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PubMedDate not supplied

[Use of methylphenidate in adults with attention deficit disorder with hyperactivity].

Attention deficit, hyperactivity disorder was recently described in adults. The clinical individualization of this syndrome progressed but the categorical approach remains to be entirely completed. The residual form of the childhood disorder does not generate diagnostic problem when childhood previous history is known. ADHD without childhood history refer us to retrospective difficulties of diagnosis and various evolutions of the infantile form linked or not, with other psychiatric pathologies. Etiology remains unknown, hypothesis of an hereditary disfunction of neurotransmitters is the more studied. These patients can benefit from a psychostimulant treatment. Four controlled studies with methylphenidate demonstrated to be significantly superior to placebo. Even if there are methodological difficulties not resolved (comorbidity, homogeneous population) results are encouraging.

Adult↗

PubMed2005

Adaptive, emotional, and family functioning of children with obsessive-compulsive disorder and comorbid attention deficit hyperactivity disorder.

OBJECTIVE: The purpose of the study was to examine adaptive, emotional, and family functioning in a well-characterized group of children and adolescents with obsessive-compulsive disorder (OCD) and to evaluate the influence of comorbid attention deficit hyperactivity disorder (ADHD) on the levels of impairment in various functional domains. METHOD: The study group included 287 children and adolescents (191 boys, 96 girls) ages 7-18 years. Fifty-six subjects had a diagnosis of OCD only, 43 had both OCD and ADHD, 95 had ADHD, and 93 were unaffected comparison children. Best estimate DSM-IV diagnoses were assigned on the basis of structured interviews and clinical ratings. The children's functioning was evaluated with a comprehensive battery of well-established, standardized measures, including the Vineland Adaptive Behavior Scales, parents' ratings of social and family functioning, and children's self-reports of emotional adjustment. RESULTS: The children with OCD only were more impaired than were unaffected comparison subjects in most areas of adaptive functioning and emotional adjustment. Children with OCD plus ADHD had additional difficulties in social functioning, school problems, and self-reported depression. Impairment in daily living skills, reduced number of activities, and self-reported anxiety were uniquely associated with the diagnosis of OCD. Family dysfunction was associated with ADHD but not with OCD. CONCLUSIONS: Children and adolescents with OCD are impaired in multiple domains of adaptive and emotional functioning. When comorbid ADHD is present, there is an additional burden on social, school, and family functioning.

Adaptation, Psychological↗

PubMed1993

Attention deficit hyperactivity disorder in children.

Recent research in attention deficit hyperactivity disorder in childhood is reviewed in the following areas: neuroanatomic and genetic linkages that may help to explain the heterogeneous nature of this disorder and possible treatments; the continued efforts by researchers to tease apart comorbid symptomatology and contribute to our understanding of the parameters of attentional problems; and the studies of medication effects on the two central domains of difficulty of children and adolescents with attention deficit hyperactivity disorder, school performance and achievement, and social relationships.

Attention Deficit Disorder with Hyperactivity↗

PubMed1995

Attention deficit hyperactivity disorder in adolescent mania.

OBJECTIVE: The purpose of this study was to examine the rate of attention deficit hyperactivity disorder in adolescents with bipolar disorder and to explore the potential effects of comorbid attention deficit hyperactivity disorder on the phenomenology of adolescent bipolar disorder. METHOD: The authors assessed the rate of attention deficit hyperactivity disorder for adolescents with bipolar disorder who were hospitalized for treatment of acute mania or hypomania. RESULTS: Eight (57%) of 14 adolescent bipolar patients also met DSM-III-R criteria for attention deficit hyperactivity disorder. Patients with both disorders were more likely to be male and Caucasian and to have mixed rather than manic bipolar disorder. Patients with attention deficit hyperactivity disorder had a higher mean total score on the Young Mania Rating Scale than patients with bipolar disorder alone. CONCLUSIONS: Although preliminary, these findings may have important implications regarding the potential relationship between bipolar disorder and attention deficit hyperactivity disorder.

Adolescent↗

PubMedDate not supplied

[Attention deficit hyperactivity disorder (ADHD)--molecular and genetic aspects].

Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood, affecting approximately 5-10% of children. ADHD is considered to be a multifactorial disorder because both genetic and environmental components may contribute to its progress. The etiology of attention deficit hyperactivity disorder (ADHD) is unknown, however family, twin and adoption studies have suggested that genetic factors are very important in its etiopathogenesis. The research of genetic basis of ADHD consists of linkage analysis, candidate gene approach and association studies. These analyses and also investigations on animal models of disease suggest that mutations in genes involved in dopaminergic, serotonergic and adrenergic systems are likely to be responsible for ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

[Association between dopamine beta hydroxylase gene and attention deficit hyperactivity disorder complicated with disruptive behavior disorder].

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD), a common behavior disorder of childhood, is a highly heterogeneous disease frequently accompanied by various mental disorders, including disruptive behavior disorder (DBD). Studies show that children suffering from ADHD with DBD are at higher risk of antisocial personality, substance abuse, and social adaptations disorder at their adulthood. The dopamine beta hydroxylase (DbetaH) is the key enzyme to ADHD since it catalyzes the conversion of dopamine to norepinephrine, and dysfunction there of is believed to be one of the causes of the disorder. To explore the association between DBH gene and ADHD complicated with or without DBD, the authors analyzed the transmission of a novel polymorphism DBH -1021C-->T, which is found associated with plasma DbetaH activity, in ADHD nuclear families using transmission disequilibrium test (TDT). METHODS: Consensus diagnoses were based on the DSM-IV. The samples included those from 292 Chinese Han nuclear families with ADHD probands. Genotypes of DBH -1021C-->T polymorphism were determined by PCR amplification, endonuclease digesting and electrophoresis. The transmission of DBH -1021C-->T polymorphism in ADHD nuclear families with or without DBD was analyzed by TDT. RESULTS: The results showed that there was transmission disequilibrium between DBH-1021C-->T polymorphism and ADHD with or without DBD. In ADHD comorbid with DBD, T allele was preferentially transmitted (P < 0.05); and in ADHD without DBD, so was the C allele (P < 0.05). Among the three subtypes of ADHD, only ADHD-C subtype with DBD had an increased transmission of T allele (P < 0.05). CONCLUSION: There is an association between DBH gene and ADHD comorbid with or without DBD, but the preferential transmission alleles are different. The low activity T allele is increased to transmit in ADHD with DBD, while the high activity C allele is preferentially transmitted in ADHD without DBD. The results support the proposition that the genetic mechanism is different between ADHD comorbid with or without DBD. We also found that only ADHD-C subtype with DBD is associated with DBH -1021C-->T polymorphism in three subtypes of ADHD, which may suggest that there is a more intense relationship between DBD and ADHD-C subtype.

Alleles↗

PubMed2005

Resting EEG theta activity predicts cognitive performance in attention-deficit hyperactivity disorder.

Quantitative electroencephalography has contributed significantly to elucidating the neurobiologic mechanisms of attention-deficit hyperactivity disorder. The most consistent and robust electroencephalographic disturbance in attention-deficit hyperactivity disorder has been abnormally increased theta band during resting conditions. Separate research using attention-demanding tests has elucidated cognitive disturbances that differentiate attention-deficit hyperactivity disorder. This study attempts to integrate electroencephalographic and neuropsychological indices to determine whether cognitive performance is specifically related to increased theta. Theta activity was recorded during a resting condition for 46 children/adolescents with attention-deficit hyperactivity disorder and their sex- and age-matched control subjects. Accuracy and reaction time during an auditory oddball and a visual continuous performance test were then recorded. Compared with control subjects, the attention-deficit hyperactivity disorder group manifested significantly increased (primarily left) frontal theta. Furthermore, the attention-deficit hyperactivity disorder group scored significantly delayed reaction time and decreased accuracy in both tasks. Correlation analysis revealed a significant relationship between frontal (primarily left) theta and oddball accuracy for the attention-deficit hyperactivity disorder group compared with a significant relationship between posterior (primarily right) theta and reaction time in the continuous performance test for the control group. These results indicate that spatial neurophysiologic deficits in attention-deficit hyperactivity disorder may be related to disturbances in signal detection. This observation has important implications for the role of trait-like biologic deficits in attention-deficit hyperactivity disorder predicting performance in information processing.

Adolescent↗

PubMed1996

Adults with attention deficit hyperactivity disorder: assessment and treatment considerations.

