共查询到20条相似文献,搜索用时 15 毫秒
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《Archives de pédiatrie》2021,28(8):668-676
Sleep disturbances are associated with an increased risk of attention-deficit and hyperactivity disorder (ADHD), which can also lead to sleep problems. In this study we aimed to determine the variables that affect the relationship between ADHD and sleep quality. Moreover, we aimed to compare these variables in children and adolescents with ADHD and healthy controls. This cross-sectional study was conducted using a random sample of 122 ADHD patients and 100 healthy children in Turkey. A self-administered questionnaire was distributed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The risk of impairment in sleep quality was associated with the presence of ADHD (OR: 13.3; 95% CI: 6.1–29.1), the presence of somatic disease (OR: 4.9; 95% CI: 1.9–12.2), and a family history of the psychiatric disorder (OR: 4.2; 95% CI: 1.3–13.1). The PSQI total score was higher in children with parental separation compared to those without parental separation (p=0.006). As the economic level of the participants decreased, the PSQI total score increased significantly (p=0.006). It was determined that combined-type ADHD was associated with impairment in sleep quality more than the other subtypes (p<0.001 and p=0.031, respectively). Our findings show that children with ADHD have significantly more sleep problems than healthy controls and that sociodemographic variables and familial characteristics affect sleep quality in healthy children and children with ADHD. 相似文献
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Multisite controlled study of OROS methylphenidate in the treatment of adolescents with attention-deficit/hyperactivity disorder 总被引:3,自引:0,他引:3
Wilens TE McBurnett K Bukstein O McGough J Greenhill L Lerner M Stein MA Conners CK Duby J Newcorn J Bailey CE Kratochvil CJ Coury D Casat C Denisco MJ Halstead P Bloom L Zimmerman BA Gu J Cooper KM Lynch JM 《Archives of pediatrics & adolescent medicine》2006,160(1):82-90
BACKGROUND: Despite the persistence of attention-deficit/hyperactivity disorder (ADHD) into adolescence, little is known about the efficacy and tolerability of stimulant medications in this age group. OBJECTIVE: To report the results of a multisite controlled study among adolescents with ADHD evaluating the efficacy and tolerability of osmotic-release oral system (OROS) methylphenidate. DESIGN: Adolescents (N = 220) having a confirmed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of ADHD underwent dose titration to identify dosages of OROS methylphenidate that improved symptoms to predefined criteria. Subjects successfully completing the dose titration phase (n = 177) (ie, tolerated and responded to treatment and adhered to the protocol) were randomized to receive 2 weeks' treatment with their individualized dosage of OROS methylphenidate (18, 36, 54, or 72 mg once daily) or placebo. Treatment effectiveness was measured using investigator, parent, and adolescent assessments of ADHD. RESULTS: A significant reduction from baseline in the investigator-rated ADHD Rating Scale, the primary efficacy measure, was found with OROS methylphenidate treatment compared with placebo. Similar findings were noted with parent- and adolescent-report measures. Based on a Clinical Global Impression improvement subscale score of much or very much improved, 52% of subjects in the OROS methylphenidate group improved compared with 31% receiving placebo. Thirty-seven percent of subjects required the maximum dosage of 72 mg/d. The incidence of drug-related adverse events was similar between the 2 study groups. CONCLUSION: In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d. 相似文献
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Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity 总被引:1,自引:1,他引:1
Kirov R Kinkelbur J Banaschewski T Rothenberger A 《Journal of child psychology and psychiatry, and allied disciplines》2007,48(6):561-570
