Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of ADHD

  • adult adhd
  • comorbid adhd

  • Terms modified by ADHD

  • adhd child
  • adhd diagnosis
  • adhd group
  • adhd patient
  • adhd subtype
  • adhd symptom

  • Selected Abstracts

    What are adolescent antecedents to antisocial personality disorder?

    Rolf Loeber PhD
    Background This paper fills a gap because there are very few studies that prospectively predict antisocial personality disorder (APD) from psychopathology earlier in life in clinic-referred samples of young males. Method The paper addresses the continuity between conduct disorder (CD) and other forms of psychopathology during ages 13,17 and modified APD at ages 18 and 19 (modified to remove the DSM-IV requirement of pre-existing CD by age 15) in the Developmental Trends Study. Results The results show that 82,90% of APD cases met criteria for CD at least once during ages 13,17, and very few youths who met criteria for ODD during this period progressed to APD without intermediate CD. While CD is a strong predictor of modified APD, when other factors were accounted for in regression analyses, the best predictors were callous/unemotional behaviour, depression and marijuana use. ADHD during ages 13,17 was not significant in the final model. Males with CD during adolescence who progressed to APD tended to commit more violence, as evident from their court records. Conclusions Implications are discussed for the conceptualization of developmental models leading to APD, the strengthening of relevant symptoms of CD predictive of APD, and preventive and remedial interventions. Copyright © 2002 Whurr Publishers Ltd. [source]

    Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder

    S. Lis
    Lis S, Baer N, Stein-en-Nosse C, Gallhofer B, Sammer G, Kirsch P. Objective measurement of motor activity during cognitive performance in adults with attention-deficit/hyperactivity disorder. Objective:, This study investigates whether hyperactivity, i.e. an increased level of motor activity, can be observed in adults with attention-deficit/hyperactivity disorder (ADHD). Method:, An infrared motion-tracking system was used to measure motor activity in 20 unmedicated adults with ADHD and 20 matched healthy controls (HC) during a 1-back working memory task. Results:, Motor activity was higher in ADHD. It increased with the duration of testing and co-varied with cognitive performance in ADHD only. Subjective and objective measurements of motor activity were related in HC, but not in ADHD. Conclusion:, Higher levels of motor activity in ADHD are objectively measurable not only in children, but in adults as well. It is linked to cognitive performance arguing against distinguishable diagnostic subtypes. The objective measurement of motor activity seems to extend the description of ADHD symptoms derived from rating scales and might thus help to bridge the gap between psychopathological symptom description and neurobiological alterations. [source]

    Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community

    M. J. A. Tijssen
    Tijssen MJA, Van Os J, Wittchen HU, Lieb R, Beesdo K, Wichers M. Risk factors predicting onset and persistence of subthreshold expression of bipolar psychopathology among youth from the community Objective:, To examine factors increasing the risk for onset and persistence of subthreshold mania and depression. Method:, In a prospective cohort community study, the association between risk factors [a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD) and temperamental/personality traits] and onset of manic/depressive symptoms was determined in 705 adolescents. The interaction between baseline risk factors and baseline symptoms in predicting 8-year follow-up symptoms was used to model the impact of risk factors on persistence. Results:, Onset of manic symptoms was associated with cannabis use and novelty seeking (NS), but NS predicted a transitory course. Onset of depressive symptoms was associated with a family history of depression. ADHD and harm avoidance (HA) were associated with persistence of depressive symptoms, while trauma and a family history of depression predicted a transitory course. Conclusion:, Different risk factors may operate during onset and persistence of subthreshold mania and depression. The differential associations found for mania and depression dimensions suggest partly different underlying mechanisms. [source]

    Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder

    Lenard A. Adler M.D.
    Abstract Background: To evaluate the effect of atomoxetine (ATX) on attention-deficit/hyperactivity disorder (ADHD) and comorbid social anxiety disorder in adults. Methods: Randomized, double-blind, placebo-controlled, conducted in adults with ADHD and social anxiety disorder. Patients received 40,100,mg ATX (n=224) or placebo (n=218) for 14 weeks following a 2-week placebo lead-in period. Efficacy measures included the Conners' Adult ADHD Rating Scale: Investigator-Rated: Screening Version (CAARS:Inv:SV), Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression-Overall-Severity (CGI-O-S), State-Trait Anxiety Inventory (STAI), Social Adjustment Scale-Self Report (SAS), and Adult ADHD Quality of Life Scale-29 (AAQoL). Safety and tolerability were also assessed. Results: ATX mean change (,8.7±10.0) from baseline (29.6±10.4) on CAARS:Inv:SV Total ADHD Symptoms score was significantly greater than placebo mean change (,5.6±10.2) from baseline (31.2±9.4; P<.001). ATX mean change (,22.9±25.3) from baseline (85.3±23.6) on LSAS Total score was significant compared to placebo mean change (,14.4±20.3) from baseline (82.1±21.3; P<.001). The visit-wise analysis revealed greater improvement on the CAARS:Inv:SV Total ADHD Symptoms score and LSAS Total score for ATX at every time point throughout the study (P values ,.012). Mean changes in CGI-O-S, STAI-Trait Anxiety scores, and AAQoL Total score were significantly greater for ATX compared to placebo. Mean change for both groups on STAI-State Anxiety scores was comparable. Improvement on SAS for ATX compared to placebo was not significant. Rates of insomnia, nausea, dry mouth, and dizziness were higher with ATX than with placebo. Discontinuation rates due to treatment-emergent adverse events were similar between groups. Conclusions: ATX monotherapy effectively improved symptoms of ADHD and comorbid social anxiety disorder in adults and was well tolerated. Depression and Anxiety, 2009. Published 2009 Wiley-Liss, Inc. [source]

    Measuring anxiety: Parent-child reporting differences in clinical samples

    Jose Barbosa M.A.
    Abstract This study examines parent-child reporting differences for childhood anxiety in normal controls (n = 16) and in children with diagnosed anxiety disorders (ANX; n = 15), attention-deficit hyperactivity disorder (ADHD; n = 15), and comorbid ANX and ADHD (n = 16). Correspondence between child reports of anxiety on two self-report inventories and diagnosis based on structured parent interview was assessed for all four groups. Parent-child agreement did not appear to be measurement dependent but did differ by diagnostic group, with poorer agreement for clinical groups. Though needing replication, these findings suggest that it is inadvisable to rely exclusively on self-report measures when assessing childhood anxiety, especially in clinical populations. Such measures can be useful in monitoring clinical progress, however, provided parent and child reports are examined separately. Depression and Anxiety 15:61,65, 2002. © 2002 Wiley-Liss, Inc. [source]

    Impulsive aggression in adults with attention-deficit/hyperactivity disorder

    J. H. Dowson
    Dowson JH, Blackwell AD. Impulsive aggression in adults with attention-deficit/hyperactivity disorder. Objective:, DSM-IV criteria for attention-deficit/hyperactivity disorder (ADHD) include examples of ,impulsivity'. This term can refer to various dysfunctional behaviours, including some examples of aggressive behaviour. However, impulsive aggression is not included in the DSM-IV criteria for ADHD. The associations of impulsive aggression with ADHD were investigated. Method:, Seventy-three male adults with DSM-IV ADHD, and their informants, completed questionnaires. Impulsive aggression was assessed by ratings of two criteria for borderline personality disorder (BPD), involving hot temper and/or self-harm. Results:, Logistic regression indicated that features of DSM-IV ADHD were predictors of comorbid impulsive aggression. However, compared with ADHD features, verbal IQ and comorbid psychopathology were more strongly associated with impulsive aggression. Conclusion:, The findings support the inclusion of features of impulsive aggression, such as hot temper/short fuse, in the ADHD syndrome in adults. These overlap with features of BPD. The findings inform the selection of research samples. [source]

    Amygdala reduction in patients with ADHD compared with major depression and healthy volunteers

    T. Frodl
    Frodl T, Stauber J, Schaaff N, Koutsouleris N, Scheuerecker J, Ewers M, Omerovic M, Opgen-Rhein M, Hampel H, Reiser M, Möller H.-J, Meisenzahl E. Amygdala reduction in patients with ADHD compared with major depression and healthy volunteers. Objective:, Results in adult attention deficit hyperactivity disorder (ADHD) on structural brain changes and the clinical relevance are contradictory. The aim of this study was to investigate whether in adult patients with ADHD hippocampal or amygdala volumes differs from that in healthy controls and patients with major depression (MD). Method:, Twenty patients with ADHD, 20 matched patients with MD and 20 healthy controls were studied with high resolution magnetic resonance imaging. Results:, Amygdala volumes in patients with ADHD were bilaterally smaller than in patients with MD and healthy controls. In ADHD, more hyperactivity and less inattention were associated with smaller right amygdala volumes, and more symptoms of depression with larger amygdala volumes. Conclusion:, This study supports findings that the amygdala plays an important role in the systemic brain pathophysiology of ADHD. Whether patients with ADHD and larger amygdala volumes are more vulnerable to affective disorders needs further investigation. [source]

