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Se reconoce que la danza afroecuatoriana es un lazo de conexión con los ancestros y la identidad, y aporta una educación del movimiento que facilita, a su vez, el desarrollo de valores educativos en torno al tratamiento del cuerpo; ello favorece la motivación hacia la práctica de la actividad física continuada. El objetivo de la investigación radica en proponer la danza afroecuatoriana como una alternativa metodológica para la inclusión de estudiantes con hiperactividad y se contextualiza en décimo año, con un total de 35 estudiantes, y una muestra de un estudiante con trastorno por déficit de atención e hiperactividad, de la Básica Superior de la Unidad Educativa "José Otilio Ramírez Reina", provincia de Esmeraldas en Ecuador. El estudio, se sustentó en un enfoque cuantitativo-cualitativo y el método dialectico-materialista; se emplearon métodos del nivel teórico como el histórico-lógico y el análisis-síntesis y del nivel empírico el análisis documental, la observación y la encuesta, para interpretar las derivaciones obtenidas en cada etapa que transitó desde el nivel exploratorio, descriptivo, hasta llegar a una explicación del fenómeno investigado. Los resultados revelan el insuficiente reconocimiento de la danza afroecuatoriana para la inclusión de estudiantes con este trastorno, así como la escasa producción científica relacionada con la temática. Del estudio realizado se concluyó que la danza afroecuatoriana constituye una vía expedita para un mejor conocimiento, disfrute y preservación de la identidad, en estos estudiantes.
Reconhece-se que a dança afro-equatoriana é um vínculo de ligação com os ancestrais e a identidade, e proporciona uma educação em movimento que facilita, por sua vez, o desenvolvimento de valores educativos em torno do tratamento do corpo; Isso favorece a motivação para a prática de atividade física continuada. O objetivo da pesquisa consiste em propor a dança afro-equatoriana como alternativa metodológica para a inclusão de alunos com hiperatividade e está contextualizada no décimo ano, com um total de 35 alunos, e uma amostra de um aluno com transtorno de déficit de atenção e hiperatividade, da Escola Básica Superior da Unidade Educacional "José Otilio Ramírez Reina", província de Esmeraldas no Equador. O estudo baseou-se na abordagem quanti-qualitativa e no método dialético-materialista; Métodos do nível teórico como histórico-lógico e análise-síntese e do nível empírico, análise documental, observação e levantamento, foram utilizados para interpretar as derivações obtidas em cada etapa que passou do nível exploratório, descritivo, até chegar a uma explicação do fenômeno investigado. Os resultados revelam o insuficiente reconhecimento da dança afro-equatoriana para a inclusão de alunos com esse transtorno, bem como a limitada produção científica relacionada ao tema. Do estudo realizado concluiu-se que a dança afro-equatoriana constitui um caminho expedito para um melhor conhecimento, diversão e preservação da identidade destes alunos.
Afro-Ecuadorian dance is a bond of connection with ancestors and identity, and provides an education in movement that facilitates, in turn, the development of educational values around the treatment of the body; this favors motivation towards the practice of continued physical activity. The objective of the research lies in proposing Afro-Ecuadorian dance as a methodological alternative for the inclusion of students with hyperactivity and is contextualized in the tenth grade, with a total of 35 students, and a sample of a student with attention deficit hyperactivity disorder, from the Higher Basic School "José Otilio Ramírez Reina" Educational Unit, province of Esmeraldas in Ecuador. The study was based on a quantitative-qualitative approach and the dialectical-materialist method; methods from the theoretical level such as historical-logical and analysis-synthesis and from the empirical level, documentary analysis, observation and survey, were used to interpret the derivations obtained in each stage that went from the exploratory, descriptive level, until reaching an explanation of the phenomenon investigated. The results reveal the insufficient recognition of Afro-Ecuadorian dance for the inclusion of students with this disorder, as well as the limited scientific production related to the topic. From the study carried out, it was concluded that Afro-Ecuadorian dance constitutes an expeditious route for better knowledge, enjoyment and preservation of identity in these students.
