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1.
JAMA Netw Open ; 7(6): e2416760, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38869906

RESUMO

Importance: The use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way. Objective: To develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings. Evidence Review: An international working group composed of clinical and research experts and service users (n = 27) was convened to develop a standard core set of accessible, valid, and reliable outcome measures for children and adolescents with NDDs. The working group participated in 9 video conference calls and 8 surveys between March 1, 2021, and June 30, 2022. A modified Delphi approach defined the scope, outcomes, included measures, case-mix variables, and measurement time points. After development, the NDD set was distributed to professionals and service users for open review, feedback, and external validation. Findings: The final set recommends measuring 12 outcomes across 3 key domains: (1) core symptoms related to the diagnosis; (2) impact, functioning, and quality of life; and (3) common coexisting problems. The following 14 measures should be administered at least every 6 months to monitor these outcomes: ADHD Rating Scale 5, Vanderbilt ADHD Diagnostic Rating Scale, or Swanson, Nolan, and Pelham Rating Scale IV; Affective Reactivity Index; Children's Communication Checklist 2; Colorado Learning Disabilities Questionnaire; Children's Sleep Habits Questionnaire; Developmental-Disability Children's Global Assessment Scale; Developmental Coordination Disorder Questionnaire; Family Strain Index; Intelligibility in Context Scale; Vineland Adaptive Behavior Scale or Repetitive Behavior Scale-Revised and Social Responsiveness Scale; Revised Child Anxiety and Depression Scales; and Yale Global Tic Severity Scale. The external review survey was completed by 32 professionals and 40 service users. The NDD set items were endorsed by more than 70% of professionals and service users in the open review survey. Conclusions and Relevance: The NDD set covers outcomes of most concern to patients and caregivers. Use of the NDD set has the potential to improve clinical practice and research.


Assuntos
Consenso , Transtornos do Neurodesenvolvimento , Avaliação de Resultados em Cuidados de Saúde , Humanos , Transtornos do Neurodesenvolvimento/diagnóstico , Criança , Adolescente , Técnica Delphi , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Feminino
2.
Transl Psychiatry ; 14(1): 251, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858375

RESUMO

This research aimed to devise and assess a mobile game therapy software for children with Attention-Deficit/Hyperactivity Disorder (ADHD), as well as evaluating its suitability and effectiveness in improving the cognitive ability of typically developing children. The study encompassed 55 children diagnosed with ADHD and 55 neurotypical children. Initial assessments involved ADHD-related scales, computerized tests for information processing, and physiological-psychological evaluations. After a 4-week home-based game intervention, participants underwent re-evaluation using baseline measures and provided feedback on treatment satisfaction. Considering the small proportion of study participants who dropped out, data was analyzed using both the Intention-to-Treat (ITT) analysis and the Per-protocol (PP) analysis. The trial was registered at ClinicalTrials.gov (NCT06181747). In ITT analysis, post-intervention analysis using linear mixed models indicated that the ADHD group improved significantly more than the neurotypical group particularly in Continuous Performance Test (CPT) accuracy (B = -23.92, p < 0.001) and reaction time (B = 86.08, p < 0.01), along with enhancements in anti-saccade (B = -10.65, p < 0.05) and delayed-saccade tasks (B = 0.34, p < 0.05). A reduction in parent-rated SNAP-IV scores was also observed (B = 0.43, p < 0.01). In PP analysis, paired-sample t-tests suggested that the ADHD group had significant changes pre- and post-intervention, in terms of CPT Accuracy (t = -7.62, p < 0.01), Anti-saccade task Correct Rate (t = -3.90, p < 0.01) and SNAP-IV scores (t = -4,64, p < 0.01). However, no significant changes post-intervention were observed in the neurotypical group. Survey feedback highlighted a strong interest in the games across both groups, though ADHD participants found the game more challenging. Parents of ADHD children reported perceived benefits and a willingness to continue the game therapy, unlike the neurotypical group's parents. The findings advocated for the integration of serious video games as a complementary tool in ADHD treatment strategies, demonstrating the potential to augment attentional abilities and alleviate clinical symptoms. However, a randomized controlled trial (RCT) is needed to further verify its efficacy.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estudos de Viabilidade , Jogos de Vídeo , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Masculino , Feminino , Aplicativos Móveis , Resultado do Tratamento
5.
Brain Nerve ; 76(6): 761-765, 2024 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-38853506

