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In March 2020, many schools were closed to prevent the spread of COVID-19 in Japan, and it is predicted that many children, especially those with neurodevelopmental disorders (NDDs), will be affected emotionally and behaviorally. Here, we examined the impact of school closures due to COVID-19 on school-aged children with NDDs using the Child Behavior Checklist. Totally, data on 121 children diagnosed with autism spectrum disorder, attention-deficit hyperactivity disorder, and/or intellectual disorder were analyzed and it was found that externalizing and aggressive behavior increased in all NDDs, regardless of the type of diagnosis. A clear prospect is important for children with NDDs children to lead a stable life, and more generous supports for children with NDDs and their families are needed. Supplementary Information The online version contains supplementary material available at 10.1007/s10803-021-05119-0.

Critical commentary on Fintan O’Regan’s paper Exclusion from School and Attention-Deficit/Hyperactivity Disorder., peer-reviewed

Critical commentary on Fintan O’Regan’s paper Exclusion from School and Attention-Deficit/Hyperactivity Disorder., peer-reviewed

Critical commentary on Fintan O’Regan’s paper Exclusion from School and Attention-Deficit/Hyperactivity Disorder, peer-reviewed

Critical commentary on Fintan O’Regan’s paper Exclusion from School and Attention-Deficit/Hyperactivity Disorder., peer-reviewed

BackgroundOptimal transition from child to adult services involves continuity, joint care, planning meetings and information transfer; commissioners and service providers therefore need data on how many people require that service. Although attention-deficit hyperactivity disorder (ADHD) frequently persists into adulthood, evidence is limited on these transitions.AimsTo estimate the national incidence of young people taking medication for ADHD that require and complete transition, and to describe the proportion that experienced optimal transition.MethodSurveillance over 12 months using the British Paediatric Surveillance Unit and Child and Adolescent Psychiatry Surveillance System, including baseline notification and follow-up questionnaires.ResultsQuestionnaire response was 79% at baseline and 82% at follow-up. For those aged 17–19, incident rate (range adjusted for non-response) of transition need was 202–511 per 100 000 people aged 17–19 per year, with successful transition of 38–96 per 100 000 people aged 17–19 per year. Eligible young people with ADHD were mostly male (77%) with a comorbid condition (62%). Half were referred to specialist adult ADHD and 25% to general adult mental health services; 64% had referral accepted but only 22% attended a first appointment. Only 6% met optimal transition criteria.ConclusionsAs inclusion criteria required participants to be on medication, these estimates represent the lower limit of the transition need. Two critical points were apparent: referral acceptance and first appointment attendance. The low rate of successful transition and limited guideline adherence indicates significant need for commissioners and service providers to improve service transition experiences.

Significance: It has been reported that children with attention-deficit hyperactivity disorder (ADHD) have impairment in the recognition of angry but not of happy facial expressions, and they show atypical cortical activation patterns in response to facial expressions. However, little is known about neural mechanisms underlying the impaired recognition of facial expressions in school-aged children with ADHD and the effects of acute medication on their processing of facial expressions. Aim: We aimed to investigate the possibility that acute administration of methylphenidate (MPH) affects processing of facial expressions in ADHD children. Approach: We measured the hemodynamic changes in the bilateral temporo-occipital areas of ADHD children observing the happy and angry facial expressions before and 1.5 h after MPH or placebo administration in a randomized, double-blind, placebo-controlled, crossover design study. Results: We found that, regardless of medication, happy expressions induced increased oxyhemoglobin (oxy-Hb) responses in the right inferior occipital region but not in the superior temporal region. For angry expressions, oxy-Hb responses increased after MPH administration, but not after placebo administration, in the left inferior occipital area, whereas there was no significant activation before MPH administration. Conclusions: Our results suggest that (1) ADHD children consistently recruit the right inferior occipital regions to process happy expressions and (2) MPH administration to ADHD children enhances cortical activation in the left inferior occipital regions when they process angry expressions.

