Effects of Late-Afternoon Methylphenidate Administration on Behavior and Sleep in Attention-Deficit Hyperactivity Disorder

PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 320-325 ◽  
Author(s):  
Jeffrey D. Kent ◽  
Joseph C. Blader ◽  
Harold S. Koplewicz ◽  
Howard Abikoff ◽  
Carmel A. Foley
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Weight Loss ◽  
Attention Deficit ◽  
Sleep Latency ◽  
Inpatient Service ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Late Afternoon ◽  
Hyperactivity Disorder ◽  
Child Psychiatric

Objective. This study evaluated the effects on behavior and sleep of methylphenidate (MPH) administered at 4 PM to children with attention-deficit hyperactivity disorder (ADHD). Methodology. Twelve children admitted to a child psychiatric inpatient service with ADHD participated in a double-blind, crossover study in which they received a 4 PM dose of either 15 mg of MPH, 10 mg of MPH, or a placebo in random order for 12 consecutive days. Ratings of behavior, including ADHD symptoms, pertaining to the period from dose administration until sleep onset, were supplied nightly by hospital staff. Sleep latency and sleep adequacy were also assessed for each night. Results. MPH resulted in markedly improved behavioral control compared with placebo; there was no difference between 15-mg and 10-mg MPH doses. MPH did not alter sleep latencies observed with the placebo. Children were more often rated as less tired on awakening after nights that they received 10 mg of MPH compared with 15 mg of MPH and the placebo. Weight loss was apparent among 83% of the patients, but dinner intake did not vary with third-dose condition. Conclusions. Morning and noon administration of stimulants to children with ADHD is a near-universal practice, but many clinicians avoid a third, late-afternoon administration for fear of inducing insomnia. This study's findings show that children with ADHD derive substantial symptom reduction from MPH administered in late afternoon, with no untoward effects on sleep. Therefore, three-times-a-day dosing should be considered for those children exhibiting ADHD symptoms in the evening. Adverse effects on sleep latency were not apparent in the sample overall. Nonetheless, monitoring for possible aggravation of sleep problems and weight loss remains sound treatment practice.

The Impact of Copper in Children with Attention Deficit Hyperactivity Disorder

2017 ◽  
Vol 68 (2) ◽  
pp. 279-283
Author(s):  
Mihail Silviu Tudosie ◽  
Elena Truta ◽  
Ana Maria Davitoiu ◽  
Luminita Stanciulescu ◽  
George Jinescu ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Copper Concentration ◽  
Graphite Furnace ◽  
Urine Samples ◽  
Health State ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
The Impact

During one year (september 2013 � september 2014), 50 children from the residential institution for children SOS Satele Copiilor Bucharest, where included in our research. The children were distributed in two groups: Group A which consisted of 25 children (12 girls, 13 boys) who were not diagnosed with attention deficit hyperactivity disorder (ADHD) and Group B which consisted of 25 children (14 boys, 11 girls) who were diagnosed with ADHD. Initially, the two groups were subjected at a psycho-diagnostic battery of tests, one of them being the Evaluating the Health State of children with ADHD questionnaire elaborated by us, particularly for this research, with the purpose of highlighting the direct link between the children health state and their ADHD symptoms. This study sought to determine the concentration of copper in urine samples from a group of children with ADHD and a group of normal children, to highlight the role of copper in the development of ADHD symptoms. Levels of copper concentration in urine samples from the two groups were processed by Student�s t-Test. Statistical analysis showed that the arithmetic averages of copper concentration in urine samples, of the two groups do not differ significantly, so copper may be causing ADHD symptoms occur. The copper content in urine samples has been determined using atomic absorption spectrometry with graphite furnace.

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.

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).

scholarly journals Individualised stepwise adaptive treatment for 3–6-year-old preschool children impaired by attention-deficit/hyperactivity disorder (ESCApreschool): study protocol of an adaptive intervention study including two randomised controlled trials within the consortium ESCAlife

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Katja Becker ◽  
Tobias Banaschewski ◽  
Daniel Brandeis ◽  
Christina Dose ◽  
Christopher Hautmann ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Preschool Children ◽  
Attention Deficit ◽  
Treatment Strategies ◽  
Stepped Care ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Treatment Research ◽  
Individualised Treatment