RESUMO

Diagnosis of ADHD in adulthood is increasing rapidly in Japan. The ADHD symptoms occur on a continuum with those of normal development and are likely to fluctuate with the growth process and environment at the time of diagnosis. Especially in adult cases, comorbid psychiatric disorders tend to influence the characteristics of ADHD. ADHD has diverse clinical manifestations and a heterogeneous biological background. In addition to the RDoC approach to elucidate the pathogenesis and etiology of the disorder, we expect that attempts will be made to classify the disorder into relatively homogeneous biological subcategories.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Humanos , Adulto
6.
Artigo em Russo | MEDLINE | ID: mdl-38884438

RESUMO

OBJECTIVE: To study the clinical and neurophysiological features of children with low cognitive tempo (NCT), as well as the effectiveness of the drug Pantogam in the treatment of this pathology. MATERIAL AND METHODS: A total of 90 children aged 8 to 10 years were examined. Of these, the main study group consisted of 30 children with NCT, the comparison group consisted of 30 children with a combined type of attention deficit hyperactivity disorder ADHD (ADHD-K), the control group consisted of 30 children without neuropsychiatric disorders. The study used clinical, neurophysiological (electroencephalography (EEG)) and parametric methods. The CMAS scale of apparent anxiety (The Children's Form of Manifest Anxiety Scale), the SNAP-IY scale (assessment of the degree of inattention, hyperactivity and impulsivity), the TOVA computer test (the Test of Variables of Attention), the scale «SCT¼ (Sluggish Cognitive Tempo) for assessing manifestations of low cognitive tempo, the «RAM¼ technique for quantifying working memory. Pantogam was used to treat patients at a dose of 750 mg per day for 8 weeks. RESULTS: Patients with NCT are characterized by more pronounced attention disorders compared with healthy peers and with children with ADHD-K, and they have a decrease in mainly not selective attention, but the overall level of functional activity. Also, the group of children with NCT has an increased level of anxiety compared to the group of children with ADHD. A comparative analysis of the level of impulsivity showed that children with NCT are less characterized by a deficit in inhibition processes. According to the quantitative analysis of the EEG, specific changes in functional activity in the frontal and central regions of the cerebral cortex were revealed (a statistically significant increase in the ratio of absolute theta rhythm to beta1 rhythm, compared with other groups), reflecting insufficient cortical arousal and less focused neural states. When re-evaluating the condition of children with NCT after a course of therapy with Pantogam, an improvement in the form of a decrease in the degree of inattention, the severity of memory impairment and a decrease in reaction time was recorded in 60% of cases. According to quantitative EEG analysis, there was a significant decrease in the ratio of absolute theta rhythm to beta1 rhythm in the central leads of both hemispheres and in the parietal-temporal leads of the left hemisphere, indicating an increase in the level of overall activation of the cerebral cortex after a course of treatment. CONCLUSION: Clinical and neurophysiological differences were revealed in patients with NCT and with combined ADHD. It has been shown that the use of Pantogam for the treatment of children with NCT leads not only to a decrease in the main manifestations of this disorder, but also to an improvement in the functional state of the brain.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Eletroencefalografia , Ácido Pantotênico , Humanos , Criança , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Masculino , Feminino , Ácido Pantotênico/análogos & derivados , Ácido Pantotênico/uso terapêutico , Cognição , Atenção/efeitos dos fármacos , Memória de Curto Prazo/efeitos dos fármacos , Ácido gama-Aminobutírico/análogos & derivados
7.
Mol Autism ; 15(1): 25, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38849897