The effectiveness of an 8-week mindfulness training for adolescents aged 11-15 years with ADHD and parallel Mindful Parenting training for their parents was evaluated, using questionnaires as well as computerized attention tests. Adolescents (N = 10), their parents (N = 19) and tutors (N = 7) completed measurements before, immediately after, 8 weeks after and 16 weeks after training. Adolescents reported on their attention and behavioral problems and mindful awareness, and were administered two computerized sustained attention tasks. Parents as well as tutors reported on adolescents’ attention and behavioral problems and executive functioning. Parents further reported on their own parenting, parenting stress and mindful awareness. Both the mindfulness training for the adolescents and their parents was delivered in group format. First, after mindfulness training, adolescents’ attention and behavior problems reduced, while their executive functioning improved, as indicated by self-report measures as well as by father and teacher report. Second, improvements in adolescent’ actual performance on attention tests were found after mindfulness training. Moreover, fathers, but not mothers, reported reduced parenting stress. Mothers reported reduced overreactive parenting, whereas fathers reported an increase. No effect on mindful awareness of adolescents or parents was found. Effects of mindfulness training became stronger at 8-week follow-up, but waned at 16-week follow-up. Our study adds to the emerging body of evidence indicating that mindfulness training for adolescents with ADHD (and their parents) is an effective approach, but maintenance strategies need to be developed in order for this approach to be effective in the longer term.

Prior studies conducted within the realm of environmental psychology and public health have shown that air pollution exposure exerts significant effects on both physical and psychological well-being, especially for children. The roles of air pollution exposure are being increasingly recognized as essential factors influencing children’s restoration. This systematic review provides an overview of existing knowledge of the impact of air pollution on children’s mental health and restorative experience in both outdoor and indoor environments. A list of keywords for paper selection was derived from a systematic investigation of the literature on children’s restorative environments. A total of 228 studies were initially identified, 18 of which met the eligibility criteria. This systematic review summarizes distinctive categories of air pollutants and discusses the assessments for both air pollution exposure and children’s restorative outcomes. Additionally, 16 barriers in air pollution exposure to children’s restorative experience were identified. The findings of this systematic review were concluded in an integrated framework, which have important implications for developing evidence-based and cross-disciplinary research on the air quality and children’s restoration.

Kozyra Magdalena, Zimnicki Patryk, Kaczerska Justyna, Śmiech Natalia, Nowińska Martyna, Milanowska Joanna. Relationship between the diet and psychiatric diseases such as depression, anxiety and attention-deficit hyperactivity disorder (ADHD). Journal of Education, Health and Sport. 2020;10(8):93-104. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.08.011 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.08.011 https://zenodo.org/record/3969370 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.07.2020. Revised: 25.07.2020. Accepted: 01.08.2020. Relationship between the diet and psychiatric diseases such as depression, anxiety and attention-deficit hyperactivity disorder (ADHD) Magdalena Kozyra1, Patryk Zimnicki1, Justyna Kaczerska1, Natalia Śmiech1, Martyna Nowińska1, Joanna Milanowska2 (1) Student Research Group of Applied Psychology, Medical University of Lublin (2) Department of Applied Psychology, Medical University of Lublin *Address for correspodence: Staffa 24, 20-454 Lublin, telephone number: 695562174, e-mail address: madzia.kozyra.1221@poczta.onet.pl ORCID ID and E-mail Magdalena Kozyra https://orcid.org/0000-0002-0260-4102 madzia.kozyra.1221@poczta.onet.pl Patryk Zimnicki https://orcid.org/0000-0002-5808-8661 patryk.zimnicki.97@o2.pl Justyna Kaczerska https://orcid.org/0000-0003-2642-9377 justynakaczerska@gmail.com Natalia Śmiech https://orcid.org/0000-0002-8920-7969 natalia.smiech@gmail.com Martyna Nowińska https://orcid.org/0000-0002-8167-698X m.nowinska98@gmail.com Joanna Milanowska https://orcid.org/0000-0001-9741-1583 joannamilanowska@umlub.pl ABSTRACT Introduction: Some people try to treat psychiatric diseases such as attention-deficit hyperactivity disorder (ADHD), depression and anxiety by practising some diets. But do they even work and have any scientific confirmation? The aim of the study: The aim of this study is to find out the relationship and influence of the diet on psychiatric diseases such as ADHD, depression and anxiety. Material and method: The research of the scientific articles was made on a database of PubMed and Google Scholar. Description of the state of knowledge: The results indicate that the lack of some nutrients such as vitamins B1, B2, B3, B6, B12, C, A, D, E, folic acid, zinc, iodine, selenium, iron, calcium, potassium, phosphorus, magnesium and chrome may increase the risk of having depression symptoms. Unhealthy diet full of trans fats, red meat and lacking of fruit and vegetables may also lead to depression. Similar results were find due to the anxiety level and the diet. When it comes to ADHD, children with this disease had lower level of vitamins B12, B6, D and folic acids. Among the newly diagnosed celiac disease people, the majority showed ADHD symptoms. After the introduction of the gluten-free diet, the symptoms of the disease subsided. Summary: The results show the huge influence of the diet on the diseases such as depression, anxiety and ADHD. Key words: attention-deficit hyperactivity disorder, depression, anxiety, diet

