Attention Deficit-Hyperactivity Disorder

2017 ◽  
Author(s):  
Mihee J. Bay ◽  
Bruce K. Shapiro
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Diagnostic Criteria ◽  
Attention Deficit ◽  
Treatment Approach ◽  
Neural Substrates ◽  
Activity Level ◽  
Hyperactivity Disorder ◽  
Dsm 5 ◽  
Catecholaminergic System

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in children and is characterized by developmentally inappropriate levels of attention and/or activity level. The current diagnostic criteria are summarized in the recently updated DSM-5. Although the neurobiology of ADHD is not completely understood, dysfunction in the fronto-striatal network and catecholaminergic system is likely implicated in pathophysiology of ADHD although recent studies suggest involvement of other neural substrates as well. Stimulants have been the mainstay of pharmacotherapy for ADHD due to its role in increasing available catecholamines in the synapse. However, treatment approach should be multimodal.

Oppositional Defiant Disorder and Its Clinical Management

2017 ◽  
Author(s):  
Paul Croarkin ◽  
Reem Shafi
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Conduct Disorder ◽  
Oppositional Defiant Disorder ◽  
Treatment Planning ◽  
Attention Deficit ◽  
Hyperactivity Disorder ◽  
Disruptive Mood Dysregulation Disorder ◽  
Dsm 5 ◽  
Oppositional Defiant ◽  
Mood Dysregulation

Oppositional defiant disorder (ODD) is a psychiatric disorder classified in the DSM-5 among disruptive, impulse control, and conduct disorder. The core features of ODD include a pervasive and impairing pattern of anger, irritability, inflexibility, defiance, malevolence, and aggression. Symptoms of ODD typically present during preschool. ODD can be a harbinger of conduct disorder. Isolated, transient symptoms of ODD are normal during development. Mood disorders, attention-deficit/hyperactivity disorder, and neurodevelopmental disorders are important considerations in differential diagnosis. However, ODD frequently co-occurs with other psychiatric diagnoses. Complex interactions with temperamental emotional dysregulation, family stress, early life stress, inconsistent parenting, and genetic and physiologic factors likely underlie the risk, pathophysiology, and prognosis of ODD. Unfortunately, these interactions and the neurobiological underpinnings of ODD are still poorly characterized. Although first-line treatments for ODD involve behavioral and psychosocial interventions, a thoughtful consideration of pharmacotherapy for co-occurring disorders and severe symptoms is an important component of treatment planning. Herein we review the epidemiology, etiology, pathophysiology, diagnostic evaluation, and treatment planning of ODD. Recent applicable controversies such as dimensional conceptualization of psychiatric disorders and the potential intersection of ODD and disruptive mood dysregulation disorder are also summarized.  This review contains 5 figures, 4 tables, and 44 references. Key words: aggression, attention-deficit/hyperactivity disorder, conduct disorder, defiance, disruptive behaviors, disruptive mood dysregulation disorder, DSM-5, irritability, oppositional defiant disorder, parent management training

625 The association between circadian rhythms and psychosocial functioning in children with attention deficit hyperactivity disorder

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A245-A245
Author(s):  
Xiao Li ◽  
Ka Sin Caroline Shea ◽  
Lok Fan Lau ◽  
Ching Kwong Dino Wong ◽  
Waiyan Vivian Chiu ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Circadian Rhythm ◽  
Attention Deficit ◽  
Psychosocial Functioning ◽  
Emotional Problems ◽  
Activity Level ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Rest Activity

Abstract Introduction Circadian rhythm disturbances, including delayed circadian rhythm and increased motor activity, are commonly seen in attention-deficit hyperactivity disorder (ADHD). Previous research suggested a link between circadian rhythm disturbances and poor psychosocial functioning in children, but such a relationship has not been examined in children with ADHD. This study aimed at examining the association between circadian-related parameters and psychosocial functioning in children with ADHD. Methods Seventy-nine children with ADHD were recruited into this study (age range: 6–12 years, 75.9% male). They were assessed by parent-report questionnaires on sleep problems (Children’s Sleep Habits Questionnaire, CSHQ), ADHD symptoms (Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Scale, SWAN), and psychosocial functioning (Strengths and Difficulties Questionnaire, SDQ). Actigraphic data collected for seven consecutive days were analyzed using parametric and nonparametric methods. The relationship between circadian parameters and psychosocial functioning was analyzed using multiple regression while controlling for age, sex, ADHD medication, total sleep time, and CSHQ total score. Results Later acrophase was significantly associated with higher scores on SDQ emotional problems (St. β = 0.30, p = 0.03) and SWAN inattention subscale (St. β = 0.27, p = 0.043). Lower relative amplitude was associated with higher scores on SDQ hyperactivity symptoms (St. β = -0.29, p = 0.045) and SDQ total difficulties (St. β = -0.31, p = 0.036). Higher levels of mean activity level during the least active 5-h period (L5) were related to higher scores on SDQ peer problems (St. β = 0.38, p = 0.021), SDQ internalizing problems (St. β = 0.38, p = 0.020) and SDQ total difficulties (St. β = 0.33, p = 0.036). Later onset of L5 was associated with increased SDQ emotional problems (St. β = 0.26, p = 0.046). Conclusion Circadian rest-activity rhythm disturbances (delayed phase, blunted rest-activity rhythms, higher level of nocturnal activity, and later onset of nocturnal rest) were associated with poor psychosocial functioning in children with ADHD. Further longitudinal studies are needed to examine the effects of circadian disruption on psychosocial functioning in children with ADHD. Support (if any) This work was supported by the Health and Medical Research Fund (Project No.: 30160604).

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