The aim of this study was to demonstrate the effectiveness of cognitive behavioural treatment (CBT) with a focus on academic skills and conduct problems and to increase parents' educational skills in managing aggressive and oppositional behaviour in a subsequent parent training (PMT). For this purpose 18 children with a diagnosis of ADHD combined type participated in the study. In an A-B study design the effects of a 12-week treatment phase (6 weeks CBT; 6 weeks PMT) were compared with a preceding 4-week baseline. Core symptoms of ADHD, conduct problems and individual problem behaviour were assessed by weekly administration of parent and teacher questionnaires. The results indicate a significant and generalized reduction of ADHD core symptoms, conduct problems and homework problems during CBT at home and at school. PMT resulted in a further amelioration of the cited symptoms. We conclude that CBT may be a promising component in the treatment of ADHD provided that aspects of generalization are considered during the treatment. PMT may be a useful adjunct in most cases as it is effective in situations where the ADHD child still has problems of self-guidance.
Attention-deficit hyperactivity disorder (ADHD) is associated with substantial functional, clinical and economic burdens. It is among the most common psychiatric disorders in children and adolescents, and often persists into adulthood. Both medication and psychosocial interventions are recommended for the treatment of ADHD. However, ADHD treatment practices vary considerably, depending on medication availability, reimbursement and the evolution of clinical practice in each country. In Europe, stimulants and atomoxetine are widely available medications for the treatment of ADHD, whereas in the US approved treatment options also include extended-release formulations of clonidine and guanfacine. Lisdexamfetamine dimesylate (lisdexamfetamine) is a long-acting, prodrug formulation of dexamfetamine. It is currently licensed in the US, Canada and Brazil, and is undergoing phase III studies in Europe. We performed a PubMed/MEDLINE search looking for recent (2005-2012) scientific papers regarding the pharmacokinetics, pharmacodynamics, efficacy and safety of lisdexamfetamine. The lisdexamfetamine molecule is therapeutically inactive and is enzymatically hydrolysed, primarily in the blood, to the active dexamfetamine. This conversion is unaffected by gastrointestinal pH and variations in normal transit times. Lisdexamfetamine was developed with the goal of providing an extended duration of effect that is consistent throughout the day. Clinical trials have demonstrated robust clinical efficacy of lisdexamfetamine in the treatment of children, adolescents and adults with ADHD with dose-dependent improvements in the core symptoms of ADHD. Studies have further shown that the duration of action of lisdexamfetamine continues for 13 hours post-dosing in children and for 14 hours in adults. The tolerability profile of lisdexamfetamine is consistent with those of other stimulant medications, with decreased appetite, insomnia, abdominal pain and irritability among the more frequent treatment-emergent adverse events, most of which are mild to moderate in intensity and transient in nature. There are currently no parallel-group, head-to-head trial data comparing the efficacy and safety of lisdexamfetamine with other medications for ADHD. However, the available data, including a large effect size and consistent plasma concentrations throughout the day, suggest that lisdexamfetamine is a useful treatment option for patients with ADHD.
COVID-19 infections in adults often result in medical, neuropsychiatric, and unspecific symp-toms, called Long COVID, and the premorbid functional status cannot be achieved. Regarding the course in children and adolescents, however, reliable data are not yet available. Objective: 380 children and adolescents/young adults aged between 6 and 21 years, being treated for various psychiatric diseases in an outpatient clinical service, were examined for COVID-19 infections and Long COVID symptoms following a structured protocol. Results: Three patients had COVID-19; one patient had symptoms of Long COVID in his medical histo-ry, but they could not be objectivized in an in-depth neuropsychiatric and neuropsychological assessment. Conclusions: Long COVID seems to occur rarely in children and adolescents. Objectivizing the symptoms is a difficult task that requires various diagnostic considerations.
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