Objectives: The current paper addresses the evidence for circadian clock characteristics associated with attention-deficit hyperactivity disorder (ADHD), and possible therapeutic approaches based on chronomodulation through bright light (BL) therapy. Methods: We review the data reported in ADHD on genetic risk factors for phase-delayed circadian rhythms and on the role of photic input in circadian re-alignment. Results: Single nucleotide polymorphisms in circadian genes were recently associated with core ADHD symptoms, increased evening-orientation and frequent sleep problems. Additionally, alterations in exposure and response to photic input may underlie circadian problems in ADHD. BL therapy was shown to be effective for re-alignment of circadian physiology toward morningness, reducing sleep disturbances and bringing overall improvement in ADHD symptoms. The susceptibility of the circadian system to phase shift by timed BL exposure may have broad cost-effective potential implications for the treatment of ADHD. Conclusions: We conclude that further research of circadian function in ADHD should focus on detection of genetic markers (e.g., using human skin fibroblasts) and development of BL-based therapeutic interventions.

Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung ist eine im Kindesalter beginnende chronische neurologische Entwicklungsstörung, welche sich durch die Kernsymptome Un-aufmerksamkeit, Hyperaktivität und Impulsivität auszeichnet, und die für die Betroffenen mit erheblichen sozialen und beruflichen Funktionsbeeinträchtigungen einhergeht. Durch die Transition der Erkrankung über die Lebensspanne verändert sich das Erscheinungsbild der ADHS. Zudem ist ein altersabhängiger Rückgang der ADHS-Prävalenz zu verzeichnen (Schrift I, IV). Dennoch berichten auch im höheren Lebensalter noch 2.8% der Befragten von einer ausgeprägten ADHS-Belastung. Nach wie vor ist das Wissen um die ADHS im Senium jedoch begrenzt (Schrift IV). Bislang liegen keine ADHS-spezifischen Skalen für Senioren vor. In der Prüfung zweier für das junge und mittlere Erwachsenalter konzipierter Verfahren, der Selbstbeurteilungsskala ADHS-SB und des Wender-Reimherr- Interviews (WRI), wurden daher an einer Stichprobe von 60- und 99-Jährigen die Einsatzmöglichkeiten dieser Verfahren bei älteren Betroffen untersucht (Schrift V). Beide Verfahren zeigen auch bei Älteren eine gute Konstruktvalidität. Das Ergebnis der Grenzwertoptimierungskurve ist akzeptabel. Unter differentialdiagnostischem Aspekt wurde der Fokus auf die Spezifität gelegt, um vor dem Hintergrund der hohen Symptomüberlappung mit anderen psychiatrischen Störungsbildern Nicht-Betroffene nicht fälschlicherweise als ADHS-Patienten zu klassifizieren. Durch Herabsetzung der Sensitivität kann für den ADHS-SB und den WRI eine Spezifität von 94% bzw. 81% ermittelt werden. Zudem werden altersspezifische Grenzwerte vorgelegt. Demnach können die ADHS-SB sowie das WRI auch im höheren Erwachsenenalter als valide Diagnoseinstrumente zur Unterstützung des klinischen Entscheidungsprozesses eingesetzt werden. Während sich der Einsatz von ADHS-Skalen in der Diagnostik der ADHS bewährt hat, ist hingegen aufgrund der neuropsychologischen Heterogenität der spezifische Einsatz neuropsychologischer Verfahren nicht möglich. Dennoch sind neuropsychologische Verfahren valide, um differentialdiagnostisch ADHS-überlappende kognitive oder mnestische Funkti-onsbeeinträchtigungen zu diskriminieren. Daher wird ein Überblick über gängige neuropsychologische Verfahren bei Erwachsenen und ihre Anwendungsmöglichkeiten gege-ben (Schrift II). ADHS-Symptome sind keine qualitativen, sondern quantitative Merkmale. Erst in Abhän-gigkeit eines bestimmten Schweregrades sind sie krankheitswertig. ADHS-assoziierte Symptome können jedoch bereits unterhalb der diagnostischen Schwelle der Klassifikati-onssysteme einen negativen Einfluss auf den Lebensalltag des Betroffenen haben (Schrift III). Um der Dimensionalität der ADHS-Symptome unabhängig von einem kategorialen Klassifikationssystem Rechnung zu tragen und eine entsprechende Einordnung zu ermöglichen, werden Referenzwerte einer nicht-klinischen Stichprobe vorgelegt (Schrift III). Zur Überprüfung der subjektiven Beeinträchtigung des Störungsbildes über die Lebespanne wurden 296 Ältere (M=69.55 Jahre) ausführlich zu ADHS-assoziierten Symptomen und einhergehenden funktionellen Beeinträchtigungen in der Kindheit, sowohl vor als