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Se estudia el desarrollo de habilidades motrices básicas en niños con trastorno por déficit de atención e hiperactividad y se planteó como objetivo diseñar y validar una estrategia didáctica inclusiva en una unidad educativa del Ecuador, con el empleo de una metodología mixta y pre experimental. Se utilizó un muestreo no probabilístico, intencional y estratificado, con criterio de inclusión, la muestra la conformaron cinco niños con trastorno por déficit de atención e hiperactividad, en su grupo, clase, y su docente de Educación Física. La medición de las variables inclusión-atención del trastorno con enfoque educativo y el desarrollo de habilidades motrices básicas, se realizó mediante ocho indicadores, con el empleo de una guía de observación, el análisis documental, y apoyada en la técnica de tarjado simple para agrupar los datos observados. Como resultado se expone una estrategia didáctica inclusiva para el desarrollo de las habilidades motrices básicas, en niños con trastorno por déficit de atención e hiperactividad, durante las clases de Educación Física, diseñada a través del enfoque sistémico estructural y funcional que mostró su efectividad en la práctica educativa, al comparar los resultados del pre- y postest, por medio de la prueba no paramétrica de los signos.
Estuda-se o desenvolvimento de habilidades motoras básicas em crianças com transtorno de déficit de atenção e hiperatividade e o objetivo foi desenhar e validar uma estratégia de ensino inclusiva em uma unidade educacional no Equador, utilizando uma metodologia mista e pré-experimental. Foi utilizada uma amostragem não probabilística, intencional e estratificada, com critérios de inclusão, a amostra foi composta por cinco crianças com transtorno de déficit de atenção e hiperatividade, em seu grupo, turma, e seu professor de Educação Física. A mensuração das variáveis inclusão-atenção do transtorno com abordagem educativa e desenvolvimento de habilidades motoras básicas foi realizada por meio de oito indicadores, com uso de guia de observação, análise documental e apoiado na técnica de pontuação simples para agrupar os dados observados. Como resultado, apresenta-se uma estratégia didática inclusiva para o desenvolvimento de habilidades motoras básicas, em crianças com transtorno de déficit de atenção e hiperatividade, durante as aulas de Educação Física, desenhada através da abordagem sistêmica estrutural e funcional que mostrou sua eficácia na prática educativa, ao comparar os resultados do pré e pós-teste, por meio do teste não paramétrico de sinais.
The development of basic motor skills in children with attention deficit and hyperactivity disorder is studied and the objective was to design and validate an inclusive teaching strategy in an educational unit in Ecuador, using a mixed and pre-experimental methodology. An intentional and stratified non-probabilistic sampling was used, with inclusion criteria, the sample was made up of five children with attention deficit and hyperactivity disorder, in their class group, and their Physical Education teacher. The measurement of the inclusion-attention variables of the disorder with an educational approach and the development of basic motor skills was carried out using eight indicators, with the use of an observation guide, documentary analysis, and supported by the simple scoring technique to group the observed data. As a result, an inclusive didactic strategy is presented for the development of basic motor skills in children with attention deficit and hyperactivity disorder during Physical Education classes, designed through the structural and functional systemic approach that showed its effectiveness in the educational practice, when comparing the results of the pre- and post-test, through the non-parametric test of signs.
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El Trastorno por Déficit de Atención e Hiperactividad se caracteriza por presentar síntomas de inatención, impulsividad e hiperactividad. La estrategia de atención plena puede ser una poderosa herramienta para contrarrestarlo al mejorar la capacidad de atención, concentración y autorregulación emocional. Objetivo. Determinar la efectividad de la atención plena como estrategia para disminuir la sintomatología de TDAH en escolares entre 6 a 12 años de Tacna, Perú. Material y método. Estudio cuantitativo de tipo experimental y corte longitudinal. Se llevó a cabo en el año 2023. La muestra estuvo constituida por 613 escolares pertenecientes a instituciones educativas de la ciudad de Tacna de Cono Norte y Sur. Se recolectó la información mediante la técnica de la encuesta y como instrumento un cuestionario sobre TDAH y uno sobre atención plena, este último usado como pre y post test. Se realizó la prueba de Wilcoxon, con una significancia del 95% y un valor p<0,05 como estadísticamente significativo. Resultados. Tienen nivel alto de inatención el 9,6 %, de impulsividad el 3,1 % y de hiperactividad el 2,3 %. Luego de ejecutarse 10 sesiones basadas en la atención plena, se logró mejor el nivel de satisfacción de un 51,4% (que había en el pre-test) a un 73,6% (en el post-test). Conclusiones. La aplicación de la estrategia de atención plena tuvo un efecto positivo y consistente en la disminución de la sintomatología de TDAH. Estos hallazgos respaldan la implementación de este tipo de intervenciones en el ámbito escolar para beneficiar a los estudiantes con esta condición.
