Management and treatment of attention-deficit/hyperactivity disorder

2020 ◽  
pp. 344-354
Author(s):  
Alessandro Zuddas ◽  
Sara Carucci
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Social Context ◽  
Protective Factors ◽  
Attention Deficit ◽  
Symptom Severity ◽  
Treatment Plan ◽  
Hyperactivity Disorder ◽  
Psychiatric Conditions ◽  
Adhd Medications ◽  
Practical Implications

Any treatment plan for attention-deficit/hyperactivity disorder (ADHD) must be based on a comprehensive diagnostic evaluation, being aware of possible concomitant medical or psychiatric conditions. Rather than focusing just on the disorder, subjects should be treated as individuals in their social context; baseline symptom severity, impairments, and strengths should be recorded, as well as any environmental risks and/or protective factors. This chapter presents how to develop a treatment plan and offers an extensive update on current available treatments and the safety of ADHD medications, with practical implications for clinicians.

Association between phthalates and externalizing behaviors and cortical thickness in children with attention deficit hyperactivity disorder

2014 ◽  
Vol 45 (8) ◽  
pp. 1601-1612 ◽  
Author(s):  
S. Park ◽  
J.-M. Lee ◽  
J.-W. Kim ◽  
J. H. Cheong ◽  
H. J. Yun ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cortical Thickness ◽  
Attention Deficit ◽  
Symptom Severity ◽  
Adhd Symptoms ◽  
Phthalate Metabolites ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Metabolite Concentrations ◽  
Phthalate Metabolite

Background.Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children.Method.A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated.Results.Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri.Conclusions.The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD.

scholarly journals Effectiveness and Tolerability of Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder

2011 ◽  
Vol 3 ◽  
pp. CMT.S6615
Author(s):  
Caroline Bodey
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Side Effects ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Treatment Plan ◽  
Immediate Release ◽  
Height Velocity ◽  
Comprehensive Treatment ◽  
Hyperactivity Disorder ◽  
Cardiovascular Side Effects

Attention deficit hyperactivity disorder (ADHD) is a common condition and important for the affected individual, their family and society. It manifests with pervasive symptoms of hyperactivity, impulsivity and inattention. In many children with ADHD these symptoms persist into adolescence and adulthood. Drug treatment with psychostimulants, including methylphenidate, is an important part of a comprehensive treatment plan for children with severe ADHD that includes psychosocial, behavioural and educational advice and interventions. Methylphenidate is a central nervous system stimulant, whose mechanism of action is thought to be due to an increase in catecholamines in areas of the brain concerned with motivation and reward. Methylphendiate is available in short acting (immediate release) and longer acting (modified release) forms. Pharmacotherapy for ADHD is in three stages: initiation, maintenance and termination. The efficacy of methylphenidate in terms of reducing core symptoms is 70% as compared to placebo. This efficacy is maintained for at least 24 months. Methylphenidate generally has a favourable side effect profile. The most significant side effects include appetite suppression with an initial deceleration in height velocity, cardiovascular side effects that are not clinically significant in children with no adverse cardiac history, and tics. Methylphenidate is generally well tolerated and liked by children and adolescents with ADHD, who appreciate the benefits that medication has on their behaviour.

Examining the Interplay Among Negative Emotionality, Cognitive Functioning, and Attention Deficit/Hyperactivity Disorder Symptom Severity

2011 ◽  
Vol 17 (3) ◽  
pp. 502-510 ◽  
Author(s):  
Dione M. Healey ◽  
David J. Marks ◽  
Jeffrey M. Halperin
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cognitive Functioning ◽  
Attention Deficit ◽  
Adhd Symptom ◽  
Symptom Severity ◽  
Rating Scale ◽  
Neuropsychological Functioning ◽  
Neuropsychological Test ◽  
Negative Emotionality ◽  
Hyperactivity Disorder

AbstractCognition and emotion, traditionally thought of as largely distinct, have recently begun to be conceptualized as dynamically linked processes that interact to influence functioning. This study investigated the moderating effects of cognitive functioning on the relationship between negative emotionality and attention deficit/hyperactivity disorder (ADHD) symptom severity. A total of 216 (140 hyperactive/inattentive; 76 typically developing) preschoolers aged 3–4 years were administered a neuropsychological test battery (i.e., NEPSY). To avoid method bias, child negative emotionality was rated by teachers (Temperament Assessment Battery for Children-Revised), and parents rated symptom severity on the ADHD Rating Scale (ADHD-RS-IV). Hierarchical Linear Regression analyses revealed that both negative emotionality and Perceptual-Motor & Executive Functions accounted for significant unique variance in ADHD symptom severity. Significant interactions indicated that when negative emotionality is low, but not high, neuropsychological functioning accounts for significant variability in ADHD symptoms, with lower functioning predicting more symptoms. Emotional and neuropsychological functioning, both individually and in combination, play a significant role in the expression of ADHD symptom severity. (JINS, 2011, 17, 502–510)

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