auch nach dem 50. Lebensjahr befragt. ADHS-Betroffene berichteten von einer hohen intraindi-viduellen Stabilität symptombedingter negativer Einflüsse über die Lebensspanne, sowohl hinsichtlich ihrer individuellen funktionellen Beeinträchtigung als auch der negativen sozi-alen Konsequenzen (Schrift VI). Die Befunde des vorliegenden Kumulus unterstreichen demnach nicht nur die Bedeutung der ADHS als eine lebenslange Erkrankung, sondern auch die klinische Implikation der Notwendigkeit adäquater therapeutischer Angebote für Betroffene aller Altersgruppen. Daher werden Behandlungsansätze für ADHS-Betroffene im jungen und mittleren Lebensalter vorgestellt (Schrift I) und Optionen für Betroffene im höheren Lebensalter diskutiert (Schrift IV). Over the past decade attention deficit hyperactivity disorder (ADHD) has been increasingly identified as an important neurodevelopmental disorder that is evident across the lifespan. ADHD is characterized by the core symptoms of inattention, hyperactivity and impulsivity, and have a complex interplay. It is a childhood onset disorder, associated with a broad range of negative functional outcomes, and persists in up to 60% of individuals into adulthood. However, the transition from young, middle to old age changes the expression of ADHD, and there is an age-dependent-decline (Paper I, IV). Nevertheless, the prevalence of ADHD in seniority is still evident since 2.8% of the older adults are reporting ADHD symptoms associated with significant negative outcomes. But the knowledge about ADHD in older age is still limited, and the older ADHD patients are largely unrecognized due to it typically being viewed as a childhood and middle age disorder (Paper IV). So far, there are also no ADHD-scales specifically in old age to support the diagnostic process. Therefore, the psychometric properties of the ADHD self-rating ADHS-SR and the observer-rating Wender-Reimherr-Interview WRI has been explored for the assessment of ADHD symptoms in old age using a sample of subjects between 60 and 99 years. The study shows, that the psychometric properties of the ADHD-SR and the WRI are adequate. Results of the study provide evidence for construct validity and a good discrimination be-tween Non-ADHD-Patients and ADHD-patients for both the ADHD-SR and the WRI, with a specificity ranging between 81% and 94%. Thus, both measures may also support the di-agnostic process in older adults. While studies provide evidence for the valid use of ADHD-psychometrics, the results of neuropsychological measurements in the assessment of ADHD are mixed. The heteroge-neity in the presentations of ADHD studies suggests differential neuropsychological impairments. The core features of ADHD are also conflated with a number of other clinical syndromes which share some of the symptoms. Hence, results of neuropsychological tests vary within ADHD-subjects and cannot provide ADHD-specific information. Nevertheless, neuropsychological measures have shown some discriminant utility in identifying overlapping cognitive and mnestic impairments that can be used in the diagnostic process. Therefore, an overview of the extant neuropsychological measures for adults and their scope is given (Paper II). ADHD symptoms are not characterized by the quality but by the quantity of their features. The severity of the symptoms is crucial in the diagnosis of the disorder. However ADHD-symptoms below the categorical diagnostic threshold can also cause a significant negative impact on the quality of life (Paper III). For a better understanding of the dimensionality of the ADHD-symptoms and their presentation in the general population, reference values of a non-clinical sample are presented (Paper III). To examine the subjective impairments of ADHD over the lifespan, 296 older adults (M=69.55 years) were assessed regarding their ADHD symptomatology and associated dysfunctions during childhood as well as before and after the age of 50. Older subjects with ADHD describe a high stability of symptom-associated negative influences over their life, regarding both individual dysfunctions and negative social consequences (Paper IV). Findings of the present study do not only underline the impact of ADHD as a chronic disorder, but also highlight the need of an adequate therapy for ADHD subjects of all ages. Therefore treatment options for young and middle age persons (Paper I) as well as seniors are discussed (Paper IV).