Attention Deficit Hyperactivity Disorder is characterized by symptoms of inattention, impulsivity, and hyperactivity. Mindfulness-based strategies can be a powerful tool to counteract ADHD by improving attention, concentration, and emotional self-regulation. Objective. To determine the effectiveness of mindfulness as a strategy to reduce ADHD symptoms in schoolchildren aged 6 to 12 years in Tacna, Peru. Materials and Methods. Quantitative experimental study with a longitudinal design, conducted in 2023. The sample consisted of 613 schoolchildren from educational institutions in the North and South Cone of Tacna. Information was collected using a survey technique and questionnaires on ADHD and mindfulness, the latter used as a pre- and post-test. The Wilcoxon test was applied, with a 95% significance and a p-value < 0.05 considered statistically significant. Results. 9.6% of the students had a high level of inattention, 3.1% had a high level of impulsivity, and 2.3% had a high level of hyperactivity. After 10 mindfulness-based sessions, the level of satisfaction improved from 51.4% (pre-test) to 73.6% (post-test). Conclusions. The application of the mindfulness-based strategy had a positive and consistent effect on the reduction of ADHD symptoms. These findings support the implementation of this type of intervention in the school setting to benefit students with this condition.
O Transtorno de Déficit de Atenção e Hiperatividade é caracterizado por sintomas de desatenção, impulsividade e hiperatividade. Estratégias baseadas em atenção plena podem ser uma ferramenta poderosa para combater o TDAH, melhorando a atenção, a concentração e a autorregulação emocional. Objetivo. Determinar a eficácia da atenção plena como estratégia para reduzir os sintomas de TDAH em escolares de 6 a 12 anos em Tacna, Peru. Materiais e Métodos. Estudo quantitativo experimental com delineamento longitudinal, realizado em 2023. A amostra foi composta por 613 escolares de instituições educacionais do Cone Norte e Sul de Tacna. As informações foram coletadas usando a técnica de pesquisa e questionários sobre TDAH e atenção plena, este último usado como pré e pós-teste. O teste de Wilcoxon foi aplicado, com 95% de significância e valor de p < 0,05 considerado estatisticamente significativo. Resultados. 9,6% dos alunos apresentaram alto nível de desatenção, 3,1% alto nível de impulsividade e 2,3% alto nível de hiperatividade. Após 10 sessões baseadas em atenção plena, o nível de satisfação melhorou de 51,4% (pré-teste) para 73,6% (pós-teste). Conclusões. A aplicação da estratégia baseada em atenção plena teve um efeito positivo e consistente na redução dos sintomas de TDAH. Esses achados apoiam a implementação desse tipo de intervenção no ambiente escolar para beneficiar os alunos com essa condição.
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Neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are characterized by persistent changes in communication and social interaction, as well as restricted and stereotyped patterns of behavior. The complex etiology of these disorders possibly combines the effects of multiple genes and environmental factors. Hence, exposure to insecticides such as imidacloprid (IMI) has been used to replicate the changes observed in these disorders. Lutein is known for its anti-inflammatory and antioxidant properties and is associated with neuroprotective effects. Therefore, the aim of this study was to evaluate the protective effect of lutein-loaded nanoparticles, along with their mechanisms of action, on Drosophila melanogaster offspring exposed to IMI-induced damage. To simulate the neurodevelopmental disorder model, flies were exposed to a diet containing IMI for 7 days. Posteriorly, their offspring were exposed to a diet containing lutein-loaded nanoparticles for a period of 24 h, and male and female flies were subjected to behavioral and biochemical evaluations. Treatment with lutein-loaded nanoparticles reversed the parameters of hyperactivity, aggressiveness, social interaction, repetitive movements, and anxiety in the offspring of flies exposed to IMI. It also protected markers of oxidative stress and cell viability, in addition to preventing the reduction of Nrf2 and Shank3 immunoreactivity. These results demonstrate that the damage induced by exposure to IMI was restored through treatment with lutein-loaded nanoparticles, elucidating lutein's mechanisms of action as a therapeutic agent, which, after further studies, can become a co-adjuvant in the treatment of neurodevelopmental disorders, such as ASD and ADHD.
