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

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

Children Aggression Scale-Parent Version (CAS-P): Turkish validity and reliability study

WOS: 000372320200009Objective: The aim of this study was to examine the psychometric properties of the Children Aggression Scale-Parent Version. CAS-P developed to help evaluate severity, frequency and diversity of aggressive behavior. Methods: The scale has 33 items representing five domains. The CAS-P was completed for 473 clinically referred children's parents. Validity was evaluated by examining the relationship of CAS-P scores to other criteria parent rating scales and for the construct validity confirmatory factor analysis (CFA) was conducted. For the reliability the internal consistency were examined. Results: Consistent with previous research, confirmatory factor analysis of the CASP confirmed the good-fit of the original model (chi(2)=842.15; sd=302; chi(2)/sd)=2.7; RMSEA=0.069; CFI=0.96; NFI=0.95). In order to test the scale for construct validity, the Child Behavior Checklist/4-18 and DSM-IV based Behavior Disorder Screening and rating scale were administered to participants, and the correlations with clinical constructs were in the expected direction. Also the reliability analysis revealed that the CAS-P subscales demonstrated high internal consistency. Conclusion: In the light of the findings, it was concluded that the Turkish version of CAS-P could be used as a reliable and valid tool in research and treatment contexts

Preschool children with obsessive-compulsive disorder and fluoxetine treatment

WOS: 000301496300008PubMed ID: 22271063Obsessive-compulsive disorder (OCD) is an anxiety disorder which can substantially disable children's ability to function at home and school. Clinicians frequently rely on knowledge about symptoms that can be examined early in treatment to determine future treatment effectiveness. However, OCD in preschoolers has also received little attention in literature. To the best of our knowledge, there is only one retrospective chart review and one case report in the literature for preschool cases treated with SSRIs. Therefore, the effect of fluoxetine on preschool children was imprecisely understood. The aim of this case report was to examine the efficacy and safety of fluoxetine treatment for pediatric OCD. Four preschool children with OCD completed an 8-week fluoxetine (up to 20 mg) trial. We diagnosed OCD according to Diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) criteria and symptoms of OCD were assessed with the Childrens' Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Initial and post-treatment symptom severity and improvement were assessed by using the severity (S) and improvement (I) scales of Clinical Global Impressions Scale (CGI). The CY-BOCS total, obsessions and compulsions subscale scores and CGI-S scores were significantly improved for all of the cases at the end of the eighth week. In this case report four preschool children, with severe OCD and resistant to the previous non-psychopharmacologic treatment responded well to fluoxetine monotherapy. On the other hand, the usage of SSRIs in preschool children remains highly controversial, due to the lack of data on safety and efficacy

Effect of Methylphenidate on Emotional Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder plus Oppositional Defiant Disorder/Conduct Disorder

WOS: 000396116100017PubMed ID: 28225747Background and Aim Emotional dysregulation (ED) is a frequent feature of attention-deficit/hyperactivity disorder (ADHD). It can be observed as a dysregulation profile or a deficient emotional self-regulation (DESR) profile. Oppositional defiant disorder/conduct disorder (ODD/CD) comorbidity is prevalent in ADHD and known to be related with ED. The first-line treatment of ADHD includes psychostimulants, but their effects on ED are not well studied. This study aimed to evaluate the outcomes of methylphenidate (MPH) treatment on ED in ADHD + ODD/CD cases. Methods A total of 118 ADHD + ODD/CD patients with a mean age of 9.0 1.9 years were treated with MPH for 1 year. Also, parents of cases were recruited for a parent-training program, which initiated after first month of MPH treatment. Symptom severity was assessed at baseline and 12th month by Turgay Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Child and Adolescent Behavior Disorders Screening and Rating Scale-Parent Form, Children Depression Inventory, Child Behavior Checklist 4-18 years, and Parental Acceptance and Rejection Questionnaire-Mother Form. Results Emotional dysregulation (DESR + DP) was present in 85.6% of cases. Conduct disorder was significantly higher in patients with DP, whereas ODD was significantly higher in the DESR and non-ED groups (P < 0.0001). Symptoms of ADHD and ED were significantly improved with 1-year of MPH treatment (P < 0.05). The improvement in ED was independent of improvement in ADHD symptoms and parent training (P < 0.05). Conclusions Emotional dysregulation is highly prevalent in disruptive behavioral disorders as ODD and CD, which are comorbid with ADHD. The MPH treatment is effective on ED independently from other clinical determinants

Who predict ADHD with better diagnostic accuracy?: Parents or teachers?

Tahillioglu, Akin/0000-0002-3952-3672WOS:000620473100001PubMed: 33612071Objective The objectives of the study were to determine which parents or teachers predict attention-deficit/hyperactivity disorder (ADHD) better in children and adolescents, and to detect both diagnostical and symptomatological agreement levels across informant reports. Method A total of 417 cases aged 6-14 from a non-referred community sample were assessed by a semi-structured interview, parent- and teacher-rated ADHD Rating Scale-IV. Also, impairment criteria were taken into account to ensure the gold standard diagnosis for ADHD. The measures of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated in each categorical sample. Besides, the agreement between parent and teacher reports of ADHD was investigated. Results Parents and teachers had similar diagnostic accuracy for predicting ADHD. Both parents and teachers predicted ADHD in similar accuracy in both boys and girls, separately. However, girls were found to be more predictable by both parents and teachers compared to boys. Parents with lower education levels had worse diagnostic accuracy than both parents with higher education levels and teachers. Low to moderate agreement and correlations between parent and teacher ADHD reports were detected. Conclusion in general, parents and teachers seem to predict ADHD in similar accuracy. Nevertheless, child gender and parental education level may alter the predictability power for ADHD. The findings can guide for clinicians that how to evaluate observation reports of parents and teachers to make accurate ADHD diagnosis in patients

Prevalence of Anxiety and Mood Disorders and Demographic Characteristics of Elementary School Students

WOS: 000343191900005PubMed ID: 25219691Objective: Childhood psychiatric disorders can prevent individuals from reaching their full potential, and disrupt normal development. Empirical data on the prevalence and incidence of childhood psychiatric disorders are fundamental to understanding the etiology and natural history of such disorders. There have been fewer epidemiologic investigations aimed at estimating the prevalence, incidence, and associated risk factors of psychiatric disorders in children and adolescents, as compared to adults. This study aimed to assess the prevalence of mood disorders (MDs) and anxiety disorders (ADs) in a representative sample of elementary school children from Turkey, providing prevalence rates that were previously unavailable. Materials and Methods: In all, 12 schools were randomly selected and stratified according to socioeconomic status by the Izmir Directorate of National Education. The sample consisted of 419 randomly selected elementary school students, with a 5% margin of error and alpha (t) of 1%. The study included children aged 6-14 years. In total, 417 students were interviewed (total response rate of 99.5 %). The 417 students were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), Child Behavior Check List (CBCL), Teacher Report Form (TRF), and Impairment Criterion Scale (ICS). Results: The prevalence of MDs and ADs without considering impairment was 2.9% and 13.9%, respectively, versus 1.4% and 2.6% with considering impairment, respectively. Conclusion: The prevalence of MDs and ADs in the present study's sample are similar to those reported from the Western studies. With the inclusion of diagnosis-specific impairment criteria the rates reduced slightly, as previously reported

The prevalence of mood and anxiety disorders in primary school children population in Turkey

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