In the statistical literature, the class of survival analysis models known as cure models has received much attention in recent years. Cure models seem not, however, to be part of the statistical toolbox of perinatal epidemiologists. In this paper, we demonstrate that in perinatal epidemiological studies where one investigates the relation between a gestational exposure and a condition that can only be ascertained after several years, cure models may provide the correct statistical framework. The reason for this is that the hypotheses being tested often concern an unobservable outcome that, in view of the hypothesis, should be thought of as occurring at birth, even though it is only detectable much later in life. The outcome of interest can therefore be viewed as a censored binary variable. We illustrate our argument with a simple cure model analysis of the possible relation between gestational exposure to paracetamol and attention-deficit hyperactivity disorder, using data from the Norwegian Mother, Father and Child Cohort Study conducted by the Norwegian Institute of Public Health, and information about the attention-deficit hyperactivity disorder diagnoses obtained from the Norwegian Patient Registry.

Technological advancement is constantly evolving, and it is also developing in the mental health field. Various applications, often based on virtual reality, have been implemented to carry out psychological assessments and interventions, using innovative human–machine interaction systems. In this context, the LEAP Motion sensing technology has raised interest, since it allows for more natural interactions with digital contents, via an optical tracking of hand and finger movements. Recent research has considered LEAP Motion features in virtual-reality-based systems, to meet specific needs of different clinical populations, varying in age and type of disorder. The present paper carried out a systematic mini-review of the available literature using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The inclusion criteria were (i) publication date between 2013 and 2020, (ii) being an empirical study or project report, (iii) written in English or Italian languages, (iv) published in a scholarly peer-reviewed journal and/or conference proceedings, and (v) assessing LEAP Motion intervention for four specific psychological domains (i.e., autism spectrum disorder, attention-deficit/hyperactivity disorder, dementia, and mild cognitive impairment), objectively. Nineteen eligible empirical studies were included. Overall, results show that protocols for attention-deficit hyperactivity disorder and autism spectrum disorder can promote psychomotor and psychosocial rehabilitation in contexts that stimulate learning. Moreover, virtual reality and LEAP Motion seem promising for the assessment and screening of functional abilities in dementia and mild cognitive impairment. As evidence is, however, still limited, deeper investigations are needed to assess the full potential of the LEAP Motion technology, possibly extending its applications. This is relevant, considering the role that virtual reality could have in overcoming barriers to access assessment, therapies, and smart monitoring.

Aim: This paper aimed at assessing the influence that probiotic supplement had on mental health and metabolic conditions of children suffering attention-deficit hyperactivity disorder (ADHD). Materials and Methods: A number of 34 children with ADHD were selected randomly. Participants were randomly allocated into a group receiving 8 × 109 CFU/g probiotic supplements (n = 17) and a group receiving placebo (n = 17) during an 8-week time period. Clinical symptoms were recorded applying the rating scale of ADHD (ADHD-RS), Children's Depression Inventory (CDI), and Hamilton Anxiety Rating Scale (HAM-A) both at onset of the study and after the 8-week interval. Moreover, samples of blood were also taken at the beginning and after the 8-week interval so that the metabolic information could be evaluated. Results: The probiotic supplementation could bring about a considerable decrease in total ADHD-RS (β −3.31; 95% confidence interval [CI]: −5.60, −1.02; P = 0.006) and HAM-A (β −1.91 [0.18]; 95% CI, −3.41, −0.41; P = 0.01) than that of the placebo. In addition, probiotic supplementation brought about a considerable decrease in high sensitivity C-reactive protein (hs-CRP) of serum (β −2.05 mg/L; 95% CI, −3.57, −0.52; P = 0.01) as well as a substantial rise in plasma overall antioxidant volume (TAC) (β 66.26 mmol/L; 95% CI, 36.83, 95.68; P < 0.001) than that of the placebo. No meaningful effects were observed on CDI and other metabolic features after the intake of probiotic supplements. Conclusions: Taking probiotic by children suffering ADHD could affect ADHD-RS, HAM-A, hs-CRP of serum, and TAC levels in plasma, while it did not show any effects on CDI and other metabolic profiles.