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Comportamento Animal , Drosophila melanogaster , Luteína , Nanopartículas , Nitrocompostos , Animais , Drosophila melanogaster/efeitos dos fármacos , Luteína/farmacologia , Luteína/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Masculino , Feminino , Nitrocompostos/toxicidade , Neonicotinoides/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Inseticidas/toxicidade , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/administração & dosagem , Transtornos do Neurodesenvolvimento/prevenção & controle , Transtornos do Neurodesenvolvimento/induzido quimicamente , Transtornos do Neurodesenvolvimento/metabolismo , Antioxidantes/farmacologia , Antioxidantes/metabolismoRESUMO
Background/Objectives: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by elevated motor activity, impulsivity, and attention deficit. Approximately 5% of the population suffers from this disorder. Among the key explanations of ADHD, executive functions play an important role in understanding the symptomatology present in this disorder and in determining the main treatment strategies for affected patients. We present a systematic review that seeks to identify the treatment methods developed to support executive functions in individuals with ADHD. Methods: Articles were analyzed in the SCOPUS, PUBMED, and Science Direct databases. Initially, 739 articles were found. After applying inclusion and exclusion criteria, 30 articles remained and were included in the data extraction process. Results: Among the primary treatments identified, 14 studies propose psychological training for executive functions, 9 studies recommend medication, 5 studies suggest digital interventions, and 1 study advocates for sports as beneficial for executive functions. Conclusions: The data are discussed around the need to develop new proposals to enhance the executive functions of individuals with ADHD, thereby improving their performance in educational, personal, social, and family activities impacted by this disorder.
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OBJECTIVES: This systematic review sought to provide evidence for the effectiveness of common pharmacological interventions used for treating attention deficit hyperactivity disorder (ADHD) symptoms in the autism spectrum disorder (ASD) population, considering studies attempting to find safe and effective drugs. METHODS: We searched for randomized controlled trials describing the effectiveness and/or safety profile of pharmacological interventions for treating ASD and ADHD or ASD with ADHD symptoms using three bibliographic databases: PubMed, Cochrane Library, and Embase. We have chosen ADHD symptoms measured by any clinical scale as the primary outcome. As additional outcomes, we have used other symptoms of aberrant behavior measured by the aberrant behavior checklist, satisfaction with treatment, and peer satisfaction. RESULTS: Twenty-two publications met the inclusion criteria for the systematic review and eight for the meta-analysis. In our investigation, we found a few articles using clonidine, modafinil, and bupropion as interventions when compared to methylphenidate (MPH). Our meta-analysis showed that MPH had positive changes compared to placebo in symptoms such as hyperactivity, irritability, or inattention. However, no effect was found in stereotyped symptoms, and our data's quantitative analysis revealed a large effect of MPH-induced adverse effects on the dropout rate. On the other hand, atomoxetine initiation had positive effects when compared to placebo on symptoms of hyperactivity and inattention. We have found no effect of atomoxetine on stereotypes or irritability. Furthermore, atomoxetine did not influence side effects that caused dropouts from studies. CONCLUSION: Our results indicated that atomoxetine has a modest effect on hyperactivity and inattention symptoms, with a relatively benign profile of side effects. MPH appears to be effective in handling hyperactivity, inattention, and irritability symptoms. However, our results on atomoxetine revealed increased dropouts due to adverse effects when compared to MPH or placebo. Evidence for other substances such as guanfacine, clonidine, bupropion, or modafinil is either preliminary or nonexistent.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Espectro Autista/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Clonidina/uso terapêutico , Metilfenidato/uso terapêutico , Resultado do TratamentoRESUMO
BACKGROUND: To sustain performance during a task that requires attention may be a challenge for children with attention deficit/hyperactivity disorder (ADHD), which strongly influences motivation for tasks and has been connected to the level of arousal. OBJECTIVE: This study aimed to analyze the effect of musical stimulus on attentional performance in children with ADHD and typically developing children. METHODS: A total of 76 boys (34 with ADHD and 42 typically developing) performed the Attention Network Test (ANT) for children under 2 experimental conditions (with and without music). Four attentional measures were extracted from the ANT. We tested the effect of the experimental condition and its interaction with the group using repeated measures ANOVA. RESULTS: We found no significant main effects or interactions for the reaction times of the alerting, orienting, and conflict attentional networks of the ANT (all P>.05). Regarding ANT errors, we found a significant main effect for music, with a moderate effect size (F1,72=9.83; P=.03; ηp2=0.06) but the condition×group interaction was not significant (F1,72=1.79; P=.18). Participants made fewer errors when listening to music compared to the control condition. CONCLUSIONS: Music seems not to interfere in the attentional network in children and adolescents. Perhaps background music affects motivation. Future studies will be needed to validate this. TRIAL REGISTRATION: ReBEC.gov U1111-12589039; https://ensaiosclinicos.gov.br/rg/RBR-8s22sh8.
