Showing papers on "Hyperkinetic disorder published in 2008"

Hyperkinetic disorder in psychiatric clinic attenders.

Abstract: Sixty-eight boys (age-range five to 11 years), referred to a child psychiatric clinic, were studied in order to determine the validity of a broadly-based concept of hyperkinetic syndrome, as generally employed in the USA. Hyperactivity was measured on the Conners' Teacher Questionnaire, the Conners' Parent Questionnaire and by systematic time-sampled observations of each child's behaviour during psychological testing. There were low and statistically insignificant correlations between these different measures of hyperkinesis. On the other hand, overactivity correlated highly with conduct disturbance. Psychiatrically abnormal children with and without hyperkinesis were compared on cognitive functioning, perinatal history, neurological examination, congenital anomalies and psycho-social circumstances. Few differences were found, and it was concluded that there was no evidence for the validity of a broad concept of hyperkinetic syndrome. Nevertheless, a small number of children were found who were overactive in all situations studied. These children had a variety of clinical diagnoses but differed significantly from their peers--matched for age, IQ and diagnosis--with respect to neurological anomalies, erratic responses on the Matching Familiar Figures Test, and early onset of hyperkinesis. It is suggested that this less common clinical picture of hyperkinesis may have some validity, but it remains uncertain whether it constitutes a distinct syndrome or rather a constitutional risk factor.

How often do children meet ICD-10/DSM-IV criteria of attention deficit-/hyperactivity disorder and hyperkinetic disorder? Parent-based prevalence rates in a national sample – results of the BELLA study

Abstract: Background There is a lack of representative prevalence rates for attention deficit-/hyperactivity disorder (ADHD) according to DSM-IV criteria and hyperkinetic disorder (HD) according to ICD-10 criteria for German subjects.

Predictive Validity of DSM-IV and ICD-10 Criteria for ADHD and Hyperkinetic Disorder.

Abstract: Background: The goal of this study was to compare the predictive validity of the two main diagnostic schemata for childhood hyperactivity – attention-deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual– IV) and hyperkinetic disorder (HKD; International Classification of Diseases– 10th Edition). Methods: Diagnostic criteria for ADHD and HKD were used to classify 419 children ages 6 to 16 years referred to a clinic for behavioral problems into one of four groups: HKD, ADHD combined subtype (ADHD-C), ADHD hyperactive-impulsive subtype (ADHD-HI), ADHD inattentive subtype (ADHD-IA). These groups were compared on clinical characteristics including total symptom severity, overall impairment, exposure to psychosocial and neuro-developmental risks, family history of ADHD in first-degree family members, rate and type of comorbidity, intelligence, academic achievement, and on laboratory tests of motor response inhibition and working memory with each other and with normal controls (47). Results: Of the 419 cases, there were 46 HKD (11.0%), 200 ADHD-C (47.7%), 60 ADHD-HI (14.3%) and 113 ADHD-IA (27.0%) cases. The HKD group had more symptoms and was more impaired on teachers’ ratings than were the other groups. The ADHD-C and HKD groups had poorer inhibitory control than the ADHD-IA, ADHD-HI and control groups, and all four clinic groups showed inhibition deficit compared to controls. Groups did not differ in working memory. Compared to controls, the HKD, ADHD-C, ADHD-HI and ADHD-IA groups had higher familial risk of ADHD, greater psychosocial risk exposure, lower intellectual level and poorer academic attainment. However, we observed no differences among the clinic groups in these characteristics. Conclusions: Like earlier versions, ICD-10 and DSM-IV continue to delineate diagnostic entities with substantially different prevalence in clinic samples. However, HKD, ADHD-C, ADHD-IA and ADHD-HI groups overlap substantially in terms of important clinical characteristics, although HKD and ADHD-C may be somewhat more severe variants of the condition than ADHD-IA and ADHD-HI.

Co-transmission of conduct problems with attention-deficit= hyperactivity disorder: familial evidence for a distinct disorder

Abstract: Common disorders of childhood and adolescence are attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent/Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD + CP), and their 1591 siblings. CP was defined as ≥4 on the SDQ conduct-subscale, and T ≥ 65, on Conners’ oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD + CP for siblings of cases with ADHD + CP (RRR = 4.9; 95%CI: 2.59–9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD + CP were lower but significant (RRR = 2.9; 95%CI: 1.6–5.3, p < 0.001). Children with ADHD + CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD + CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD + CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).

