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OBJECTIVE: To investigate meta-analytically if the association between ADHD and illicit substance use (ISU) is maintained when controlling for conduct disorder/oppositional-defiant disorder (CD/ODD). METHOD: A systematic literature review was conducted through Medline from 1980 to 2008. Data extracted and selections made by one author were reviewed by another. RESULTS: Fifteen articles presented odds ratios (ORs) for the development of ISU in individuals with ADHD controlling for CD/ODD. In total, the study covered results for more than 1,000 individuals. The combined OR for studies that included in their analysis exclusively ISU was 1.35 (0.90-2.03), p = .15, heterogeneity = 55%. Lack of control for socioeconomic status was related with a weaker association between ADHD and ISU. CONCLUSION: The existing data do not indicate that ADHD increases the risk of ISU beyond the effects of CD/ODD. However, the combination of all existing data is limited in power to detect a small increase in chance.

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Despite the importance of objective measures of attention to clinical practice, there is a paucity of Brazilian standardized tests. OBJECTIVE: The aim of the present study was the standardization of a normative group for the third version of a computerized test of visual attention (TAVIS-3), developed to evaluate children and adolescents in the 6 to 17 years age range. METHODS: 631 students from 3 schools in Rio de Janeiro city were assessed with TAVIS-3, administered by experienced psychologists, following parents' authorization. RESULTS: The normative groups were determined considering performance of different age groups: from 6 to 10 years (with scores for 5 different ages); from 11 to 12 and from 13 to 17 years. Three tasks (focused, shifted and sustained attention) were standardized for each age group. CONCLUSION: The standardization of a normative group for TAVIS-3 discriminated performance ranges for distinct age groups, allowing its use as a neuropsychological assessment of attention.

Embora a avaliação objetiva da atenção seja de extrema importância para a prática clínica, observa-se escassez de testes neuropsicológicos com padronização brasileira para esta função. OBJETIVO: O objetivo do presente estudo foi desenvolver um grupo normativo de referência para a terceira versão de teste computadorizado de atenção visual (TAVIS-3), destinado à avaliação de crianças e adolescentes com idades entre 6 e 17 anos. MÉTODOS: 631 alunos de 3 instituições de ensino da cidade do Rio de Janeiro foram submetidos ao TAVIS-3, administrado por aplicadores treinados, mediante autorização dos pais. RESULTADOS: A divisão dos grupos etários levando-se em consideração as diferenças de desempenho permitiu identificar faixas etárias de 6 aos 10 anos (com escores para cada uma das 5 idades compreendidas); de 11 a 12 anos e de 13 a 17 anos. Três tarefas distintas de atenção (seletiva, alternada e sustentada) foram padronizadas para cada faixa etária avaliada. CONCLUSÕES: A padronização de grupo normativo para o TAVIS-3 permitiu individualizar o desempenho de acordo com a idade, para uso como instrumento de avaliação neuropsicológica de atenção.

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OBJETIVO: Identificar se o desempenho num teste de atenção visual permite diferenciar crianças e adolescentes portadoras de TDAH de indivíduos normais. MÉTODOS: 102 crianças e adolescentes com diagnóstico de TDAH, segundo os critérios do DSM-IV, submeteram-se ao Teste de Atenção Visual (TAVIS-III) e tiveram seus desempenhos comparados a 678 controles pareados de um grupo controle. Os indivíduos foram selecionados de duas escolas particulares e uma escola pública, de modo seqüencial com autorização dos pais. RESULTADOS: Uma análise com curvas ROC revelou que os índices tempo médio de reação na tarefa de atenção seletiva, número de erros por omissão na tarefa de atenção alternada e número de erros por ação na tarefa de atenção sustentada, quando comprometidos simultaneamente, revelaram sensibilidade e especificidade elevadas, com um valor preditivo positivo de 87,5 por cento. O valor preditivo negativo da associação de escores normais naqueles três índices foi de 99 por cento. CONCLUSÃO: TAVIS-III revelou-se eficiente para discriminar indivíduos normais de portadores de TDAH nesta amostra.

OBJECTIVE: To investigate if performances in a visual attention test could discriminate between children and adolescents with ADHD and normal subjects. METHODS: 102 children and adolescents diagnosed with ADHD according to DSM-IV were submitted to the Test of Visual Attention (TAVIS-III) and had their performance compared to 678 normal paired subjects who comprised a control comparison group. All of the subjects were sequentially recruited from one public and two private schools, following parents’ authorization. RESULTS: ROC curves analysis have shown that simultaneous impairment in hit reaction time of focused attention, omission errors in shifted attention and commission errors in sustained attention revealed high sensibility and specificity, with positive predictive value of 87.5 percent. The negative predictive value was of 99 percent when the aforementioned indexes occurred simultaneously within normal range. CONCLUSION: The Test of Visual Attention (TAVIS-III) was efficient to discriminate persons with ADHD and normal persons in this non clinical sample.

