Sleep and Attention Deficit Hyperactivity Disorder

Diagnosis of Attention Deficit Hyperactivity Disorder by Using MR Imaging and Radiomics: A Potential Tool for Clinicians.

This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and retrospective reporting of childhood symptoms were addressed. Using data from the Pittsburgh ADHD Longitudinal Study (PALS), parent, teacher, and self-reports of symptoms and impairment were examined for 164 adolescents with a childhood diagnosis of ADHD (age M = 14.74 years) and 119 demographically similar non-ADHD controls (total N = 283). Results indicated that 70% of the well-diagnosed childhood ADHD group continued to meet Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) diagnostic criteria for ADHD in adolescence; however, an additional 17% possessed clinically significant impairment in adolescence but did not qualify for a current ADHD diagnosis. The optimal source of information was combined reports from the parent and a core academic teacher. Adolescents with ADHD met criteria for very few symptoms of hyperactivity/impulsivity, suggesting a need to revisit the diagnostic threshold for these items. Additionally, emphasis on impairment, rather than symptom threshold, improved identification of adolescents with a gold-standard childhood diagnosis of ADHD and persistent ADHD symptoms. Parent retrospective reports of baseline functioning, but not adolescent self-reports, were significantly correlated with reports collected at baseline in childhood. Recommendations are offered for diagnosing ADHD in adolescence based on these findings.

Living with symptoms of Attention Deficit-Hyperactivity Disorder (ADHD) in adulthood: a systematic review protocol of qualitative evidence

Association between sleep and working memory in children with ADHD: a cross-sectional study

Prior follow-up studies of attention-deficit/hyperactivity disorder (ADHD) have mostly been from North America. They have provided a good deal of information about ADHD, but whether these results generalize to population samples and to other countries is not certain. Most prior studies have also not assessed predictors of possible new onsets of ADHD in non-ADHD youth or the validity of subthreshold forms of the disorder. 1,012 families were recruited at baseline, when a telephone interview assessed a child in the 6-12 years age range. The interview covered symptoms of ADHD, conduct disorder, and oppositional defiant disorder as well as family living situation, school performance, sleep disturbance, eating habits, use of supplemental iron, and history of ADHD treatment. Nine years later, the persistence of ADHD and its impairments and the emergence of new conditions were assessed. DSM-5 diagnostic criteria were used to diagnose ADHD. 492 of the 1,012 participants seen at baseline were followed up 9 years later, at a mean age of 18 years. At follow-up, 16.7% of the children diagnosed with ADHD at baseline met full criteria for ADHD and 11.1% met criteria for subthreshold ADHD, yielding a persistence rate of 27.8%. Among children not diagnosed with ADHD at baseline, 1.1% met criteria for ADHD at follow-up. The persistence of ADHD and new onsets of ADHD were predicted by several baseline clinical features and by a family history of ADHD. We replicated predictors of the persistence of ADHD found in prior studies and provide new data about predictors of new ADHD onsets in the population. Our findings about subthreshold ADHD support a dimensional conceptualization of the disorder, highlighting the potential clinical utility of a subthreshold diagnostic category. This study also contributes to the ongoing debate regarding adult-onset ADHD.

According to current classification systems, attention-deficit/hyperactivity disorder (ADHD) cannot be diagnosed unless its symptoms have been present already in childhood. Recently, this view has begun to be challenged with the thesis that the disorder may have its onset later in life (adolescence or young adulthood). The Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for ADHD are more liberal than those of the International Classification of Disease (ICD). Moreover, reports have begun to emerge demonstrating a different clinical picture in patients diagnosed with ADHD according to current guidelines and in a cohort with the onset in adulthood. The symptomatology of the disease in adults differs from that presented by children. Additionally, theories on the different etiopathogenesis of these entities have been advanced. These data have led to the proposal of distinguishing late-onset ADHD. There are also critical voices in the literature that question the possibility of developing ADHD symptoms in adulthood. Despite insufficient data and arguments to support the thesis of late-onset ADHD, there is a need for discussion and further exploration of the age at which ADHD may appear.

To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group. Cross-sectional survey. Nationally representative sample of the US population from 2001 to 2004. Eight- to 15-year-old children (N = 3082) in the National Health and Nutrition Examination Survey. The Diagnostic Interview Schedule for Children (caregiver module) was used to ascertain the presence of ADHD in the past year based on Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) criteria. Prior diagnosis of ADHD by a health professional and ADHD medication use were assessed by caregiver report. Of the children, 8.7% met DSM-IV criteria for ADHD. The poorest children (lowest quintile) were more likely than the wealthiest (highest quintile) to fulfill criteria for ADHD (adjusted odds ratio [AOR], 2.3; 95% confidence interval [CI], 1.4-3.9). Among children meeting DSM-IV ADHD criteria, 47.9% had a prior diagnosis of ADHD and 32.0% were treated consistently with ADHD medications during the past year. Girls were less likely than boys to have their disorder identified (AOR, 0.3; 95% CI, 0.1-0.8), and the wealthiest children were more likely than the poorest to receive regular medication treatment (AOR, 3.4; 95% CI, 1.3-9.1). Of US children aged 8 to 15 years, 8.7%, an estimated 2.4 million, meet DSM-IV criteria for ADHD. Less than half of children meeting DSM-IV criteria report receiving either a diagnosis of ADHD or regular medication treatment. Poor children are most likely to meet criteria for ADHD yet are least likely to receive consistent pharmacotherapy.

Poster #177 THE USE OF THE NSA-16 BY VIDEOCONFERENCING IN A CLINICAL TRIAL

Auditory Event-related Potentials in Children With Attention Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder and posttraumatic stress disorder: Differential diagnosis in childhood sexual abuse

Lack of global precedence and global-to-local interference without local processing deficit: A robust finding in children with attention-deficit/hyperactivity disorder under different visual angles of the Navon task.