RESUMO

BACKGROUND: Autism and different neurodevelopmental conditions frequently co-occur, as do their symptoms at sub-diagnostic threshold levels. Overlapping traits and shared genetic liability are potential explanations. METHODS: In the population-based Norwegian Mother, Father, and Child Cohort study (MoBa), we leverage item-level data to explore the phenotypic factor structure and genetic architecture underlying neurodevelopmental traits at age 3 years (N = 41,708-58,630) using maternal reports on 76 items assessing children's motor and language development, social functioning, communication, attention, activity regulation, and flexibility of behaviors and interests. RESULTS: We identified 11 latent factors at the phenotypic level. These factors showed associations with diagnoses of autism and other neurodevelopmental conditions. Most shared genetic liabilities with autism, ADHD, and/or schizophrenia. Item-level GWAS revealed trait-specific genetic correlations with autism (items rg range = - 0.27-0.78), ADHD (items rg range = - 0.40-1), and schizophrenia (items rg range = - 0.24-0.34). We find little evidence of common genetic liability across all neurodevelopmental traits but more so for several genetic factors across more specific areas of neurodevelopment, particularly social and communication traits. Some of these factors, such as one capturing prosocial behavior, overlap with factors found in the phenotypic analyses. Other areas, such as motor development, seemed to have more heterogenous etiology, with specific traits showing a less consistent pattern of genetic correlations with each other. CONCLUSIONS: These exploratory findings emphasize the etiological complexity of neurodevelopmental traits at this early age. In particular, diverse associations with neurodevelopmental conditions and genetic heterogeneity could inform follow-up work to identify shared and differentiating factors in the early manifestations of neurodevelopmental traits and their relation to autism and other neurodevelopmental conditions. This in turn could have implications for clinical screening tools and programs.


Assuntos
Fenótipo , Humanos , Noruega , Feminino , Masculino , Pré-Escolar , Estudos de Coortes , Transtornos do Neurodesenvolvimento/genética , Transtornos do Neurodesenvolvimento/diagnóstico , Mães , Transtorno Autístico/genética , Predisposição Genética para Doença , Adulto , Pai , Estudo de Associação Genômica Ampla , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Esquizofrenia/genética , Heterogeneidade Genética
8.
J Atten Disord ; 28(9): 1331-1339, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38817116

RESUMO

OBJECTIVE: This study examined the prevalence, associated factors, and psychiatric comorbidities of adult ADHD during the COVID-19 pandemic by analyzing nationally representative data. METHODS: Among the 5,511 respondents of the 2021 National Mental Health Survey, South Korea, 2,764 (18-49 years) were selected. The Korean versions of the Adult ADHD Self-Report Scale, Composite International Diagnostic Interview, and Structured Clinical Interview for Internet Gaming Disorder were used as diagnostic assessments. RESULTS: The 6-month prevalence of positive screens for adult ADHD was 3.1%. In individuals aged 18 to 29 years exhibiting adult ADHD symptoms, high prevalence rates of alcohol use, depression, and Internet gaming disorders were observed in the last 12 months. Adults who screened positive for ADHD reported significantly lower life satisfaction and resilience, and higher loneliness and social isolation (vs. non-ADHD group). CONCLUSION: Adult ADHD symptoms significantly influenced mental well-being, highlighting the need for an appropriate treatment/prevention system, particularly for individuals aged 18 to 29 years.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , COVID-19 , Comorbidade , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , República da Coreia/epidemiologia , Adulto , COVID-19/epidemiologia , COVID-19/psicologia , Masculino , Feminino , Adulto Jovem , Prevalência , Adolescente , Pessoa de Meia-Idade , Transtorno de Adição à Internet/epidemiologia , Transtorno de Adição à Internet/psicologia , Depressão/epidemiologia , Depressão/psicologia , Depressão/diagnóstico , SARS-CoV-2 , Isolamento Social/psicologia , Inquéritos Epidemiológicos , Solidão/psicologia
9.
BMC Pediatr ; 24(1): 378, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38822278