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OBJECTIVES: To investigate the associations among symptoms of attention deficit hyperactivity disorder (ADHD) with binge eating spectrum conditions - BESC - [binge eating disorder (BED), bulimia nervosa (BN), and recurrent binge eating (RBE)], and psychiatric and somatic comorbidity and healthcare utilization in a representative sample of a Brazilian city. METHODS: A household survey with 2,297 adults and residents in Rio de Janeiro was conducted. The Adult Self-Rating Scale Screener was used to assess ADHD symptoms. BESC was assessed using the Questionnaire of Eating and Weight Patterns 5 and confirmed by telephone interview. Standardized questionnaires were used to assess psychiatric comorbidity. Close-ended questions investigated somatic comorbidity and healthcare utilization. RESULTS: ADHD symptoms were highly associated with BESC [BED, OR=13.2, 95%CI= 4.3-40.6; BN, OR=27.5, 95%CI= 5.9-128.7; RBE, OR=5.8, 95%CI= 2.9-11.4). However, with further adjustment for psychiatric comorbidity (depression, anxiety, alcohol use and impulsivity), the ORs were no longer significant. Healthcare resource utilization was significantly higher in participants with ADHD and BESC but lost significance after controlling for the psychiatric comorbidity. CONCLUSION: ADHD was associated with an increased prevalence of BESC, and healthcare utilization. Nonetheless, there was an essential interplay among psychiatric comorbidity in the associations of ADHD and BESC.
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General pediatricians and those specialized in developmental-behavioral and neurodevelopmental disabilities support children with neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). We identified substantial geographic disparities in pediatrician availability (eg, urban > rural areas), as well as regions with low pediatrician access but high ASD/ADHD prevalence estimates (eg, the US Southeast).
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AIM: To evaluate the prevalence and types of sleep problems and their correlations with melatonin content and behavior in Attention-Deficit Hyperactivity Disorder (ADHD) children. METHOD: Sleep in ADHD children and typically developing children (TD) aged 6-14 was assessed by the Sleep Disorders Scale for Children (SDSC) and actigraphy, salivary melatonin quantified by ELISA, and behavior was analyzed using the Strengths and Difficulties Questionnaire. RESULTS: ADHD children showed a higher frequency of sleep disturbances, higher sleep latency, and lower sleep efficiency than in the TD group. The ADHD group presented lower melatonin nocturnal content compared to the TD group. Disorders of Initiating and Maintaining Sleep (DIMS) was moderately associated with nocturnal melatonin. The total behavior difficulties were correlated with Disorders of Initiating and Maintaining Sleep (DIMS), Sleep/Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DES), Sleep Hyperhidrosis (SHY) and Total SDSC Score. The behavior was the only determinant of the total SDSC score (R2 = 0.499; p < 0.002). CONCLUSION: This study provides, for the first time, evidence that among the frequent sleep disturbances in ADHD, the disorders in initiating and maintaining sleep are associated with the low levels of melatonin found in this population. Additionally, these, along with other sleep disturbances, are linked to behavioral problems in ADHD.
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Actigrafia , Transtorno do Deficit de Atenção com Hiperatividade , Melatonina , Transtornos do Sono-Vigília , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Melatonina/metabolismo , Criança , Masculino , Feminino , Transtornos do Sono-Vigília/epidemiologia , Adolescente , Saliva/metabolismo , Saliva/química , Inquéritos e QuestionáriosRESUMO
Over half of youth with attention-deficit/hyperactivity disorder (ADHD) have co-occurring psychiatric or medical conditions that present treatment challenges. Stimulants are the most effective pharmacologic treatment of ADHD for preschoolers to adults but questions about safety with co-occurring conditions frequently arise. In addition, stigma surrounding diagnosis and treatment can negatively impact care. This manuscript presents evidence-based practice pearls to guide treatment decisions for youth with ADHD and common coexisting psychiatric and medical conditions. Recommendations address specific stimulant adverse effects (i.e., anxiety, cardiac, growth, mania, psychosis) along with management strategies. Pearls were developed for the most common clinical questions, controversial topics, or therapeutic issues that may not be widely known. The goals of this manuscript are to: 1) provide a detailed resource for interprofessional teams regarding stimulant use in youth with ADHD, 2) improve therapeutic outcomes for youth with ADHD and co-occurring psychiatric and/or medical conditions through evidence-based recommendations, and 3) decrease stigma associated with stimulant use through education.
