OBJECTIVETo investigate influential factors for the tendency to medicate and medication compliance in children with attention deficit hyperactivity disorder (ADHD).

METHODSA total of 188 children aged from 5 to 16 years, who were initially diagnosed with ADHD according to DSM-IV criteria, were included in the study. They underwent symptom assessment and cognitive function test. The compliance of methylphenidate treatment was evaluated.

RESULTSPatients with better emotional state, and fewer oppositional and hyperactive behaviors and those who had a family history of psychiatric diseases and who obtained lower scores in the number cancellation test (NCT), were more prone to medication and/or exhibited better medication compliance. Logistic regression analysis showed that fewer oppositional and hyperactive behaviors and lower NCT scores were the predictive factors for a higher tendency to medicate, and a better emotional state was the predictive factor for better medication compliance. Patients of predominantly inattentive type were more prone to medication and showed better medication compliance, as compared with those of combined type. Gender, age and symptom severity were not associated with the tendency to medicate and/or medication compliance.

CONCLUSIONSThere is a need to enhance medication compliance in children with ADHD who have hyperactive, impulsive and oppositional behaviors, and to improve their long-term social functions.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; psychology ; Central Nervous System Stimulants ; therapeutic use ; Child ; Child, Preschool ; Emotions ; Female ; Humans ; Logistic Models ; Male ; Medication Adherence ; Methylphenidate ; therapeutic use

Caffeine,as an important component of refreshment beverage,has been used for a long history. In recent years,its effect on pain relief has been widely explored. As one of nonselective adenosine receptor blockers,caffeine plays different roles in the central and peripheral pain. This review explores the roles of caffeine in acute and chronic pain and the potential mechanisms.
Adenosine ; antagonists & inhibitors ; metabolism ; Caffeine ; pharmacology ; therapeutic use ; Central Nervous System Stimulants ; pharmacology ; therapeutic use ; Chronic Pain ; drug therapy ; Humans ; Pain ; drug therapy

Adolescent ; Attention Deficit Disorder with Hyperactivity ; diagnosis ; etiology ; therapy ; Behavior Therapy ; Central Nervous System Stimulants ; therapeutic use ; Child ; Humans ; Methylphenidate ; therapeutic use ; Young Adult

OBJECTIVETo explore the effect of Jiangqian granule (JQG) in treating children attention deficit hyperactivity disorder (ADHD) and its mechanism.

METHODSEighty children with ADHD were randomly divided into two groups, the treated group treated with JQG and the control group treated with Ritalin. Blood lead concentration and Conners' scoring were measured before and after 3 months treatment and the therapeutic effects were assessed. Besides, blood lead concentration and Conners' scoring in 60 healthy children were also determined for control.

RESULTSThe total effective rate in the treated group and the control group was 92.5% and 72.5% respectively, significant difference existed between the two groups. Blood lead level and Conners' scores in ADHD patients were significantly higher than those in the healthy control (P < 0.01). The two parameters decreased after treatment in both groups, but the lowering was more significant in the treated group (P < 0.05, P < 0.01).

CONCLUSIONBlood lead concentration raised in ADHD patients, JQG could enhance the clinical therapeutic effect by means of reducing the blood lead.

Attention Deficit Disorder with Hyperactivity ; blood ; drug therapy ; Central Nervous System Stimulants ; therapeutic use ; Child ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Lead ; blood ; Male ; Methylphenidate ; therapeutic use ; Phytotherapy

OBJECTIVETo seek for a good therapy for childhood hyperkinetic syndrome (CHS).

METHODSTwo hundred and ten patients of CHS were randomly divided into three groups, the Yizhi mixture (YZM) group, the Ritalin group and the combined treated group, 70 in each group. They were treated with YZM alone, Ritalin alone and combined YZM and Ritalin respectively for 12 weeks. The effect was assessed by Conners' questionnaire for hyperkinetic scoring, Achenbach's questionnaire for behavior estimation, clinical general image questionnaire and Tess's questionnaire before and after treatment.