Heart Rate and Treatment Effect in Children with Disruptive Behavior Disorders

Abstract: Objective To examine whether children with disruptive behavior disorders (DBDs; hyperkinetic conduct disorder, conduct disorder, hyperkinetic disorder) characterized by low heart rate profit less from an intensive cognitive behavioral intervention aimed at reducing impulsive, oppositional and aggressive behavior problems. Method Basal heart rate was studied in twenty-three children (aged 7–12 years) with DBD at the beginning of intervention comprising an intensive day-care treatment and parent training. The disruptive behavior of the child was assessed before treatment and after termination (12 weeks later). Therapy responders and non-responders were compared in regard to heart rate and other risk factors (cognitive functioning and socio-economic status). Results Statistical analyses yielded evidence for a significant reduction of disruptive problem behaviors (aggression, delinquency) that is more prominent in DBD children with high heart rate scores compared to patients with low heart rate scores. Heart rate was significantly lower in children who did not profit from therapy. A logistic regression analysis revealed that heart rate is a significant predictor for therapy success whereas other risk factors had no impact on therapy success. Conclusion Further studies investigating biological and psychosocial predictors of treatment effectiveness are necessary. In addition, it might be helpful to consider different subtypes of aggressive behavior for selecting the best possible treatment options.

Validity and clinical feasibility of the ADHD rating scale (ADHD-RS) A Danish Nationwide Multicenter Study

Abstract: Aim: To establish the validity of a Danish version of the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS), secondly to present national norm scores compared to that of United States and other European data and thirdly to evaluate ADHD-RS when used for monitoring treatment effectiveness. Methods: A Danish translation of the ADHD-RS was used on a normative sample of 837 children. Two clinical samples, 138 hyperkinetic disorder (HKD) cases and 110 clinical controls were recruited from eleven Danish Child and Adolescent Mental Health (CAMH) centres and assessed according to usual clinical standards. The HKD children were rated by parents and teachers at baseline and at follow-up 3 months later. Results: Internal validity of ADHD-RS was high and the factor structure supported the diagnostic classification system ICD-10. The questionnaire discriminated HKD patients in a mixed clinical sample, and was sensitive to change in symptom load as measured before and after commencing of the treatment. Conclusion: The Danish version of ADHD-RS is valid and clinically feasible when measuring HKD symptom load in a CAMH-setting. The questionnaire provides useful data in patient management, quality improvement and service planning as well as in effectiveness studies of different interventions for patients with HKD and related disorders in routine clinical settings.

Five Years On: Public Sector Service Use Related to Mental Health in Young People with ADHD or Hyperkinetic Disorder Five Years After Diagnosis

Abstract: Background: Little is known about ongoing service use among young people with ADHD, but this information is important to the development of services to support these young people. Methods: A cohort of young people with ADHD or hyperkinetic disorder (n = 115) was followed up five to seven years after diagnosis. Details are presented of their use of public sector services over the 12 months preceding reassessment, compared to young people with ADHD from a large epidemiological study. Results: Most children remained in contact with CAMHS, with high rates of contact with schools, educational professionals and the criminal justice system. Nearly all had taken medication at some point, while many still were using it. There were low reported rates of psychological and group interventions within the last twelve months, but this does not rule out earlier access to such treatments. Conclusions: Children with ADHD utilise long-term support from public sector services, and cross agency strategies or clinics may help to optimise functioning.

[Long-acting medications for the treatment of hyperkinetic disorders - a systematic review and European treatment guideline. Part 1: overview and recommendations].

Abstract: A panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder. Based on this analysis detailed recommendations about the use of these drugs in practice have been developed: (1) Long-acting preparations should be licensed and used; (2) They should not completely replace short-acting drugs (which will be the initial treatment for many children in view of cost and the greater flexibility of dosing). Individual clinical choices are necessary. (3) Both ATX and extended-release stimulants should be available. In addition, detailed recommendations will be made with regard to the criteria to be applied in choosing a preparation for the individual patient.