    The heterogeneity of causes and courses of attention-deficit/hyperactivity disorder

    H-C. Steinhausen
    Objective:, Attention-deficit / Hyperactivity Disorder (ADHD) is a frequent mental disorder with onset in childhood and persistence into adulthood in a sizeable number of people. Despite a rather simple clinical definition, ADHD has many facets because of frequent co-morbid disorders and varying impact on psychosocial functioning. Thus, there is considerable heterogeneity in various domains. Method:, A review of recent research findings in: i) selected domains of aetiology reflecting the role of genes, brain structures and functioning and the interplay of causal factors and ii) clinical heterogeneity in terms of co-morbidities, gender effects, courses and outcomes. Results:, Molecular genetic studies have identified a number of candidate genes which have a small effect on behavioural variation in ADHD. In the most recent Genome Scan Meta Analysis of seven ADHD linkage studies, genome-wide significant linkage was identified on chromosome 16. The volume of both the total brain and various regions including the prefrontal cortex, the caudate nucleus and the vermis of the cerebellum is smaller in ADHD. Functional MRI has documented a specific deficit of frontostriatal networks in ADHD. Integrative aetiological models have to take the interaction of gene and environment on various dysfunctions into account. Clinical heterogeneity results from frequent associations with various co-morbidities, the impact of the disorder on psychosocial functioning, and gender effects. Partly, these effects are evident also in the course and outcome of ADHD. Conclusion:, ADHD is a chronic mental disorder with a complex aetiology. So far, various neurobiological factors have been identified that need to be studied further to better understand their interaction with environmental factors. The clinical presentation and the long-term course of ADHD are manifold. [source]

    A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD

    E. Rydén
    Objective:, The occurrence of comorbid attention-deficit hyperactivity disorder (ADHD) might have an impact of the course of the bipolar disorder. Method:, Patients with bipolar disorder (n = 159) underwent a comprehensive evaluation with respect to affective symptoms. Independent psychiatrists assessed childhood and current ADHD, and an interview with a parent was undertaken. Results:, The prevalence of adult ADHD was 16%. An additional 12% met the criteria for childhood ADHD without meeting criteria for adult ADHD. Both these groups had significantly earlier onset of their first affective episode, more frequent affective episodes (except manic episodes), and more interpersonal violence than the bipolar patients without a history of ADHD. Conclusion:, The fact that bipolar patients with a history of childhood ADHD have a different clinical outcome than the pure bipolar group, regardless of whether the ADHD symptoms remained in adulthood or not, suggests that it represent a distinct early-onset phenotype of bipolar disorder. [source]

    Inhibitory functioning across ADHD subtypes: Recent findings, clinical implications, and future directions

    Zachary W. Adams
    Abstract Although growing consensus supports the role of deficient behavioral inhibition as a central feature of the combined subtype of ADHD (ADHD/C; Barkley 1997 Psychol Bull 121:65,94; Nigg 2001 Psychol Bull 127:571,598), little research has focused on how this finding generalizes to the primarily inattentive subtype (ADHD/I). This question holds particular relevance in light of recent work suggesting that ADHD/I might be better characterized as a disorder separate from ADHD/C (Diamond 2005 Dev Psychopathol 17:807,825; Milich et al. 2001 Clin Psychol Sci Pract 8:463,488). This article describes major findings in the area of inhibitory performance in ADHD and highlights recent research suggesting important areas of divergence between the subtypes. In particular, preliminary findings point to potential differences between the subtypes with respect to how children process important contextual information from the environment, such as preparatory cues that precede responses and rewarding or punishing feedback following behavior. These suggestive findings are discussed in the context of treatment implications, which could involve differential intervention approaches for each subtype targeted to the specific deficit profiles that characterize each group of children. Future research avenues aimed toward building a sound theoretical model of ADHD/I and a better understanding of its relation to ADHD/C are also presented. Specifically, investigators are encouraged to continue studying the complex interplay between inhibitory and attentional processes, as this area seems particularly promising in its ability to improve our understanding of the potentially distinct pathologies underlying the ADHD subtypes. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:268,275. [source]

