Psychiatric Comorbidity in the Subtypes of ADHD in Children and Adolescents with ADHD According to DSM-IV

Introduction: The prevalence rate of psychiatric comorbidity in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) was 60-80%. The objective of this study was to examine comorbid disorders associated with ADHD and the subtypes of ADHD in children and adolescents with the diagnosis of ADHD. Method: The study included 326 children and adolescents aged between 8-15 years who were diagnosed with ADHD for the first time as a result of an interview by psychiatry, in a child adolescent psychiatry clinic in Izmir. Sociodemographic form, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version were used to assess psychiatric comorbidity. Results: The comorbidities accompanied ADHD were disruptive behavior disorder (28.8%), depressive disorder (13.2%), obsessive-compulsive disorder (9.5%) and anxiety disorder (6.1%), in respectively. When the subtypes of ADHD were assessed according to psychiatric comorbidity, oppositional defiant disorder and conduct disorder were frequently seen with ADHD combined type, whereas anxiety disorder was seen more frequent in children diagnosed with ADHD inattentive type. Discussion: Especially the presents of comorbidities in cases with ADHD Combined type increases the severity of disease, causes to retard in responses to treatment and exacerbates prognosis. Therefore, it is very important to determine which psychiatric diagnosis accompany with ADHD

Increased cerebral blood flow in the right anterior cingulate cortex and fronto-orbital cortex during go/no-go task in children with ADHD

Objective Arterial spin labeling (ASL) is a relatively new imaging modality in the field of the cognitive neuroscience. In the present study, we aimed to compare the dynamic regional cerebral blood flow alterations of children with ADHD and healthy controls during a neurocognitive task by using event-related ASL scanning. Methods The study comprised of 17 healthy controls and 20 children with ADHD. The study subjects were scanned on 3 Tesla MRI scanner to obtain ASL imaging data. Subjects performed go/no-go task during the ASL image acquisition. The image analyses were performed by FEAT (fMRI Expert Analysis Tool) Version 6. Results The mean age was 10.88 +/- 1.45 and 11 +/- 1.91 for the control and ADHD group, respectively (p = .112). The go/no-go task was utilized during the ASL scanning. The right anterior cingulate cortex (BA32) extending into the frontopolar and orbitofrontal cortices (BA10 and 11) displayed greater activation in ADHD children relative to the control counterparts (p < .001). With a lenient significance threshold, greater activation was revealed in the right-sided frontoparietal regions during the go session, and in the left precuneus during the no-go session. Conclusion These results indicate that children with ADHD needed to over-activate frontopolar cortex, anterior cingulate as well as the dorsal and ventral attention networks to compensate for the attention demanded in a given cognitive task

Esrar bağımlılarında algılanan ebeveyn kabul reddinin, psikolojik uyumları ve yetişkinlikteki yakın ilişkiler üzerindeki etkilerinin incelenmesi