RESULTSThe total effective rate in the YZM group, Ritalin group and combined treated group was 75.7%, 74.2% and 82.8% respectively, and the markedly effective rate in the three groups was 44.3%, 45.7% and 80.0% respectively. By chi 2 test, comparison among the three groups showed that the difference of the total effective rate was insignificant, while that of the markedly effective rate was significant (chi 2 = 23.31, P < 0.01). Further analysis conducted by partitioning method to make comparison between each two groups showed that the markedly effective rate was significantly higher in the combined treated group than that in the YZM group (chi 2 = 18.98, P < 0.01) and in the Ritalin group (chi 2 = 17.62, P < 0.01). The low hyperkinetic score, behavior score, achievement of Chinese and mathematics in the CHS patients were improved after treatment, the improvements were significantly higher in the combined treated group than those in the other two groups (P < 0.05, by q-test). Moreover, the soft nerve signs and abnormal encephalogram were significantly improved in the combined treated and the YZM groups, and the side-effect occurred in the two groups was less than that in the Ritalin group (P < 0.01).

CONCLUSIONThe therapeutic effect of combined treatment of YZM and Ritalin was better than that of YZM or Ritalin alone.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; Central Nervous System Stimulants ; therapeutic use ; Child ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Methylphenidate ; therapeutic use ; Phytotherapy

We examined short- and long-term medication compliance among youth with attention-deficit hyperactivity disorder (ADHD), using data from the National Health Insurance database in Korea. Of the 5,699,202 6-14-year-old youth in 2008, we chose those with at least 1 medical claim containing an ICD-10 code for diagnosis of ADHD (F90.0) and no prescription for ADHD within the previous 365 days. We tracked the data every 6 months between 2008 and 2011, to determine treatment compliance among newly diagnosed, medicated patients. Further, we checked every 1 month of the 6 months after treatment commencement. Treatment continuity for each patient was calculated by sequentially counting the continuous prescriptions. For measuring compliance, we applied the medication possession ratio (MPR) as 0.6, 0.7, and 0.8, and the gap method as 15- and 30-days' intervals. There were 15,133 subjects; 11,934 (78.86%) were boys. Overall 6-month treatment compliance was 59.0%, 47.3%, 39.9%, 34.1%, 28.6%, and 23.1%. Monthly drop-out rates within the first 6 months were 20.6%, 6.5%, 4.7%, 3.7%, 3.0%, and 2.5%, respectively. When applying MPR more strictly or shorter gap days, treatment compliance lessened. This is the first nationwide report on 36-month treatment compliance of the whole population of 6-14-year-olds with ADHD. We found the beginning of the treatment, especially the first month, to be a critical period in pharmacotherapy. These results also suggest the importance of setting appropriate treatment adherence standards for patients with ADHD, considering the chronic course of ADHD.
Adolescent ; Attention Deficit Disorder with Hyperactivity/diagnosis/*drug therapy ; Central Nervous System Stimulants/*therapeutic use ; Child ; Databases, Factual ; Female ; Humans ; Male ; *Medication Adherence ; Methylphenidate/*therapeutic use ; Republic of Korea ; Retrospective Studies

OBJECTIVETo investigate the effect of parent training combined with methylphenidate treatment on family relationships in children with attention deficit/hyperactivity disorder (ADHD).

METHODSFifty-nine parents of children with ADHD under methylphenidate treatment participated in a modified 5-week training program. The intervention effect was evaluated using the Conners Parent Symptom Questionnaire, ADHD Rating Scale-IV Home Version (ADHD-RS-IV Home Version), Caregiver Strain Questionnaire, Parent-Child Relationship Self-rating Scale and Piers-Harris Children's Self-Concept Scale. Parents also completed the training satisfaction survey before and after the intervention.

RESULTSAfter the 5-week parent training, compared with the baseline values, total scores of Conners Parent Symptom Questionnaire and scores of conduct problems and anxiety significantly decreased, and scores of attention deficit, hyperactivity, impulsivity and oppositional defiant behaviors of ADHD-RS-IV Home Version, and Caregiver Strain Questionnaire total scores were all significantly decreased (P<0.05), while total scores of the Parent-Child Relationship Self-Rating Scale and Piers-Harris Children's Self-Concept Scale were significantly increased (P<0.05).

CONCLUSIONSModified 5-week parent training program may improve parent-child relationship and reduce parenting stress in ADHD families.

Adolescent ; Attention Deficit Disorder with Hyperactivity ; drug therapy ; psychology ; Central Nervous System Stimulants ; therapeutic use ; Child ; Female ; Humans ; Male ; Methylphenidate ; therapeutic use ; Parent-Child Relations ; Parents ; education ; psychology ; Self Concept

OBJECTIVETo determine whether long-term treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate influences the growth in height and weight of children.

