:G-protein coupled amine receptor activity,catecholamine binding,monoamine transmembrane transporter activity and neurotransmitter receptor activity.Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis indicated that Shichangpu(Rhizoma Acori Tatarinowii)-regulated pathways were mainly classified into signal transduction and monoamine neurotransmitters.CONCLUSION:Our investigation revealed that Shichangpu(Rhizoma Acori Tatarinowii)could improve the symptoms of ADHD by regulating neurotransmitter,in multiple types of compounds-target-pathway,which may be implicated in the major pathological processes of ADHD.
文摘Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset in early childhood.It is a clinically heterogenous condition with comorbidity posing a distinct challenge to diagnosing and managing these children and adolescents.This review aims to provide an overview of comorbidity with ADHD including other neurodevelopmental disorders,learning disorders,externalising and internalising disorders.Challenges in screening for,diagnosing and managing comorbidity with ADHD are summarised.Also,methodological challenges and future directions in research in this interesting field are highlighted.
文摘Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder in children and adolescents, with prevalence ranging between 5% and 12% in the developed countries. Tic disorders(TD) are common co-morbidities in paediatric ADHD patients with or without pharmacotherapy treatment. There has been conflicting evidence of the role of psychostimulants in either precipitating or exacerbating TDs in ADHD patients. We carried out a literature review relating to the management of TDs in children and adolescents with ADHD through a comprehensive search of MEDLINE, EMBASE, CINAHL and Cochrane databases. No quantitative synthesis(meta-analysis) was deemed appropriate. Metaanalysis of controlled trials does not support an association between new onset or worsening of tics and normal doses of psychostimulant use. Supratherapeutic doses of dextroamphetamine have been shown to exacerbate TD. Most tics are mild or moderate and respond to psychoeducation and behavioural management. Level A evidence support the use of alpha adrenergic agonists, including Clonidine and Guanfacine, reuptake noradrenenaline inhibitors(Atomoxetine) and stimulants(Methylphenidate and Dexamphetamines) for the treatment of Tics and comorbid ADHD. Priority should be given to the management of co-morbid Tourette's syndrome(TS) or severely disabling tics in children and adolescents with ADHD. Severe TDs may require antipsychotic treatment. Antipsychotics, especially Aripiprazole, are safe and effective treatment for TS or severe Tics, but they only moderately control the co-occurring ADHD symptomatology. Short vignettes of different common clinical scenarios are presented to help clinicians determine the most appropriate treatment to consider in each patient presenting with ADHD and co-morbid TDs.
文摘AIM: To determine the prevalence of bipolar disorder(BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder(ADHD) through 14 years' follow-up, when participants were between 21-24 years old.METHODS: First, we examined rates of BD type Ⅰ?and Ⅱ diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD(MTA). We used the diagnostic interview schedule for children(DISC), administered to both parents(DISC-P) and youth(DISCY). We compared the MTA study subjects with ADHD(n = 579) to a local normative comparison group(LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts(TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic(PM) and non-specific manic(NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD(1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time(df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability(BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG(χ2 = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM(df 3, 2538; F = 43.2; P < 0.0001).CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2(A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.
基金funding from NIMH, AHRQ, Marriott Foundation, Mayo Foundation
文摘AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.
基金supported by grants from the National Natural Science Foundation of China (31460263, 30990263, and 31271171)the National Basic Research Development Program (973 Program) of China (2013CB835101)
文摘Attention deficit and hyperactivity disorder （ADHD）, a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive development in childhood, and may lead to chronic under-achievement, academic failure, problematic peer relationships, and low self-esteem. There are at least three challenges for the treatment of ADHD. First, the neurobiological bases of its symptoms are still not clear. Second, the commonly prescribed medications, most showing short-term therapeutic efficacy but with a high risk of serious side-effects, are mainly based on a dopamine mechanism. Third, more novel and efficient animal models, especially in nonhuman primates, are required to accelerate the development of new medications. In this article, we review research progress in the related fields, focusing on our previous studies showing that blockade of prefrontal cortical a2A-adrenoceptors in monkeys produces almost all the typical behavioral symptoms of ADHD.
基金We are thankful to The Gujarat Council on Science and Technology(GUJCOST)for providing financial support in form of minor research project(GUJCOST/MRP/2014-15/2592)
文摘Objective:To explore the effect and mechanism of action of Celastrus paniculatus oil on the treatment of perinatal rats with attention deficit hyperactivity disorder.Methods:In the perinatal stage,the rats were either isolated or administered with lead acetate to establish an animal model of attention deficit hyperactivity disorder.Atomoxetine served as the reference standard.Animals’behaviours were assessed through Y-maze,novel object preference,fear conditioning and residentintruder aggression tests.Oxidative stress parameters,bioamine concentration(dopamine,noradrenaline and 5-hydroxytryptamine),nerve growth factor,interleukin-6,nuclear factor-κB,and tumour necrosis factor(TNF)-αwere estimated.Synaptophysin immunohistochemical assay was performed.Results:Celastrus paniculatus oil significantly improved behavioural parameters in Y maze,novel object preference,discrimination index,fear conditioning and resident intruder aggressive tests.The treatment groups showed a decrease in malondialdehyde level.Changes in the levels of dopamine,noradrenaline,and serotonin were restored by Celastrus paniculatus oil.Celastrus paniculatus oil increased nerve growth factor and decreased interleukin-6,nuclear factor-κB,and TNF-α.Synaptophysin immunoreactivity was also improved by Celastrus paniculatus oil with alleviated reactive gliosis,degeneration,and vascular proliferation.Conclusions:This research shows the therapeutic potential of Celastrus paniculatus oil for the treatment of attention deficit hyperactivity disorder.
