Impact of medications prescribed for treatment of attention-deficit hyperactivity disorder on physical growth in children and adolescents with HIV.

OBJECTIVE: To examine the relationships between physical growth and medications prescribed for symptoms of attention-deficit hyperactivity disorder in children with HIV. METHODS: Analysis of data from children with perinatally acquired HIV (N = 2251; age 3-19 years), with and without prescriptions for stimulant and nonstimulant medications used to treat attention-deficit hyperactivity disorder, in a long-term observational study. Height and weight measurements were transformed to z scores and compared across medication groups. Changes in z scores during a 2-year interval were compared using multiple linear regression models adjusting for selected covariates. RESULTS: Participants with (n = 215) and without (n = 2036) prescriptions were shorter than expected based on US age and gender norms (p < .001). Children without prescriptions weighed less at baseline than children in the general population (p < .001) but gained height and weight at a faster rate (p < .001). Children prescribed stimulants were similar to population norms in baseline weight; their height and weight growth velocities were comparable with the general population and children without prescriptions (for weight, p = .511 and .100, respectively). Children prescribed nonstimulants had the lowest baseline height but were similar to population norms in baseline weight. Their height and weight growth velocities were comparable with the general population but significantly slower than children without prescriptions (p = .01 and .02, respectively). CONCLUSION: The use of stimulants to treat symptoms of attention-deficit hyperactivity disorder does not significantly exacerbate the potential for growth delay in children with HIV and may afford opportunities for interventions that promote physical growth. Prospective studies are needed to confirm these findings.

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

Association between attention-deficit/hyperactivity disorder symptoms and obesity and hypertension in early adulthood: a population-based study.

OBJECTIVE: To examine the associations between attention-deficit/hyperactivity disorder (ADHD) symptoms, obesity and hypertension in young adults in a large population-based cohort. DESIGN, SETTING AND PARTICIPANTS: The study population consisted of 15,197 respondents from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2009 in the United States. Multinomial logistic and logistic models examined the odds of overweight, obesity and hypertension in adulthood in relation to retrospectively reported ADHD symptoms. Latent curve modeling was used to assess the association between symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood. RESULTS: Linear association was identified between the number of inattentive (IN) and hyperactive/impulsive (HI) symptoms and waist circumference, BMI, diastolic blood pressure and systolic blood pressure (all P-values for trend <0.05). Controlling for demographic variables, physical activity, alcohol use, smoking and depressive symptoms, those with three or more HI or IN symptoms had the highest odds of obesity (HI 3+, odds ratio (OR)=1.50, 95% confidence interval (CI) = 1.22-2.83; IN 3+, OR = 1.21, 95% CI = 1.02-1.44) compared with those with no HI or IN symptoms. HI symptoms at the 3+ level were significantly associated with a higher OR of hypertension (HI 3+, OR = 1.24, 95% CI = 1.01-1.51; HI continuous, OR = 1.04, 95% CI = 1.00-1.09), but associations were nonsignificant when models were adjusted for BMI. Latent growth modeling results indicated that compared with those reporting no HI or IN symptoms, those reporting 3 or more symptoms had higher initial levels of BMI during adolescence. Only HI symptoms were associated with change in BMI. CONCLUSION: Self-reported ADHD symptoms were associated with adult BMI and change in BMI from adolescence to adulthood, providing further evidence of a link between ADHD symptoms and obesity.

Obsessive-compulsive disorder: Influence of age at onset on comorbidity patterns

Purpose: This study investigates the influence of age at onset of OCS on psychiatric comorbidities, and tries to establish a cut-off point for age at onset. Methods: Three hundred and thirty OCD patients were consecutively recruited and interviewed using the following structured interviews: Yale-Brown Obsessive Compulsive Scale; Yale Global Tic Severity Scale and the Structured Clinical Interview for DSM-IV. Data were analyzed with regression and cluster analysis. Results: Lower age at onset was associated with a higher probability of having comorbidity with tic, anxiety, somatoform, eating and impulse-control disorders. Longer illness duration was associated with lower chance of having tics. Female gender was associated with anxiety, eating and impulse-control disorders. Tic disorders were associated with anxiety disorders and attention-deficit/hyperactivity disorder. No cut-off age at onset was found to clearly divide the sample in homogeneous subgroups. However, cluster analyses revealed that differences started to emerge at the age of 10 and were more pronounced at the age of 17, suggesting that these were the best cut-off points on this sample. Conclusions: Age at onset is associated with specific comorbidity patterns in OCD patients. More prominent differences are obtained when analyzing age at onset as an absolute value. © 2008 Elsevier Masson SAS. All rights reserved.

Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs

Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in liability. The genetic correlation calculated using common SNPs was high between schizophrenia and bipolar disorder (0.68 +/- 0.04 s.e.), moderate between schizophrenia and major depressive disorder (0.43 +/- 0.06 s.e.), bipolar disorder and major depressive disorder (0.47 +/- 0.06 s.e.), and ADHD and major depressive disorder (0.32 +/- 0.07 s.e.), low between schizophrenia and ASD (0.16 +/- 0.06 s.e.) and non-significant for other pairs of disorders as well as between psychiatric disorders and the negative control of Crohn's disease. This empirical evidence of shared genetic etiology for psychiatric disorders can inform nosology and encourages the investigation of common pathophysiologies for related disorders.

Portrait sociodémographique, anamnestique et psychopathologique des enfants placés en Centre jeunesse et à qui l'on prescrit des médicaments psychotropes.

Cette thèse a pour but de mieux comprendre le recours aux médicaments psychotropes chez les enfants hébergés en Centre jeunesse, une population qui compte parmi les plus médicalisées. Afin d’y parvenir, les caractéristiques sociodémographiques, anamnestiques et psychopathologiques des enfants placés qui reçoivent des psychopharmacoprescriptions ont été analysées. L’échantillon se compose de 101 enfants de 6 à 12 ans placés en foyer de groupe ou centre de réadaptation, dont 71 recevant des médicaments psychotropes. Les données ont été obtenues par le biais de questionnaires remplis par les éducateurs, par une entrevue semi-structurée réalisée auprès des enfants et une analyse du dossier. Sur le plan de la structure, cet ouvrage comprend une introduction, quatre articles et une conclusion. Le premier article comporte une recension des écrits sur l’usage de la psychopharmacothérapie chez les jeunes placés dans les services de la protection de la jeunesse. Il a été constaté que les taux de prescriptions peuvent varier entre 13% et 77%, selon le type de placement et les régions à l’étude. La symptomatologie des enfants placés qui reçoivent des médicaments psychotropes est caractérisée par des problèmes extériorisés et des troubles psychotiques. Les corrélats du recours à la prescription concernent à la fois la sévérité du tableau clinique, mais aussi le type et l’instabilité du placement, l’âge et le sexe de l’enfant ainsi que la formation des intervenants. Enfin, les écrits recensés font état de l’influence des neurosciences dans les milieux médicaux sur les décisions de prescrire. Le deuxième article présente la prévalence des psychopharmacoprescriptions chez les enfants de 6 à 12 ans placés hors d’un milieu familial. Les résultats indiquent que 70,3% des jeunes reçoivent au moins une prescription, le plus souvent signées par des médecins spécialistes. La plupart se composent de psychostimulants et d’antipsychotiques atypiques, prescrits pour des troubles de l’attention avec hyperactivité. Le troisième article cherche à préciser les caractéristiques sociodémographiques et anamnestiques des enfants placés qui prennent des médicaments psychotropes. Les résultats indiquent que les sujets médicamentés et non médicamentés ont vécu des stresseurs psychosociaux similaires. Par contre, les enfants placés qui reçoivent une psychopharmacothérapie ont été retirés de leur milieu familial à un plus jeune âge. Le quatrième article consiste à cibler leur portrait psychopathologique et à connaître leur niveau de fonctionnement global. Il s’intéresse également aux connaissances et aux perceptions des éducateurs sur la psychopharmacothérapie. Les résultats révèlent que les enfants médicamentés ont plus souvent un diagnostic de trouble mental inscrit à leur dossier. Selon les éducateurs, ils présentent davantage de problèmes extériorisés et intériorisés. À partir de données autorévélées, aucune distinction ne peut être établie entre les sujets, puisque les uns et les autres rapportent un niveau comparable de symptômes et de signes diagnostiques. Enfin, les symptômes de stress post-traumatique et l’opinion favorable des éducateurs sur la psychopharmacothérapie constituent des prédicteurs significatifs de la probabilité de recourir à un traitement médicamenteux. En conclusion, l’apport des résultats de cette recherche est analysé à la lumière des études antérieures. Les retombées cliniques sont discutées et des pistes de recherche futures sont suggérées. .