BACKGROUND: In children, attention-deficit/hyperactivity disorder (ADHD), tic disorder (TD), and their coexistence (ADHD + TD comorbidity) are very common and clinically important. Associated sleep patterns and their clinical role are still insufficiently investigated. This study aimed at characterizing these sleep patterns in children with ADHD, TD, and ADHD + TD comorbidity and determining whether, in ADHD + TD, the factors ADHD and TD may affect the sleep pattern in an independent (additive) or in a complex (interactive) manner. METHOD: By means of polysomnography, sleep patterns were investigated in 4 groups of unmedicated 8.0-16.4-year-old children (healthy controls, ADHD-only, TD-only, and ADHD + TD). Each group consisted of 18 subjects matched for age, gender, and intelligence. RESULTS: ADHD was primarily characterized by increase in rapid eye movement (REM) sleep, whereas TD patients displayed lower sleep efficiency and elevated arousal index in sleep. In children with ADHD + TD, both effects appeared. No interaction between the ADHD and TD factors was found for any of the sleep parameters. Significant correlations between sleep patterns and clinical symptoms were found. CONCLUSIONS: ADHD and TD are characterized by specific sleep alterations. When coexisting, the two disorders alter the sleep pattern in an additive manner, suggesting a high impact on clinical and therapeutic perspectives. 相似文献
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Zeiner P Bryhn G Bjercke C Truyen K Strand G 《Acta paediatrica (Oslo, Norway : 1992)》1999,88(3):298-303
The response to methylphenidate was examined in 36 boys, aged 7-11 y, with attention-deficit hyperactivity disorder (ADHD) in a double-blind, placebo-controlled, crossover design. Hyperactivity and conduct problems were significantly reduced during methylphenidate treatment. Stimulant medication was associated with improvements on tests of sustained attention, working memory and motor steadiness. When individual changes were studied, it was found that 83% showed a significant improvement in their hyperactivity at home or at school, and for 60% their levels of hyperactive behaviour were within the normal range. High levels of hyperactivity at school and relatively low age were significant predictors of normalization of hyperactivity in at least one setting. However, these predictors could only classify correctly 71% of the children. In clinical practice a trial with stimulants is indicated in ADHD children who show symptoms that are sufficiently severe to cause impairment at home and at school. 相似文献
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儿童注意缺陷多动障碍诊疗建议 总被引:23,自引:0,他引:23
Editorial Board of Chinese Journal of Pediatrics;Chinese Pediatric Neurology Society;Chinese Society of Child Healthcare 《中华儿科杂志》2006,44(10):758-759
本建议主要参考美国精神障碍诊断和统计手册第4版(DSM-IV)的诊断标准,旨在规范我国临床诊疗工作,并为今后更深入的研究儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)提供参考。 相似文献
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Carla Arpino Maria Marzio Luigi D'Argenzio Benedetta Longo Paolo Curatolo 《European journal of paediatric neurology》2005,9(5):363-365
Rash causing viral diseases may be transmitted during pregnancy, causing severe congenital disease. Although neurological and psychiatric disorders are common consequences of congenital rubella, children born to women who developed a viral rash during pregnancy do not appear to be at increased risk of these disorders if they were asymptomatic at birth. In a case-control study conducted to evaluate risk factors for ADHD, we found an increased risk of this disorder among children born to women experiencing a viral rash during pregnancy. The viral rash (i.e. measles, varicella, or rubella) was reported by 4 of 71 mothers of children with ADHD and none of the 118 controls' mothers (P<0.01). The difference remained statistically significant after adjusting for potential confounders (i.e. other factors found associated with ADHD, such as gender and familiarity). Although, the viral disease reported by the mothers, in accordance with their physician's diagnosis, did not represent a homogeneous nosological group, the unexpectedly high rate found among ADHD cases' mothers suggest a role for viral diseases occurring during pregnancy in the development of ADHD. 相似文献
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Silver LB 《Pediatric clinics of North America》1999,46(5):965-975