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Introduction Insomnia is highly prevalent among individuals with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the biological mechanisms shared between both conditions is still elusive. We aimed to investigate whether insomnia's genomic component is able to predict ADHD in childhood and adolescence. Methods A Brazilian sample of 259 ADHD probands and their biological parents were included in the study. Their genomic DNA genotypes were used to construct the polygenic risk score for insomnia (Insomnia PRS), using the largest GWAS summary statistics as a discovery sample. The association was tested using logistic regression, under a case-pseudocontrol design. Results Insomnia PRS was nominally associated with ADHD (OR = 1.228, p = 0.022), showing that the alleles that increase the risk for insomnia also increase the risk for ADHD. Discussion Our results suggest that genetic factors associated with insomnia may play a role in the ADHD genetic etiology, with both phenotypes likely to have a shared genetic mechanism.
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Resumen El Trastorno de Tourette (TT) y el Trastorno por déficit de atención / hiperactividad (TDAH) son entidades neu ropsiquiátricas que usualmente inician en la infancia. Esta revisión busca colaborar con los clínicos, quienes suelen confrontarse al dilema de saber si existe una comorbilidad o un diagnóstico diferencial, ya que esta pregunta cobra vital importancia en el momento de decidir el tratamiento. Invitamos al colega a revisar nuestros hallazgos, soportados por bases moleculares, fisiológicas y neuroanatómicas, además de los datos epidemiológicos. Al final, brindamos una propuesta de algoritmo diag nóstico que podrá utilizar cuando se encuentre ante síntomas compartidos entre los dos diagnósticos. El TDAH y el TT deben ser intervenidos tempranamente, para mejorar la calidad de vida y funcionalidad del paciente y prevenir secuelas, no solo en niños, niñas y adolescentes (NNA), también a lo largo de la vida.
Abstract Tourette Disorder (TD) and attention deficit hyperac tivity disorder (ADHD) are both major neuropsychiatric conditions that usually begin during infancy. This revision aims to collaborate with pediatricians, who are often confronted with the question of co-mor bidity or differential diagnosis between ADHD and TD. The question becomes urgent when the clinician must decide if he/she can start ADHD or TD treatment. We encourage our colleagues to revise our findings, based in bimolecular and neuroanatomic shared issues in ad dition to updated epidemiological findings. The clinician will find an original proposed algorithm that they can use when the shared symptoms are pres ent in a little patient. TD and ADHD must be intervened early, so we can get better outcomes. The consequences of letting the symptoms increase can generate sequels and handicaps, that can interfere with the quality of life and functionality not only during infancy and adoles cence but also in adult life.
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Resumen El trastorno por déficit de atención/hiperactividad (TDAH) es un trastorno del neurodesarrollo complejo y heterogéneo desde una perspectiva causal, clínica y pro nóstica. La investigación refleja su carácter multifactorial con un papel destacado de los factores genéticos. Los estudios poblacionales han señalado históricamente la implicación de numerosas variantes genéticas de escaso tamaño de efecto, las cuales por sí mismas apenas incre mentan el riesgo de TDAH y difícilmente justifican su ele vada heredabilidad. Muchas de ellas están presentes en más del 60% de la población general, lo que sugiere su pa pel modulador más que causal. No obstante, gracias a la irrupción de nuevas técnicas genéticas en los últimos 15 años, se están identificando un mayor número de casos con trastornos genéticos (muchos de ellos monogénicos), cuyas variantes genéticas explican por sí mismas la presencia del TDAH. El estudio detallado de los antecedentes personales y familiares, así como una exploración física completa, puede ayudar a identificar algunos de ellos. La identificación de la causa en este conjunto de casos tiene un valor crucial en el asesoramiento clínico, el consejo genético-familiar y la anticipación pronóstica, así como en la realización o evitación de estudios complementarios y en el diseño del plan terapéutico.
Abstract Attention-deficit/hyperactivity disorder (ADHD) is a complex and heterogeneous neurodevelopmental disor der from a causal, clinical and prognostic perspective. Research reflects its multifactorial nature with a promi nent role of genetic factors. Population studies have historically pointed to the involvement of numerous genetic variants of small effect size, which hardly by themselves increase the risk of presenting the disorder and hardly justify its high heritability. Many of them are present in more than 60% of the general population, suggesting their modulatory rather than causal role. However, after the irruption of new genetic techniques in the last 15 years, a greater number of cases are be ing identified with genetic disorders (many of them monogenic), whose genetic variants alone explain the presence of ADHD. A detailed study of the personal and family history, as well as a complete physical examination, can help to identify some of them. The identification of the cause in this group of cases has a crucial value in clinical counseling, genetic-familial counseling and prognostic anticipation, as well as in the performance or avoidance of complementary stud ies and in the design of the intervention plan.
