Towards an understanding of sleep problems in childhood depression.
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Catechol O-Methyltransferase↗
Biomedical subjects
Reut Gruber
Publications and source records attributed to Reut Gruber.
Sleep and COMT polymorphism in ADHD children: preliminary actigraphic data.
OBJECTIVE: To examine whether COMT (catechol-O-methyltransferase) polymorphism modulates aspects of sleep in children diagnosed with attention-deficit/hyperactivity disorder (ADHD). METHOD: Nightly sleep actigraphic recordings during a double-blind, placebo-controlled, crossover clinical study (1 week of 0.5 mg/kg MPH; 1 week of placebo) were obtained for 34 children, 7.4 to 12 years old, diagnosed with ADHD (DSM-IV). Diagnosis was generated by the Diagnostic Interview Schedule for Children and was confirmed by multidisciplinary consensus. RESULTS: Children who were Val allele carriers had poorer sleep continuity compared with children with the Met-Met genotype while receiving a placebo and while receiving methylphenidate. CONCLUSIONS: The findings of the present study support the hypothesis that sleep disturbances in children with ADHD are related to the underlying pathophysiology of the disorder.
Attention Deficit Disorder with Hyperactivity↗
Construct validity of an instrument to assess major depression in parents in epidemiologic studies.
OBJECTIVE: The Longitudinal Study of Child Development in Quebec (LSCDQ) is a community study of children that examines the risk factors, such as parental depression, linked to childhood psychopathology and maladaptive functioning. Our goal was to test the construct validity of an instrument to assess major depression in the parents. METHOD: Parents of a representative sample of 2120 infants born in the province of Quebec in 1998 were selected. The major depression instrument was administered to the parents when the infants were aged 29 months. We tested the construct validity of the instrument by examining 1) sex differences in symptoms and prevalence, 2) the rank order of the prevalence of symptoms, 3) the clustering of symptoms, and 4) the association of depression with functional impairment and treatment-seeking behaviour. RESULTS: Depression was twice as common in mothers as in fathers. Most mothers and fathers who reported ever being depressed for 2 or more weeks had also experienced at least 4 additional depression symptoms. The rank order of symptom prevalence was comparable to that found in other studies. At least 50% of parents reported having talked to a professional and that suffering from depression had interfered with their functioning. CONCLUSIONS: The expected sex differences, the rank order of symptom prevalence, the symptom clustering, and the associations with functional impairment and treatment-seeking behaviour support the construct validity of a brief questionnaire on parental major depression.
Adult↗
Sleep and neurobehavioral functioning in boys with attention-deficit/hyperactivity disorder and no reported breathing problems.
STUDY OBJECTIVE: To investigate by objective measures the neurobehavioral correlates of sleep patterns in boys with attention-deficit/hyperactivity disorder (ADHD) and no reported breathing problems and in control children. DESIGN: Sleep assessment was conducted for 5 consecutive days and neurobehavioral assessment was conducted in the morning of the third day of measurement in children with ADHD and no breathing problems and control children. SETTING: The neurobehavioral assessment was conducted in the school; sleep was assessed in the home. PARTICIPANTS: 25 controls and 24 boys diagnosed with ADHD between 7 and 11 years of age. MEASUREMENTS: Sleep was monitored using actigraphy for 5 consecutive nights. A computerized neurobehavioral evaluation system was used to assess children's neurobehavioral functioning. RESULTS: Canonical correlation analyses revealed different patterns of associations between sleep and neurobehavioral functioning for the 2 groups. Significant relationships were found between measures of sleep and performance on complicated neurobehavioral tasks in the control group but not in the ADHD group. In addition, children with ADHD had increased instability of sleep parameters compared to the controls. CONCLUSIONS: The findings highlighted the distinct nature of associations between sleep and neurobehavioral functioning in boys with ADHD children and no reported breathing problems compared to controls. Despite the similarity between symptoms caused by sleep fragmentation and symptoms of ADHD, these appear to be different clinical conditions. The source of inattentiveness in children should be identified for best planning of clinical intervention.
Attention Deficit Disorder with Hyperactivity↗
Methylphenidate treatment for attention-deficit/hyperactivity disorder in children and adolescents with velocardiofacial syndrome: an open-label study.
BACKGROUND: Velocardiofacial syndrome (VCFS) is a common microdeletion syndrome associated with psychiatric morbidity and developmental disabilities. Although attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric problem associated with VCFS, there are no reports on methylphenidate treatment in this patient population. Indeed, clinicians have commonly avoided the use of methylphenidate in children with VCFS because of concerns about ineffectiveness or psychotic exacerbation. METHOD: Forty subjects of mean +/- SD age 11.0 +/- 5.0 years with VCFS were assessed for DSM-IV diagnoses using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime Version, and its extended ADHD module (K-SADS-P-ADHD). Those found to have comorbid ADHD were treated with methylphenidate, 0.3 mg/kg once daily. Treatment efficacy was evaluated after 4 weeks with the K-SADS-P-ADHD, the Conners' Abbreviated Teacher Questionnaire, and the Conners' Continuous Performance Test. Side effects were evaluated with a modified version of the Barkley Side Effects Rating Scale. RESULTS: Of the 18 subjects (45%) diagnosed with ADHD, 12 agreed to participate in the study. Their ADHD symptoms, both behavioral and cognitive, improved significantly with treatment. None of the patients showed clinical worsening or psychotic symptoms. Side effects were usually mild and did not warrant discontinuation of methylphenidate. The most common side effects were anorexia and depressive-like symptoms. CONCLUSION: This open-label study indicates that methylphenidate is effective and safe in patients with VCFS. Therefore, its current limited use in this population seems to be unjustified. Larger, controlled clinical and pharmacogenetic studies are needed to confirm these findings.
Adolescent↗
Sleep, neurobehavioral functioning, and behavior problems in school-age children.
The aim of this study was to examine the associations between sleep and neurobehavioral functioning (NBF) in school-age children. These variables were assessed for 135 unreferred, healthy school children (69 boys and 66 girls), from second-, fourth-, and sixth-grade classes. Objective assessment methods were used on the participants in their regular home settings. Sleep was monitored using actigraphy for 5 consecutive nights; and NBF was assessed using a computerized neurobehavioral evaluation system, administered twice, at different times of the day. Significant correlations between sleep-quality measures and NBF measures were found, particularly in the younger age group. Children with fragmented sleep were characterized by lower performance on NBF measures, particularly those associated with more complex tasks such as a continuous performance test and a symbol-digit substitution test. These children also had higher rates of behavior problems as reported by their parents on the Child Behavior Checklist. These results highlight the association between sleep quality, NBF, and behavior regulation in child development; and raise important questions about the origins of these associations and their developmental and clinical significance.
Attention↗
The effects of sleep restriction and extension on school-age children: what a difference an hour makes.
This study assessed the effects of modest sleep restriction and extension on children's neurobehavioral functioning (NBF). The sleep of 77 children (age: M = 10.6 years; range = 9.1-12.2 years) was monitored for 5 nights with activity monitors. These children (39 boys and 38 girls) were all attending regular 4th- and 6th-grade classes. Their NBF was assessed using computerized tests on the 2nd day of their normal sleep schedule. On the 3rd evening, the children were asked to extend or restrict their sleep by an hour on the following 3 nights. Their NBF was reassessed on the 6th day following the experimental sleep manipulation. Sleep restriction led to improved sleep quality and to reduced reported alertness. The sleep manipulation led to significant differential effects on NBF measures. These effects may have significant developmental and clinical implications.
Child↗