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Diagnosis and Treatment of ADHD in Adolescents

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 45232

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Special Issue Editors

Prof. Dr. Cheng-Fang Yen

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Guest Editor

Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Interests: child and adolescent psychiatry; addiction; sex and gender research
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Dr. Liang-Jen Wang

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Assistant Guest Editor

Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
Interests: child and adolescent psychiatry; neuropsychoendocrinology; psychiatry epidemiology; psychopharmacology
Special Issues, Collections and Topics in MDPI journals

Dr. Ray C. Hsiao

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Assistant Guest Editor

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
Interests: child and adolescent psychiatry; addiction

Dr. Mu-Hong Chen

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Assistant Guest Editor

Department of Psychiatry, Taipei Veterans General Hospital, Tapei 112, Taiwan
Interests: child and adolescent psychiatry; resistant depression; secondary data analysis

Dr. Yi-Ling Chien

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Assistant Guest Editor

Department of Psychiatry, National Taiwan University Hospital, Tapei 112, Taiwan
Interests: child and adolescent psychiatry; autism spectrum disorder

Special Issue Information

Dear Colleagues,

Assessing and managing attention-deficit/hyperactivity disorder (ADHD) in adolescence are unique challenges to physicians. Research has established that nearly 80% of children with ADHD continue to experience symptoms into the adolescent years and suffer from significant disability. There are many factors affecting physicians’ comfort and ability to screen, diagnose and treat adolescent ADHD. First, many of the ADHD symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria are primarily written for younger children and may not be applicable to adolescetns. Some of the ADHD symptoms, such as extreme hyperactivity, may be more subtle in adolescents than in younger children. Second, obtaining reliable reports of adolescents’ current and past symptoms from parents and teachers is more difficult. Third, the presence of comorbidities, such as mood disorders and substance use disorder, may complicate the diagnosis of ADHD. Fourth, demands for all adolescents grow with expected increases in responsibility, planning, futureorientation and organization, yet these are the key areas that are problematic for those with ADHD. Thus, it can be difficult to determine if the adolescent is exhibiting “typical immaturity” within the range of the healthy adolescence or ADHD. The consequences of ADHD symptoms during the adolescent years can have profound longterm impacts for the individuals. Thus, this Special Issue is open to researchers to submit empirical studies associated with the diagnosis and treatment of ADHD in adolescents. This issue is also open to the submission of studies investigating the risk factors of adolescent ADHD and risk-taking behaviors in adolescents with ADHD. The studies can provide knowledge to diminish scientific gaps in research on adolescent ADHD.

Prof. Cheng-Fang Yen
Dr. Liang-Jen Wang
Dr. Ray C. Hsiao
Dr. Mu-Hong Chen
Dr. Yi-Ling Chien
Guest Editors

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Keywords

attention-deficit/hyperactivity disorder
adolescent

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Second Edition: Diagnosis and Treatment of ADHD in Adolescents in International Journal of Environmental Research and Public Health (3 articles)

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12 pages, 1586 KiB

Open AccessArticle

Incidence of Attention Deficit Hyperactivity Disorder (ADHD) Diagnoses in Navarre (Spain) from 2003 to 2019

by Leire Leache, Olast Arrizibita, Marta Gutiérrez-Valencia, Luis Carlos Saiz, Juan Erviti and Julián Librero

Int. J. Environ. Res. Public Health 2021, 18(17), 9208; https://doi.org/10.3390/ijerph18179208 - 31 Aug 2021

