Showing papers by "Samuele Cortese published in 2007"

Attention-Deficit/Hyperactivity Disorder (Adhd) and Binge Eating

Abstract: Attention-deficit/hyperactivity disorder (ADHD) is characterized by a persistent and pervasive pattern of inattention and/or hyperactivity-impulsivity. Emerging data suggest higher than expected rates of binge eating occur in subjects with ADHD. Several hypotheses may explain this newly described comorbidity: 1) inattention and/or impulsivity foster binge eating, 2) ADHD and binge eating share common neurobiological bases, 3) binge eating contributes to ADHD, or 4) psychopathological factors common to both binge eating and ADHD mediate the association. In patients with ADHD and binge eating, both conditions might benefit from common therapeutic strategies. Further research is needed to gain insight into the association between ADHD and binge eating in order to facilitate more appropriate clinical management and, ultimately, a better quality of life for patients with both conditions.

Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents.

Abstract: Association between symptoms of attention-deficit/hyperactivity disorder and bulimic behaviors in a clinical sample of severely obese adolescents

Sleep problems associated with ADHD: a review of current therapeutic options and recommendations for the future

Abstract: In recent years, there has been a growing interest in sleep problems associated with attention-deficit/hyperactivity disorder (ADHD). The etiology of these sleep problems is multifactorial. In this paper, we review the current literature on the treatment of the most common disorders or factors underlying sleep problems associated with ADHD. In particular, we focus on the management of sleep problems associated with ADHD medications, restless legs syndrome, excessive nocturnal motricity in sleep, sleep disordered breathing, sleep-onset insomnia and psychiatric comorbidities associated with ADHD. Given the paucity of randomized, controlled, double-blinded, placebo-controlled studies, it is hoped that this review will encourage further methodologically sound studies in order to be able to develop treatment guidelines.

Short communication Parent reports of sleep/alertness problems and ADHD symptoms in a sample of obese adolescents

Abstract: Objective: Recent evidence suggests an association between obesity and Attention Deficit/Hyperactivity Disorder (ADHD) or ADHD traits. The characteristics of obese subjects with a higher probability of ADHD symptoms are still unclear. We explore the hypothesis that obese adolescents with sleep/alertness problems represent a subgroup at high risk for ADHD traits, independently from associated symptoms of anxiety/depression. The aim of this study was to assess the relationship between parent reports of sleep/alertness problems and ADHD traits in a clinical sample of obese adolescents, controlling for symptoms of anxiety/depression. Methods: Seventy obese subjects (age range, 10–16 years) were included. The parents filled out the Sleep Disturbance Scale for Children (SDSC), the Conners Parents Rating Scale-Revised (Short Version) (CPRS-R:S), and the Child Behavior Checklist (CBCL). The ADHD Rating Scale (ADHD-RS) was completed by

Predictors of diagnostic delay in a clinical sample of French children with attention-deficit/hyperactivity disorder

Abstract: Background Early recognition of attention-deficit/hyperactivity disorder (ADHD) may improve the educational and psychosocial outcome of most affected children. To date, factors associated with diagnostic delay of ADHD have not specifically been addressed. Aims of this study were to evaluate the mean diagnostic delay (time between first consultation and definite diagnosis) in a clinical sample of French children with ADHD referred to an outpatient university clinic, and to determine associated factors. Method A total of 129 consecutively referred ADHD patients aged 6–16 years. A detailed history of the children was obtained from their parents. The Kiddie-SADS-PL, the ADHD-Rating Scale, and the Clinical Global Impression Scale were used for clinical assessment. Results Mean diagnostic delay was 32.89 months. A previous suspicion of ADHD by any health care professional, therapist or teacher was significantly associated with a reduced diagnostic delay. Co-morbidity with anxiety/depressive disorders and previous contact with a mental health professional were associated with a significant delay in diagnosis. Conclusion Delay in diagnosis of ADHD in France is among the longest reported. Children with co-morbid anxiety or depressive disorders are particularly at risk of having a significant delay in the diagnosis. Health professionals, therapists and teachers may play a relevant role to accelerate the diagnostic procedure.

Attention-Deficit/Hyperactivity Disorder, Binge Eating, and Obesity

Abstract: Comment on: Association between attention-deficit/hyperactivity disorder and bulimia nervosa: analysis of 4 case-control studies. [J Clin Psychiatry. 2006]

Lead and neuroprotection by iron in ADHD.

Abstract: We read with special interest the article by Braun et al. (2006). In this large survey, the authors concluded that prenatal exposure to tobacco and environmental lead are risk factors for attention deficit hyperactivity disorder (ADHD). We would like to focus on the potential neuroprotective role of iron against the deleterious effect of lead on the development of ADHD symptoms. Although the mechanisms underlying ADHD remain unclear, both genetic and environmental factors have been implicated. In a recent review on the implication of the dopaminergic system in the etiology of ADHD, Swanson et al. (2007) highlighted the importance of environmental risk factors as possible etiologies of dopamine deficit. Among these environmental factors, Swanson et al. (2007) cited the effects of lead exposure (at levels < 10 μg/dL) on ADHD-related behaviors and ADHD diagnosis. Lead in the central nervous system may contribute to dopaminergic dysfunction inducing alteration of dopamine release and dopamine receptor density (Gedeon et al. 2001; Lidsky et al. 2003). Moreover, lead may disrupt the structure of the blood–brain barrier function essential for brain integrity (Dyatlov et al. 1998). Interestingly, Wang et al. (2007) recently reported that iron supplementation protects the integrity of the blood–brain barrier against lead insults. On the other hand, iron deficiency could increase the toxic effect of lead, suggesting a potent neuroprotective effect of iron supplementation on dopaminergic dysfunction due to lead exposure (Wright 1999; Wright et al. 2003) In a controlled comparison group study, we (Konofal et al. 2004) showed that iron deficiency was correlated to ADHD symptoms severity, hypothesizing that iron supplementation may improve symptoms of ADHD in those subjects with low ferritin levels. Given that lead exposure may contribute to ADHD and iron deficiency may exacerbate deleterious effects caused by lead, we recommend systematically seeking for iron deficiency in children with ADHD. We also think that controlled studies assessing the potential effectiveness of iron supplementation on ADHD symptoms should be encouraged. Such studies could aid the understanding of the complex pathophysiology underlying ADHD and provide effective therapeutic strategies for this disorder.

Les enjeux de l'évaluation du trouble déficitaire attentionnel avec hyperactivité (TDAH) : à propos de deux cas d'enfants

Abstract: Resume Les troubles du comportement constituent un des principaux motifs de consultation. L'enjeu de la consultation sera de reperer la semiologie des troubles afin d'emettre un diagnostic et pouvoir ainsi mettre en place les moyens therapeutiques adaptes aux difficultes de l'enfant. Dans les comportements externalises, il est necessaire de differencier l'hyperactivite motrice de l'instabilite pouvant etre reactionnelle et/ou liee a un trouble de la personnalite pouvant evoluer vers une pathologie limite. Au travers de deux cas cliniques issus de notre pratique, nous discuterons le diagnostic d'un point de vue psychopathologique. Dans le premier cas, l'enfant presente un TDAH avec predominance des troubles attentionnels et dans le second cas une instabilite reactionnelle liee a une relation conflictuelle mere/enfant. Afin d'etablir le diagnostic, pour chaque cas nous nous sommes appuyes sur un bilan psychologique complet (entretien clinique, echelles standardisees, bilan intellectuel…).