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Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos das Habilidades Motoras , Destreza Motora , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/diagnóstico , Criança , Masculino , Feminino , Estudos Transversais , Destreza Motora/fisiologia , Desempenho Psicomotor/fisiologiaRESUMO
BACKGROUND: In Mexico, this pioneering research was undertaken to assess the accessibility of timely diagnosis of Dyads [Children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and their primary caregivers] at specialized mental health services. The study was conducted in two phases. The first phase involved designing an "Access Pathway" aimed to identify barriers and facilitators for ADHD diagnosis; several barriers, with only the teacher being identified as a facilitator. In the second phase, the study aimed to determine the time taken for dyads, to obtain a timely diagnosis at each stage of the Access Pathway. As well as identify any disparities based on gender and socioeconomic factors that might affect the age at which children can access a timely diagnosis. METHOD: In a retrospective cohort study, 177 dyads participated. To collect data, the Acceda Survey was used, based on the robust Conceptual Model Levesque, 2013. The survey consisted of 48 questions that were both dichotomous and polytomous allowing the creation of an Access Pathway that included five stages: the age of perception, the age of search, the age of first contact with a mental health professional, the age of arrival at the host hospital, and the age of diagnosis. The data was meticulously analyzed using a comprehensive descriptive approach and a nonparametric multivariate approach by sex, followed by post-hoc Mann-Whitney's U tests. Demographic factors were evaluated using univariable and multivariable Cox regression analyses. RESULTS: 71% of dyads experienced a late, significantly late, or highly late diagnosis of ADHD. Girls were detected one year later than boys. Both boys and girls took a year to seek specialized mental health care and an additional year to receive a formal specialized diagnosis. Children with more siblings had longer delays in diagnosis, while caregivers with formal employment were found to help obtain timely diagnoses. CONCLUSIONS: Our findings suggest starting the Access Pathway where signs and symptoms of ADHD are detected, particularly at school, to prevent children from suffering consequences. Mental health school-based service models have been successfully tested in other latitudes, making them a viable option to shorten the time to obtain a timely diagnosis.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Diagnóstico Precoce , Acessibilidade aos Serviços de Saúde , Serviços de Saúde Mental , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Masculino , Feminino , México/epidemiologia , Adolescente , Estudos Retrospectivos , Serviços de Saúde Mental/estatística & dados numéricos , Fatores SocioeconômicosRESUMO
Abstract Objective: Enuresis is associated with attentional and emotional comorbidities in 20 to 30 % of cases. The Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) is a questionnaire that allows the initial screening of these comorbidities. This study aimed to translate, culturally adapt, and validate the SSIPPE for Brazilian children and adolescents (SSIPPE-Br). Methods: Six steps were performed for translation and cross-cultural adaptation: translation, synthesis of translations, back-translation, preparation of the pre-final version of the translated instrument, test of comprehensibility of the pre-final version of the tool, and elaboration of the instrument cross-culturally adapted for Brazil, named 13-itens version SSIPPE-Br. To validate the SSIPPE-Br, a cross-sectional study was carried out, in which the validated Brazilian version of the Child and Adolescent Behavior Inventory (CABI) was used. Results: Validation was performed on 127 children and adolescents with a mean age of 9.7 ± 2.8 years, 48 % male. The reliability was estimated using Cronbach's alpha, ranging from 0.86 to 0.89, indicating good internal consistency. The factorial analysis had a good agreement adjustment (KMO 0.755, Bartlett's test < 0.001) and explained 70.5 % of the data variability. In the reproducibility analysis, the Kappa coefficient ranged from 0.94 to 1, which can be considered almost perfect. A highly significant (p-value < 0.001) and direct correlation existed between the three SSIPPE-Br domains and all evaluated CABI domains. Conclusion: The SSIPPE-Br is a valid and reliable tool for emotional problems screening and ADHD symptoms in children and adolescents with enuresis whose first language is Brazilian Portuguese.
