Predictors of ADHD persistence in elementary school children who were assessed in earlier grades: A prospective cohort study from Istanbul, Turkey.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders among school-age children worldwide. In a more recent follow-up study, Biederman et al. found that 78% of children diagnosed with ADHD between the ages of 6-17 years continued to have a full (35%) or a partial persistence after eleven years. OBJECTIVE: In this study, it was aimed to identify the factors contributing to the persistence of ADHD symptoms in elemantary school children who were prospectively assessed both in their earlier and upper grades. METHODS: The sample was drawn from a previous community-based study where ADHD symptoms in 3696 first/or second graders were examined in regard to their school entry age. Two years after, the families of the children that participated in the initial study were called by phone and invited to a re-evaluation session. Among those who were reached, 154 were consequently eligible and were assessed with Swanson, Nolan and Pelham questionnaire (SNAP-IV), Conners' rating scales (CRS) and the Kiddie schedule for affective disorders and schizophrenia (K-SADS). RESULTS: Of the 154 children, 81 had been evaluated to have "probable ADHD" by the initial interview. Among these 81 children, 50 (61.7%) were indeed diagnosed with ADHD after two years. Initial scores of the teacher reported SNAP-IV inattention subscale predicted the ADHD diagnosis after two years, with an odds ratio of 1.0761 (p = 0.032, Wald: 4.595). CONCLUSIONS: Our results suggest that high inattention symptom scores reported by the teacher in the earlier grades, might predict an ADHD diagnosis in upper grades.

Executive Functions and Social Responsiveness in Children and Adolescents With Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Objective: To evaluate the executive functions and social reciprocity of children and adolescents diagnosed with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and compared them with healthy controls. Material and Method: Patients aged 6-17 years diagnosed with ASD (n = 33) and ADHD (n = 37) and healthy controls in the same age range (n = 33) were included in the study. Behavioral Rating Inventory of Executive Functions (BRIEF) sub-scales and Social Responsiveness Scale (SRS) were used for evaluating executive function areas and social responsiveness. Results: Our results revealed that children and adolescents with ASD and ADHD were significantly impaired for all BRIEF sub-scales except emotional control and that the significant increase in sub-scale scores expressing deterioration continued after adjustment for SES, verbal IQ scores, and gender. ASD patients received significantly higher SRS scores compared to ADHD and control groups and ADHD patients also had significantly higher values compared to the controls. Conclusion: Further studies with parent-report scales that allow easier and faster evaluation of executive functions and social reciprocity will contribute to better understanding of the personal needs of children with neurodevelopmental disorders and the finding of new treatments.

Central choroidal thickness in children and adolescents with anxiety disorders: enhanced depth imaging optical coherence tomography findings.

AIM: To measure the central choroidal thickness (ChT) in children and adolescents with anxiety disorders. METHODS: Totally 41 anxiety patients (8-16y) and 35 healthy controls (age-matched) were evaluated. Complete ophthalmic examination was performed. Inclusion criteria were best corrected visual acuity ≥20/20, normal intraocular pressure (IOP; 10-21 mm Hg), and no systemic or ocular diseases according to history. The diagnosis of psychiatric disorders was determined using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version (K-SADS-PL). Enhanced depth imaging optical coherence tomography (EDI-OCT) was used to measure the central ChT. RESULTS: The mean age was 12.18±3.24y in the patient group and 12.86±3.15y in the control group. Age and gender distribution of the two groups was similar. Central ChT mean value was 353.26±31.9 µm in anxiety patients while 318.75±60.9 µm in the control group. Mean central ChT was statistically significantly higher in the children and adolescents with anxiety disorders than healthy controls (P=0.002). CONCLUSION: The children and adolescents with anxiety disorders have significantly thicker central ChT than controls. In the larger sample, longitudinal studies will contribute to the use of choroidal differences as a clinical marker for monitoring anxiety disorders.