The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder

Objectives. This study aims to evaluate the effects of methylphenidate (MPH) on eating patterns and body mass index (BMI) in children with attention deficit/hyperactivity disorder (ADHD). The secondary aim of this study is the comparison between weight and eating behavior of children with ADHD undergoing an MPH treatment, and of children without ADHD. Methods. One hundred fourty three children and adolescents who diagnosed with ADHD were enrolled, and the effects of MPH on the eating patterns and BMI were evaluated. All participants completed a number of tests to analyze eating patterns and clinical psychopathological profiles. Results. Children and adolescents with ADHD had significantly higher scores on the EDE-Q- eating concern, EDE-Q- shape concern, and all CPRS-RSF subscales than individuals without ADHD (p \u3c .05). MPH treatment was associated with a notional reduction in height-sds and weight-sds. The results of the correlation analysis which assessed the possible contribution of the different treatment-related factors revealed no significant correlations between MPH mean dose [mg/(kg/d)], the duration of use (months), and the core characteristics of eating disorders except the restraint subscale of EDE Q. Conclusions. Our findings add to the growing research suggesting that MPH may be associated with disordered eating behaviors. Although the literature is limited, our findings conclude that MPH may not be associated with the reduction of growth velocity and disordered eating behaviors

PSYCHOSOCIAL ASPECTS OF CHILDREN WITH JUVENILE IDIOPATHIC ARTHRITIS

Juvenil idiopatik artritler (JİA) en yaygın çocukluk çağı romatizmal hastalıklarıdır. Juvenil idiopatik artritli çocuklar genellikle akut ve kronik ağrı, hareket kısıtlılığı, sabah katılığı, büyüme geriliği, göz sorunları, serbest zamanlarını kısıtlayan hekim ziyaretleri, etkinliklere katılımın azalması ve okul devamsızlığı deneyimlemektedirler. JİA'lı çocuk ve gençler psikolojik sorunlar için risk altındadır. Psikiyatrist ve romatoloji uzmanı için psikiyatrik belirtilerin varlığının araştırılması, pek çok nedenle önemlidir. Bu yazıda çocukluk çağı JİA'lı hastaların ve ailelerin deneyimledikleri psikososyal sorunlar ve tedavideki güncel yaklaşımlara yer verilmiştir. Juvenile idiopathic arthritis (JIA) is common pediatric rheumatoid diseases. Children with juvenile idiopathic arthritis commonly experience acute and chronic pain, decreased mobility, excessive stiffness, growth retardation, vision problems, frequent visits to the doctor that limit free time, restrictions on activities, and school absenteeism. The children and adolescents with JIA are at increased risk for psychological problems. It is important for the psychiatrist and rheumatologist to detect the presence of Psychiatric symptoms for many reasons. In this paper, psychosocial problems of children with JIA and their families and recent management strategies was discussed

The effects of stimulants on eating patterns in children and adolescents with Attention Deficit Hyperactivity Disorder

Objectives. This study aims to evaluate the effects of methylphenidate (MPH) on eating patterns and body mass index (BMI) in children with attention deficit/hyperactivity disorder (ADHD). The secondary aim of this study is the comparison between weight and eating behavior of children with ADHD undergoing an MPH treatment, and of children without ADHD. Methods. One hundred fourty three children and adolescents who diagnosed with ADHD were enrolled, and the effects of MPH on the eating patterns and BMI were evaluated. All participants completed a number of tests to analyze eating patterns and clinical psychopathological profiles. Results. Children and adolescents with ADHD had significantly higher scores on the EDE-Q- eating concern, EDE-Q- shape concern, and all CPRS-RSF subscales than individuals without ADHD (p \u3c .05). MPH treatment was associated with a notional reduction in height-sds and weight-sds. The results of the correlation analysis which assessed the possible contribution of the different treatment-related factors revealed no significant correlations between MPH mean dose [mg/(kg/d)], the duration of use (months), and the core characteristics of eating disorders except the restraint subscale of EDE Q. Conclusions. Our findings add to the growing research suggesting that MPH may be associated with disordered eating behaviors. Although the literature is limited, our findings conclude that MPH may not be associated with the reduction of growth velocity and disordered eating behaviors