The comorbidity of attention deficit hyperactivity disorder (ADHD) and schizophrenia poses a considerable diagnostic challenge due to significant symptom overlap, and represents a highly debilitating condition for the patient. This case report aims to present the history of a 19-year-old patient suffering from these two diagnostic entities, and thereby seeks to elucidate diagnostic and therapeutic approaches for this condition. The Diagnostic and Statistical Manual of Mental Disorders (fourth edition) criteria for ADHD and schizophrenia were used to establish clinical diagnoses. Furthermore, an in-depth clinical interview with the patient's mother was carried out. Finally, a clinical interview was conducted with the patient and the Wender Utah Rating Scale was applied to assess ADHD symptoms retrospectively. Outcomes of the mentioned diagnostic approaches confirmed the diagnosis of ADHD in the patient suffering from schizophrenia. As amphetamines would be contraindicated in the described patient, atomoxetine, a drug approved for the treatment of ADHD due to its efficacy as a selective norepinephrine reuptake inhibitor, was chosen. Following a 6-week interval after treatment initiation, a clinical re-evaluation was carried out, which showed an improvement of symptoms according to the International Classification of Diseases (tenth revision) criteria. The present case report indicates that atomoxetine may be effective in treating symptoms of ADHD in patients with schizophrenia, without increasing psychotic symptoms. Results are discussed in terms of diagnostic and therapeutic implications.

Objective To investigate the psychiatric status in their young adulthood of children with attention deficit hyperactivity disorder (ADHD).Methods This was a prospedive study.The follow-up study of a cohort of clinic-referred ADHD children was conducted.At baseline, The consecutively referred children (n = 300) with DSM-Ⅳ ADHD, aged 7.5 - 17.0 years were assessed.At the 2.0 - 13.5-year follow-up, 116 ( 38.7% ) of them were reassessed ( aged 18.0 - 23.5 years ) using the structured psychiatric interviews to make DSM-Ⅳ diagnoses by trained clinicians, including the Conners Adult ADHD Diagnostic Interview for DSM-Ⅳ (CAADID), Structured Clinical Interview for DSM-Ⅳ Axis Ⅰ Disorders, Non-Patient Version ( SCID- Ⅰ/NP), and Structured Clinical Interview for DSM-Ⅳ Personality Disorders (SCID-Ⅱ).Results In the former 116 ADHD children, 50.9% (n =59) still met the ADHD criteria, in which 15.5% (n = 18) with pure ADHD, and 35.3% (n =41 ) fulfilled both ADHD and psychiatric/ personality disorders, 14.7% ( n = 17) met the criteria of psychiatric/personality disorders, but not ADHD,34.5% (n = 40) fulfilled none of the psychiatric/personality diagnoses at follow-up.Among 116 former ADHD children, 34.5% (n=40) had at least one DSM-Ⅳ axis Ⅰ disorders, in which 18.1% comorbid mood disorders, 10.3% anxiety disorders, 5.2% abuse disorders; and 32.8% (n=38) had at least one DSM-Ⅳ axis Ⅱ personality disorders, in which 5.2% type A personality disorders, 19.8% type B ( 17.2%anti-social personality disorders), 15.5% type C, and 6.0% others.Conclusion It indicates that ADHD youth be at high risk for a wide range of adverse psychiatric outcomes, and 2/3 of them have diagnoses of adult ADHD and/or psychiatric/personality disorders. Key words: Attention deficit hyperactivity disorder; Follow-up study; Adult; Prognosis

We aimed to investigate the association of attention-deficit hyperactivity disorder (ADHD) symptoms and social competence outcomes with cognitive status in preschool children. The study population was drawn from three birth cohorts belonging to the Spanish INMA (Infancia y Medio Ambiente) project: Menorca (n=289), Ribera d'Ebre (n=60), and Granada (n=108). Children were assessed at the age of 4years for cognitive functions (McCarthy Scales of Children's Abilities, MSCA) by psychologists and for inattention and hyperactivity symptoms (ADHD Criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ADHD-DSM-IV) and social competence (California Preschool Social Competence Scale) by their teachers. Multiple regression analyses were conducted to examine potential associations between behavioral outcomes (ADHD symptoms and social competence) and MSCA cognitive outcomes, adjusting for confounders. The presence of general ADHD symptoms (inattention, hyperactivity, or both) and poorer social competence both showed negative associations with cognitive outcomes. When we compared children according to ADHD subtypes, those with inattention symptoms alone and those with both inattention and hyperactivity symptoms showed significantly lower cognitive function scores in comparison to children with no ADHD symptoms. Behavioral dysfunctions in preschoolers may be associated with impairment of cognitive functions.

ABSTRACTObjective: The aim of this study was to investigate electroencephalogram (EEG) dynamics using complexity analysis in children with attention-deficit/hyperactivity disorder (ADHD) compared with healthy control children when performing a cognitive task. Method: Thirty 7–12-year-old children meeting Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM–5) criteria for ADHD and 30 healthy control children underwent an EEG evaluation during a cognitive task, and Lempel–Ziv complexity (LZC) values were computed. There were no significant differences between ADHD and control groups on age and gender. Results: The mean LZC of the ADHD children was significantly larger than healthy children over the right anterior and right posterior regions during the cognitive performance. In the ADHD group, complexity of the right hemisphere was higher than that of the left hemisphere, but the complexity of the left hemisphere was higher than that of the right hemisphere in the normal group. Conclusion: Although fronto-striatal dysfunction is considered conclusive evidence for the pathophysiology of ADHD, our arithmetic mental task has provided evidence of structural and functional changes in the posterior regions and probably cerebellum in ADHD.