Oxidative stress in children with attention deficit hyperactivity disorder

ObjectiveThe aim of this study was to investigate oxidative stress in ADHD children.Design and methodsLevels of oxidant parameters malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHDG), advanced oxidation protein products (AOPP) and antioxidant parameters paraoxonase (PON1) and thiol levels were measured in thirty children with ADHD (27 boys, 3 girls) who were firstly diagnosed according to DSM-IV and thirty healthy children (18 boys, 12 girls) aged 6–12 years.ResultsThe levels of the oxidant parameters MDA and 8-OHDG were statistically significantly lower in ADHD children compared to the controls. We did not find a significant difference between the groups regarding AOPP, PON1, and thiol levels.ConclusionWe found low levels of some oxidants and no difference of antioxidant parameters in ADHD children. Our study points out that there may not be a direct relationship between oxidative stress and ADHD.     

Self-perception in children with attention deficit/hyperactivity disorder

The purpose of this study was to compare self-perceptions of children diagnosed with attention deficit/hyperactivity disorder (ADHD) with those of children not diagnosed with ADHD. Seventy-seven children aged 8-12 years composed the two groups-38 participants with ADHD and 39 control participants without ADHD. The children completed the Self-Perception Profile for Children Questionnaire designed to measure self-perceptions in school-aged children. t Tests compared differences in mean scores between the groups. The ADHD group had a significantly lower overall score and a lower score on the behavioral conduct subscale compared with children without ADHD. Findings suggest a difference in the way school-aged children with ADHD perceive themselves as compared with their peers. The cumulative effect of years of low self-esteem and negative self-perception may have significant life consequences. Attention should be focused on fostering self-esteem and positive self-perception in children with ADHD through support groups and behavioral training.     

注意缺陷多动障碍儿童行为特征评估

目的探讨注意缺陷多动障碍儿童的行为特征。方法采用中国修订韦氏儿童智力量表、Achenbach儿童行为量表、Conners父母症状问卷对78例注意缺陷多动障碍儿童及其父母进行测试和问卷调查,并与正常对照组进行对比分析。结果注意缺陷多动障碍患儿的社交和活动能力保持较好,男患儿Achenbach儿童行为量表总分及学习能力、焦虑、抑郁、交往不良、强迫、体诉、社交退缩、多动、攻击、违纪因子分均高于对照组（P〈0．05或0．01）,女患儿总分、抑郁、社交退缩、多动、性问题、攻击等因子分均高于对照组（P〈0．05或0．01）。男患儿的智商总分、言语智商、操作智商分以及知识、分类、词汇、数字广度、木块图案等因子分均显著低于对照组（P〈0．05或0．01）,而女患儿智商评分与女对照组差异无显著性（P〉0．05）。结论注意缺陷多动障碍儿童有较多的行为和智商问题,家长应该根据他们的行为特征,有针对性的进行辅导,帮助患儿改善不良行为和社交技能。     

Treatment of attention deficit hyperactivity disorder in children

These are controversial times for those who care for children with attention deficit hyperactivity disorder (ADHD). Class action law suits have been filed in federal courts in California and New Jersey accusing a manufacturer of methylphenidate and the American Psychiatric Association of conspiring to expand the use of this drug. These suits have recently been dismissed. This is just the latest chapter in the long-running debate over the existence, diagnosis, and treatment of ADHD. Controversies relating to ADHD continue to polarize physicians, educators, caregivers, and parents of these children. There are those who believe that ADHD does not exist as a true disorder. At the other end of the spectrum are those who are too quick to make the diagnosis without an adequate patient workup. Parents can unfortunately get caught in the middle of this debate when making treatment decisions for their children.     