CHRONIC ILLNESS, HOSPITALIZATION AND CHILD

Duygusal sorunlar, kronik hastalığa sahip çocuk ve ergenler ve ailelerde evrensel anlam taşımamalarına karşın, araştırmalardan gelen kanıtlar; kronik pediatrik hastalıkların psikolojik bozukluklar için esas bir risk etkeni oluşturduğunu göstermiştir. Kronik hastalıklarla beraber olan psikolojik sorunlarla sıklıkla ruh sağlığı konsultanları yüzleşirler. Bunları tanımlamak için bir yapıya ihtiyaç vardır. Hasta değerlendirilirken, klinisyenler, en azından teorik olarak, psikosomatik komponentin kronik hastalıkların her fazında var olacağını mutlaka hatırlamalıdırlar. Kronik hastalığa tepki, bireysel, gelişimsel ve çevresel etmenlerden etkilenir. Etkin psikiyatrik konsultasyon ve psikolojik yardım kronik hastalıkların tedavisi sırasında daha iyi prognoz ve uyuma yol açabilir. Although emotional disturbances do not mean universal in chronically ill children and adolescents and their families, the evidence from studies indicated that the chronic pediatric illness constitutes a substantial risk factor for psychological disorder. Psychological problems associated with chronic illness frequently confront the mental health consultant, and a framework for conceptualizing them is required. In evaluating a patient, the clinicians must remember that a psychosomatic component is at least theoretical possible in every phase of all chronic disorders. Reacting to the chronic illness is influenced by individual, developmental and environmental factors The effective psychiatric consultation and psychological support can lead to better prognosis and compliance during the treatment of chronic illness

Emotion Dysregulation in Attention Deficit and Hyperactivity Disorder and its Treatment

Attention deficit hyperactivity disorder is a neurodevelopmental disorder that may seriously affect youth’s home, school, and social functions. Comorbidity with emotion dysregulation in attention deficit hyperactivity disorder increases the severity of symptoms, leads to more risky behaviors, more deterioration in peer relationships, social and romantic relationships. There are many methods for assessing emotion dysregulation in attention deficit hyperactivity disorder. There are several pharma-cological and non-pharmacological treatment approaches available in treatment of emotion dysregu-lation among patients with attention deficit hyperactivity disorder. The aim of this article is to review the impact of emotion dysregulation in attention deficit hyperactivity disorder and its treatment

Atomoxetine treatment may decrease striatal dopaminergic transporter availability after 8 weeks: pilot SPECT report of three cases

Attention deficit/hyperactivity disorder is one of the most common neurodevelopmental disorders. The pathophysiology is thought to involve noradrenaline and dopamine. The role of dopamine transporter (DAT) was evaluated in imaging studies using mostly dopamine reuptake inhibitors. Atomoxetine is a selective noradrenaline reuptake inhibitor. Here we report the results of a pilot study conducted to evaluate changes in striatal DAT after 8 weeks of atomoxetine treatment. Our results suggest that 8 weeks of atomoxetine treatment may change striatal DAT bioavailability as measured via SPECT but that change was not correlated with genotype or clinical improvement

Irritability In Attention Deficit Hyperactivity Disorder And Treatment Approaches