RESUMO
OBJECTIVE: To investigate attention deficit and hyperactivity disorder (ADHD) symptoms and impulsivity among individuals diagnosed with opioid use disorder (OUD) who also exhibit symptoms of problematic internet use (PIU). METHODS: The study involved the participation of 360 patients with OUD enrolled at an alcohol and drug addiction treatment center (ADATC) from October to December 2022. Various assessment tools were administered, including Young's Internet Addiction Scale (YIAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Barratt Impulsiveness Scale (BIS), and Adult ADHD Self-Report Scale (ASRS). PIU was identified by YIAS scores equal to or exceeding 50. RESULTS: Most participants diagnosed with OUD had comorbid PIU, with high levels of depression, anxiety, and ADHD symptoms. Both BDI and BAI scores were significantly increased in the PIU group compared to the non-PIU group (p < 0.001). Significant differences were observed in BIS Motor Impulsivity, Attentional Impulsivity, and total scores, indicating higher impulsivity in the PIU group (all p < 0.001). Additionally, higher ASRS scores were found in the PIU group (p < 0.001). CONCLUSION: These findings highlight the importance of addressing PIU and comorbidities in OUD treatment. Interventions targeting ADHD symptoms and emotional well-being may benefit PIU management.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Comportamento Impulsivo , Transtorno de Adição à Internet , Transtornos Relacionados ao Uso de Opioides , Escalas de Graduação Psiquiátrica , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Opioides/psicologia , Transtorno de Adição à Internet/psicologia , Adulto Jovem , Autorrelato , Adolescente , Estudos Transversais , Pessoa de Meia-Idade , Depressão/psicologia , Ansiedade/psicologiaRESUMO
BACKGROUND: Female orgasmic disorder is listed in the DSM-5 and is defined as the persistent or recurrent inability to have an orgasm. Many depressed women may experience sexual dysfunction, including female orgasmic disorder. AIM: The study sought to analyze the relationship between depressive disorders and attention-deficit/hyperactivity disorder (ADHD) and their influence on the development of female orgasmic disorder. METHODS: A total of 221 Dominican women participated in this case-control study. The case group consisted of 107 women diagnosed with female orgasmic disorder, while the control group consisted of 114 women without any sexual dysfunction. OUTCOMES: The diagnosis of ADHD was obtained from the participants' medical records, previously conducted using the DSM-5-TR criteria. The Beck Depression Inventory II was used to assess the severity of depressive symptoms in both groups. RESULTS: There was a significant relationship between female orgasmic disorder and ADHD and depression. The results of multiple logistic regression indicated that the highest risk of female orgasmic disorder was observed in women with ADHD (odds ratio [OR], 4.91; 95% confidence interval [CI], 2.46-9.20; P < .001), women with severe depression (OR, 2.50; 95% CI, 1.08-6.96; P = .04), and women who had sexual intercourse that focused on penetration (OR, 2.02; 95% CI, 1.03-3.98; P = .04). CLINICAL IMPLICATIONS: These findings may have important implications for the prevention and treatment of sexual disorders in women. STRENGTHS AND LIMITATIONS: This design selected all diagnosed cases of female orgasmic disorder and did not select a specific subgroup. However, some limitations must be considered. This study was conducted in a single clinic, although it should be noted that it is the main clinic for the treatment of sexual dysfunction in the country. A further limitation could be that this type of study design does not allow for statements about causality to be made. CONCLUSION: There is an increased risk of female orgasmic disorder in women with ADHD, with severe depression, and who engage in penetrative sex.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Depressão , Disfunções Sexuais Psicogênicas , Humanos , Feminino , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Adulto , Estudos de Casos e Controles , Disfunções Sexuais Psicogênicas/epidemiologia , Disfunções Sexuais Psicogênicas/psicologia , Depressão/epidemiologia , República Dominicana , Adulto Jovem , Orgasmo , Pessoa de Meia-Idade , Escalas de Graduação PsiquiátricaRESUMO
Preeclampsia (PE) is a multisystem disorder characterized by elevated blood pressure in the mother, typically occurring after 20 weeks of gestation and posing risks to both maternal and fetal health. PE causes placental changes that can affect the fetus, particularly neurodevelopment. Its key pathophysiological mechanisms encompass hypoxia, vascular and angiogenic dysregulation, inflammation, neuronal and glial alterations, and disruptions in neuronal signaling. Animal models indicate that PE is correlated with neurodevelopmental alterations and cognitive dysfunctions in offspring and in humans, an association between PE and conditions such as cerebral palsy, autism spectrum disorder, attention deficit hyperactivity disorder, and sexual dimorphism has been observed. Considering the relevance for mothers and children, we conducted a narrative literature review to describe the relationships between the pathophysiological mechanisms behind neurodevelopmental alterations in the offspring of PE mothers, along with their potential consequences. Furthermore, we emphasize aspects pertinent to the prevention/treatment of PE in pregnant mothers and alterations observed in their offspring. The present narrative review offers a current, complete, and exhaustive analysis of (i) the pathophysiological mechanisms that can affect neurodevelopment in the children of PE mothers, (ii) the relationship between PE and neurological alterations in offspring, and (iii) the prevention/treatment of PE.