Cited by 8 | Viewed by 3416

Abstract

(1) Background: Attention deficit hyperactivity disorder (ADHD) constitutes one of the leading mental health and behavioral disorders in childhood and adolescence. The main objective of this study was to analyze the time trend in the incidence of ADHD diagnoses in Navarre (Spain) from 2003 to 2019 in children and adolescents from 5 to 19 years old. Additionally, the seasonal trends of ADHD incidence and ADHD prevalence were determined. (2) Methods: A population-based observational retrospective study, which included people born between 1991 and 2011 and who attended compulsory education between 2007 and 2017 in Navarre (Spain), was carried out with data from both the Education and Health Department databases. (3) Results: The incidence rate increased from 4.18 cases per 1000 person-years in 2003 to 7.43 cases per 1000 person-years in 2009, before decreasing progressively to 2.1 cases per 1000 person-years in 2019. A peak incidence rate at 7–8 years of age was observed, which is consistent across the study period and for both genders. Males were more than twice as likely to be diagnosed with ADHD than females, with similar time trends in both. A seasonal pattern in ADHD diagnosis was found, with peaks in February–March and the lowest rates in the summer months. Inattentive cases were much more frequent than hyperactive cases, whereas combined cases remained low across the study period. (4) Conclusions: In this age-period-cohort analysis, a clear period and age effect was observed. We found a decreasing trend in the ADHD incidence rate since 2015. Further research is needed to confirm whether a change of trend is occurring globally. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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10 pages, 332 KiB

Open AccessArticle

Did Affiliate Stigma Predict Affective and Behavioral Outcomes in Caregivers and Their Children with Attention-Deficit/Hyperactivity Disorder?

by Chih-Cheng Chang, Yu-Min Chen, Ray C. Hsiao, Wen-Jiun Chou and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2021, 18(14), 7532; https://doi.org/10.3390/ijerph18147532 - 15 Jul 2021

Cited by 8 | Viewed by 2600

Abstract

The aim of this follow-up study was to examine the predictive values of caregivers’ affiliate stigma at baseline for depression in caregivers and internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD) 1 year later. The Study on Affiliate Stigma in Caregivers of Children with ADHD surveyed the levels of affiliate stigma and depression in 400 caregivers and the behavioral problems of their children with ADHD. The levels of the caregivers’ depression and children’s behavioral problems were assessed 1 year later. The associations of caregivers’ affiliate stigma at baseline with depression in caregivers and internalizing and externalizing symptoms in children with ADHD at follow-up were examined using stepwise multiple regression. The results indicated that before caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline positively predicted caregivers’ depression and all children’s behavioral problems. After caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline still positively predicted children’s affective and somatic problems. Parenting training and cognitive behavioral therapy should be provided to caregivers with intense affiliate stigma to prevent emotional problems and difficulties in managing their children’s behavioral problems. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

9 pages, 306 KiB

Open AccessArticle

Risk of Respiratory Infectious Diseases and the Role of Methylphenidate in Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Cohort Study

by Dian-Jeng Li, Yi-Lung Chen, Ray C. Hsiao, Hsiu-Lin Chen and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2021, 18(11), 5824; https://doi.org/10.3390/ijerph18115824 - 28 May 2021

Cited by 7 | Viewed by 3090

Abstract

Children with attention-deficit/hyperactivity disorder (ADHD) are commonly affected by medical illness. The aim of the present study was to explore the risks of contracting respiratory infectious diseases (RIDs), including upper and lower RIDs and influenza, in children with ADHD. We also examined whether methylphenidate has a protective effect regarding the risk of contracting RIDs among children with ADHD who have a history of methylphenidate treatment. Children in the Taiwan Maternal and Child Health Database from 2004 to 2016 were included in the present study. Upper and lower RIDs, influenza, ADHD, age, sex, and records of methylphenidate prescription were identified. A Cox proportional hazards regression model was used to estimate the significance of the risk of RIDs among children with ADHD in comparison with that among children without ADHD after adjustment for sex and age. The self-controlled case series analysis was conducted to examine the protective effect of methylphenidate treatment against RIDs. In total, 85,853 children with ADHD and 1,458,750 children without ADHD were included in the study. After controlling for sociodemographic variables, we observed that children with ADHD had significantly higher risks of upper RIDs, lower RIDs, and influenza infection than did those without ADHD. Among the children with ADHD who had a history of methylphenidate treatment, the risk of contracting RIDs was lower during the methylphenidate treatment period than during the nontreatment period. Children with ADHD had a higher RID risk than those without ADHD. Methylphenidate might reduce the risk of RIDs among children with ADHD who have a history of methylphenidate treatment. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

9 pages, 776 KiB

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Increased Risk of Traumatic Injuries among Parents of Children with Attention Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study

by Dian-Jeng Li, Yi-Lung Chen, Ying-Yeh Chen, Ray C. Hsiao, Wei-Hsin Lu and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2021, 18(7), 3586; https://doi.org/10.3390/ijerph18073586 - 30 Mar 2021