Amaç: Dikkat Eksikliği ve Hiperaktivite Bozukluğu (DEHB), çocukluk döneminde yaygın görülen nörogelişimsel bir bozukluktur. DEHB tanısı başlıca dikkat sorunları, hareketlilik ve dürtüsellik bulguları üzerinden konulsa da; DEHB tanılı çocuk ve gençlerin çoğunda duyguların düzenlenmesinde sorunlar ve bunun sonucunda irritabilite görülebilmektedir. Bu gözden geçirmenin amacı; DEHB ile birlikte çok sık görülen irritabilite bulgularının gelişim mekanizmalarını, DEHB’nin klinik gidişine etkilerini ve tedavi alternatifl erini araştırarak bir derleme oluşturmaktır. Yöntem: Çalışma kapsamında çeşitli veri tabanlarından, “Dikkat Eksikliği Hiperaktivite Bozukluğu”, “irritabilite” anahtar kelimeleri kullanılarak ulaşılabilen İngilizce ve Türkçe dilinde yayınlanmış toplam 55 çalışma gözden geçirilmiştir. Sonuçlar: Yapılan çalışmalar; irritabilite ve DEHB’nin çok sık birliktelik gösterdiğini ve duygu düzenleme güçlüğü ile belirli ailesel bir DEHB alt-tipinin olabileceğini desteklemektedirler. Tartışma: İrritabilite bulgularının değerlendirilmesinde; patolojik ve patolojik olmayan irritabilitenin ayrımının yapılması kadar, irritabilitenin kronik seyirli olup olmadığı da mutlaka değerlendirilmelidir. Belirtilerin ortaya çıkmasında özellikle olumsuz uyaranların amigdalada işlenmesi ve bu verilerin frontal beyin merkezleri ile bağlantılarındaki sorunlar üzerinde durulmaktadır. Tedavide ise psikostimülan tedavisinin irritabilite bulgularının azaltılmasında etkili olduğu belirtilmekle birlikte çocuk odaklı davranışsal girişimler ve aile odaklı psikoeğitimsel girişimlerin tedaviye mutlaka eklenmesi gerekmektedir.Objective: Attention Defi cit and Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder widely seen in childhood. Even if the diagnosis of ADHD is made primarily through observation and review of symptoms involving attention problems, hyperactivity and impulsivity; most of these children have irritability symptoms as a result of emotional dysregulation. The aim of this review was to evaluate relevant studies to shed light on emergence of irritability symptoms that are frequently observed in ADHD, their effects on the clinical course of the disorder, along with an exploration of treatment alternatives. Method: “Attention Defi cit Hyperactivity Disorder” and “irritability” key words were used to determine relevant studies for review and a total of 55 reseach papers in Turkish and English language were included. Results: Studies support that ADHD and irritability show high rates of comorbidity and there might be a hereditary sub-type of ADHD which is characterized by emotional dysregulation. Discussion: While evaluating irritability symptoms, it would be important to determine if irritability is of chronic nature just as differentiating pathological and non-pathological irritability from one another. Problems in processing of negative stimuli in amygdala specifi cally as well as problems in connectivity of these regions with frontal brain regions might take part in emerging irritability symptoms. Stimulant medication is found to be effective in dealing with irritability symptoms in ADHD; with this said, child-focused behavioral and family-focused psycho-educational interventions should as well be integrated to treatment

The effects of methylphenidate on weight, height, and body mass index in Turkish children and adolescents with ADHD