RESUMO

BACKGROUND: To translate and culturally adapt the Children's Sleep Habits Questionnaire (CSHQ) to a Swedish version, CSHQ-SWE, and to assess its validity and reliability for use with children with attention deficit hyperactivity disorder (ADHD). METHODS: A total of 84 children with ADHD (51 boys and 33 girls; 6-12 years) and parents (7 men and 77 women; 28-51 years) were included in the study. CSHQ was translated and culturally adapted to Swedish, and assessed for concurrent validity with sleep actigraphy (analyzed by Kendall's Tau) and for reliability by internal consistency (analyzed by McDonald's Omega H). Face and content validity was evaluated by parents (n = 4) and healthcare professionals (n = 6) qualitatively (comprehensiveness, relevance, and comprehensibility assessed by interviews and analyzed by thematic analysis) and quantitatively (analyzed by content validity ratio and content validity index for 33 items and four non-scored inquiries). RESULTS: Parent-reported sleep problems (CSHQ-SWE total score) were moderately correlated with less "Sleep Efficiency" (Tau = -0.305; p < 0.001) measured by sleep actigraphy. Parent-reported problems with "Sleep Onset Delay" was moderately correlated with measured time for "Sleep Onset Latency" (Tau = 0.433; p < 0.001). Parent-reported problems with "Night Wakings" were weakly correlated with measured time for "Wake After Sleep Onset" (Tau = 0.282; p < 0.001). Parents estimation of "Total daily sleep duration" was moderately correlated with measured "Total Sleep Time" (Tau = 0.386; p < 0.001). Five of the seven subscales reached an acceptable level for internal consistency (McDonald's Omega H > 0.700). Comprehensiveness, relevance, and comprehensibility of CSHQ-SWE were satisfactory overall. Content validity ratio was 0.80 to 1.00 for six items, 0.00 to 0.60 for 22 items, and < 0.00 for nine items. Content validity index was 0.22. CONCLUSIONS: CSHQ-SWE demonstrated acceptable concurrent validity with objectively measured sleep and internal consistency, whereas the overall results of face and content validity assessment varied. The instrument needs to be further evaluated regarding construct validity, responsiveness, test-retest reliability, and its generalization to other populations.


Assuntos
Actigrafia , Transtorno do Deficit de Atenção com Hiperatividade , Pais , Humanos , Masculino , Feminino , Criança , Reprodutibilidade dos Testes , Suécia , Inquéritos e Questionários/normas , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Adulto , Pessoa de Meia-Idade , Traduções , Sono , Hábitos , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/etiologia
10.
Ugeskr Laeger ; 186(15)2024 Apr 08.
Artigo em Dinamarquês | MEDLINE | ID: mdl-38708700

RESUMO

ADHD and bipolar disorder (BP) commonly coexist, and both share key symptoms, depending on affective state and emotional dysregulation. The overlap poses diagnostic challenges and may lead to underdiagnoses. Comorbid cases exhibit worsened symptom burden, increased psychiatric morbidity, admissions, and suicide attempts. Treating BP before ADHD is recommended. Stimulant use combined with mood stabilisers may be effective and relatively safe; however, this review finds that well-designed randomised controlled studies in the area is warranted.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Bipolar , Estimulantes do Sistema Nervoso Central , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/diagnóstico , Adulto , Estimulantes do Sistema Nervoso Central/uso terapêutico , Estimulantes do Sistema Nervoso Central/efeitos adversos
11.
Asian J Psychiatr ; 97: 104087, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38820852