Cited by 2 | Viewed by 2417

Abstract

Children with attention deficit/hyperactivity disorder (ADHD) are vulnerable to traumatic injuries. Parents of children with ADHD experience undesirable impacts more frequently than parents of children without ADHD. The aim of this study was to evaluate whether traumatic injuries are more prevalent in parents of children with ADHD than in parents of children without ADHD. We compared the prevalence of traumatic injuries between parents of children with and without ADHD by using data from the Taiwan Maternal and Child Health Database from 2004 to 2017. The Cox proportional-hazards regression model was used to examine differences in burn injury, fracture, and traumatic brain injury between parents of children with and without ADHD after adjustment for age, urbanicity, and income level. In total, 81,401 fathers and 87,549 mothers who had at least one offspring with ADHD and 1,646,100 fathers and 1,730,941 mothers with no offspring with ADHD were included in the analysis. The results indicated that both fathers and mothers of children with ADHD had higher risks of burn injury, fracture, and traumatic brain injury than fathers and mothers of children without ADHD. Mothers of children with ADHD had higher risks for all kinds of traumatic events than fathers of children with ADHD. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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15 pages, 376 KiB

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Physical Activity Improves Mental Health in Children and Adolescents Irrespective of the Diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)—A Multi-Wave Analysis Using Data from the KiGGS Study

by Parisa Ganjeh, Thomas Meyer, York Hagmayer, Ronny Kuhnert, Ulrike Ravens-Sieberer, Nicole von Steinbuechel, Aribert Rothenberger and Andreas Becker

Int. J. Environ. Res. Public Health 2021, 18(5), 2207; https://doi.org/10.3390/ijerph18052207 - 24 Feb 2021

Cited by 19 | Viewed by 6265

Abstract

Physical activity (PA) may have positive effects on mental health in children and adolescents. This post hoc study aimed to further investigate the relationship between different frequency levels of PA and general mental health as well as specific hyperactivity/inattention symptoms in children and adolescents. Methods: The analyses were based on data drawn from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, a regularly conducted large-scale, epidemiological investigation of somatic and mental health of children and adolescents in Germany. Parents were asked about their children’s attention deficit hyperactivity disorder (ADHD) records and answered questionnaires concerning any mental health problem behavior of the children and adolescents using the Strengths and Difficulties Questionnaire (SDQ). The overall problem score as well as the hyperactivity/inattention symptoms subscale (SDQ-H/I) were entered as outcomes in a regression model controlling for parental socio-economic status and participants’ sex, age, and body mass index (BMI). Cross-sectional analyses were conducted at three time points of the KiGGS study (baseline, wave 1, and wave 2) using general linear models (GLM). This was performed for different age groups (4–5, 6–9, 10–17 years). Results: Significant negative relationships were found between PA and general mental health problems. For the relationship between PA and SDQ-H/I, different patterns emerged at the three time points. There was no interaction between PA frequency levels and diagnosis of ADHD (ADHD vs. non-ADHD controls) regarding the SDQ total score. Conclusion: This study underlines the importance of a high frequency level of PA for a good mental health status among children and adolescents, irrespective of the diagnosis of ADHD. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

16 pages, 1045 KiB

Open AccessArticle

The Association between Low Blood Pressure and Attention-Deficit Hyperactivity Disorder (ADHD) Observed in Children/Adolescents Does Not Persist into Young Adulthood. A Population-Based Ten-Year Follow-Up Study

by Jan Schulz, Franziska Huber, Robert Schlack, Heike Hölling, Ulrike Ravens-Sieberer, Thomas Meyer, Luise Poustka, Aribert Rothenberger, Biyao Wang and Andreas Becker

Int. J. Environ. Res. Public Health 2021, 18(4), 1864; https://doi.org/10.3390/ijerph18041864 - 14 Feb 2021

