To review literature regarding existing and recommended roles for nurses in the management of children with ADHD.
MEDLINE and CINAHL were searched from 2010 to the end of 2019 with the following ...keywords: ADHD, nurse, child, and inclusion criteria published in an English journal.
Forty-three records were found. However, only five articles scientifically evaluated the nurse role. The nurse role in ADHD management seemed to vary across countries with nurses working independently or as part of a team with delegated responsibility.
The literature review gave information to suggest that nurses can have a significant role in providing a range of medical and non-medical management.
Impulsivity has a strong genetic component and is considered an endophenotype in many psychiatric disorders. Impulsivity in adult ADHD has become a focus of interest more recently because of its ...suggested prominence in this age. Objective: This study aimed to access self-reported impulsivity levels in biological parents of ADHD offspring, according to their status: non-ADHD (controls), remitted, nonremitted. Method: Impulsivity levels of 155 parents of ADHD children were compared according to their status using the Barratt Impulsiveness Scale (BIS-11). Results: The ADHD group presented the highest levels of impulsivity compared with all other groups. The remitted ADHD and control groups showed no significant differences in impulsivity levels. Conclusion: Impulsivity tended to remit alongside ADHD symptoms in remitters and to persist in those presenting with the residual form of adult ADHD suggesting it should not be considered as an endophenotype. Only the attentional dimension was impaired, cautioning against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) impulsivity proposed criteria.
In the last two decades, there has been a growing body of research that identified sex-related differences in attention-deficit hyperactivity disorder (ADHD). Our objective was to quantify whether ...these sex differences are based on altered functional brain connectivity profiles. In addition, we investigated whether the presence of comorbid disorders, including depression, substance use disorder (SUD) and overweight, influenced these sex differences. A seed-based connectivity analysis of the external globus pallidus (GPe), an important inhibitory relay hub of the fronto-thalamo-striatal-loop, was performed. In a first step, we searched for sex-related differences in ADHD patients (
N
= 137) and separately in healthy controls (HC) (
N
= 45), after that, we compared an equal group of HC and ADHD patients to compare sex-related differences in ADHD patients and HC. In a second step, we studied whether the neural basis of comorbidity patterns is different between male and female patients. We observed that male ADHD patients demonstrated a decrease in functional connectivity (FC) from the GPe to the left middle temporal gyrus compared to female ADHD patients. Moreover, within the full ADHD group (
N
= 137), there was a lower FC in male patients from GPe to the right frontal pole/middle frontal gyrus compared to female patients. Male ADHD patients with depression demonstrated decreased FC from the GPe to parts of the occipital cortex compared to female ADHD patients with depression. No such effect was demonstrated for overweight or SUD. The current study reveals different FC profiles in males and females with ADHD, which are centered around altered connectivity with the GPe. An improved understanding of sex-differences in ADHD, and the role of comorbid disorders, therein can result in improved diagnostic and therapeutic opportunities for ADHD patients.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common comorbidity in Autism Spectrum Disorder (ASD). ADHD is a risk factor for alcohol misuse whereas ASD is often regarded as protective; ...however, research on ASD and alcohol use has yielded conflicting findings, sometimes implicating the role of comorbid ADHD. The possibility that certain transdiagnostic features (i.e., characteristics associated with multiple disorders) may underlie relationships of both disorders to alcohol use in adults was examined in the present study. A nonclinical young adult sample of 248 alcohol users (117 men, 131 women) completed validated self-report measures of ASD and ADHD symptoms as well as the transdiagnostic features alexithymia, impulsivity, and negative moods. ASD and ADHD symptoms were normally distributed, suggesting that the respective disorders represent extreme, dysfunctional ends of population distributions of symptoms. Path analysis indicated that the significant positive association between ASD and ADHD symptom measures was fully mediated by alexithymia, impulsivity, and negative moods. Hierarchical regression and path analysis indicated that the positive relationship between ADHD symptoms and alcohol use severity was fully mediated by transdiagnostic features, particularly alexithymia and impulsivity, whereas the relationship between ASD and alcohol use severity was positively mediated by these features (especially alexithymia), with a highly significant and negative direct effect. Present findings may help reconcile previous conflicting evidence on the relationship of ASD to alcohol use, and the role of comorbid ADHD, by emphasizing the roles of alexithymia and impulsivity in both ASD and ADHD as transdiagnostic traits promoting excessive drinking.
•Research has yielded mixed results on the relationship of ASD symptoms to alcohol use.•ADHD is the most common comorbidity in ASD and is a risk factor for alcohol misuse.•Transdiagnostic features alexithymia, impulsivity and negative mood mediated the positive association of ADHD symptoms with alcohol use severity in a community sample.•Transdiagnostic features alexithymia, impulsivity and negative mood also mediated a positive indirect association of ASD symptoms with alcohol use severity.•The direct effect of ASD symptoms indicated a negative relationship to alcohol use severity.•Findings for ASD symptoms suggest that alexithymia in particular should be taken into account when investigating the relationship of ASD to alcohol use.