In this study, 75 (50%) cannabis users and 75 (50%) non cannabis users men were compared in terms of parental acceptance-rejection, psychological adjustment, intimate partner acceptance-rejection and self-destructive behavior, suicidal ideation and behavior and the existence of traumatic experiences in childhood. Subjects were administered Parental Acceptance-Rejection Questionnaire, Personality Assessment Questionnaire, and Intimate Partner Acceptance-Rejection/Control Questionnaire developed by Rohner (1986/1999). The findings of this study revealed that cannabis users perceived more neglect and more reject, feel more doubt about on their loved by their mothers and fathers than non users. Multiple substance use is associated with perceived neglect and undifferentiated rejection by their fathers. In terms of intimate partner acceptance and rejection, cannabis users perceived from their partners more neglect, aggressive and undifferentiated rejection than control group. Additionally, cannabis users are perceived more reject and thought more controlled by their partners. In terms of general psychological adjustment, the findings of this study demonstrated that cannabis users were less adjusted than control group. Cannabis users had more negative self-concept, feeling of inadequacy and had more difficulty in giving appropriate emotional responses and showing their feelings. They were more angry and had more negative World view than control group. The findings of this study revealed that general psychological adjustment of cannabis users is significantly associated with perceived rejection-acceptance from either mother or father during childhood and perceived rejection or acceptance from their partner. When the mediation effect of parental acceptance and rejection on the relationship between partner acceptance and rejection and current psychological adjustment was examined, it was found maternal acceptance had a full mediating effect in the dependent group and had no effect in the control group. While father acceptance had a partial mediating effect on the relationship between intimate partner acceptance-rejection and current psychological adjustment in the dependent group, in the control group it had no mediation effect. Finally, cannabis users had be exposed to more physical, emotional and verbal abuse than control group. They had more suicidal ideation and behavior, and self destructive behavior than control group.Bu araştırmada esrar bağımlısı olan 75 (50%) ile esrar bağımlısı olmayan 75 (50%) erkek; sosyodemografik özellikler, anne ve baba kabul-reddi, psikolojik uyum, eş kabul-reddi ile kendine zarar verme davranışı, intihar düşüncesi ve girişimi ve çocukluk çağı travmatik yaşantının varlığı açısından karşılaştırılmalı olarak incelenmiştir. Araştırmada Rohner (1986, 1999) tarafından geliştirilen Ebeveyn Kabul-Red Ölçeği Anne-Baba formları, Kişilik Değerlendirme Ölçeği ve Eş Kabul-Red Ölçeği uygulanmıştır. Araştırmadan elde edilen bulgular, esrar bağımlısı olan kişilerin çocukluklarında hem anneleriyle hem de babalarıyla ilişkilerinde esrar bağımlısı olmayan kişilere göre daha fazla ihmal edildiklerini ve anneleri ve babaları tarafından sevildikleri hakkında daha fazla şüpheye düştüklerini ve daha az kabul algıladıklarını göstermiştir. Esrar bağımlısı olan kişilerin babalarıyla ilişkilerinde ihmal edilmiş olmaları ve algıladıkları ayrışmamış red ile kişilerin çoklu madde kullanımıları arasında güçlü bir bağ olduğu görülmüştür. Yakın ilişkilerinde algıladıkları kabul red açısından esrar bağımlısı olanların normal gruba göre, eşlerini daha saldırgan, ve görünürde belirgin ihmal, saldırganlık ya da soğukluk olmadığı halde eşlerini daha ilgisiz ve daha sevgisiz algıladıkları görülmüştür. Ayrıca, esrar bağımlısı olan kişilerin, eşleri tarafından daha fazla kontrol edildiklerini ve daha az kabul edildiklerini düşündükleri bulunmuştur. Genel psikolojik uyum açısından, araştırmadan elde edilen bulgular esrar bağımlısı olan kişilerin genel psikolojik uyumunun normal gruba göre daha sağlıksız olduğunu ortaya koymuştur. Esrar bağımlısı olanlar normal gruba göre daha olumsuz benlik algısına ve yetersizlik duygusuna sahiptirler, duygularını göstermekte ve uygun duygusal tepkiler vermekte zorlanmaktadırlar. Ayrıca normal gruba göre daha öfkelidirler ve dünya görüşleri daha olumsuzdur. Araştırmadan elde edilen bulgular, esrar bağımlısı olan kişilerin genel psikolojik uyumlarının çocuklukta anne-babalarıyla bugün ise eşleriyle yaşadıkları yakın ilişkilerde algıladıkları kabul-red ile anlamlı düzeyde ilişkili olduğunu ortaya koymuştur. Çocukluk dönemine ilişkin ebeveyn kabul-reddi anılarının, yetişkinlik döneminde algılanan eş kabul-reddi ile psikolojik uyum arasındaki ilişkide aracılık etkisi incelendiğinde, esrar bağımlılarının oluşturduğu grupta çocuklukta algılamış olan anne kabulü, eş kabulü ile psikolojik uyum arasındaki ilişkiye tam aracılık etmiştir. Kontrol grubunda ise, çocuklukta algılamış olan anne kabulünün eş kabul-reddi ile psikolojik uyum arasındaki ilişki üzerinde aracılık etkisi yoktur. Bağımlı grupta, baba kabul-reddinin psikolojik uyum ve eş kabul-reddi üzerinde dolaylı aracılık etkisi bulunduğu ancak kontrol grubunda yer alanlar için çocuklukta algılanmış olan baba kabul-reddi eş kabul-red ile psikolojik uyum arasındaki ilişkiye aracılık etmediği bulunmuştur. Son olarak esrar bağımlısı olan kişilerin çocuklukta fiziksel, sözel şiddete ve duygusal istismara bağımlı olmayan gruptan belirgin düzeyde daha fazla maruz kaldığı, kendine zarar verme davranışının, intihar düşüncesinin ve girişiminin daha fazla olduğu görülmüştü

Methylphenidate significantly improves neurocognitive impairments in children with ADHD

This study aimed to investigate the effects of methylphenidate (MPH) on scores on a neurocognitive test battery for individuals with various presentations of attention deficit/hyperactivity disorder (ADHD) and the effect of comorbidities on executive function. This study included 861 children and adolescents aged 7-17 years who were diagnosed with ADHD according to DSM-V criteria. The CNS Vital Signs Battery was utilized to compare the neuropsychological characteristics and MPH treatment responses of patients with predominantly inattentive (ADHD-I) and combined (ADHD-C) presentations of ADHD. Before MPH administration, a statistically significant difference was observed between groups only for complex attention. In addition, the overall prevalence rate of psychiatric comorbidities was 45.5%, and no statistically significant differences were found in the ADHD-I group pre-versus post-MPH administration. Prior to the administration of MPH, statistically significant differences were observed within the ADHD-C group between those with or without comorbidities. However, after MPH administration, these differences between the groups disappeared. The effects of MPH on improving scores on neuropsychological subtests were similar between the groups with different presentations of ADHD. Additionally, MPH treatment was effective despite the presence of comorbidities