    The neurobiological profile of girls with ADHD

    E. Mark Mahone
    Abstract Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and neurobiological basis of these deficits is less consistently observed. There is growing evidence that boys' and girls' brains develop and mature at different rates, suggesting that the trajectory of early anomalous brain development in ADHD may also be sex-specific. It remains unclear, however, whether earlier brain maturation observed in girls with ADHD is protective. In this review, we outline the current theory and research findings that seek to establish a unique neurobiological profile of girls with ADHD, highlighting sex differences in typical brain development and among children with ADHD. The review highlights findings from neurological, neurocognitive, and behavioral studies. Future research directions are suggested, including the need for longitudinal neuroimaging and neurobehavioral investigation beginning as early as the preschool years, and continuing through adolescence and adulthood, with consideration of identified sex differences in the development of ADHD. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:276,284. [source]

    Attention deficits, Attention-Deficit Hyperactivity Disorder, and intellectual disabilities

    Curtis K. Deutsch
    Abstract Attention-Deficit Hyperactivity Disorder (ADHD) and its earlier nosologic classifications have been extensively investigated since the 1960s, with PubMed listings alone exceeding 13,000 entries. Strides have been made in the diagnosis and treatment of ADHD in individuals with intellectual function in the normal range, as described in companion reviews in this special issue. In contrast, comparatively little is known about ADHD in intellectual developmental disabilities (IDD) despite the possibility that ADHD is statistically overrepresented among individuals with IDD (Pearson et al. 1997 Attention-deficit/hyperactivity disorder in mental retardation: nature of attention deficits. In: Burack J, Enns J, editors. Attention, development, and psychopathology. New York: Guilford Press. p 205,229; Pearson et al. 2000 Am. J. Ment. Retard. 105:236,251). Here, we provide a review of diagnostic controversies in ADHD with IDD, and discuss several topics that are currently attracting research efforts in the field. These include behavioral phenotyping and attempts to come to grips with problems of behavioral and etiological heterogeneity. Additionally, we consider issues relating to methodologically sound assessment of attention disorders and evidence-based intervention procedures that may clarify and/or ameliorate attention deficits in individuals with IDD. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:285,292. [source]

    Cognitive and neuropsychological outcomes: More than IQ scores

    Glen P. Aylward
    Abstract Improved survival in preterm infants has broadened interest in cognitive and neuropsychological outcomes. The incidence of major disabilities (moderate/severe mental retardation, neurosensory disorders, epilepsy, cerebral palsy) has remained consistent, but high prevalence/low severity dysfunctions (learning disabilities, ADHD, borderline mental retardation, specific neuropsychological deficits, behavioral disorders) have increased. The follow-up literature contains methodologic problems that make generalizations regarding outcome difficult, and these are discussed. Although mean IQs of former VLBW infants generally are in the low average range and are 3,9 points below normal birth weight peers, these scores mask subtle deficits in: visual-motor and visual-perceptual abilities, complex language functions, academics (reading, mathematics, spelling and writing), and attentional skills. There is an increased incidence of non-verbal learning disabilities, need for special educational assistance, and behavioral disorders in children born prematurely. Males have more problems, and there is a trend for worsening outcome over time, due to emergence of more subtle deficits in response to increased performance demands. In addition to IQ and achievement testing in follow-up, there should be evaluation of executive functions and attention, language, sensorimotor functions, visuospatial processes, memory and learning, and behavioral adjustment. MRDD Research Reviews 2002;8:234,240. © 2002 Wiley-Liss, Inc. [source]

    The epidemiology of attention-deficit/hyperactivity disorder (ADHD): A public health view

    Andrew S. Rowland
    Abstract Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. However, basic information about how the prevalence of ADHD varies by race/ethnicity, sex, age, and socio-economic status remains poorly described. One reason is that difficulties in the diagnosis of ADHD have translated into difficulties developing an adequate case definition for epidemiologic studies. Diagnosis depends heavily on parent and teacher reports; no laboratory tests reliably predict ADHD. Prevalence estimates of ADHD are sensitive to who is asked what, and how information is combined. Consequently, recent systematic reviews report ADHD prevalence estimates as wide as 2%,18%. The diagnosis of ADHD is complicated by the frequent occurrence of comorbid conditions such as learning disability, conduct disorder, and anxiety disorder. Symptoms of these conditions may also mimic ADHD. Nevertheless, we suggest that developing an adequate epidemiologic case definition based on current diagnostic criteria is possible and is a prerequisite for further developing the epidemiology of ADHD. The etiology of ADHD is not known but recent studies suggest both a strong genetic link as well as environmental factors such as history of preterm delivery and perhaps, maternal smoking during pregnancy. Children and teenagers with ADHD use health and mental health services more often than their peers and engage in more health threatening behaviors such as smoking, and alcohol and substance abuse. Better methods are needed for monitoring the prevalence and understanding the public health implications of ADHD. Stimulant medication is the treatment of choice for treating ADHD but psychosocial interventions may also be warranted if comordid disorders are present. The treatment of ADHD is controversial because of the high prevalence of medication treatment. Epidemiologic studies could clarify whether the patterns of ADHD diagnosis and treatment in community settings is appropriate. Population-based epidemiologic studies may shed important new light on how we understand ADHD, its natural history, its treatment and its consequences. MRDD Research Reviews 2002;8:162,170. © 2002 Wiley-Liss, Inc. [source]