Cited by 3 | Viewed by 3474

Abstract

Background: Attention-deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood and adolescence associated with relevant psychosocial impairments. The basic pathophysiology of ADHD may be related, at least partly, to a deficit in autonomic arousal processes, which not only influence core symptoms of the disorder, but may also lead to blood pressure (BP) deviations due to altered arousal regulation. Objectives: This study examined long-term changes in BP in children and adolescents with ADHD up to young adulthood. Methods: In children and adolescents aged between 7 and 17 years at baseline, we compared BP recordings in subjects with (n = 1219, 11.1%) and without (n = 9741, 88.9%) ADHD over a 10-year follow-up using data from the nationwide German Health Survey for Children and Adolescents (KiGGS). Propensity score matching was used to improve the comparability between children in the ADHD and control groups with now n = 1.190 in each group. Results: The results of these matched samples revealed that study participants with ADHD showed significantly lower systolic BP (107.6 ± 10.7 mmHg vs. 109.5 ± 10.9 mmHg, p < 0.001, Cohen’s d = 0.17) and diastolic BP (64.6 ± 7.5 mmHg vs. 65.8 ± 7.4 mmHg, p < 0.001, Cohen’s d = 0.16) at baseline. In a sensitivity analysis with a smaller (n = 272) and more stringently diagnosed ADHD group, the significant differences remained stable with somewhat higher Cohen’s d; i.e., 0.25 and 0.27, respectively. However, these differences did not persist after 10-year follow-up in a smaller matched longitudinal sub-group (ADHD n = 273; control n = 323), as subjects with and without ADHD had similar levels of systolic (123.4 ± 10.65 vs. 123.78 ± 11.1 mmHg, p = 0.675, Cohen’s d = 0.15) and diastolic BP (71.86 ± 6.84 vs. 71.85 ± 7.06 mmHg, p = 0.992, Cohen’s d = 0.16). Conclusions: At baseline, children and adolescents with ADHD had significantly lower BP (of small effect sizes) compared to the non-ADHD group, whereas this difference was no longer detectable at follow-up ten years later. These developmental alterations in BP from adolescence to early adulthood may reflect changes in the state of autonomic arousal, probably modulating the pathophysiology of ADHD. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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7 pages, 300 KiB

Open AccessArticle

Increased Alopecia Areata Risk in Children with Attention-Deficit/Hyperactivity Disorder and the Impact of Methylphenidate Use: A Nationwide Population-Based Cohort Study

by Hsing-Ying Ho, Chih-Kai Wong, Szu-Yuan Wu, Ray C. Hsiao, Yi-Lung Chen and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2021, 18(3), 1286; https://doi.org/10.3390/ijerph18031286 - 1 Feb 2021

Cited by 5 | Viewed by 3914

Abstract

Alopecia areata (AA) is an autoimmune disease that causes sudden hair loss. Although few studies have reported the association between AA and attention-deficit/hyperactivity disorder (ADHD), the impact of methylphenidate (MPH) on AA has not been examined. This study examined whether AA risk is higher in children with ADHD than in those without ADHD as well as the impact of MPH use on AA risk in children with ADHD. From the Taiwan Maternal and Child Health Database, we enrolled all 1,750,456 newborns from 2004 to 2017 in Taiwan. Of them, 90,016 children received a diagnosis of ADHD whereas the remaining 1,660,440 did not. To compare AA risk in ADHD and the impact of MPH treatment on it, multiple Cox regression with adjustments for covariates (i.e., age, sex, and psychiatric comorbidities) was performed. The results indicated that 88 (0.098%) children with ADHD and 1191 (0.072%) children without ADHD had AA. Nevertheless, after adjustment for the covariates, AA risk was higher in children with ADHD than in those without ADHD (adjusted hazard ratio [aHR]: 1.30, 95% confidence interval [CI]: 1.04–1.64). Our data indicated a considerable reduction in AA risk (aHR: 0.64) among children with ADHD who received MPH than among those who did not receive MPH; however, this difference was nonsignificant, indicated by a wide 95% CI (0.32–1.25). In conclusion, ADHD and AA may share some underlying mechanisms. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

11 pages, 366 KiB

Open AccessArticle

Stress/Immune Biomarkers in Saliva among Children with ADHD Status

by Anna Krahel, Elzbieta Paszynska, Agnieszka Slopien, Maria Gawriolek, Justyna Otulakowska-Skrzynska, Szymon Rzatowski, Amadeusz Hernik, Tomasz Hanć, Ewa Bryl, Paula Szczesniewska, Karolina Bilska, Joanna Duda, Marta Tyszkiewicz-Nwafor and Monika Dmitrzak-Weglarz