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a psychosocially impairing and cost-intensive mental disorder, with first symptoms occurring in early childhood. It can usually be diagnosed reliably at preschool age. Early detection of children with ADHD symptoms and an early, age-appropriate treatment are needed in order to reduce symptoms, prevent secondary problems and enable a better school start. Despite existing ADHD treatment research and guideline recommendations for the treatment of ADHD in preschool children, there is still a need to optimise individualised treatment strategies in order to improve outcomes. Therefore, the ESCApreschool study (Evidence-Based, Stepped Care of ADHD in Preschool Children aged 3 years and 0 months to 6 years and 11 months of age (3;0 to 6;11 years) addresses the treatment of 3–6-year-old preschool children with elevated ADHD symptoms within a large multicentre trial. The study aims to investigate the efficacy of an individualised stepwise-intensifying treatment programme. Methods The target sample size of ESCApreschool is 200 children (boys and girls) aged 3;0 to 6;11 years with an ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or a diagnosis of oppositional defiant disorder (ODD) plus additional substantial ADHD symptoms. The first step of the adaptive, stepped care design used in ESCApreschool consists of a telephone-assisted self-help (TASH) intervention for parents. Participants are randomised to either the TASH group or a waiting control group. The treatment in step 2 depends on the outcome of step 1: TASH responders without significant residual ADHD/ODD symptoms receive booster sessions of TASH. Partial or non-responders of step 1 are randomised again to either parent management and preschool teacher training or treatment as usual. Discussion The ESCApreschool trial aims to improve knowledge about individualised treatment strategies for preschool children with ADHD following an adaptive stepped care approach, and to provide a scientific basis for individualised medicine for preschool children with ADHD in routine clinical care. Trial registration The trial was registered at the German Clinical Trials Register (DRKS) as a Current Controlled Trial under DRKS00008971 on 1 October 2015. This manuscript is based on protocol version 3 (14 October 2016).

scholarly journals Attention Deficit-Hyperactivity Disorder Symptoms and Daytime Voiding Symptoms in Children with Primary Enuresis: An Observational Study to Evaluate the Effectiveness of Desmopressin Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Teng-Kai Yang ◽  
Ya-Jun Guo ◽  
Hong-Chiang Chang ◽  
Hung-Ju Yang ◽  
Kuo-How Huang
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Sleep Quality ◽  
Attention Deficit ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Tertiary Referral Center ◽  
Hyperactivity Disorder ◽  
Voiding Symptoms ◽  
High Prevalence ◽  
Voided Volume

Purpose. To evaluate the effectiveness of presence of desmopressin in treating primary enuresis (PE) for children with attention deficit-hyperactivity disorder (ADHD) symptoms.Materials and Methods. Children aged from 5 to 12 years with the chief complaint of PE treated with desmopressin were enrolled in pediatric urology clinics. The parent-reported SNAP-IV questionnaire was used to evaluate ADHD symptoms (cut-off value: 90th percentile). Voiding symptoms were assessed by the Dysfunctional Voiding Scoring System (DVSS) questionnaire. The responses to desmopressin were analyzed in children with and without ADHD symptoms.Results. The study sample comprised 68 children; 27 (39.7%) presented with ADHD symptoms and 41 (60.3%) with non-ADHD symptoms. The children collected from a tertiary referral center may explain the high prevalence of ADHD symptoms in the present study. The total DVSS score in the ADHD symptoms group was significantly higher than in the non-ADHD symptoms group (7.72 versus 5.65,P=0.05). In the ADHD symptoms group, there were significantly higher score in the “pee 1-2 times/day” and “can’t wait” subscales of DVSS and lower sleep quality based on the Pediatric Sleep Quality questionnaire, as well as significantly lower peak flow rate and voided volume. The responses to desmopressin for enuresis were comparable between children with ADHD and non-ADHD symptoms.Conclusions. Approximately 39.7% of PE children presented with ADHD symptoms at urologic clinics. PE children with ADHD symptoms had higher risk of daytime LUTS and comparable response to desmopressin treatment for PE. To evaluate ADHD symptoms and daytime voiding symptoms is important in children with PE.

scholarly journals Alpha power, working memory (WM) and Attention Deficit Hyperactivity Disorder (ADHD) symptoms among children with ADHD

