Aims and Methodological Problems in Multimodal Treatment Studies

1993 ◽  
Vol 38 (6) ◽  
pp. 458-464 ◽  
Author(s):  
Lily Hechtman
Keyword(s):  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Multimodal Treatment ◽  
Childhood And Adolescence ◽  
Treatment Approaches ◽  
Attention Deficit Hyperactive Disorder ◽  
Comparison Groups ◽  
Methodological Problems

The paper outlines the growing acceptance and use of multimodal treatment approaches to treat a variety of psychiatric disorders in childhood and adolescence. It then explores some of the problems of multimodal treatment studies. Problems in assessing outcome of efficacy of the interventions, particularly as they pertain to specific interventions and particular areas of functioning are discussed as well as the issues of appropriate control and comparison groups. The problems with regard to appropriate control and comparison groups are explored with respect to diagnosis and interventions. Finally, an ongoing multimodal treatment study of children with attention deficit hyperactive disorder is used to illustrate how some of the problems described can be solved.

Psychiatric Disorders Associated With Infancy, Childhood, and Adolescence

2021 ◽  
pp. 348-352
Author(s):  
Jyoti Bhagia
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Nervous System ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Age At Diagnosis ◽  
Childhood And Adolescence ◽  
Hyperactivity Disorder ◽  
Toxin Exposure ◽  
Us Children

This chapter covers key psychiatric disorders of infancy, childhood, and adolescence. In some instances, the disorders are mentioned briefly herein and covered in more detail in other chapters, as indicated. Attention-deficit/hyperactivity disorder (ADHD) is a neurobiologic disorder present in 11% of US children between the ages of 4 and 17 years and is 3 times more common in boys than in girls. Some symptoms must be present before age 12 years, although the average age at diagnosis is 7 years. The causes of ADHD are unknown. However, several factors have been suggested that likely mediate expression of ADHD, including prematurity, prenatal toxin exposure, mechanical insults to the nervous system, and natal stress.

Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA)

2008 ◽  
Author(s):  
Howard B. Abikoff ◽  
C. Keith Conners ◽  
Laurence L. Greenhill ◽  
Stephen P. Hinshaw ◽  
William E. Pelham ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Multimodal Treatment ◽  
Hyperactivity Disorder

Risk of attention deficit/hyperactivity disorder (ADHD) and other psychiatric disorders in siblings of ADHD probands

2019 ◽  
Vol 48 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Catalina Hidalgo-López ◽  
Alejandra María Gómez-Álzate ◽  
Jenny García-Valencia ◽  
Juan David Palacio-Ortiz
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Hyperactivity Disorder

Patients Who Attend Alone at a First Memory Consultation: Are They a Specific Population,or Is It an Instance of Confounding Bias?

2019 ◽  
Vol 81 (1-2) ◽  
pp. 81-86
Author(s):  
Pierre Koskas ◽  
Mouna Romdhani ◽  
Olivier Drunat
Keyword(s):  
Selection Bias ◽  
Confounding Bias ◽  
Significant Difference ◽  
Comparison Groups ◽  
Methodological Problems ◽  
Group 2 ◽  
The Impact ◽  
First Time ◽  
State Examination ◽  
Group 1

As commonly happens in epidemiological research, none of the reported studies were totally free of methodological problems. Studies have considered the influence of social relationships on dementia, but the mechanisms underlying these associations are not perfectly understood. We look at the possible impact of selection bias. For their first memory consultation, patients may come alone or accompanied by a relative. Our objective is to better understand the impact of this factor by retrospective follow-up of geriatric memory outpatients over several years. All patients over 70 who were referred to Bretonneau Memory Clinic for the first time, between January 2006 and 2018, were included in the study. The patients who came alone formed group 1, the others, whatever type of relative accompanied them, formed group 2. We compared the Mini-Mental State Examination (MMSE) scores of patients; and for all patients who came twice for consultation with at least a 60-day interval, we compared their first MMSE with the MMSE performed at the second consultation. In total, 2,935 patients were included, aged 79.7 ± 8.4 years. Six hundred and twenty-five formed group 1 and 2,310 group 2. We found a significant difference in MMSE scores between the 2 groups of patients; and upon second consultation in group 2, but that difference was minor in group 1. Our finding of a possible confounding factor underlines the complexity of choosing comparison groups in order to minimize selection bias while maintaining clinical relevance.

The role of brain-derived neurotrophic factor in the pathophysiology of adolescent suicidal behavior

2011 ◽  
Vol 23 (3) ◽  
Author(s):  
Leo Sher
Keyword(s):  
At Risk ◽  
Psychiatric Disorders ◽  
Suicidal Behavior ◽  
Neurotrophic Factor ◽  
Adolescent Suicide ◽  
Developmental Change ◽  
Brain Derived Neurotrophic Factor ◽  
Childhood And Adolescence ◽  
Compulsive Disorder

Abstract Adolescent suicide research has mostly focused on demographic risk factors. Such studies focus on who is at risk, but do not explain why certain adolescents are at risk for suicide. Studies of the neurobiology of adolescent suicide could clarify why some youths are more suicidal than others and help to find biological markers of suicidal behavior in teenagers. Over the past decade the role of brain-derived neurotrophic factor (BDNF) in the pathophysiology of suicidal behavior has attracted significant attention of scientists. BDNF is involved in the pathophysiology of many psychiatric disorders associated with suicidal behavior including depression, post-traumatic stress disorder, schizophrenia, and obsessive-compulsive disorder. BDNF dysregulation could be associated with increased suicidality independently of psychiatric diagnoses. BDNF plays an important role in the regulation and growth of neurons during childhood and adolescence. Prominent among the brain regions undergoing developmental change during adolescence are stressor-sensitive areas. The serotonin dysfunction found in adolescent and adult suicidal behavior could be related to the low level of BDNF, which impedes the normal development of serotonin neurons during brain development. BDNF dysfunction could play a more significant role in the pathophysiology of psychiatric disorders and suicidal behavior in adolescents than in adults. Treatment-induced enhancement in the BDNF function could reduce suicidal behavior secondary to the improvement in psychiatric pathology or independently of improvement in psychiatric disorders. It is interesting to hypothesize that BDNF could be a biological marker of suicidal behavior in adolescents or in certain adolescent populations.

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