Int. J. Environ. Res. Public Health 2021, 18(2), 769; https://doi.org/10.3390/ijerph18020769 - 18 Jan 2021

Cited by 11 | Viewed by 3584

Abstract

Background. This cross-sectional study aimed to evaluate stress and immune biomarkers in saliva samples of attention-deficit/hyperactivity disorder ADHD compared to healthy non-ADHD children. Material and methods. A total of 132 children under 11 years old (8.5 ± 1.1) enrolled in a cross-sectional study: with confirmed ADHD (n = 60) and healthy controls (n = 72). The clinical evaluation included physical measurements (height, waist, hip circumference, body weight, body mass index BMI, BMI z-score) and unstimulated saliva collection and measurements of free cortisol, salivary alpha-amylase (sAA), and secreted immunoglobulins (sIgA, IgG, and IgM) with quantitative assay (ELISA) analysis. Unpaired t-test, Welch test, or Mann–Whitney U test were applied for group comparisons when appropriate, and the correlation between variables was analyzed with Spearman’s rank coefficient. Results were considered significant at p < 0.05. Results. In the ADHD group, body weight (p ≤ 0.01), BMI (p ≤ 0.009), and hip circumference (p ≤ 0.001) significantly differed, while waist size and BMI z-score did not (p > 0.05). Significant elevation of the salivary sAA (p = 0.03), sIgA (p = 0.02), and IgM (p ≤ 0.001) biomarkers were detected, without differences in the morning cortisol (p > 0.05). Significant correlations between cortisol and BMI, hip size, and IgA, as well as between IgG and sAA and IgA were obtained. Conclusions. Saliva can be used to monitor ADHD status with regard to biomarkers indicating the hypothalamus–pituitary–adrenal axis, as HPA axis, and sympathetic activity. The results indicate that morning collection of saliva in contrast to unchanged salivary cortisol, may evaluate mentioned above system dysregulations by measurements of sAA and immunoglobulins among ADHD children. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

17 pages, 3855 KiB

Open AccessArticle

Objective Analysis of Movement in Subjects with ADHD. Multidisciplinary Control Tool for Students in the Classroom

by Mireia Sempere-Tortosa, Francisco Fernández-Carrasco, Francisco Mora-Lizán and Carlos Rizo-Maestre

Int. J. Environ. Res. Public Health 2020, 17(15), 5620; https://doi.org/10.3390/ijerph17155620 - 4 Aug 2020

Cited by 9 | Viewed by 3889

Abstract

The term Attention Deficit Hyperactivity Disorder (ADHD) has a long history of problems behind it. The origin of all these problems lies in the lack of agreement in the assessment procedures and evaluation instruments. The diagnosis is clinical and is determined by the observation and information provided by parents and teachers. So, this is highly subjective and leads to disparate results. Therefore, on the one hand the inaccuracy of the diagnosis of ADHD, which has been based on subjective criteria, together with the fact that hyperactivity is one of the main symptoms of this disorder, implies that several studies (with limitations) have been carried out to record objective measures of movement in subjects in at least the last ten years. In order to solve some of this derived problems and limitations of previous studies, a computer program has been developed to objectively record the amount of movement of subjects. The main objective of this study is threefold: first to register the amount of movement of both experimental group and control group, then to compare them with the movement registered by observers and finally to determine the validity of the software developed as a tool to support the diagnosis of ADHD. Results show that there are significant differences in the amount of objective movement between a clinical group of subjects with ADHD and a control group, obtaining a higher average of movement the experimental group. In addition, results also demonstrate that the developed software is a valid tool for the evaluation of movement that solves the limitations of previous studies. The proposed tool is developed from different aspects to give it a multidisciplinary character. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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11 pages, 324 KiB

Open AccessArticle

Adolescent–Parent Agreement on Callous–Unemotional Traits in Adolescents with Attention-Deficit/Hyperactivity Disorder

by Yi-Lung Chen, Ray C. Hsiao, Wen-Jiun Chou and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(11), 3888; https://doi.org/10.3390/ijerph17113888 - 30 May 2020