Self-concept in children and adolescents with attention deficit hyperactivity disorder

Children with attention deficit hyperactivity disorder (ADHD) struggle with behavioral symptoms, yet little research has provided information about how behavioral symptoms impact their self-concept, especially in terms of gender, age, and ethnicity. Data were collected from 145 children and adolescents with ADHD and their mothers. African Americans, Hispanic Americans, and Caucasians were nearly equally represented in the sample, with approximately one third each. The Child Behavior Checklist was used to assess ADHD symptom severity, and Piers--Harris Children's Self-Concept Scale was used to measure self-concept. Older ages and more internalizing behavior problems predicted lower self-concept. There were no significant differences between ethnic groups on behavior problem and self-concept scores, although post hoc analyses revealed a trend for Caucasian children with ADHD to have lower self-concept scores than those of African American or Hispanic children. The findings indicate that there is a need to assess self-concept in children and adolescents with ADHD, especially those who are older and have comorbid conditions of anxiety and depression.     

Treating attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a chronic childhood disorder characterized by inattention, distractibility, impulsivity, and restlessness. ADHD symptoms impair the child's ability to function at home, in school, and in the community. When ADHD is untreated, the child is at increased risk for school failure, substance abuse, and psychiatric disorders. New clinical practice guidelines from the American Academy of Pediatrics specify diagnosis and treatment for childhood ADHD, including psychosocial interventions, psychopharmacology, educational modifications, skill training, and social support.     

Atomoxetine versus stimulants for treatment of attention deficit/hyperactivity disorder

OBJECTIVE: To identify, review, and analyze studies comparing atomoxetine with psychostimulants with the intent of determining the role of atomoxetine in the pharmacologic management of attention deficit/hyperactivity disorder (ADHD). DATA SOURCES: Primary, review, and meta-analysis articles were identified by a MEDLINE search (1966-December 2005). MeSH headings used in the search include: attention deficit/hyperactivity disorder, ADHD, atomoxetine, stimulants, psychostimulants, methylphenidate, and amphetamine salts. Relevant data presented at professional meetings that we attended were also identified. STUDY SELECTION AND EXTRACTION: All clinical studies comparing atomoxetine with psychostimulants, regardless of study design, were evaluated. Relevant efficacy and safety data from these studies were included in the discussion. DATA SYNTHESIS: At time of writing, 5 head-to-head trials had compared psychostimulants and atomoxetine in the treatment of ADHD. No significant difference between atomoxetine and methylphenidate immediate-release were found on the ADHD Rating Scale total score. Osmotic oral release system (OROS) methylphenidate showed significantly greater improvement at weeks 1 and 2, and significantly more patients treated with OROS methylphenidate were classified as responders. Patients on both atomoxetine and mixed amphetamine salts extended-release (MAS XR) showed significant improvements at endpoint over baseline; however, Swanson, Kotkin, Agler, M-Flynn, and Pelham (SKAMP) scores were significantly better with MAS XR. Tolerability was similar between atomoxetine and stimulant medications. CONCLUSIONS: Based on available evidence, psychostimulants are regarded as first-line pharmacologic treatment for children and adolescents with ADHD, as the efficacy and safety of these agents have been well established based on clinical trials and extensive naturalistic use. Adverse effects in some patients and abuse potential have led to the search for new treatments. Atomoxetine represents an alternative treatment for ADHD and is unlikely to be associated with abuse; however, long-term safety data are needed to further establish its place in therapy.     

Subcategories of attention deficit hyperactivity disorder.

It is estimated that as many as 20% of school-aged children have an attention deficit hyperactivity disorder (ADHD). Hyperactivity is recognized as a common symptom of a variety of childhood disorders. In many instances the symptoms of ADHD signal the onset of severe psychopathology and indicate comorbidity. Because a significant number of children exhibiting symptoms of ADHD are unresponsive to stimulants or have side effects, the use of such drugs is contraindicated. In this article we describe ADHD according to subcategories in an effort to distinguish diverse groups of children with ADHD and to identify those responding best to psychopharmacologic agents other than stimulants. Further understanding of the neurobiology of ADHD is needed to more clearly define and treat this condition.     