    Developmental coordination disorder in children with ADHD and physical therapy intervention

    No abstract is available for this article. [source]

    Worster-Drought syndrome: poorly recognized despite severe and persistent difficulties with feeding and speech

    Aim, Worster-Drought syndrome (WDS), or congenital suprabulbar paresis, is a permanent movement disorder of the bulbar muscles causing persistent difficulties with swallowing, feeding, speech, and saliva control owing to a non-progressive disturbance in early brain development. As such, it falls within the cerebral palsies. The aim of this study was to describe the physical and neuropsychological profiles of children with WDS. Method, Forty-two children with WDS (26 males, 16 females; mean age 7y 10mo, SD 3y 1mo; range 2y 6mo to 16y 5mo) were studied prospectively using a standard protocol. Results, All of the children had severe bulbar dysfunction; 36 out of 42 had feeding difficulties and 23 of 38 had unintelligible speech, which was poorly compensated for by augmentative communication. There were accompanying disturbances in cognition (mean non-verbal IQ 59), behaviour (12/40 attention-deficit,hyperactivity disorder [ADHD]), social communication (8/42 autism), and epilepsy (12/39). The severity of bulbar dysfunction and impact of additional impairments made it difficult to use formal assessments. Interpretation, WDS causes severe and persistent bulbar dysfunction that is often accompanied by additional impairments, as in other cerebral palsies. Speech prognosis is particularly poor. Early diagnosis with appreciation of the underlying neurology would encourage critical evaluation of interventions and long-term planning to improve outcome. [source]

    Developmental coordination disorder in children with attention-deficit,hyperactivity disorder and physical therapy intervention

    Nathan Watemberg MD
    Although physical therapy (PT) is effective in improving motor function in children with developmental coordination disorder (DCD), insufficient data are available on the impact of this intervention in children with combined attention-deficit,hyperactivity disorder (ADHD) and DCD. This prospective study aimed to establish the prevalence of DCD among a cohort of patients with ADHD, characterize the motor impairment, identify additional comorbidities, and determine the role of PT intervention on these patients. DCD was detected in 55.2% of 96 consecutive children with ADHD (81 males, 15 females), mostly among patients with the inattentive type (64.3% compared with 11% of those with the hyperactive/impulsive type, p<0.05). Mean age was 8 years 4 months (SD 2y). Individuals with both ADHD and DCD more often had specific learning disabilities (p=0.05) and expressive language deficits (p=0.03) than children with ADHD only. Twenty-eight patients with ADHD and DCD randomly received either intensive group PT (group A, mean age 9y 3mo, SD 2y 3mo) or no intervention (group B, mean age 9y 3mo, SD 2y 2mo). PT significantly improved motor performance (assessed by the Movement Assessment Battery for Children; p=0.001). In conclusion, DCD is common in children with ADHD, particularly of the inattentive type. Patients with both ADHD and DCD are more likely to exhibit specific learning disabilities and phonological (pronunciation) deficits. Intensive PT intervention has a marked impact on the motor performance of these children. [source]

    Working memory, processing speed, and set-shifting in children with developmental coordination disorder and attention-deficit,hyperactivity disorder

    Jan P Piek BSc (Hons) PhD
    It has been suggested that the high levels of comorbidity between attention-deficit-hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) may be attributed to a common underlying neurocognitive mechanism. This study assessed whether children with DCD and ADHD share deficits on tasks measuring working memory, set-shifting, and processing speed. A total of 195 children aged between 6 years 6 months and 14 years 1 month (mean 10y 4mo [SD 2y 2mo]) were included in this study. A control group (59 males, 79 females), a DCD group (12 males, six females), an ADHD-predominantly inattentive group (16 males, four females), and an ADHD-combined group (15 males, four females), were tested on three executive functioning tasks. Children with DCD were significantly slower on all tasks, supporting past evidence of a timing deficit in these children. With few exceptions, children with ADHD did not perform more poorly than control children. These findings demonstrate the importance of identifying children with motor deficits when examining tasks involving a timing component. [source]