RESUMO

BACKGROUND: We aimed to identify important features of white matter microstructures collectively distinguishing individuals with attention-deficit/hyperactivity disorder (ADHD) from those without ADHD using a machine-learning approach. METHODS: Fifty-one ADHD patients and 60 typically developing controls (TDC) underwent diffusion spectrum imaging at two time points. We evaluated three models to classify ADHD and TDC using various machine-learning algorithms. Model 1 employed baseline white matter features of 45 white matter tracts at Time 1; Model 2 incorporated features from both time points; and Model 3 (main analysis) further included the relative rate of change per year of white matter tracts. RESULTS: The random forest algorithm demonstrated the best performance for classification. Model 1 achieved an area-under-the-curve (AUC) of 0.67. Model 3, incorporating Time 2 variables and relative rate of change per year, improved the performance (AUC = 0.73). In addition to identifying several white matter features at two time points, we found that the relative rate of change per year in the superior longitudinal fasciculus, frontal aslant tract, stria terminalis, inferior fronto-occipital fasciculus, thalamic and striatal tracts, and other tracts involving sensorimotor regions are important features of ADHD. A higher relative change rate in certain tracts was associated with greater improvement in visual attention, spatial short-term memory, and spatial working memory. CONCLUSIONS: Our findings support the significant diagnostic value of white matter microstructure and the developmental change rates of specific tracts, reflecting deviations from typical development trajectories, in identifying ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Aprendizado de Máquina , Substância Branca , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Deficit de Atenção com Hiperatividade/patologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Masculino , Feminino , Estudos Longitudinais , Criança , Adolescente , Imagem de Tensor de Difusão/métodos
12.
CNS Spectr ; 29(3): 215-220, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38695189

RESUMO

OBJECTIVE: Difficulties with emotion regulation have been associated with multiple psychiatric conditions. In this study, we aimed to investigate emotional regulation difficulties in young adults who gamble at least occasionally (ie, an enriched sample), and diagnosed with a range of psychiatric disorders using the validated Difficulties in Emotion Regulation Scale (DERS). METHODS: A total of 543 non-treatment-seeking individuals who had engaged in gambling activities on at least 5 occasions within the previous year, aged 18-29 were recruited from general community settings. Diagnostic assessments included the Mini International Neuropsychiatric Inventory, Minnesota Impulsive Disorders Interview, attention-deficit/hyperactivity disorder World Health Organization Screening Tool Part A, and the Structured Clinical Interview for Gambling Disorder. Emotional dysregulation was evaluated using DERS. The profile of emotional dysregulation across disorders was characterized using Z-scores (those with the index disorder vs. those without the index disorder). RESULTS: Individuals with probable ADHD displayed the highest level of difficulties in emotional regulation, followed by intermittent explosive disorder, social phobia, and generalized anxiety disorder. In contrast, participants diagnosed with obsessive-compulsive disorder showed relatively lower levels of difficulties with emotional regulation. CONCLUSIONS: This study highlights the importance of recognizing emotional dysregulation as a trans-diagnostic phenomenon across psychiatric disorders. The results also reveal differing levels of emotional dysregulation across diagnoses, with potential implications for tailored treatment approaches. Despite limitations such as small sample sizes for certain disorders and limited age range, this study contributes to a broader understanding of emotional regulation's role in psychiatric conditions.


Assuntos
Regulação Emocional , Humanos , Masculino , Feminino , Adulto , Adolescente , Transtornos Mentais/psicologia , Transtornos Mentais/diagnóstico , Jogo de Azar/psicologia , Adulto Jovem , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico
13.
Zhonghua Er Ke Za Zhi ; 62(6): 548-552, 2024 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-38763877