Medication to treat ADHD must be seen as part of a multimodal approach that includes education, counseling, behavioral management, and family work along with the medication. If in addition to ADHD the patient has other psychiatric disorders, they also must be treated. The stimulant medications are still the first choice in treating ADHD. Should there be reasons why they cannot be used, the TCAs become the second line of treatment. Other alternative medications such as buproprion, clonidine, and guanfacine also can be considered. This article provides information and guidelines for the use of the alternative, nonstimulant medications to treat ADHD. These medications can be used separately or in combination to reduce the primary behaviors of ADHD and comorbid conditions. The reader is encouraged to refer to reviews of the pharmaceutical company literature and the Physician's Desk Reference before initiating treatment with any of these medications. 相似文献
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Konofal E Lecendreux M Arnulf I Mouren MC 《Archives of pediatrics & adolescent medicine》2004,158(12):1113-1115
BACKGROUND: Iron deficiency causes abnormal dopaminergic neurotransmission and may contribute to the physiopathology of attention-deficit/hyperactivity disorder (ADHD). OBJECTIVE: To evaluate iron deficiency in children with ADHD vs iron deficiency in an age- and sex-matched control group. DESIGN: Controlled group comparison study. SETTING: Child and Adolescent Psychopathology Department in European Pediatric Hospital, Paris, France. PATIENTS: Fifty-three children with ADHD aged 4 to 14 years (mean +/- SD, 9.2 +/- 2.2 years) and 27 controls (mean +/- SD, 9.5 +/- 2.8 years). MAIN OUTCOME MEASURES: Serum ferritin levels evaluating iron stores and Conners' Parent Rating Scale scores measuring severity of ADHD symptoms have been obtained. RESULTS: The mean serum ferritin levels were lower in the children with ADHD (mean +/- SD, 23 +/- 13 ng/mL) than in the controls (mean +/- SD, 44 +/- 22 ng/mL; P < .001). Serum ferritin levels were abnormal (<30 ng/mL) in 84% of children with ADHD and 18% of controls (P < .001). In addition, low serum ferritin levels were correlated with more severe general ADHD symptoms measured with Conners' Parent Rating Scale (Pearson correlation coefficient, r = -0.34; P < .02) and greater cognitive deficits (r = -0.38; P < .01). CONCLUSIONS: These results suggest that low iron stores contribute to ADHD and that ADHD children may benefit from iron supplementation. 相似文献
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AIM: To assess recurrent subjective health complaints in Swedish schoolchildren with attention-deficit/hyperactivity disorder (ADHD). METHODS: Cohort study of 577 fourth-graders (10-y-olds) in one municipality in Stockholm County. All children were screened for attention and behaviour problems through interviews with their parents and teachers. Children with high scores underwent further clinical and cognitive assessments. Information about health complaints was collected from the children themselves in a classroom questionnaire. The 516 children for whom there was information from all three data sources were included in the final study population. Hypotheses were tested in multivariate analyses with adjustment for sex and parental education. RESULTS: Recurrent abdominal pain (RAP), sleeping problems and tiredness were associated with ADHD (stratified relative risks: 2.2 [1.4-3.4], 1.7 [1.1-2.7] and 2.7 [1.7-4.1], respectively), while there was no association with headache. CONCLUSION: This study indicates that treatment strategies for children with ADHD need to include an effective evaluation and treatment of RAP, tiredness and sleeping disturbances. Evaluation of ADHD should be considered in children with recurrent health complaints. 相似文献
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儿童注意缺陷伴多动障碍(ADHD)的临床表现非常复杂,被认为是一种导致多种问题和障碍的临床综合征,至今无特效治疗。随着医学研究的不断深入,一种多模式、多角度、综合性的治疗方案逐渐被提了出来——多维治疗(MTA)。美国国立精神卫生研究所(NIMH)对此进行了系统研究。 相似文献
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Meta分析阿托西汀治疗儿童注意力缺陷多动障碍的临床疗效 总被引:3,自引:0,他引:3