O teatro do oprimido e sua contribuição na formação da criança com transtorno do déficit de atenção com hiperatividade

This research investigates and reports the contributions of the Theatre of the Oppressed and its techniques as a therapeutic resource in the education of children with Attention Deficit Disorder with Hyperactivity. In the first chapter organize one studying theoretical seeking to conceptualize and understand the Learning, Attention Deficit Hyperactivity Disorder, seeking to better understand the behavior and the behavior of children with ADHD. Researching on the symptoms, causes and effects of this syndrome. Trace a relationship between familyschool- specialists in an attempt to prove the importance of family support in the teachinglearning process and treatment of these children. In the second chapter start conceptualizing theater, the relationship between work-Theatre-Education Therapy, explain the difference between the theatrical stage and the therapeutic stage. Account the importance of theater games in the classroom and its contribution to social and educational training of the child. Justify the choice of the Theatre of the Oppressed recognizing him as the primary method for this research, because it is a set of exercises, games and techniques that help the child regain equilibrium relations, developing autonomy, encourages creativity and spontaneity, freeing them from their oppression. Besides being an efficient transformation behavior, improving behavior, allowing the inclusion of children in society. It is verified the effectiveness of the method and techniques in their work with children Municipal School Professor. Antonio Severiano in Natal / RN, allowing these children develop body awareness, working senses, thought, memory, inhibition, teaching to expose your point of view, understand and deal with their emotions, respecting its limits and develop their motor and cognitive skills

Função motora fina, sensorial e perceptiva de escolares com transtorno do déficit de atenção com hiperatividade

OBJETIVO: Caracterizar e comparar as funções motoras fina, sensorial e perceptiva de escolares com Transtorno do Déficit de Atenção com Hiperatividade (TDAH) e escolares com bom desempenho escolar sem alterações de comportamento. MÉTODOS: Participaram 22 escolares do ensino fundamental, de gênero masculino, distribuídos em: GI - 11 escolares com Transtorno do Déficit de Atenção com Hiperatividade; e GII - 11 escolares com bom desempenho acadêmico e sem alterações de comportamento. Os escolares foram submetidos à aplicação do Protocolo de Avaliação da Função Motora Fina, Sensorial e Perceptiva e da Escala de Disgrafia. RESULTADOS: Houve diferença nas tarefas de função motora fina, função sensorial e função perceptiva entre o GI e o GII, com desempenho inferior do GI. Todos os escolares de GI apresentaram disgrafia. CONCLUSÃO: Escolares com Transtorno do Déficit de Atenção com Hiperatividade apresentam desempenho inferior aos escolares com bom desempenho acadêmico em relação às funções motoras fina, sensorial e perceptiva. Tais dificuldades podem causar impacto significativo sobre o desempenho acadêmico, uma vez que comprometem o desenvolvimento da linguagem escrita, ocasionando disgrafia nesses escolares.

Coordenação motora fina de escolares com dislexia e transtorno do déficit de atenção e hiperatividade

OBJETIVOS: descrever e comparar o desempenho da coordenação motora fina em escolares com dislexia e com transtorno do déficit de atenção e hiperatividade utilizando parâmetros de desempenho motor e idade cronológica da Escala de Desenvolvimento Motor. MÉTODO: participaram 22 escolaresdo ensino fundamental, de ambos os gêneros, na faixa etária de 6 a 11 anos de idade distribuídos em: GI: 11 escolares com transtorno do déficit de atenção e hiperatividade e GII: 11 com dislexia. Como procedimento, provas de motricidade fina da Escala de Desenvolvimento Motor foram aplicadas. RESULTADOS: os resultados revelaram diferença estatisticamente significante entre a idade motora fina e a idade cronológica de GI e GII. Conforme a classificação da Escala do Desenvolvimento Motor, 90% dos escolares de GI e GII apresentaram desenvolvimento motor fino muito inferior ao esperado para a idade e 10% dos escolares com dislexia apresentam desenvolvimento normal baixo ao esperado para a idade e 10% dos escolares com transtorno do déficit de atenção e hiperatividade apresentaram desenvolvimento inferior ao esperado para a idade. CONCLUSÃO: concluímos que tanto os escolares com dislexia como os com TDAH deste estudo apresentam atrasos na coordenação motora fina, demonstrando que os participantes desta pesquisa apresentam dificuldades em atividades que exijam destreza, quadro característico do transtorno do desenvolvimento da coordenação. Estudos complementares estão sendo conduzidos pelos autores deste estudo para poder verificar e comprovar se o perfil motor fino dos escolares encontrados neste estudo se assemelham ou se diferem de acordo com o quadro apresentado pelos mesmos.