Objective: The pathophysiological mechanisms underlying the effects of psychostimulants (methylphenidate) treatment on growth still remain controversial. We examined the long term effects of methylphenidate on height, weight and body mass index in Turkish children and adolescents with attention deficit hyperactivity disorder (ADHD). Methods: Participants (6-18 years, 330 boys, 103 girls) diagnosed with ADHD who received treatment with methylphenidate for at least 1 year at the Department of Child and Adolescent Psychiatry at Dokuz Eylul University Medical School were included in a retrospective study. Weight, height, and BMI z scores were converted to age- and gender-corrected z scores using norms from the Turkish population at baseline and last follow-up. Results: Height and weight standard deviation score (SDS) were reduced by treatment (baseline height-SDS (SDS]: 0.74 +/- 1.43, followup height-SDS [SDS]: -0.67 +/- 4.35, t-test p<0.001; baseline weight SDS [SDS]: 0.61 +/- 1.28, and follow-up weight-SDS [SDS]: -0.41 +/- 0.76, t-test p<0.001). There were no differences in BMI-SDS before and after stimulant treatment (baseline BMI-SDS [SDS]: 0.27 +/- 1.21, follow-up BMI-SDS [SDS]: -0.20 +/- 4.54, t-test p=0.353). However, considering whether patients were children (6-12 years) or adolescents (13-18 years) when they started medication, in the group of children, height and BMI was affected by treatment (baseline height-SDS [SDS]: 0.87 +/- 1.42; follow-up height-SDS [SDS]: -0.78 +/- 4.81]; p=0.002; baseline BMI-SDS [SDS]: 0.29 +/- 1.19; follow-up BMI-SDS [SDS]: -0.21 +/- 0.69; p<0.001). Results of multiple linear regression analysis which assess the possible contribution of the different treatment-related factors, only age starting treatment (B=-0.039, p=0.011) predicted final weight. Conclusions: We conclude that methylphenidate shows a negative effect on height and BMI in children. It was thought that the findings obtained at the end of the study might be helpful in assessing the growth parameters that may facilitate the course of the ADHD, and in the improvement of more efficient and permanent treatment approaches, and the adherence of patients to the treatment

Comparision of Parent Reported Sleeping Habits and Sleep Problems Between Attention Deficit and Hyperactivity Disorder and Healthy Controls

Attention Deficit and Hyperactivity Disorder (ADHD) children has been shown to affect the quality of sleep. In this study it is aimed to evaluate sleep habits and sleep problems between the cases who are diagnosed with ADHD and healthy controls. The study group consisted of 61 children (8-12 years old) with ADHD; the control group (87 children) comprised patients of other clinics at hospital. The Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) and DuPaul ADHD Rating Scale vere used. Children's sleep habits and sleep problems were assessed with the Children's Sleep Habits Questionnaire. ADHD group compared to healthy controls; statistical significant difference was found in bedtime resistance, the sleep onset delay, the sleep duration, the sleep anxiety, the night wakings, the parasomnias and the daytime sleepiness but statistical significant difference wasnt found the sleep disordered breathing. In our study, problems in the sleep habits evaluated by parents ADHD are more than campared with healty controls likewise literature. However, further studies with larger sample size and objective measures such as actigraphy and polysomnography may allow us to have more knowledge in this area. [JCBPR 2017; 6(3.000): 108-114

Assessment of health-related quality of life in children with ADHD by comparison with type 1 diabetes and healthy control groups

WOS: 000486651400012Objective: The purpose of this study is to compare health related quality of life of children and adolescents with attention deficit hyperactivity disorder (ADHD) both with health related quality of life of type 1 diabetes mellitus (T1DM) and healthy control groups. Methods: Sixty ADHD newly diagnosed cases with no treatment, age and gender matched two control groups; 60 T1DM and 60 healthy control groups aged between 8 and 16 years were enrolled in this study. The diagnostic assessments and exclusion criteria of psychiatric disorders of all subjects were made according to the DSM-IV criteria and the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and the Lifetime (K-SADS PL). Sociodemographic Form, Pediatric Quality of Life Scale for Children (PedsQL 4.0 TM) were applied to all of participants and their parents. DSM-IV based Turgay ADHD and Distruptive Behavior Disorders Screening Scale, ADHD Rating Scale-IV and Clinical Global Impression Scale were additionally administered to ADHD group. HbA1c levels were used in terms of T1DM disease severity. Results: Children and adolescents diagnosed ADHD reported lower self-concept in emotional functioning and psychosocial health summary scores than children and adolescents with T1DM. Compared with healthy controls, children and adolescents diagnosed ADHD reported lower self-concept in all subscales and total scores of PedsQL except physical health summary. Parent of ADHD children reported lower concept in all scores of quality of life than parents of healthy controls. Conclusions: Life quality in terms of psychosocial health were found to be impaired in newly diagnosed ADHD subjects more than T1DM and healthy controls. Evaluation of quality of life during diagnosis and treatment stages of ADHD may help to identify and manage the overall impact of the disorder