RESUMO

Objective: To explore the optimization of the standardized assessment tool for clinical diagnosis of Chinese developmental dyslexia (DD). Methods: A cross-sectional study was conducted from May to December 2023, in which 130 primary school children in grades 1 to 3 with clinical signs of literacy lag and positive screening results on the screening scales were recruited from the outpatient clinic of Child Health Care Medical Division, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine. Chinese dyslexia screening behavior checklist for primary students (CDSBC) was used as the screening scales, and supplemented by dyslexia checklist for Chinese children. Referring to the standard procedure of the"expert advice on diagnosis and intervention of Chinese developmental dyslexia", the developmental dyslexia scale for standard mandarin (DDSSM) was used to evaluate the children's literacy-related cognitive abilities and conduct the diagnostic assessment, and divided the children into learning backward group and the DD group. The t-test and χ2 test were used to compare the differences in the distribution of intelligence, literacy and attention deficit hyperactivity disorder between the two groups. Spearman's correlation was used to analyze the correlation between the scores for each cognitive ability in the DDSSM and the CDSBC. Results: Of the 130 children, 90 were male, aged (8.3±1.0) years; 40 were female, aged (8.1±0.9) years. A final diagnosis of DD was made in 59 cases, of which 41 were males. There was no statistically significant difference in operational intelligence quotient (101±15 vs.100±15, t=0.53, P>0.05) and statistically significant difference in literacy of DDSSM (32±5 vs.21±4, t=11.56, P<0.001) between the learning backward group and the DD group. Eighteen cases (25.4%) of the learning backward group were children with attention deficit subtype attention deficit hyperactivity disorder (ADHD-I), and 16 cases (27.1%) in DD group, the difference in incidence between the two groups was not statistically significant (χ2=0.05, P>0.05). There were correlations between the DDSSM (for oral vocabulary, morphological awareness and orthographic awareness) and the CDSBC total score (r=-0.42, -0.32, -0.35, all P<0.01), but the correlations for visuospatial perception and rapid automatized naming with CDSBC total score were not statistically significant (r=-0.09 and -0.20,both P>0.05). Conclusion: For literacy-related cognitive abilities, screening scales CDSBC are not sufficiently useful for assessment, so the introduction of standardized assessment tools DDSSM is an optimization of the clinical diagnosis of Chinese DD, which is crucial for achieving accurate diagnosis and intervention.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Dislexia , Leitura , Criança , Feminino , Humanos , Masculino , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , China , Cognição , Estudos Transversais , Dislexia/diagnóstico , População do Leste Asiático , Inteligência , Alfabetização , Programas de Rastreamento/métodos , Estudantes
14.
Autism Res ; 17(6): 1276-1286, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38695661

RESUMO

Autism and attention deficit hyperactivity disorder (ADHD) comorbidity in the school population have been understudied. This study estimates its prevalence considering both parents' and teachers' reports and clinical diagnosis. Sociodemographic, clinical, and cognitive data were compared by diagnostic groups: autism, ADHD, autism and ADHD, subthreshold autism spectrum disorder (ASD), subthreshold ADHD, and children without neurodevelopmental conditions. Following a two-phase design, 3727 parents and teachers (1802 preschoolers, 1925 school-age children) participated in the first phase. Subsequently, 781 participants underwent individual assessment for DSM-5 diagnoses. The estimated prevalence of the comorbid diagnosis was 0.51% (0.28%-0.74%), with significant sex differences (0.16% girls, 0.89% boys). The cooccurrence of symptoms of autism and ADHD reported by parents or teachers was 3.2% and 2.6%, respectively. ADHD comorbidity was observed in 32.8% of autistic children and 31.4% of those with subthreshold ASD. ASD comorbidity was observed in 9.8% of children with ADHD and 5.7% of those with subthreshold ADHD. Comorbidity was reported by at least one informant in 95% of children. Only 15.8% of children with autism and ADHD had been previously diagnosed with both conditions. Early detection and accurate comorbidity diagnosis are crucial to address the clinical and socio-educational needs of these children.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Comorbidade , Instituições Acadêmicas , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Masculino , Feminino , Criança , Prevalência , Pré-Escolar , Instituições Acadêmicas/estatística & dados numéricos , Transtorno do Espectro Autista/epidemiologia , Pais , Transtorno Autístico/epidemiologia , Professores Escolares/estatística & dados numéricos
15.
Autism Res ; 17(6): 1094-1105, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38747403