感觉统合训练治疗儿童注意缺陷多动障碍

目的探讨感觉统合训练治疗儿童注意缺陷多动障碍的临床疗效。方法将30名注意缺陷障碍儿童进行感觉统合训练40次;治疗前后分别采用CONNRS量表、注意力(划消测验、数字记忆能力)感觉统合评定量表评定疗效,并进行对比分析。结果治疗后学习问题、冲动多动有显著改善;注意错误率明显低于治疗前;治疗后大肌肉与平衡不良及本体感觉不佳因子分显著高于治疗前,差异有极显著性(P<0.01);触觉防御不当及学习能力发展不足因子分高于治疗前,差异有显著性(P<0.05)。结论感觉统合训练治疗儿童注意缺陷多动障碍有一定疗效。     

Serum ferritin levels in children with attention deficit hyperactivity disorder and tic disorder

BACKGROUNDIron plays an important role in neurodevelopmental functions in the brain. Serum ferritin levels are different in children with attention deficit hyperactivity disorder and tic disorder than in healthy children.AIMTo explore the current status of iron deficiency in children with neurodevelopmental disorders and its sex and age effects.METHODSA total of 1565 children with attention deficit hyperactivity disorder (ADHD), 1694 children with tic disorder (TD), 93 children with ASD and 1997 healthy control children were included between January 1, 2020, and December 31, 2021 at Beijing Children''s Hospital. We describe the differences in age levels and ferritin levels between different disease groups and their sex differences. The differences between the sexes in each disease were analyzed using the t test. The incidence rate of low serum ferritin was used to describe the differences between different diseases and different age groups. A chi-square test was used to analyze the difference in the incidence of low serum ferritin between the disease group and the control group. Analysis of variance was used for comparisons between subgroups, and regression analysis was used for confounding factor control.RESULTSA total of 1565 ADHD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 36.82 ± 20.64 μg/L and 35.64 ± 18.56 μg/L, respectively. A total of 1694 TD patients aged 5-12 years were included in this study, and the average serum ferritin levels of male and female children were 35.72 ± 20.15 μg/L and 34.54 ± 22.12 μg/L, respectively. As age increased, the incidence of low serum ferritin in ADHD and TD first decreased and then increased, and 10 years old was the turning point of rising levels. The incidence of ADHD with low serum ferritin was 8.37%, the incidence of TD with low serum ferritin was 11.04%, and the incidence of the healthy control group with low serum ferritin was 8.61%, among which male children with TD accounted for 9.25% and female children with TD accounted for 11.62%. There was a significant difference among the three groups (P < 0.05). In addition, there were 93 children with ASD with an average serum ferritin level of 30.99 ± 18.11 μg/L and a serum ferritin incidence of 15.05%.CONCLUSIONIn conclusion, low serum ferritin is not a risk factor for ADHD or TD. The incidence of low serum ferritin levels in children with ADHD and TD between 5 and 12 years old decreases first and then increases with age.     

多动症儿童的脑电图变化机制

目的：通过儿童多动症患儿脑电图的变化探讨其发病机制及其疾病的本质。方法：在现代儿童多动症脑电研究成果的基础上，结合传统中医理论，探讨其脑电图变化机制，为中西医结合治疗儿童多动症提出新的思路。结果：儿童多动症是儿童期发病率较高的心理行为障碍性疾患，其疾病本质是由于脑功能障碍引起的心理、行为异常。脑电描计术就是通过检测脑神经电生理活动而反映脑功能改变情况的临床检测手段。近年来对于儿童多动症的脑电图研究进展较快。结论：儿童多动症被认为是特殊大脑调节功能失调的外在表现。患儿整个环路，即脑干网状结构一丘脑非特异性核团一大脑皮质的调节能力不足，脑功能紊乱，适宜的调节不能被强化，不利的调节得不到抑制，从而表现出儿童多动症的诸多问题。每个行为都是皮质与皮质、皮质与皮质下的网络建立联系来保持一种激活状态。网络保持激活状态或抑制状态时，其刺激性与脑电图方面同步，皮质活动和控制情况可以通过皮质神经活动诸如脑电图波谱的密度、分布、波幅及波形等观察到。     