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OBJETIVO: Comparar o desempenho dos tipos de TDAH em tarefas de seletividade, sustentação e atenção alternada, considerando tempo médio de reação, número de erros por ação e número de erros por omissão em teste computadorizado de atenção visual (TAVIS-III). MÉTODOS: Cento e duas crianças e adolescentes de duas escolas particulares e uma escola pública da cidade do Rio de Janeiro, com idades entre 6 e 17 anos com diagnóstico de TDAH, segundo DSM-IV, foram submetidas ao TAVIS-III. A separação por grupos respeitou os tipos determinados por entrevista semi-estruturada (P-CHIPS), e os resultados foram comparados levando-se em consideração o fator grupo. RESULTADOS: O tipo combinado (C) revelou-se o mais comum (n = 65; 63,7 por cento), seguido pelo predominantemente desatento (D) (n = 32; 31,4 por cento). O tipo predominantemente hiperativo-impulsivo (HI) foi excluído das análises estatísticas em virtude da baixa freqüência. O desempenho do grupo C revelou-se inferior apenas em tarefa de atenção sustentada, no que tange ao número de erros por ação e tempo médio de reação (p < 0,05), ambos maiores quando comparados ao grupo D. CONCLUSÃO: Apenas em tarefa de atenção visual por tempo mais prolongado, o tipo combinado revelou diferenças significativas em relação ao grupo desatento.

OBJECTIVE: To compare the effect of ADHD subtypes in tasks of focused, shifted and sustained attention in a visual attention test (TAVIS-III). Indexes of hit reaction time, omission errors and commission errors were considered for each task. METHODS: One hundred two children and adolescents aged from 6 to 17 years old recruited from one public and two private schools in the city of Rio de Janeiro with ADHD diagnosis, according to DSM-IV criteria, were evaluated. Three groups were created following the subtypes determined by the semi-structured interview (P-CHIPS). Group performances were compared in order to determine subtype effects. RESULTS: The combined subtype (C) was the most common group (n = 65; 63.7 percent), followed by the inattentive subtype (I) (n = 32; 31.4 percent). Hyperactive-impulsive (HI) group was excluded from statistical analysis due to its low frequency. The performance of the C group was found comparatively worse only in the sustained attention task, where subjects presented slower hit reaction time and committed more commission errors (p < 0.05) than the I group. CONCLUSION: Only in longer tasks of visual attention, combined patients had a worse performance than Inattentive ones.

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In order to compare the use of a structured self-report questionnaire with direct questioning about memory problems, 71 healthy and independent aged individuals (63 women) from the community without risk factors for cognitive deficits were objectively asked about subjective memory complaints (SMC), given the Memory Complaint Questionnaire (MAC-Q) and then submitted to the Rey Auditory Verbal Learning Test (RAVLT). SMC positively correlated with higher scores on MAC-Q, although a significant percentage of the sample had SMC and lower scores on MAC-Q and also no SMC and higher scores on MAC-Q. Performance on RAVLT was significantly worse (p<0.05) for the group presenting SMC but not for the group with higher scores on the MAC-Q. We conclude that direct questioning maybe more clinically significant than a self report questionnaire, at least for elderly persons from the community without risk factors for cognitive decline or depression

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In order to compare the use of a structured self-report questionnaire with direct questioning about memory problems, 71 healthy and independent aged individuals (63 women) from the community without risk factors for cognitive deficits were objectively asked about subjective memory complaints (SMC), given the Memory Complaint Questionnaire (MAC-Q) and then submitted to the Rey Auditory Verbal Learning Test (RAVLT). SMC positively correlated with higher scores on MAC-Q, although a significant percentage of the sample had SMC and lower scores on MAC-Q and also no SMC and higher scores on MAC-Q. Performance on RAVLT was significantly worse (p<0.05) for the group presenting SMC but not for the group with higher scores on the MAC-Q. We conclude that direct questioning maybe more clinically significant than a self report questionnaire, at least for elderly persons from the community without risk factors for cognitive decline or depression.

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We portray a case of traumatic brain injury followed by symptoms of disexecutive or frontal lobe syndrome: apathy, lack of pragmatism and loss of previous abilities, specially those concerning social interaction - in particular with opposite sex - resulting in impairment of his characteristic charm. The results of the neuropsychological examination included retrieval anemic deficits with normal recognition, impaired motor dexterity and cognitive flexibility in the presence of normal intelligence. The cognitive-behavioural symptomatology contrasted with a normal neurologic examination.

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É apresentado caso de traumatismo craniencefálico com sintomas de síndrome disexecutiva ou do lobo frontal: apatia, apragmatismo e perda de habilidades prévias, mais evidentes na interaçäo social - em especial com o sexo oposto - que resultou em prejuízo do charme que lhe era característico. Säo comentados os resultados do exame neuropsicológico, que evidenciou dismnésia de recuperaçäo com reconhecimento normal, diminuiçäo da destreza motora e da flexibilidade cognitiva, na presença de inteligência normal. Os sintomas cognitivo-comportamentais contrastavam com exame neurológico normal

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