Psychiatry Finals: EMQs and OSCEs

Abstract: Preface. List of Abbreviations. Introduction. Part 1 Extended matching questions (EMQs). Chapter 1 Introduction to psychiatry. Answers. Chapter 2 General adult psychiatry. Answers. Chapter 3 Organic and substance psychiatry. Answers. Chapter 4 Developmental disorders and other clinical syndromes. Answers. Chapter 5 Treatments in psychiatry. Answers. Chapter 6 Management issues in psychiatry. Answers. Chapter 7 Determinants of psychiatric illnesses. Answers. Chapter 8 Integrated diagnosis. Answers. Part 2 Objective structured clinical examinations (OSCEs). Approaches to objective structured clinical examination stations. 1 History and assessment: Depression. 2 History and assessment: Bipolar affective disorder. 3 History and assessment: Anxiety disorders. 4 History and assessment: Obsessive-compulsive disorder. 5 History and assessment: Eating disorders. 6 History and assessment: Post-traumatic stress disorder. 7 History and assessment: Psychotic illness. 8 History and assessment: Puerperal psychosis. 9 History and assessment: Alcohol history. 10 History and assessment: Opiate misuse and. risk minimisation. 11 History and assessment: Risk assessment for suicidality. 12 History and assessment: Risk assessment for violence. 13 Communication: Schizophrenia. 14 Communication: Alzheimer's disease. 15 Communication: Attention-deficit/hyperkinetic disorder. 16 Communication: Autism (pervasive developmental disorder). 17 Communication: Antidepressant therapy with selective. serotonin reuptake inhibitors. 18 Communication: Lithium therapy. 19 Communication: Clozapine. 20 Communication: Cognitive behavioural therapy. 21 Communication: Electroconvulsive therapy. 22 Communication: Detention under the. Mental Health Act (1983). 23 Practical: Interpretation of blood tests. Further reading

Cambridge Textbook of Effective Treatments in Psychiatry: ADHD and hyperkinetic disorder

Abstract: Editor's note Attention deficit and hyperactivity disorder (ADHD) and hyperkinetic disorder (HKD) are not exactly synonymous. ADHD comes from DSM, and there can be some symptoms of inattention and/or impulsivity and hyperactivity, while HKD comes from ICD, and inattention, impulsivity and hyperactivity must all be present for the diagnosis of HKD to be made. Thus ADHD is a broader diagnostic term, and there is clearer evidence for the effectiveness of medications, especially the stimulants, in HKD than in ADHD. Nonetheless, medications, especially first-line treatment with the psychostimulants, has a great deal of data to support its effectiveness. There are less data supporting the use of other non-stimulant drugs such as atomoxetine and bupropion, and the data are less convincing and have smaller effect sizes than the psychostimulants. While psychosocial treatments, particularly behaviour therapy, have evidence for effectiveness, the evidence is not as strong as for the pharmacologic interventions, and the treatments seem more behaviour specific, less generalizable and quite often lose their effectiveness when the treatments end. While combined psychosocial and psychopharmacologic treatments are effective, it appears that most of the effectiveness comes from the pharmacologic intervention, although patients in combined treatment appear to need lower doses of pharmacologic agents. Introduction Attention deficit hyperactivity disorder (ADHD) or hyperkinetic disorder (HKD) is a common childhood condition affecting children and youth around the world across various cultures (Biederman et al ., 1991; Rohde et al ., 2001)).

Copilul cu adhd - o problemă mondială? abordare din punct de vedere epidemiologic the child with adhd - a worldwide issue? epidemiological approach

Abstract: A relatively great number of children in school age presents a series of behavioral, hyperkinetic or attention disorders. Thus, parents, teachers and specialists often encounter issues as scholar absence, social problems or oppositional defiant disorder when dealing with children. ADHD (attention deficit/hyperkinetic disorder) is one of the most frequent behavioral disorders characterizing childhood and adolescence age.The study proposes to reveal some epidemiological aspects of ADHD in children populaion and adolescent individuals by collecting data from speciality literature. Secondly the study was ment to evaluate the quality of life for these subjects by taking into account the parameters of the disease itself, the comorbidities and the domestic and socio-cultural aspects.