Attention deficit/hyperactivity disorder (ADHD) may affect all aspects of a child’s life. Indeed, it impacts not only on the child, but also on parents and siblings, causing disturbances to family ...and marital functioning. The adverse effects of ADHD upon children and their families changes from the preschool years to primary school and adolescence, with varying aspects of the disorder being more prominent at different stages. ADHD may persist into adulthood causing disruptions to both professional and personal life. In addition, ADHD has been associated with increased healthcare costs for patients and their family members.
Long-Term Outcomes of ADHD Harpin, V.; Mazzone, L.; Raynaud, J. P. ...
Journal of attention disorders,
04/2016, Letnik:
20, Številka:
4
Journal Article
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Objective: To compare the long-term self-esteem and social function outcomes of individuals with untreated and treated ADHD across childhood, adolescence, and adulthood. Method: A systematic search ...of 12 databases was performed to identify peer-reviewed, primary research articles, published January 1980 to December 2011, reporting long-term self-esteem and/or social function outcomes (≥2 years; life consequences distinct from symptoms) of individuals with untreated or treated ADHD. Results: Overall, 127 studies reported 150 outcomes. Most outcomes were poorer in individuals with untreated ADHD versus non-ADHD controls (57% 13/23 for self-esteem; 73% 52/71 for social function). A beneficial response to treatment (pharmacological, nonpharmacological, and multimodal treatments) was reported for the majority of self-esteem (89% 8/9) and social function (77% 17/22) outcomes. Conclusion: Untreated ADHD was associated with poorer long-term self-esteem and social function outcomes compared with non-ADHD controls. Treatment for ADHD was associated with improvement in outcomes; however, further long-term outcome studies are needed.
To identify the ongoing service needs of young people with attention-deficit hyperactivity disorder (ADHD).
A case note review of all children aged 14 and over with a diagnosis of ADHD seen in a ...paediatric neurodisability clinic.
139 young people aged 14 years and over on 1 September 2007 with a diagnosis of ADHD were identified from ADHD service user databases at a centre in Sheffield, UK.
102 young people were on medication for ADHD and just over 50% had well controlled ADHD. 71% had at least one co-morbid condition. 46 patients had had intervention from child and adolescent mental health services and 17% had offended. 37% were likely to need transition to adult mental health services as soon as they left paediatric services and 36% would benefit from the expertise of a clinical nurse specialist, either to support a general practitioner (GP) or adult mental health professionals.
The recent National Institute for Health and Clinical Excellence guidelines highlight the need to provide transition services for young people with ADHD who have continuing impairment. The need for services for adults with ADHD is also recognised. The study confirms and refines the nature of this need in the local population. Young people with mental health problems in addition to their ADHD will need support from adult mental health services. However, a significant group of young adults are likely to be managed well by specialist nurses working with GPs in a primary care setting or adult mental health.
The Quality Assurance Agency for Higher Education (QAA) defines distance learning (DL) as “a way of providing higher education that involves the transfer to the student’s location of the materials ...that form the main basis of study, rather than the student moving to the location of the resource provider”.1
In recent years the medication options for the treatment of ADHD in children and young people have increased. The National Institute for Health and Clinical Excellence (NICE) produced updated ...guidelines in 2006. This paper aims to interpret these guidelines by reviewing the medication options in light of relevant research and clinical practice. The properties of methylphenidate, dexamfetamine and atomoxetine are discussed.
Introduction GXR, a selective α2A-adrenergic agonist, is a non-stimulant ADHD treatment approved in the USA for children and adolescents, and in Canada for children. Objectives To evaluate long-term ...maintenance of efficacy of GXR in children and adolescents with ADHD who respond to an initial open-label, short-term trial. Aims To determine if there is a higher rate of treatment failure for placebo vs GXR during the double-blind randomised-withdrawal phase (RWP) (NCT01081145). Methods Patients (6–17 years) meeting DSM-IV-TR criteria for ADHD, baseline ADHD Rating Scale-IV (ADHD-RS-IV) ≥32 and Clinical Global Impressions-Severity (CGI-S) ratings ≥4 were enrolled. Following 7-week dose optimization and 6-week maintenance periods on open-label GXR (1–7 mg/day), eligible patients entered a 26-week, double-blind, RWP with GXR or placebo. The primary endpoint was rate of treatment failure (≥50% increase in ADHD-RS-IV total score and ≥2-point increase in CGI-S at two consecutive visits, compared to the RWP baseline). The key secondary endpoint was time-to-treatment failure. Safety assessments included treatment-emergent adverse events (TEAEs), electrocardiograms and vital signs. Results Of 528 patients enrolled, 316 (60.0%) entered the RWP. At study end, 49.3% (GXR) and 64.9% (placebo) (95%CI; −26.6, −4.5, p<0.01) of patients had relapsed (Figure). Time-to-treatment failure was 56 days (placebo) versus 218 days (GXR), p=0.003. During the RWP, the most common GXR TEAEs (≥5% patients) were headache, somnolence and nasopharyngitis. Conclusions GXR demonstrated long-term maintenance of efficacy versus placebo in children and adolescents with ADHD.
Polymerase chain reaction/electrospray ionization-mass spectrometry (PCR/ESI-MS, previously known as “TIGER”) utilizes PCR with broad-range primers to amplify products from a wide array of organisms ...within a taxonomic group, followed by analysis of PCR amplicons using mass spectrometry. Computer analysis of precise masses allows for calculations of base compositions for the broad-range PCR products, which can then be compared to a database for identification. PCR/ESI-MS has the benefits of PCR in sensitivity and high-throughput capacity, but also has the distinct advantage of being able to detect and identify organisms with no prior characterization or sequence data. Existing broad range PCR primers, designed with an emphasis on human pathogens, were tested for their ability to amplify DNA of well characterized phytobacterial strains, as well as to populate the existing PCR/ESI-MS bacterial database with base counts. In a blinded panel study, PCR/ESI-MS successfully identified 93% of unknown bacterial DNAs to the genus level and 73% to the species/subspecies level. Additionally, PCR/ESI-MS was capable of detecting and identifying multiple bacteria within the same sample. The sensitivity of PCR/ESI-MS was consistent with other PCR based assays, and the specificity varied depending on the bacterial species. Preliminary tests with real life samples demonstrate a high potential for using PCR/ESI-MS systems for agricultural diagnostic applications.
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