Background In this research the symptom improvement of attention-deficit hyperactivity disorder (ADHD) of children was assessed by oral vitamin D administration in Tabriz,Iran.Methods In this double-blind,randomized c...Background In this research the symptom improvement of attention-deficit hyperactivity disorder (ADHD) of children was assessed by oral vitamin D administration in Tabriz,Iran.Methods In this double-blind,randomized clinical trials,96 children (2-18 years) were enrolled to placebo and vitamin D groups.Children took vitamin D pearl (50,000 IU/week) or placebo for 6 weeks.Children,who had the change in methylphenidate dosage and received any anticonvulsants and corticosteroids were excluded from the research.ADHD symptoms were diagnosed by Conners parent rating scale (CPRS) test at baseline and after intervention.ADHD Conners divided into inattention (IA),hyperactivity/impulsivity (H/I) and combination type (C) subscales.Vitamin D serum level was assessed at baseline and after 8 weeks in both groups.Results The differences between CPRS and its subscales were not significant at baseline (P > 0.05).The Conners IA score was decreased in vitamin D group (P < 0.05;adjusted with age and baseline values).ADHD Conners and all subscale scores reduced remarkably after intervention in patients with insufficient level of vitamin D compared to placebo (P < 0.05).Conclusions Oral vitamin D improved ADHD symptoms with a particular effect on inattention symptoms.In addition,symptoms related to all subscales were improved remarkably in patients with insufficient level of vitamin D.Vitamin D treatment in children with ADHD could be considered due to the expand benefit of vitamin D in body.展开更多
BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medicati...BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.展开更多
目的探讨小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍的临床疗效。方法选择2012年1月—2014年12月重庆市开县人民医院儿科收治儿童注意缺陷多动障碍患者90例,随机分为对照组和治疗组,每组45例。对照组患者口服盐酸哌甲酯片,2...目的探讨小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍的临床疗效。方法选择2012年1月—2014年12月重庆市开县人民医院儿科收治儿童注意缺陷多动障碍患者90例,随机分为对照组和治疗组,每组45例。对照组患者口服盐酸哌甲酯片,2片/次,1次/d。治疗组患者在对照组的治疗基础上口服小儿智力糖浆,10 m L/次,2次/d。3周为1个疗程,全部患者均治疗3个疗程。观察两组的临床疗效,同时比较两组治疗前后Conner行为评定量表各因子评分及不良反应情况。结果治疗后,对照组和治疗组总有效率分别为77.78%、88.89%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者冲动多动、多动指数、学习问题、品行问题、焦虑、身心问题评分均较较治疗前显著降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组治疗后各评分均显著低于对照组,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍,能够显著提高临床疗效,且无严重不良反应,具有一定的临床推广价值。展开更多
目的分析学前儿童注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)的临床特征。方法以符合美国《精神障碍诊断与统计手册(第5版)》诊断标准并经诊断性婴幼儿及学前儿童评估(diagnostic infant and preschool assessme...目的分析学前儿童注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)的临床特征。方法以符合美国《精神障碍诊断与统计手册(第5版)》诊断标准并经诊断性婴幼儿及学前儿童评估(diagnostic infant and preschool assessment,DIPA)访谈的326例ADHD学前儿童(4岁0个月~5岁11个月)作为研究对象,分为注意缺陷为主型、多动冲动为主型和混合型。使用学前儿童中文版SNAP评定量表(Chinese version of the Swanson,Nolan,and Pelham rating scale)、长处和困难问卷(strengths and difficulties questionnaire,SDQ)及家长动机问卷(parent motivational questionnaire)进行评定。结果326例ADHD学前儿童中,男孩271例,女孩55例,男女性别比为5∶1;ADHD亚型构成,混合型216例,多动冲动为主型81例,注意缺陷为主型29例,3种亚型的构成比约为7∶3∶1;110例(33.7%)存在共病,其中93例共病对立违抗性障碍(oppositional defiant disorder,ODD)。SDQ结果显示,69.0%的ADHD学前儿童存在伙伴问题;家长动机问卷结果提示,79.9%的家长有(强烈)改变的意愿。结论学前儿童ADHD,男孩多见,混合型为主,共病中对立违抗性障碍的比例最高;患病儿童的伙伴问题突出,家长有着强烈的治疗动机。展开更多
AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS...AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.展开更多
Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the e...Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.展开更多
AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). M...AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). METHODS: This cross-sectional study investigated children with bilateral CC aged 3-8 y(CC group) using Conners’ Parent Rating Scale-48(CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision(NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS: A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children(46.22% vs 20.28%, Pearson’s χ2=20.062;P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5 y. Furthermore, male children aged between 6 and 8 y showed a higher impulsive/hyperactive score than females of the same age(t=6.083, P<0.001). CONCLUSION: Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.展开更多
文摘Background In this research the symptom improvement of attention-deficit hyperactivity disorder (ADHD) of children was assessed by oral vitamin D administration in Tabriz,Iran.Methods In this double-blind,randomized clinical trials,96 children (2-18 years) were enrolled to placebo and vitamin D groups.Children took vitamin D pearl (50,000 IU/week) or placebo for 6 weeks.Children,who had the change in methylphenidate dosage and received any anticonvulsants and corticosteroids were excluded from the research.ADHD symptoms were diagnosed by Conners parent rating scale (CPRS) test at baseline and after intervention.ADHD Conners divided into inattention (IA),hyperactivity/impulsivity (H/I) and combination type (C) subscales.Vitamin D serum level was assessed at baseline and after 8 weeks in both groups.Results The differences between CPRS and its subscales were not significant at baseline (P > 0.05).The Conners IA score was decreased in vitamin D group (P < 0.05;adjusted with age and baseline values).ADHD Conners and all subscale scores reduced remarkably after intervention in patients with insufficient level of vitamin D compared to placebo (P < 0.05).Conclusions Oral vitamin D improved ADHD symptoms with a particular effect on inattention symptoms.In addition,symptoms related to all subscales were improved remarkably in patients with insufficient level of vitamin D.Vitamin D treatment in children with ADHD could be considered due to the expand benefit of vitamin D in body.
