Electroencephalography as a clinical tool for diagnosing and monitoring attention deficit hyperactivity disorder: a cross-sectional study.

OBJECTIVES: The aim of this study was to develop and test, for the first time, a multivariate diagnostic classifier of attention deficit hyperactivity disorder (ADHD) based on EEG coherence measures and chronological age. SETTING: The participants were recruited in two specialised centres and three schools in Reykjavik. PARTICIPANTS: The data are from a large cross-sectional cohort of 310 patients with ADHD and 351 controls, covering an age range from 5.8 to 14 years. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria using the K-SADS-PL semistructured interview. Participants in the control group were reported to be free of any mental or developmental disorders by their parents and had a score of less than 1.5 SDs above the age-appropriate norm on the ADHD Rating Scale-IV. Other than moderate or severe intellectual disability, no additional exclusion criteria were applied in order that the cohort reflected the typical cross section of patients with ADHD. RESULTS: Diagnostic classifiers were developed using statistical pattern recognition for the entire age range and for specific age ranges and were tested using cross-validation and by application to a separate cohort of recordings not used in the development process. The age-specific classification approach was more accurate (76% accuracy in the independent test cohort; 81% cross-validation accuracy) than the age-independent version (76%; 73%). Chronological age was found to be an important classification feature. CONCLUSIONS: The novel application of EEG-based classification methods presented here can offer significant benefit to the clinician by improving both the accuracy of initial diagnosis and ongoing monitoring of children and adolescents with ADHD. The most accurate possible diagnosis at a single point in time can be obtained by the age-specific classifiers, but the age-independent classifiers are also useful as they enable longitudinal monitoring of brain function.

[Relationship between pre-adoptive risk factors and psychopathological difficulties of internationally adopted children in Iceland]. / Afdrif barna á Íslandi sem eru ættleidd erlendis frá.

OBJECTIVE: In recent years a number of children have been adopted to Iceland. The aim of our study was to evaluate which factors may affect their mental and behavioural health. MATERIALS AND METHODS: Information was collected on the health of internationally adopted children in Iceland as well as on pre-adoptive risk factors. This was done using a survey developed by Dr. Dana Johnson from the International Adoption Project at the University of Minnesota in the United States. Other questionnaires include the Child Behavior Checklist (CBCL), Strenghts and Difficulties Questionnaires (SDQ), Attention Deficit/Hyper activity Rating Scale (ADHD-RS-IV) and Austism Spectrum Screening Questionaire (ASSQ). For the comparative analysis data from the general population was used. RESULTS: Children adopted after 18 months of age and who have been institutionalised for 18 months or more showed higher risk for ADHD symptoms and behavioral and emotional problems than the general population. In addition, those who were subject to severe emotional neglect had significantly higher scores on CBCL, SDQ and ADHD-RS. A trend was seen between risk factors and scores on ASSQ. Children adopted before 12 months of age scored within the normal range on all questionnaires. CONCLUSION: These results suggest that children adopted after 18 months of age are at risk of psychopathological difficulties. These results emphasize the importance of early adoption and of minimizing the time spent in an institution.