Attention deficit/hyperactivity disorder (ADHD) is characterized as a neurodevelopmental disorder. However, data from several recent studies suggest that there may be adults who meet current criteria ...for ADHD, yet did not experience symptoms until adulthood (i.e., “adult-onset ADHD”). This systematic review evaluated and synthesized the empirical evidence on adult-onset ADHD to answer the question:
Is the extant literature strong enough to evaluate adult-onset ADHD?
Nine studies met strict inclusion/exclusion criteria. Results suggest that the methodologies of the extant studies were not strong enough to evaluate adult-onset ADHD. Insufficient methodologies provide presently unclear information about the nature of late-onset symptoms. These symptoms seem to exist but their source could be (1) adult-emergent symptoms that were previously surpassed due to lower environmental demands/supportive facilitators, (2) mimics that were not properly assessed, or (3) childhood-onset symptoms that were not detected earlier due to failure to come to clinical attention. Future directions, clinical recommendations, and limitations of the literature and the current review are discussed.
Latent class analysis (LCA) is a statistical procedure used to identify qualitatively different subgroups within populations who often share certain outward characteristics. The assumption underlying ...LCA is that membership in unobserved groups (or classes) can be explained by patterns of scores across survey questions, assessment indicators, or scales. The application of LCA is an active area of research and continues to evolve. As more researchers begin to apply the approach, detailed information on key considerations in conducting LCA is needed. In the present article, we describe LCA, review key elements to consider when conducting LCA, and provide an example of its application.
Executive dysfunction has been shown to be a promising endophenotype in neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This ...article reviewed 26 studies that examined executive function comparing ASD and/or ADHD children. In light of findings from this review, the ASD + ADHD group appears to share impairment in both flexibility and planning with the ASD group, while it shares the response inhibition deficit with the ADHD group. Conversely, deficit in attention, working memory, preparatory processes, fluency, and concept formation does not appear to be distinctive in discriminating from ASD, ADHD, or ASD + ADHD group. On the basis of neurocognitive endophenotype, the common co-occurrence of executive function deficits seems to reflect an additive comorbidity, rather than a separate condition with distinct impairments.
Attention deficit hyperactivity disorder (ADHD) is a common pediatric neurodevelopmental disorder. The core symptoms include a functionally significant level of inattentiveness and distractibility. ...The aim of the present study is to detect the abnormalities in clinical andpolysomnography (PSG) studies in children with ADHD. It aims at finding the relation between ADHD symptoms severity and results of sleep studies, and exploring the correlations between them.
The study included 40 ADHD patients and 40 healthy control children. All patients and controls were subjected to history taking, clinical examination, psychaitric assessment, and then to electrophysiological studies including overnight long-term electroencephalography (EEG) and PSG. Results: EEG results showed increased theta activity, central sharp waves and generalized spikes, sharp and slow waves. PSG studies revealed statistically significant increased nocturnal movements and greater night-to-night variability in sleep patterns among children with ADHD, with otherwise inconsistent differences in sleep architecture between children with and without ADHD. Discussion: Some of our results came in agreement with other simulating researches, however, video monitoring may be used in future studies to detect any subtle events.
ADHD is frequently associated with sleep-disordered breathing and limb movement disorder.
EEG abnormalities and sleep abnormalities can play a role in the etiology or even accentuation of ADHD. Aiming at their treatment can ameliorate the symptoms of the disease.
The histamine H3 receptor is a favourable target for the treatment of cognitive deficits. Here we report the in vitro and in vivo profile of RGH-235, a new potent, selective, and orally active H3 ...receptor antagonist/inverse agonist developed by Gedeon Richter Plc. Radioligand binding and functional assays were used for in vitro profiling. Procognitive efficacy was investigated in rodent cognitive tests, in models of attention deficit hyperactive disorder (ADHD) and in cognitive tests of high translational value (rat touch screen visual discrimination test, primate fixed-foreperiod visual reaction time task). Results were supported by pharmacokinetic studies, neurotransmitter release, sleep EEG and dipsogenia. RGH-235 displayed high affinity to H3 receptors (Ki = 3.0–9.2 nM, depending on species), without affinity to H1, H2 or H4 receptors and >100 other targets. RGH-235 was an inverse agonist (35S GTPγS binding) and antagonist (pERK1/2 ELISA), showing favourable kinetics, inhibition of the imetit-induced dipsogenia and moderate effects on sleep-wake EEG. RGH-235 stimulated neurotransmitter release both in vitro and in vivo. RGH-235 was active in spontaneously hypertensive rats (SHR), generally considered as a model of ADHD, and revealed a robust pro-cognitive profile both in rodent and primate tests (in 0.3–1 mg/kg) and in models of high translational value (e.g. in a rodent touch screen test and in non-human primates). The multiple and convergent procognitive effects of RGH-235 support the view that beneficial cognitive effects can be linked to antagonism/inverse agonism of H3 receptors.
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