Attention Deficit Hyperactivity Disorder (ADHD) has, historically, been viewed as a childhood disorder which would be outgrown by adulthood. More recent findings have established that the disorder often persists into adult-hood in a significant number of those diagnosed as children. Due to increased awareness and media attention being focused on ADHD in adults, greater numbers of adults are seeking evaluation and treatment for this disorder. The symptoms of ADHD are common to a variety of other psychiatric disorders including learning disabilities, so clinicians need to update their knowledge of assessment, treatment, and differential diagnosis issues regarding this often misunderstood disorder. This article discusses some current methods used in the assessment and treatment of adults with ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2004

[Attention deficit hyperactivity disorder in adults. An overview].

Attention deficit hyperactivity disorder (ADHD), which is characterized by the inability to appropriately modulate attention and/or impulse control and hyperactivity, resulting in social, academic and occupational underachievement, is presently the topic of intensive discussion in German psychiatry. With a prevalence of 3-5%, ADHD is one of the most frequently seen disorders in child and adolescent psychiatry. With nearly 50% of childhood patients also affected during adulthood, this disorder is of much higher clinical significance for psychiatry than presumed thus far. The present review discusses current results of epidemiology, etiology, clinical symptoms and comorbidity, diagnostic assessment, pharmacotherapy, and psychological interventions for adults with ADHD.

Adolescent↗

PubMed1991

Attention-deficit hyperactivity disorder: a clinical review.

Attention-deficit hyperactivity disorder is a common psychiatric disorder, with onset before age seven. The diagnosis is based on a careful history and standardized rating scales, and stimulant medications remain the drugs of choice. Children who do not respond to stimulants, or who have other significant psychiatric disorders, should be referred to appropriate mental health professionals.

Attention Deficit Disorder with Hyperactivity↗

PubMedDate not supplied

Dental management considerations in children with attention-deficit hyperactivity disorder.

Children suffering from attention-deficit hyperactivity disorder frequently have numerous orofacial anomalies of concern to the dentist. Behavioral manifestations of the disorder frequently impair the patient's ability to perform home care adequately, make dental treatment arduous, and place the patient at risk of physical abuse from family and peers. Familiarity with the symptoms and treatment of the disorder will better prepare the dentist to meet the needs of this unique group of patients.

Attention Deficit Disorder with Hyperactivity↗

PubMed2003

Attention deficit hyperactivity disorder (ADHD)--life insurance implications.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in youth. About one-half of these youngsters continue to have symptoms as they enter their 20s. Of these, some also have co-morbid conditions such as conduct disorders, psychiatric problems and substance abuse. The medical director must be able to recognize the small subset of affected individuals whose mortality due to ADHD is greater than that of the standard population.

Actuarial Analysis↗

PubMed1999

Attention deficit hyperactivity disorder, CNS stimulants and sport.

Attention deficit hyperactivity disorder (ADHD) affects 1 to 10% of children and is characterised by a persistent pattern of inattention and/or hyperactivity/impulsivity. Over one-half of children with ADHD have associated conditions, including learning disabilities, conduct disorders, poor coordination, depression, anxiety, obsessive-compulsive disorders and bipolar disorders. CNS stimulant medication used in the management of ADHD is not permitted for use in competition by the International Olympic Committee (IOC) and this poses a problem for the physicians of patients with ADHD. On the one hand, attention and concentration are improved by stimulant medication and fine motor coordination and balance are improved after methylphenidate administration, but these therapeutic and sport-related benefits are not available to the athlete with ADHD who wishes to compete under IOC rules. It has been suggested that treatment with methylphenidate may be suitable for athletes with ADHD, as cessation of therapy 24 hours before competition is usually adequate to allow drug clearance which should avoid a positive result being returned on drug testing. More research is needed to establish whether stimulant medication for athletes with ADHD provides an unfair advantage in competition.

Attention Deficit Disorder with Hyperactivity↗

PubMed1999

[Assessment of the attention-deficit hyperactivity disorder in adults].

The attention-deficit hyperactivity disorder (ADHD) is one of the most common disorders in childhood and adolescence with a prevalence of app. 5%. The importance of ADHD in childhood as a factor of vulnerability for psychiatric disorders in adults is becoming a focus of discussion. It was shown that there is a comorbidity in adults with substance abuse, delinquency and personality disorders. There is a growing evidence that ADHD will persist in a significant number of patients during adulthood. This is the first german study to evaluate this interdependence. We examined 164 adult inpatients and 48 healthy volunteers with the Wender Utah Rating Scale (WURS), a retrospective self-evaluation scale for the diagnosis of ADHD in childhood, and the Eysenck impulsiveness questionnaire I7. It could be shown that the WURS and the I7 are suitable instruments for the evaluation of the ADHD in adults especially concerning the aspects of attention deficits and impulsiveness.