基金Supported by Ningbo Science and Technology Plan Project Public Welfare Plan(Municipal Level),No:2019C50099Ningbo Medical Key Supporting Discipline Child Health Science,No:2022-F26。
文摘BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.
文摘目的探讨小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍的临床疗效。方法选择2012年1月—2014年12月重庆市开县人民医院儿科收治儿童注意缺陷多动障碍患者90例,随机分为对照组和治疗组,每组45例。对照组患者口服盐酸哌甲酯片,2片/次,1次/d。治疗组患者在对照组的治疗基础上口服小儿智力糖浆,10 m L/次,2次/d。3周为1个疗程,全部患者均治疗3个疗程。观察两组的临床疗效,同时比较两组治疗前后Conner行为评定量表各因子评分及不良反应情况。结果治疗后,对照组和治疗组总有效率分别为77.78%、88.89%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者冲动多动、多动指数、学习问题、品行问题、焦虑、身心问题评分均较较治疗前显著降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组治疗后各评分均显著低于对照组,两组比较差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论小儿智力糖浆联合盐酸哌甲酯片治疗儿童注意缺陷多动障碍,能够显著提高临床疗效,且无严重不良反应,具有一定的临床推广价值。
文摘目的分析学前儿童注意缺陷多动障碍(attention deficit/hyperactivity disorder,ADHD)的临床特征。方法以符合美国《精神障碍诊断与统计手册(第5版)》诊断标准并经诊断性婴幼儿及学前儿童评估(diagnostic infant and preschool assessment,DIPA)访谈的326例ADHD学前儿童(4岁0个月~5岁11个月)作为研究对象,分为注意缺陷为主型、多动冲动为主型和混合型。使用学前儿童中文版SNAP评定量表(Chinese version of the Swanson,Nolan,and Pelham rating scale)、长处和困难问卷(strengths and difficulties questionnaire,SDQ)及家长动机问卷(parent motivational questionnaire)进行评定。结果326例ADHD学前儿童中,男孩271例,女孩55例,男女性别比为5∶1;ADHD亚型构成,混合型216例,多动冲动为主型81例,注意缺陷为主型29例,3种亚型的构成比约为7∶3∶1;110例(33.7%)存在共病,其中93例共病对立违抗性障碍(oppositional defiant disorder,ODD)。SDQ结果显示,69.0%的ADHD学前儿童存在伙伴问题;家长动机问卷结果提示,79.9%的家长有(强烈)改变的意愿。结论学前儿童ADHD,男孩多见,混合型为主,共病中对立违抗性障碍的比例最高;患病儿童的伙伴问题突出,家长有着强烈的治疗动机。
基金funding from NIMH, AHRQ, Marriott Foundation, Mayo Foundation
文摘AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.
文摘Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.
基金Supported by the National Natural Science Foundation of China (No.81770967 No.91546101)+4 种基金National Key R&D Program (No.2018YFC0116500)the Fundamental Research Funds for the Central Universities (No.18ykpy33 No.16ykjc28)the Youth Pearl River Scholar Funded Scheme(2016-2018)the Fundamental Research Funds of the State Key Laboratory of Ophthalmology (2018-2019)
文摘AIM: To investigate the behavioral and psychological disorders and the prevalence of parent ratings of attention deficit hyperactivity disorder(ADHD) symptoms among children with bilateral congenital cataracts(CCs). METHODS: This cross-sectional study investigated children with bilateral CC aged 3-8 y(CC group) using Conners’ Parent Rating Scale-48(CPRS-48) from July to December 2016. The abnormal rates of psychological symptoms in CC children and normal vision(NV) children were compared using the Chi-square test. The scores of CC children were compared with those of NV children and the Chinese urban norm using the independent samples t-test and one-sample t-test, respectively. RESULTS: A total of 262 valid questionnaires were collected. The ratio of CC children to NV children was 119:143. The overall rate of psychological symptoms in CC children was 2.28 times higher than that in NV children(46.22% vs 20.28%, Pearson’s χ2=20.062;P<0.001). CC children showed higher scores for conduct problems, learning problems, impulsiveness/hyperactivity, anxiety, and hyperactivity index than NV children and the Chinese urban norm, particularly between the ages of 3 and 5 y. Furthermore, male children aged between 6 and 8 y showed a higher impulsive/hyperactive score than females of the same age(t=6.083, P<0.001). CONCLUSION: Children with bilateral CCs have a higher rate of ADHD symptoms than children with NV. This study provides clinical evidence that screening for psychological symptoms and particularly for ADHD symptoms in children with bilateral CC are recommended for an early diagnosis and timely treatment.