    Stimulant medication in 47,XYY syndrome: a report of two cases

    Anne Ruud MD
    In two males, 11 and 12 years of age, referred for attention-deficit-hyperactivity disorder (ADHD), 47,XYY syndrome was diagnosed. A team that included a neuropsychologist, a physiotherapist, and a physician examined them. Stature (patients were above 97.5% height for age), muscle consistency, and tremor indicated chromosome analysis. Psychological tests results did not fully fit the ADHD diagnosis. On the basis of our clinical observation we felt that stimulant medication was indicated. Administration of methylphenidate led to improved motor and cognitive functions as well as social adaptation in both patients. We suggest that this treatment might well be considered in clinically similar patients with XYY sex chromosomes; we further suggest that learning problems in such individuals may be related to ADHD. [source]

    Immediate effects of methylphenidate on cognitive attention skills of children with attention-deficit-hyperactivity disorder

    Jane Hood MSc
    This study investigated the immediate effects of stimulant medication (methylphenidate) on cognitive attention processes in children with attention-deficit-hyperactivity disorder (ADHD). Thirteen males and two females (mean age 9y 5mo, SD 18.3mo) with a diagnosis of ADHD and who were to be prescribed methylphenidate were assessed twice on one day with the Test of Everyday Attention for Children, a neuropsychological battery designed to tap different aspects of cognitive attention. Between assessments, the children were administered methylphenidate (10mg). Each child had at least average intelligence (IQ 80 or over, as measured by the Wechsler Intelligence Scale for Children - III UK) and was on no other medication. A group of 16 children, who were matched for age, sex, and intelligence, also performed the cognitive tests twice on the same day to control for practice effects of testing. At the first assessment, children with ADHD demonstrated significant impairments in several aspects of cognitive attention in comparison with the control group, particularly sustained attention. After administration of methylphenidate for the children with ADHD, they showed significant improvements in their performance on measures of cognitive attention compared to controls. The immediate effects of methylphenidate and the significance of measuring cognitive aspects of attention as well as behavioural measures are discussed. [source]

    Modulation of spatial attention in a child with developmental unilateral neglect

    Veronika B Dobler MD
    Attentional neglect of left space is one of the most striking acquired neurological disorders of adulthood. Recent evidence indicates a link between left spatial neglect and general right-hemisphere impairments in sustained attention and alertness. Poor sustained attention and alertness is also a central feature of other disorders, particularly childhood attention-deficit-hyperactivity disorder (ADHD). Here we present the case of a 7-year-old male showing that frank neglect can be present in children with sustained attention problems without a clear aetiological event, or obvious structural brain abnormalities as indicated by a normal MRI. Experimental amelioration of the neglect through left-hand movement and externally alerting stimulation by uninformative sounds further suggest close similarities to the adult disorder. We suggest that such distortions of spatial attention may be more common in childhood than previously thought. [source]

    Whither causal models in the neuroscience of ADHD?

    Dave Coghill
    In this paper we examine the current status of the science of ADHD from a theoretical point of view. While the field has reached the point at which a number of causal models have been proposed, it remains some distance away from demonstrating the viability of such models empirically. We identify a number of existing barriers and make proposals as to the best way for these to be overcome in future studies. These include the need to work across multiple levels of analysis in multidisciplinary teams; the need to recognize the existence of, and then model, causal heterogeneity; the need to integrate environmental and social processes into models of genetic and neurobiological influence; and the need to model developmental processes in a dynamic fashion. Such a model of science, although difficult to achieve, has the potential to provide the sort of framework for programmatic model-based research required if the power and sophistication of new neuroscience technologies are to be effectively exploited. [source]

    Characterizing the ADHD phenotype for genetic studies

    Jim Stevenson
    The genetic study of ADHD has made considerable progress. Further developments in the field will be reliant in part on identifying the most appropriate phenotypes for genetic analysis. The use of both categorical and dimensional measures of symptoms related to ADHD has been productive. The use of multiple reporters is a valuable feature of the characterization of psychopathology in children. It is argued that the use of aggregated measures to characterize the ADHD phenotype, particularly to establish its pervasiveness, is desirable. The recognition of the multiple comorbidities of ADHD can help to isolate more specific genetic influences. In relation to both reading disability and conduct disorder there is evidence that genes may be involved in the comorbid condition that are different from pure ADHD. To date, progress with the investigation of endophenotypes for ADHD has been disappointing. It is suggested that extending such studies beyond cognitive underpinnings to include physiological and metabolic markers might facilitate progress. [source]