Adult↗

PubMed2003

Attention deficit hyperactivity disorder in sport: a review.

Attention deficit hyperactivity disorder (ADHD) is a controversial problem in sport since participants with this disorder often require banned stimulant medication while competing. Little information is available in the literature concerning this problem or whether sports people should be allowed to participate while on stimulant therapy. The intention of this review is to undertake a brief review of recent findings in ADHD, especially as they apply to sport, and suggest some guidelines that could then be applied by sporting bodies to allow ADHD sufferers to compete. Recent scientific evidence, clinical, genetic, and imaging techniques, confirm that ADHD is characterised by dysfunction in dopamine transmission in the frontal lobes and basal ganglia structures, regions associated with attention and behaviour. The dopamine transporter (DAT) regulates dopamine by removing excess. In ADHD people, the number and density of DATs and DAT binding sites are increased by up to 70 %. The dopamine agonist methylphenidate blockades DAT, significantly increasing extra cellular dopamine, so correcting the dopamine deficiency. Methods. A search of the English literature was made using Medline from the years 1980 to 2002. [nl]The aim of this review is not to debate the use of stimulants or how often they are necessary or successful in this condition but to point out that a number of young sport people with ADHD require such medication on a regular basis. Although there are problems with their use as far as the International Olympics Committee (IOC) is concerned, it would seem most unfair to penalise sports people by having to give up their medication, even for a few days or at some arbitrary age, in order to compete.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

Association between tryptophan hydroxylase gene polymorphisms and attention deficit hyperactivity disorder in Chinese Han population.

Attention deficit hyperactivity disorder (ADHD) is a severe behavioral disorder in children known to have a substantial genetic component. Prior studies have implicated serotonin genes in the etiology of ADHD but have not examined tryptophan hydroxylase (TPH), which is a rate-limiting enzyme in serotonin biosynthesis. The current study examined the relationship between the A218C and A-6526G polymorphisms of the TPH gene and ADHD. Three hundred sixty-two unrelated ADHD probands and their biological parents were recruited to participate in this study. No biased transmission of any allele of the two polymorphisms was observed using TDT analysis. However, haplotype analyses found that the rare 218A/-6526G haplotype was significantly not transmitted to probands with ADHD (chi(2) = 4.4995, P = 0.034), regardless of subtype. Although this finding for ADHD in the Chinese Han population.

Adolescent↗

PubMedDate not supplied

Attention-deficit hyperactivity disorder--etiology, diagnosis, and management.

Attention deficit hyperactivity disorder is a developmentally disabling disorder of inattention, impulsivity, and hyperactivity that affects 3%-20% of school-aged children. It affects the child at home, at school, and with peers, and persists into adolescence and young adulthood. The author reviews the diagnostic criteria, etiological considerations, evaluation process, and management of this handicapping disorder. Included is a discussion of the most frequently used medications and suggestions for home and classroom management strategies that assist the child to behave and achieve success in school. It is pertinent to all nurses, since children with ADHD are in all settings and nurses are often asked questions about this controversial health care issue in both professional and personal arenas.

Adolescent↗

PubMed1992

Enantioselective pharmacokinetics and pharmacodynamics of dl-threo-methylphenidate in children with attention deficit hyperactivity disorder.

Nine boys with attention-deficit hyperactivity disorder took part in a study in which d-methylphenidate, l-methylphenidate, dl-methylphenidate, or placebo were administered in a double-blind, four-way, randomized, crossover design. Plasma levels of the isomers of methylphenidate were monitored by means of an enantioselective assay method. The ability of the children to perform tasks that required sustained attention was monitored by a battery of computer tests. There was no evidence of interconversion between the enantiomers in vivo, although the presence of the d-isomer significantly altered the pharmacokinetics of the l-antipode. The presence of the l-isomer did not affect the pharmacokinetics of d-methylphenidate. The computer tests revealed a drug-induced improvement in sustained attention that was entirely attributable to the d-enantiomer. There was no evidence to suggest that the effectiveness of d-methylphenidate was in any way compromised by the presence of its antipode.

Analysis of Variance↗