RESUMO

Early motor delays and differences are common among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Yet, little work has shown whether there are early atypical motor signs that differentiate these groups. Quantitative measures of movement variability hold promise for improving the identification of subtle and specific differences in motor function among infants and toddlers at high likelihood for ASD and ADHD. To this end, we created a novel quantitative measure of movement variability (movement curvature) and conducted a preliminary investigation as to whether this measure improves outcome predictions. We used a wearable triaxial accelerometer to evaluate continuous motion-based activity in infants at high and low likelihood for ASD and ADHD at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into three outcome groups: ASD (n = 19), ADHD concerns (n = 17), and a comparison group (n = 82). We examined group differences in movement curvature and whether movement curvature is predictive of a later ASD or ADHD concerns classification. We found that movement curvature was significantly lower in infants with later ASD diagnosis at 18, 24, and 36 months of age compared to infants with either ADHD concerns or those in the comparison group. Movement curvature was also a significant predictor of ASD at 18, 24, and 36 months (AUC 0.66-0.71; p = 0.005-0.039) and when adjusting for high ASD likelihood at 18 and 24 months (AUC 0.90, p = 0.05-0.019). These results indicate that lower movement curvature may be a feature of early motor differences in infants with later ASD diagnosis as early as 18 months of age.


Assuntos
Acelerometria , Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Movimento , Dispositivos Eletrônicos Vestíveis , Humanos , Transtorno do Espectro Autista/fisiopatologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Masculino , Feminino , Lactente , Pré-Escolar , Movimento/fisiologia , Acelerometria/métodos , Acelerometria/instrumentação
16.
J Neural Eng ; 21(3)2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38718789

RESUMO

Objective.Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children. While numerous intelligent methods are applied for its subjective diagnosis, they seldom consider the consistency problem of ADHD biomarkers. In practice, these data-driven approaches lead to varying learned features for ADHD classification across diverse ADHD datasets. This phenomenon significantly undermines the reliability of identified biomarkers and hampers the interpretability of these methods.Approach.In this study, we propose a cross-dataset feature selection (FS) module using a grouped SVM-based recursive feature elimination approach (G-SVM-RFE) to enhance biomarker consistency across multiple datasets. Additionally, we employ connectome gradient data for ADHD classification. In details, we introduce the G-SVM-RFE method to effectively concentrate gradient components within a few brain regions, thereby increasing the likelihood of identifying these regions as ADHD biomarkers. The cross-dataset FS module is integrated into an existing binary hypothesis testing (BHT) framework. This module utilizes external datasets to identify global regions that yield stable biomarkers. Meanwhile, given a dataset which waits for implementing the classification task as local dataset, we learn its own specific regions to further improve the performance of accuracy on this dataset.Main results.By employing this module, our experiments achieve an average accuracy of 96.7% on diverse datasets. Importantly, the discriminative gradient components primarily originate from the global regions, providing evidence for the significance of these regions. We further identify regions with the high appearance frequencies as biomarkers, where all the used global regions and one local region are recognized.Significance.These biomarkers align with existing research on impaired brain regions in children with ADHD. Thus, our method demonstrates its validity by providing enhanced biological explanations derived from ADHD mechanisms.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Biomarcadores , Máquina de Vetores de Suporte , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/classificação , Humanos , Biomarcadores/análise , Criança , Masculino , Feminino , Conectoma/métodos , Encéfalo/metabolismo , Bases de Dados Factuais , Reprodutibilidade dos Testes
17.
BMC Health Serv Res ; 24(1): 599, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38715039