    Transcranial magnetic stimulation in child psychiatry: disturbed motor system excitability in hypermotoric syndromes

    Gunther H. Moll
    Normal development and dysfunctions of motor system excitability can be investigated in vivo by means of single- and paired-pulse transcranial magnetic stimulation (TMS). While different TMS-parameters show different developmental time courses between 8 and 16 years of age, distinct dysfunctional patterns of motor system excitability can be demonstrated in child psychiatric disorders with hypermotoric behavior: in tic disorder, a shortened cortical silent period can be stated providing evidence for deficient inhibitory mechanisms within the sensorimotor loop, probably primarily at the level of the basal ganglia. In attention deficit hyperactivity disorder (ADHD), a decreased intracortical inhibition indicates deficient inhibitory mechanisms within the motor cortex (but enhancement of intracortical inhibition after oral intake of 10 mg methylphenidate). In children with comorbid ADHD and tic disorder, the findings of a reduced intracortical inhibition as well as a shortened cortical silent period provide evidence for additive effects at the level of motor system excitability. Thus, TMS allows us to obtain substantial insight into both the normal development and the neurobiological basis of hypermotoric syndromes in child psychiatry. [source]

    Attention deficit hyperactivity disorder and suicide: a review of possible associations

    A. James
    Objective:, To review the evidence of a possible association between attention deficit hyperactivity disorder (ADHD) and suicide. Design:, We searched the electronic data bases: Medline, Psych LIT, between 1966 and March 2003 looking for articles on ADHD, attention deficit disorder, hyperactivity and suicide. Results:, An association of ADHD and completed suicide was found, especially for younger males. However, the evidence for any direct or independent link was modest with an overall suicide rate from long-term follow-up studies of ADHD of 0.63,0.78%. The estimated relative risk ratio, compared with US national suicide rates (males 5,24 years) is 2.91 (95% confidence interval 1.47,5.7, ,2 = 9.3, d.f. = 1, P = 0.002). ADHD appears to increase the risk of suicide in males via increasing severity of comorbid conditions, particularly conduct disorder (CD) and depression. Conclusion:, Identification of those at risk, particularly males with comorbid ADHD, depression and CD, may represent a useful clinical means of reducing completed suicide. [source]

    On the role of cortical glutamate inobsessive-compulsive disorder and attention-deficit hyperactivity disorder, two phenomenologically antithetical conditions

    Maria L. CarlssonArticle first published online: 24 DEC 200
    Objective: The objective of the present study was to compare the phenomenology and pathophysiology of obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder/deficits in attention, motor control and perception (ADHD/DAMP). Method: Through detailed studies of the literature on OCD and ADHD/DAMP the phenomenology of these two conditions is compared, and possible underlying pathophysiological mechanisms involving interactions between glutamate, dopamine, serotonin and acetylcholine are discussed, with emphasis on OCD. The present paper also discusses possible mechanisms of action for current pharmacological treatments of OCD and ADHD, as well as possible future treatment strategies for these disorders. Results: OCD and ADHD/DAMP are common neuropsychiatric conditions which in many regards appear to be each other's antipodes with respect to clinical manifestations, associated personality traits and brain biochemistry, notably prefrontal cortical glutamate activity. Future pharmacological treatments of these disorders may involve manipulations with glutamate, dopamine D1, serotonin 2A and nicotine receptors. Conclusion: It appears that OCD is a hyperglutamatergic and ADHD a hypoglutamatergic condition, with prefrontal brain regions being especially affected. [source]

    Monoamine reuptake inhibitors: highlights of recent research developments

    Magnus W. WalterArticle first published online: 21 NOV 200
    Abstract Monoamine reuptake inhibitors are in clinical use for the treatment of major psychiatric disorders. Selective serotonin reuptake inhibitors are widely used in the treatment of depression. Selective norepinephrine reuptake inhibitors are used in the treatment of ADHD and depression. Compounds that enhance multiple monoamines appear to have synergistic effects and have been used for various indications. This review presents highlights from the literature on monoamine reuptake inhibitors published between 2000 and July 2005. It focuses on novel structure-activity relationship studies in established classes of monoamine reuptake inhibitors and structurally novel types. Drug Dev. Res. 65:97,118, 2005. © 2005 Wiley-Liss, Inc. [source]

