Diagnostic overshadowing in a population of children with neurological disabilities: A cross sectional descriptive study on acquired ADHD

Hendriksen, Jos G.M.; Peijnenborgh, Janneke; Aldenkamp, Albert P.; Vles, Johan S.H.

doi:10.1016/j.ejpn.2015.04.004

Cited by 37 publications

(25 citation statements)

References 13 publications

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“…Recently, the term “diagnostic overshadowing” was used to describe the underdiagnoses of comorbid psychiatric conditions in children with severe neurological diseases (Hendriksen, Peijnenborgh, Aldenkamp, & Vles, ). The authors suggested that more obvious and important somatic features may overshadow a comorbid ADHD.…”

Section: Discussionmentioning

confidence: 99%

Tyrosinemia Type 1 and symptoms of ADHD: Biochemical mechanisms and implications for treatment and prognosis

Barone

Bliksrud

Elgen

et al. 2019

American J of Med Genetics Pt B

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Hereditary tyrosinemia Type 1 (HT-1) is a rare metabolic disease where the enzyme catalyzing the final step of tyrosine breakdown is defect, leading to accumulation of toxic metabolites. Nitisinone inhibits the degradation of tyrosine and thereby the production of harmful metabolites, however, the concentration of tyrosine also increases. We investigated the relationship between plasma tyrosine concentrations and cognitive functions and how tyrosine levels affected enzyme activities of human tyrosine hydroxylase (TH) and tryptophan hydroxylase 2 (TPH2). Eight Norwegian children between 6 and 18 years with HT-1 were assessed using questionnaires measuring Attention Deficit Hyperactivity Disorder (ADHD)-symptoms and executive functioning. Recent and past levels of tyrosine were measured and the enzyme activities of TH and TPH2 were studied at conditions replicating normal and pathological tyrosine concentrations. We observed a significant positive correlation between mean tyrosine levels and inattention symptoms. While TH exhibited prominent substrate inhibition kinetics, TPH2 activity also decreased at elevated tyrosine levels.Inhibition of both enzymes may impair syntheses of dopamine, noradrenaline, and serotonin in brain tissue. Inattention in treated HT-1 patients may be related to decreased production of these monoamines. Our results support recommendations of strict guidelines on plasma tyrosine levels in HT-1. ADHD-related deficits, particularly inattention, should be monitored in HT-1 patients to determine whether intervention is necessary. K E Y W O R D SADHD, dopamine, hereditary tyrosinemia Type 1, inattention, serotonin

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Section: Discussionmentioning

confidence: 99%

Tyrosinemia Type 1 and symptoms of ADHD: Biochemical mechanisms and implications for treatment and prognosis

Barone

Bliksrud

Elgen

et al. 2019

American J of Med Genetics Pt B

View full text Add to dashboard Cite

show abstract

“…“Diagnostic overshadowing” is a form of bias in which somatic symptoms or complaints may be misattributed to pre-existing neuropsychiatric pathology, and presumably lead to delays in accurate diagnosis. It has been previously reported in children with neurological conditions such as intellectual disability (48) and autism spectrum conditions (49) and psychiatric patients presenting to Emergency Departments (50, 51). To date, there have been no well-powered longitudinal epidemiological studies clarifying the role of diagnostic overshadowing or demonstrating symptoms of bipolar disorder consistently predating multiple sclerosis.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Bipolar Disorders and Association With Quality of Life in a Cohort of Patients With Multiple Sclerosis

Jun-O’Connell¹,

Butala²,

Morales³

et al. 2017

JNP

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Clinical observations of mood instability in multiple sclerosis (MS) have led to the hypothesis that bipolar disorder (BD) may be more prevalent in persons with MS than in the general population. This cross-sectional study assesses the prevalence of BD among patients with MS using standardized psychiatric diagnostic interviews, and evaluates quality of life. This study demonstrates a higher prevalence of BD in patients with MS compared to the general population. It also shows the negative impact of BD on quality of life, raises the concern that BD can occur before the onset of neurological symptoms in MS, and reveals how BD may delay diagnosis of MS in patients.

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“…Attention Deficit-Hyperactivity Disorder (ADHD) is the most common psychological disorder in childhood with estimated prevalence of 5.29% worldwide and 10% in Iran [14,15]. The results of this study indicate that there is no significant difference between The clinician who visit the ADHD children usually focus on improving hyperactivity, attention deficit and impulsiveness.…”

Section: Discussionmentioning

confidence: 55%

Comparison of Risperidone and Melatonin Effects in Methylphenidate Treated Children with Attention Deficit Hyperactivity Disorder for Treatment of Sleep Disorders

F¹,

J²,

Sabzali³

et al. 2017

J Sleep Disord Ther

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Objectives: Some studies reported a significant improvement in sleep parameters by melatonin therapy in children with ADHD. Utilizing risperidone along with stimulants is another pharmacologic approach for ADHD treatment. In this study we investigated the effect of melatonin and risperidone on sleep disorders in children with ADHD and compared their effectiveness as well.Methods & Methods: 29 patient aged 6 years to 12 years old with ADHD were randomly divided into two groups based on file number: either received melatonin (3 mg to 6 mg) combined with Ritalin or received risperidone (0.25mg to 0.5 mg) combined with Ritalin in a single blind randomized clinical trial. Assessments were performed at baseline and were repeated at 2 and 4 weeks after beginning of the treatment. Results:In risperidone group significant differences has been found in total score of sleep disorders (P=0.000), sleep onset and maintenance score (P=0.000), Sleep-wake transition disorders (P=0.000), but no significant differences in breathing (P=0.104), and hyperhidrosis (P=0.105) and excessive daytime sleepiness score (p=0.065), and in arousal group after 2 weeks (p=0.027) and after 4 weeks (p=0.150). comparison of melatonin group in different weeks (Base line with 2 and 4 weeks after treatment), show significant differences in total score of sleep disorders (P=0.000), sleep onset and maintenance score (P=0.000), Sleep-wake transition disorders (P=0.003), excessive daytime sleepiness (P=0.004), but no significant differences in breathing (P=0.068) and arousal (P=0.218) and hyperhydrosis score (P=0.336). Conclusion:The results showed the equal effect of risperidone and melatonin. It can be concluded that the risperidone has the same effect of melatonin in the treatment of sleep disorders in children with ADHD.

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Diagnostic overshadowing in a population of children with neurological disabilities: A cross sectional descriptive study on acquired ADHD

Cited by 37 publications

References 13 publications

Tyrosinemia Type 1 and symptoms of ADHD: Biochemical mechanisms and implications for treatment and prognosis

Tyrosinemia Type 1 and symptoms of ADHD: Biochemical mechanisms and implications for treatment and prognosis

The Prevalence of Bipolar Disorders and Association With Quality of Life in a Cohort of Patients With Multiple Sclerosis

Comparison of Risperidone and Melatonin Effects in Methylphenidate Treated Children with Attention Deficit Hyperactivity Disorder for Treatment of Sleep Disorders

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