2018 ◽  
Vol 18 (10) ◽  
pp. 978
Author(s):  
shira frances-israeli ◽  
inbar trinczer ◽  
shlomit greenberg-yuval ◽  
roy amit ◽  
noa rotman ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Working Memory ◽  
Attention Deficit ◽  
Alpha Power ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder

scholarly journals Predictors of Depressive Symptoms in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: A One-Year Follow-Up Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8835
Author(s):  
Wen-Jiun Chou ◽  
Ray C. Hsiao ◽  
Chih-Cheng Chang ◽  
Cheng-Fang Yen
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Depressive Symptoms ◽  
Family Support ◽  
Attention Deficit ◽  
Stress Coping ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Follow Up Study

This 1-year follow-up study examined the predictive values of the demographics, depressive symptoms, stress-coping orientations, and perceived family support of caregivers as well as the internalizing, externalizing and ADHD symptoms of children with attention-deficit/hyperactivity disorder (ADHD) at baseline on the depressive symptoms of the caregivers after 1 year. A total of four hundred caregivers of children with ADHD were recruited. The baseline levels of the caregivers’ depressive symptoms, stress-coping orientations, and perceived family support and the internalizing and externalizing problems of the children were assessed using the Center for Epidemiological Studies Depression Scale, the Coping Orientation to Problems Experienced, Family Adaptation, Partnership, Growth, Affection, Resolve Index, and the Child Behavior Checklist For Ages 6–18, respectively. Their predictions for the caregiver’s depressive symptoms 1 year after the baseline were examined using linear regression analysis. In total, 382 caregivers of children with ADHD underwent the follow-up assessment 1 year from the baseline. A marital status of being separated or divorced, less effective coping and depressive symptoms orientation, and children with internalizing problems and ADHD symptoms at baseline were positively associated with the caregivers’ depressive symptoms at follow-up, whereas the caregivers’ perceived family support and an emotion-focused coping orientation at baseline were negatively associated with depressive symptoms at follow-up. Multiple characteristics of the caregivers and children with ADHD at baseline predicted the caregivers’ depressive symptoms 1 year later.

scholarly journals Mothers’ Perspectives on the Play of Their Children with Attention Deficit Hyperactivity Disorder

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Zainab A. Jasem ◽  
Susan M. Delport
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Video Games ◽  
Attention Deficit ◽  
Positive Influence ◽  
Adhd Symptoms ◽  
Daily Experience ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Semistructured Interviews ◽  
The Impact

Background. Play, which is fundamental to children’s lives, can be utilised to enrich their daily experience. However, the available knowledge regarding the impact of play on children with attention deficit hyperactivity disorder (ADHD) is limited. Therefore, this study is aimed at investigating mothers’ perspectives on their children with ADHD in Kuwait regarding their play preferences, the impact of play on ADHD behaviours, and the strategies used to regulate their children’s ADHD symptoms. Methods. Eight mothers of children aged five to ten years old with ADHD were recruited via purposive sampling. Their perspectives were qualitatively explored through one-week diaries of their children’s routines followed by semistructured interviews. The data were analysed using thematic analysis. Results. Four themes emerged: (1) play characteristics for children with ADHD, (2) play preferences, (3) play settings and their impact on ADHD symptoms, and (4) mothers’ values, understanding, and influence on play. Children were found to spend most of their playtime in indoor settings, largely playing video games. The mothers acknowledged the positive influence on their children of outdoor play and the deleterious effect of video games. However, they undervalued the contribution of play to their children’s development. Their strategies for regulating the types of play that diminish their children’s ADHD behaviours were less well understood. The weather and mothers’ other responsibilities were the main barriers. Conclusions. Understanding the play of children with ADHD revealed the requirement for more opportunities for different types of play, with more consideration of those that positively manage ADHD behaviours.

scholarly journals Attention-deficit hyperactivity disorder in adults

1999 ◽  
Vol 5 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Brian Toone ◽  
Maria Clarke ◽  
Susan Young
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Support Group ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Psychiatric Comorbidity ◽  
Hyperkinetic Disorder ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder are well-established diagnoses in children, with estimates of prevalence in pre-adolescent children from 3 to 5%. Until recently ADHD was not thought to persist beyond adolescence, but results from long-term prospective outcome studies indicate that 30–70% of children with ADHD exhibit some symptoms as adults. Recognition of this disorder is important as the persistence of ADHD symptoms has been shown to be associated with academic and occupational failure and high rates of psychiatric comorbidity. With the establishment of a UK support group (LADDER) and increasing media attention highlighting this problem it is likely that there will be an increased demand for psychiatric assessment of adult ADHD in the next few years.

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