    New insights on attention-deficit/hyperactivity disorder pharmacogenomics

    Luis Augusto Rohde
    Abstract Although there is an impressive literature documenting both a strong participation of genetics in the etiology of attention-deficit/hyperactivity disorder (ADHD) and a high rate of response to stimulants and atomoxetine, surprisingly few studies on the pharmacogenomics of ADHD were conducted. This review aims to present a critical discussion of findings from recent investigations on this emerging new area of research. We performed a systematic computer review of the literature on ADHD pharmacogenomics. In addition, we contacted some research centers involved in research on ADHD genetics, asking for any kind of nonpublished data relevant for the topic of this revision. This review strategy identified only seven papers presenting nonduplicated research findings on ADHD pharmacogenomics. Contact with other investigators resulted in five more studies presented in medical meetings or still nonpublished. The majority of investigations are on dopaminergic genes, especially on polymorphisms at the dopamine transporter gene (DAT1). Although there were some instigating preliminary results suggesting the association between the homozygosity for the 10-repeat allele at DAT1 gene and response to methylphenidate, recent studies were not able to replicate these previous findings. Very few investigations addressed the role of nondopaminergic genes, or gene-to-gene interactions in ADHD pharmacogenomics. Pharmacogenomic studies of ADHD are in their infancy. We presented a discussion on the limitations and possible future directions of the research in the field. Drug Dev. Res. 62:172,179, 2004. © 2004 Wiley-Liss, Inc. [source]

    Time reproduction in finger tapping tasks by children with attention-deficit hyperactivity disorder and/or dyslexia

    DYSLEXIA, Issue 4 2004
    Margaret C. Tiffin-Richards
    Abstract Aim: Deficits in timing and sequencing behaviour in children with dyslexia and with attention-deficit hyperactivity disorder have already been identified. However many studies have not controlled for comorbidity between dyslexia and ADHD. This study investigated timing performance of children with either dyslexia or ADHD, or ADHD + dyslexia or unaffected children using a finger-tapping paradigm. Method: Four groups of children (ADHD × Dyslexia) with a total of 68 children were compared using a four factorial design with two between-subject factors (ADHD (yes/no), dyslexia (yes/no)) and two within-subject factors, inter-stimulus interval (263, 500, 625, 750, 875 and 1000 ms) and tapping condition (free tapping, synchronous tapping, and unpaced tapping). In addition the complexity of rhythm reproduction pattern (unpaced tapping) was varied (simple/complex). Results: No significant differences were found either in the ability of the ADHD or the dyslexia groups to sustain a self-chosen free tapping rate or to generate a stable inter-response interval either by synchronising to a signal or in reproducing a given interval without the previous pacing signal. Response averages showed the expected asynchrony and variability. In rhythm pattern reproduction the groups did not differ significantly in their ability to reproduce rhythms. However, a significant two way interaction effect between dyslexia and complexity was apparent indicating that the difference in levels of performance for simple versus complex rhythms was more pronounced for dyslexia than for the two other groups. Conclusion: The results indicate that motor timing ability in the millisecond range below 1000 ms in children with ADHD and/or dyslexia is intact. The performance of the comorbid group was revealed to be similar to the performance of the single disorder groups, but both the dyslexic groups were relatively worse than either the ADHD-only or the unimpaired group at reproducing complex versus simple rhythms. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Early weaning and alcohol disorders in offspring: biological effect, mediating factors or residual confounding?

    ADDICTION, Issue 8 2009
    Rosa Alati
    ABSTRACT Aims This study explores associations between early weaning and alcohol use disorders in youth and mechanisms by which these associations may operate. Design We used data from the Mater University Study of Pregnancy and its outcomes, an Australian birth cohort study based in Brisbane. Setting and participants: This study is based on a subsample of 2370 participants for whom complete data were available at age 21 years. Length and method of breastfeeding were assessed at 6 months. Measurements Alcohol use disorders were assessed at age 21 using the life-time version of the Composite International Diagnostic Interview,computerized version (CIDI-Auto). We adjusted for maternal age, marital status, education, alcohol, tobacco use, anxiety, depression and maternal attitudes towards the baby. Attention Deficit and Hyperactivity Disorders (ADHD) and Intellect Quotient (IQ) were measured with the Child Behaviour Checklist (5 years) and the Ravens SM (14 years), respectively. Findings Those who had been weaned within 2 weeks of being born and breastfed at regular intervals were at increased risk of meeting criteria for alcohol use disorders at age 21 [odds ratio (OR) 1.71, 95% confidence interval (CI):1.07, 2.72]. Conclusion This study confirms a small but robust association between early weaning and increased risk of alcohol use disorders. [source]