Treatment of preschool children with obsessive compulsive disorder

The aim was to examine the clinical features of Obsessive-Compulsive Disorder (OCD) in preschool and the effectiveness of aripiprazole with a standardized Cognitive-Behavioral Family Therapy (CBFT) in the treatment of preschoolers with OCD. Twelve preschool children, 36–72 months of age were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS) at baseline, at the end of the 12th and 24th weeks of treatment. The baseline mean of total CY-BOCS score decreased from 33.67 to 13.83 at the 12th week and 5.58 at the end of the 24th week of treatment. Also, 66.7% of them had at least one psychiatric comorbidity. Overall, this study revealed the effect of aripiprazole with CBFT in preschool-aged children with OCD. Also, the presence of comorbidity that is seen frequently in preschoolers with OCD may complicate the treatment. Therefore, there is a need to increase awareness of OCD and its comorbidities in preschoolers to supply treatment at an early age.Publisher's VersionScience Citation Index Expanded (SCI-EXPANDED)Social Sciences Citation Index (SSCI)WOS:000825726000001PubMed ID: 35801811Affiliation ID: 6001047

Internet use and aggression in adolescents with attention deficit hyperactivity disorder

Objective: the aim of this study was to investigate the relationship between internet addiction and aggression in adolescents with Attention Deficit Hyperactivity Disorder (ADHD). in addition, we aimed to explore the differences between ADHD subtypes (inattentive type; combination type; hyperactive-impulsive type). Method: the sample consisted of a total of 120 adolescents. the study group included 60 individuals aged between 13 and 17 years (14.70±2.07) who had presented to a child and adolescent psychiatry clinic and received a diagnosis of ADHD according to the DSM-IV after being interviewed by a specialist, while 60 adolescents without a diagnosis of ADHD made up the control group. Kiddie-Schedule for Affective Disorders and Schizophrenia, present and life time version (K-SADS-PL), Buss-Perry Aggression Questionnaire (BPAQ), Internet Addiction Diagnostic Questionnaire (IADQ), and a semi structured sociodemographic form were used as measurement devices. Results: According to the results of statistical analyses, the ratio of internet addiction and aggression were higher in adolescents with ADHD than in the control group. Especially the rate of internet addiction and aggression was higher in adolescents with ADHD combination type. in addition, there is a positive relationship between internet addiction and aggression in adolescents with ADHD. Conclusion: According to our study results, there is a positive relationship between internet addiction and aggression in adolescents with ADHD. the results of our study will be helpful to develop future protective measures in internet addiction aimed at preventing aggressive behavior of adolescents with ADHD

Eye movement desensitization and reprocessing therapy in adolescents with panic disorder: a twelve-week follow-up study

The aim of this study is to investigate the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) treatment in adolescents with panic disorder (PD). This follow-up study consists of 30 adolescents with PD without agoraphobia, aged 14–17 (15.53 ±.97). They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, also the Panic and Agoraphobia Scale (PAS) and Beck Anxiety Inventory (BAI) were administered at baseline, at the end of the 4th and 12th weeks of treatment. EMDR therapy which is an eight-phase treatment approach composed of standardized protocols and procedures was applied for 12 weeks, one session per week. The baseline mean of the total PAS score decreased from 40.06 to 13.13 at fourth week and 1.2 at the end of 12th week of treatment. In addition, BAI score decreased significantly from 33.67 to 13.83 at 4 weeks and 5.31 at the end of 12th week of treatment. Overall, our results underscore the effectiveness of EMDR in adolescents with PD. Moreover, the current study suggests that EMDR may represent an effective intervention technique for PD in adolescents to protect against relapses and to overcome a fear of future attacks.Publisher's VersionQ3WOS:001009295300001PMID: 3732819

The relationships of neuropsychological factors and loneliness preference in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome

This study aimed to examine emotion dysregulation and internalizing disorders mediating the relationship between selective and sustained attention and loneliness preference in children diagnosed with attention deficit hyperactivity disorder (ADHD) and Cognitive Disengagement Syndrome (CDS). This study included 176 children and adolescents between ages 8 and 12. The solitude scale for children, Difficulties in Emotion Regulation Scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, and CNS Vital Signs test were used. The results suggest that difficulties in emotion regulation and having an internalizing disorder had a mediating effect between difficulties in selective attention and preference for the loneliness of children with ADHD + CDS. Also, it was likely that the association between sustained attention and preference for loneliness is mediated by internalizing disorders. The results suggest that the social problems commonly exhibited by children with ADHD + CDS may be related to deficits in sustained and selective attention.Publisher's VersionQ3WOS:001122508500001PMID:3807941