METHODSAnalyses were performed on 146 school age children (126 boys) diagnosed as ADHD and treated with methylphenidate [0.27-0.64 mg/(kg.day)] for methylphenidate group and 29 children with ADHD who did not receive any medication for ADHD (controls). These children were followed-up for 2-4 years. Changes in height and weight after long-term treatment with methylphenidate were recorded and the factors affecting growth of height, weight, and height velocity were analyzed.

RESULTSThe change of difference between patients' height and mean height in methylphenidate group and controls was (-1.86 +/- 0.82) cm (paired t test, t = 27.335, P < 0.001) and (-0.26 +/- 0.51) cm (P < 0.05), respectively; the change of height standard deviation score (SDS) in methylphenidate group and controls was -0.14 +/- 0.23 SD (paired t test, t = 7.326, P < 0.001) and +0.05 +/- 0.10 SD (P < 0.05), respectively. When the height change and height SDS change in methylphenidate group and controls were compared by using independent-samples T-test, the t value was -10.078 and -4.262 respectively, P for both was < 0.001. Both of bivariate correlation analysis and stepwise multiple-regression analysis indicated that the duration of treatment contributed significantly to the variance in change of height (P < 0.001); but age, sex, DSM-IV type, NJ22 degree and dose of methylphenidate did not contribute significantly to the variance of height. The mean height velocity from 1st to 4th year was 4.28 cm/year, 4.90 cm/year, 4.98 cm/year and 4.95 cm/year, respectively. With Friedman test, Chi-square = 253.673, P < 0.001. The change of difference of patients' weight to weight for height after methylphenidate was (-0.14 +/- 1.25) kg (paired t test, t = 1.326, P > 0.05).

CONCLUSIONSmall but significant deceleration of height velocity is the identified long-term side effect of methylphenidate, the magnitude of height deficit is related to duration of treatment. The height velocity was significantly attenuated in the first year. Methylphenidate had no significant influence on weight.

Attention Deficit Disorder with Hyperactivity ; drug therapy ; Body Height ; drug effects ; Body Weight ; drug effects ; Case-Control Studies ; Central Nervous System Stimulants ; adverse effects ; therapeutic use ; Child ; Child Development ; Female ; Humans ; Male ; Methylphenidate ; adverse effects ; therapeutic use ; Regression Analysis

Attention Deficit Disorder with Hyperactivity ; psychology ; therapy ; Behavior Therapy ; methods ; Central Nervous System Stimulants ; therapeutic use ; Child ; Combined Modality Therapy ; Humans ; National Institute of Mental Health (U.S.) ; Social Adjustment ; Treatment Outcome ; United States

PURPOSE: The aim of this study was to clarify the relationship between the autonomic nervous system and attention deficit hyperactivity disorder (ADHD) rating scales and to evaluate the usefulness of heart rate variability (HRV) as a psychophysiological biomarker for ADHD. MATERIALS AND METHODS: Subjects were recruited from outpatients in the Department of Child and Adolescent Psychiatry at the Korea University Medical Center from August 2007 to December 2010. Subjects received methylphenidate. Time- and frequency-domain analyses of HRV, the Korean ADHD rating scale (K-ARS), and computerized ADHD diagnostic system were evaluated before treatment. After a 12-week period of medication administration, we repeated the HRV measurements and K-ARS rating. RESULTS: Eighty-six subjects were initially enrolled and 37 participants completed the 12-week treatment and HRV measurements subsequent to the treatment. Significant correlations were found between the K-ARS inattention score and some HRV parameters. All of the HRV parameters, except the standard deviations of the normal-to-normal interval, very low frequency, and low frequency to high frequency, showed a significant positive correlation between baseline and endpoint measures in completers. High frequency (HF) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD), which are related to parasympathetic vagal tone, showed significant decreases from baseline to endpoint. CONCLUSION: The HRV test was shown to be reproducible. The decrease in HF and RMSSD suggests that parasympathetic dominance in ADHD can be altered by methylphenidate treatment. It also shows the possibility that HRV parameters can be used as psychophysiological markers in the treatment of ADHD.
Adolescent ; Attention/drug effects/*physiology ; Attention Deficit Disorder with Hyperactivity/diagnosis/*drug therapy ; Autonomic Nervous System/physiopathology ; Biomarkers ; Central Nervous System Stimulants/pharmacology/*therapeutic use ; Child ; Female ; Heart Rate/*drug effects/physiology ; Humans ; Male ; Methylphenidate/pharmacology/*therapeutic use ; Prospective Studies ; Republic of Korea ; Treatment Outcome