Desempenho de escolares com transtorno de déficit de atenção e hiperatividade em tarefas metalinguisticas e de leitura

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Distúrbio de hiperatividade e déficit de atenção na síndrome de apnéia obstrutuiva do sono: Há melhora com tratamento cirúrgico?

Neuropsychological disorders are frequently associated with obstructive ventilatory disorders (OVD). Aim: To analyze the incidence of neuropsychological disorders in Brazilian children with OVD, using a screening questionnaire and to compare the answers given before and after surgery. Patients and Methods: We studied 30 children with clinical diagnosis of OVD. The children were divided into 3 groups: group I, children aged 4 to 7; group II, from 8 to 10; and group III, children over 11. The applied questionnaires were answered by the parents or tutors, and comprised 30 questions, 10 for each disorder: attention deficit, hyperactivity and impulsivity. The children were diagnosed with one of the disorders when presented 3 or more positive answers. The follow up interview occurred 6 months after adenotonsillectomy. Results: There was a predominance of male gender (60.6%) over female gender (39.4%). Group II presented the highest number of significant changes, with reductions raging from 87.5% to 33.3% of patients with attention deficit, 75% to 50% of the hyperactive patients, and 50% to 33% of the impulsive patients. Conclusion: There was neuropsychological improvement after the surgery, which occurred mainly in the children from group II. More interaction among health professionals is necessary when diagnosing and following up similar cases.

Percepção viso-motora de escolares com Transtorno do Déficit de Atenção com Hiperatividade

PURPOSE: The aim of this study was to characterize and to compare the visual-motor perception of students with Attention Deficit with Hyperactivity Disorder (ADHD) with students with good academic performance. METHODS: Forty students from 2nd to 5th grades of an elementary public school, male gender (100%), aged between 7 and 10 years and 8 months old participated, divided into: GI (20 students with ADHD) and GII (20 students with good academic performance), paired according to age, schooling and gender with GI. The students were submitted to Developmental Test of Visual Perception (DTVP-2). RESULTS: The students of GI presented low performance in spatial position and visual closure (reduced motor) and inferior age equivalent in reduced motor perception, when compared to GII. CONCLUSION: The difficulties in visual-motor perception presented by students of GI cannot be attributed to a primary deficit, but to a secondary phenomenon of inattention that interferes directly in their visual-motor performance.

Relação entre as habilidades metalinguísticas, leitura e compreensão leitora em escolares com Transtorno do Déficit de Atenção com Hiperatividade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

O teatro do oprimido e sua contribuição na formação da criança com transtorno do déficit de atenção com hiperatividade

This research investigates and reports the contributions of the Theatre of the Oppressed and its techniques as a therapeutic resource in the education of children with Attention Deficit Disorder with Hyperactivity. In the first chapter organize one studying theoretical seeking to conceptualize and understand the Learning, Attention Deficit Hyperactivity Disorder, seeking to better understand the behavior and the behavior of children with ADHD. Researching on the symptoms, causes and effects of this syndrome. Trace a relationship between familyschool- specialists in an attempt to prove the importance of family support in the teachinglearning process and treatment of these children. In the second chapter start conceptualizing theater, the relationship between work-Theatre-Education Therapy, explain the difference between the theatrical stage and the therapeutic stage. Account the importance of theater games in the classroom and its contribution to social and educational training of the child. Justify the choice of the Theatre of the Oppressed recognizing him as the primary method for this research, because it is a set of exercises, games and techniques that help the child regain equilibrium relations, developing autonomy, encourages creativity and spontaneity, freeing them from their oppression. Besides being an efficient transformation behavior, improving behavior, allowing the inclusion of children in society. It is verified the effectiveness of the method and techniques in their work with children Municipal School Professor. Antonio Severiano in Natal / RN, allowing these children develop body awareness, working senses, thought, memory, inhibition, teaching to expose your point of view, understand and deal with their emotions, respecting its limits and develop their motor and cognitive skills