RESUMO

BACKGROUND: In Mexico, this pioneering research was undertaken to assess the accessibility of timely diagnosis of Dyads [Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and their primary caregivers] at specialized mental health services. The study was conducted in two phases. The first phase involved designing an "Access Pathway" aimed to identify barriers and facilitators for ADHD diagnosis; several barriers, with only the teacher being identified as a facilitator. In the second phase, the study aimed to determine the time taken for dyads, to obtain a timely diagnosis at each stage of the Access Pathway. As well as identify any disparities based on gender and socioeconomic factors that might affect the age at which children can access a timely diagnosis. METHOD: In a retrospective cohort study, 177 dyads participated. To collect data, the Acceda Survey was used, based on the robust Conceptual Model Levesque, 2013. The survey consisted of 48 questions that were both dichotomous and polytomous allowing the creation of an Access Pathway that included five stages: the age of perception, the age of search, the age of first contact with a mental health professional, the age of arrival at the host hospital, and the age of diagnosis. The data was meticulously analyzed using a comprehensive descriptive approach and a nonparametric multivariate approach by sex, followed by post-hoc Mann-Whitney's U tests. Demographic factors were evaluated using univariable and multivariable Cox regression analyses. RESULTS: 71% of dyads experienced a late, significantly late, or highly late diagnosis of ADHD. Girls were detected one year later than boys. Both boys and girls took a year to seek specialized mental health care and an additional year to receive a formal specialized diagnosis. Children with more siblings had longer delays in diagnosis, while caregivers with formal employment were found to help obtain timely diagnoses. CONCLUSIONS: Our findings suggest starting the Access Pathway where signs and symptoms of ADHD are detected, particularly at school, to prevent children from suffering consequences. Mental health school-based service models have been successfully tested in other latitudes, making them a viable option to shorten the time to obtain a timely diagnosis.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Diagnóstico Precoce , Acessibilidade aos Serviços de Saúde , Serviços de Saúde Mental , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Masculino , Feminino , México/epidemiologia , Adolescente , Estudos Retrospectivos , Serviços de Saúde Mental/estatística & dados numéricos , Fatores Socioeconômicos
19.
PLoS One ; 19(5): e0299980, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38758772

RESUMO

BACKGROUND: To fulfil the diagnostic criteria of Attention Deficit Hyperactivity Disorder in the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms should be observed in two or more settings. This implies that diagnostic procedures require observations reported from informants in different settings, such as teachers in school and caregivers at home. This study examined parent-teacher agreement in reporting hyperactivity/inattention and its relationship with child's, parent's, and family's characteristics. METHOD: We used data from the 2004 United Kingdom Mental Health of Children and Young People survey, including 7977 children aged 4-17, to investigate cross-informant agreement between parents and teachers on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. The characteristics of different patterns of informant agreement were assessed using multinomial logistic regression. RESULTS: Cross-informant agreement of parent and teacher was low (weighted kappa = .34, 95% C.I.: .31, .37). Some characteristics, such as male child and parental emotional distress, were associated with higher likelihood of parent-teacher discrepancy. CONCLUSION: We found low informant agreement in the hyperactive/inattention subscale, as hypothesised and consistent with previous studies. The current study has found several factors that predict discrepancy, which were partly consistent with previous research. Possible explanation, implications, and further research on parent-teacher informant discrepancy in reporting hyperactivity/inattention were discussed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Pais , Professores Escolares , Humanos , Masculino , Feminino , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Reino Unido/epidemiologia , Pais/psicologia , Adolescente , Professores Escolares/psicologia , Pré-Escolar , Inquéritos e Questionários
20.
J Atten Disord ; 28(9): 1299-1319, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38651640

RESUMO

OBJECTIVE: This review aimed to systematically gather empirical data on the link between social anxiety disorder and ADHD in both clinical and non-clinical populations among adolescents and adults. METHOD: Literature searches were conducted in PsycInfo, PubMed, Scopus, and Web of Science, resulting in 1,739 articles. After screening, 41 articles were included. Results were summarized using a narrative approach. RESULTS: The prevalence of ADHD in adolescents and adults with SAD ranged from 1.1% to 72.3%, while the prevalence of SAD in those with ADHD ranged from 0.04% to 49.5%. Studies indicate that individuals with both SAD and ADHD exhibit greater impairments. All studies were judged to be of weak quality, except for two studies which were rated moderate quality. DISCUSSION: Individuals with SAD should be screened for ADHD and vice versa, to identify this common comorbidity earlier. Further research is needed to better understand the prevalence of comorbid ADHD and SAD in adolescents.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Comorbidade , Fobia Social , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Fobia Social/epidemiologia , Fobia Social/diagnóstico , Fobia Social/psicologia , Adolescente , Adulto , Prevalência
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