多动症儿童的脑电图变化机制

目的:通过儿童多动症患儿脑电图的变化探讨其发病机制及其疾病的本质。方法:在现代儿童多动症脑电研究成果的基础上,结合传统中医理论,探讨其脑电图变化机制,为中西医结合治疗儿童多动症提出新的思路。结果:儿童多动症是儿童期发病率较高的心理行为障碍性疾患,其疾病本质是由于脑功能障碍引起的心理、行为异常。脑电描计术就是通过检测脑神经电生理活动而反映脑功能改变情况的临床检测手段。近年来对于儿童多动症的脑电图研究进展较快。结论:儿童多动症被认为是特殊大脑调节功能失调的外在表现。患儿整个环路,即脑干网状结构-丘脑非特异性核团-大脑皮质的调节能力不足,脑功能紊乱,适宜的调节不能被强化,不利的调节得不到抑制,从而表现出儿童多动症的诸多问题。每个行为都是皮质与皮质、皮质与皮质下的网络建立联系来保持一种激活状态。网络保持激活状态或抑制状态时,其刺激性与脑电图方面同步,皮质活动和控制情况可以通过皮质神经活动诸如脑电图波谱的密度、分布、波幅及波形等观察到。     

Assessment of attention deficit hyperactivity disorder

Increasing numbers of referrals of children with possible attention deficit hyperactivity disorder (ADHD) for psychiatric assessment are significantly adding to psychiatrists' workloads. In Forth Valley Primary Care NHS Trust the situation had reached a point where children with other mental health problems were having to wait longer for appointments. Two developments were implemented that aimed to ameliorate the problem by making better use of the skills of clinical nurse specialists and nurse therapists. Guidelines were drawn up for nurse assessment of children with suspected ADHD, and a dedicated active behaviour clinic was established to diagnose and review children with the condition. The developments have improved the services for children with ADHD and have given psychiatrists more time to spend with other client groups.     

儿童注意缺陷多动障碍的家庭危险因素调查

目的:了解儿童注意缺陷多动障碍(attentiondeficithyperactivitydisor-der,ADHD)的患病率及患病的家庭危险因素,为其防治提供依据。方法:使用自编的家庭情况调查表和小学生行为问卷,调查泉州市实验小学的1～6年级小学生1726名(回收1675份);根据美国精神障碍诊断统计手册第三版(DSM-Ⅲ-R)有关ADHD的诊断标准、辅以注意力缺陷测试仪和神经精神检查等手段确定ADHD病例,分析其家庭危险因素。结果:检出ADHD患者75名,检出率为4.48%,其中男生患病率(6.03%)明显高于女生(2.54%)(χ2=11.80,P<0.01),男生患病率随着年龄的增加有升高的趋势(χ2趋势=4.70,P<0.05),女生的情况则相反(χ2趋势=7.43,P<0.01);父亲或母亲的文化越低,子女的ADHD患病率越高(χ2趋势=6.96,P<0.05;χ2趋势=21.27,P<0.01);父亲或母亲为“干部”的,其子女ADHD患病率明显低于父亲或母亲为“非干部”的子女(χ2=4.69,P<0.05;χ2=12.5,P<0.01);男生ADDH患病的危险因素为12～13岁(P=0.0005)和母亲的职业为“非干部”(P=0.0295),而女生ADDH患病的危险因素为7～8岁(P=0.0000)、母亲的文化中学以下(P=0.0241)和父母的职业为“非干部”(P=0.0024,P=0.0784)。结论:男生较女生有更高的患病率,男女学生有不同的ADDH高危因素,对(小学一年级)学习的不适应和     

Enantioselective pharmacokinetics and pharmacodynamics of dl-threo-methylphenidate in children with attention deficit hyperactivity disorder.

Nine boys with attention-deficit hyperactivity disorder took part in a study in which d-methylphenidate, l-methylphenidate, dl-methylphenidate, or placebo were administered in a double-blind, four-way, randomized, crossover design. Plasma levels of the isomers of methylphenidate were monitored by means of an enantioselective assay method. The ability of the children to perform tasks that required sustained attention was monitored by a battery of computer tests. There was no evidence of interconversion between the enantiomers in vivo, although the presence of the d-isomer significantly altered the pharmacokinetics of the l-antipode. The presence of the l-isomer did not affect the pharmacokinetics of d-methylphenidate. The computer tests revealed a drug-induced improvement in sustained attention that was entirely attributable to the d-enantiomer. There was no evidence to suggest that the effectiveness of d-methylphenidate was in any way compromised by the presence of its antipode.