目的评价阿托西汀治疗18岁以下注意缺陷多动障碍(ADHD)患儿的临床疗效。方法2006-09—2006-12在北京大学第三医院儿科应用计算机检索Medline/PubMed(1977~2006)医学数据库、荷兰医学文摘(Embase,1989~2006)和OVID全文数据库、Cochrane系统评价数据库(2006年)、中国学术期刊网全文数据库(CNKI,1994~2006)、中国生物医学文献数据库(CBMdisc,1978~2006)和国家科技图书文献中心,收集阿托西汀治疗儿童ADHD的临床试验,进行质量评价,并对符合纳入标准的研究进行Meta分析。结果共查阅到国内外相关临床研究42篇,纳入随机对照研究14篇,其中国外13篇,国内1篇,均为高质量研究(Jadad评分均≥3分)。其中小剂量组[<1.5mg/(kg.d)]阿托西汀与安慰剂的疗效对比共5篇,患儿1125例;大剂量组[≥1.5mg/(kg.d)]阿托西汀与安慰剂的疗效对比共6篇,患儿1351例;阿托西汀与哌甲酯的临床疗效对比共3篇,患儿446例。合并分析表明,不同剂量阿托西汀与安慰剂相比,均可显著降低患儿ADHD-RS量表的评分(P<0.01),其中小剂量组平均减分值[95%可信限(95%CI)]为[-3.62(-4.51,-2.72)],大剂量组平均减分值(95%CI)为[-5.97(-8.67,-3.27)];阿托西汀与哌甲酯在改善患儿核心症状方面差异无显著性(P=0.31),平均减分值之差(95%CI)为[-1.18(-3.43,1.08)]。结论从现有的临床证据看,阿托西汀在改善18岁以下ADHD患儿的核心症状方面,疗效显著。阿托西汀与哌甲酯尤其是缓释哌甲酯的疗效对比仍需大规模、高质量、随访结局统一的临床试验以进一步验证。 相似文献
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Rodopman-Arman A Perdahli-Fiş N Ekinci O Berkem M 《The Turkish journal of pediatrics》2011,53(4):397-403
Considerable clinical data support an association between sleep problems and attention deficit hyperactivity disorder (ADHD). We aimed to investigate the sleep habits, associated parasomnias and behavioral symptoms in primary school children with ADHD. Forty primary school children with a clinical diagnosis of ADHD and 40 age-sex-matched healthy community controls were recruited. The Children's Sleep Habits Questionnaire providing information regarding sleep habits and nighttime and daytime symptoms was used. About 22% of children with ADHD (versus 2.9% of the controls) needed their parents to accompany them while going to sleep (p: 0.008). Transitional objects were needed by 8.1% of ADHD children in contrast to 2.9% of controls. Nightmares, overactivity during sleep, habitual snoring, and bed-wetting were significantly higher in the ADHD group. ADHD children needed significantly more time to go to sleep on school days (p < 0.02). Children undergoing evaluation for ADHD should be routinely screened for sleep disturbances. 相似文献
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Rasmussen ER Neuman RJ Heath AC Levy F Hay DA Todd RD 《Journal of child psychology and psychiatry, and allied disciplines》2004,45(3):589-598
BACKGROUND: Findings from family and twin-based studies of Attention Deficit/Hyperactivity Disorder (ADHD) have indicated that inattentive and combined subtypes cluster together among sibling pairs who both express ADHD symptoms. The current report examines the familial clustering of ADHD subtypes, defined according to latent class and DSM-IV criteria, in a general population sample of 2,848 Australian twins, 1,013 of their non-twin siblings and 4,036 female twins from Missouri, USA. Significant clustering of DSM-IV inattentive and combined subtypes, and significant clustering of the same latent classes among siblings was predicted. METHOD: Logistic regression was used to assess 1) the clustering of same and different subtype combinations among twin and twin-sibling pairs and 2) whether genetic influences contribute significantly to the observed patterns of subtype combinations among siblings. RESULTS: With the exception of the DSM-IV hyperactive-impulsive subtype and the severe hyperactive-impulsive latent class, all other sibling DSM-IV and latent class ADHD subtypes consistently exhibited significant same-subtype clustering with MZ probands, DZ probands and their siblings in both samples. Furthermore, a significant genetic influence contributing to subtype concordance was detected for every DSM-IV subtype excluding hyperactive-impulsive, and for all eight latent classes. While some instances of significant different-subtype clustering among siblings was observed across both classification systems and samples, the particular subtype combinations involved were largely inconsistent across samples and no significant genetic influences contributing towards these discordant subtype combinations were detected. CONCLUSIONS: For both DSM-IV and latent class subtypes, the overall pattern of findings in both samples indicated significant familial clustering of same-subtype combinations and significant genetic influences contributing to these patterns of subtype concordance, despite important sample differences. These findings further extend previous work and are most consistent with the presence of multiple independent forms of ADHD. 相似文献