Cited by 1 | Viewed by 2359

Abstract

This study examined the levels of agreement between the reports of 207 adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents regarding the adolescents’ callous–unemotional (CU) traits and investigated the factors influencing adolescent–parent agreement. Adolescent–parent agreement about CU traits in three dimensions according to the Chinese version of the Inventory of Callous and Unemotional Traits was examined. The influence of demographic characteristics, comorbid conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD symptoms on adolescent–parent agreement was also examined. The results indicated that adolescent–parent agreement on the CU trait of uncaringness was moderate, whereas agreement on the CU traits of callousness and unemotionality was poor. Adolescent–parent agreement on the three dimensions of CU traits varied depending on the adolescents’ sex and comorbid CD and ODD symptoms as well as parental age. Therefore, multiple sources of information are required when assessing the severity of CU traits in adolescents with ADHD. The factors influencing the levels of the agreement should also be considered. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

10 pages, 641 KiB

Open AccessArticle

Attention-Deficit/Hyperactivity Disorder, Its Pharmacotherapy, and Adrenal Gland Dysfunction: A Nationwide Population-Based Study in Taiwan

by Pin-Han Peng, Meng-Yun Tsai, Sheng-Yu Lee, Po-Cheng Liao, Yu-Chiau Shyu and Liang-Jen Wang

Int. J. Environ. Res. Public Health 2020, 17(10), 3709; https://doi.org/10.3390/ijerph17103709 - 25 May 2020

Cited by 2 | Viewed by 3942

Abstract

This study aims to examine the co-occurrence rate of attention deficit hyperactivity disorder (ADHD) and adrenal gland disorders, as well as whether pharmacotherapy may affect ADHD patients’ risk of developing adrenal gland disorder. One group of patients newly diagnosed with ADHD (n = 75,247) and one group of age- and gender-matching controls (n = 75,247) were chosen from Taiwan′s National Health Insurance database during the period of January 1999 to December 2011. Both patients and controls were monitored through December 31, 2011, in order to identify the occurrence of adrenal gland disorders (ICD-9-CM code 255.X). We also explored the potential effect of methylphenidate (MPH) and atomoxetine (ATX) treatments on the risk of developing adrenal gland disorders. We found that ADHD patients showed a significantly increased probability of developing an adrenal gland disorder compared to the control group (0.2% of ADHD vs. 0.1% of controls). However, neither MPH nor ATX treatment significantly influenced the patients’ risk of developing adrenal gland dysfunction. We propose that patients with ADHD had greater comorbid rates with adrenal gland dysfunction than the control subjects. Nevertheless, undergoing treatment with MPH or ATX did not significantly influence the risk of developing adrenal gland dysfunction among ADHD patients. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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12 pages, 666 KiB

Open AccessArticle

Correlations between Quality of Life, School Bullying, and Suicide in Adolescents with Attention-Deficit Hyperactivity Disorder

by Yi-Lung Chen, Hsing-Ying Ho, Ray C. Hsiao, Wei-Hsin Lu and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(9), 3262; https://doi.org/10.3390/ijerph17093262 - 7 May 2020

Cited by 11 | Viewed by 5029

Abstract

Although adolescents with attention-deficit hyperactivity disorder (ADHD) have a higher risk of suicidality and more problems related to school bullying, and quality of life (QoL) is reportedly associated with school bullying, suicide, and ADHD, no study has examined their correlation. This study examined the complex relationships between QoL, school bullying, suicide, and ADHD symptoms. A total of 203 adolescents with ADHD aged between 12 and 18 years were recruited. School bullying and QoL were examined using the Chinese version of the School Bullying Experience Questionnaire and the Taiwanese Quality of Life Questionnaire for Adolescents. Network model analysis was conducted to graphically present their relationships. We identified triangular correlations between school bullying, QoL, and suicidality, indicating possible pathways from school bullying to suicidality, and the originating or mediating roles of personal competence and psychological well-being. Furthermore, the ADHD symptoms of inattention and hyperactivity/impulsivity may differentially regulate these pathways. Longitudinal studies are warranted to confirm these findings. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of ADHD in Adolescents)

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