The current paper addresses the evidence for circadian clock characteristics associated with Attention-Deficit Hyperactivity Disorder (ADHD), and possible therapeutic approaches based on chronomodulation through bright light therapy. Methods: We review the data reported in ADHD on genetic risk factors for phase-delayed circadian rhythms and on the role of photic input in circadian re-alignment. Results: Single nucleotide polymorphisms (SNPs) in circadian genes were recently associated with core ADHD symptoms, increased evening-orientation and frequent sleep problems. Additionally, alterations in exposure and response to photic input may underlie circadian problems in ADHD. Bright light (BL) therapy was shown to be effective for re-alignment of circadian physiology toward morningness, reducing sleep disturbances and bringing overall improvement in ADHD symptoms. The susceptibility of the circadian system to phase shift by timed BL exposure may have broad cost-effective potential implications for the treatment of ADHD. Conclusions: We conclude that further research of circadian function in ADHD should focus on detection of genetic markers (e.g., using human skin fibroblasts) and development of BL-based therapeutic interventions.

Attention-Deficit Hyperactive Disorder (ADHD) is one of the most common mental health disorders amongst school-aged children with an estimated prevalence of 5% in the global population (American Psychiatric Association, 2013). Stimulants, particularly methylphenidate (MPH), are the first-line option in the treatment of ADHD (Reeves and Schweitzer, 2004; Dopheide and Pliszka, 2009) and are prescribed to an increasing number of children and adolescents in the US and the UK every year (Safer et al., 1996; McCarthy et al., 2009), though recent studies suggest that this is tailing off, e.g., Holden et al. (2013). Around 70% of children demonstrate a clinically significant treatment response to stimulant medication (Spencer et al., 1996; Schachter et al., 2001; Swanson et al., 2001; Barbaresi et al., 2006). However, it is unclear which patient characteristics may moderate treatment effectiveness. As such, most existing research has focused on investigating univariate or multivariate correlations between a set of patient characteristics and the treatment outcome, with respect to dosage of one or several types of medication. The results of such studies are often contradictory and inconclusive due to a combination of small sample sizes, low-quality data, or a lack of available information on covariates. In this paper, feature extraction techniques such as latent trait analysis were applied to reduce the dimension of on a large dataset of patient characteristics, including the responses to symptom-based questionnaires, developmental health factors, demographic variables such as age and gender, and socioeconomic factors such as parental income. We introduce a Bayesian modeling approach in a "learning in the model space" framework that combines existing knowledge in the literature on factors that may potentially affect treatment response, with constraints imposed by a treatment response model. The model is personalized such that the variability among subjects is accounted for by a set of subject-specific parameters. For remission classification, this approach compares favorably with conventional methods such as support vector machines and mixed effect models on a range of performance measures. For instance, the proposed approach achieved an area under receiver operator characteristic curve of 82-84%, compared to 75-77% obtained from conventional regression or machine learning ("learning in the data space") methods.

Este artigo apresenta parte do trajeto histórico da Neurolingüística Discursiva, retomando conceitos e práticas que articulam discurso com atividade constitutiva, cérebro com linguagem/trabalho. Os dados de linguagem produzidos em meio à visão discursiva e à reflexão acerca da afasia possibilitam por em destaque processos de significação que se interpõem na impossibilidade de dizer por meio de arranjos que selecionam e combinam palavras, o que faz fluir o discurso. Os dados mostram que sujeitos afásicos não dispõem, como antes, dos recursos expressivos para significar, mas experimentam na interlocução outros processos de significação que ajudam na tradução intra e inter-semiótica.PALAVRAS-CHAVE: Neurolingüística. Afasia. Dislexia. Transtorno do déficit de atenção. Práticas com a linguagem.ABSTRAC This paper shows part of the historical course of Discursive Neurolinguistics, retaking concepts and practices that articulate discourse with constitutive activity, brain with language and work. A discursive point of view enabled us to show up specific processes in aphasic language that affect the speech flow. The data show that aphasics subjects do not have, as before, the expressive resources to mean, but use other ways and the experience in other processes to help them in the translation meaning intra-and inter-semiotics. KEYWORDS: Neurolinguistic. Aphasia. Dyslexia. Attention-deficit hyperactivity disorder. Language practices., This paper shows part of the historical course of Discursive Neurolinguistics, retaking concepts and practices that articulate discourse with constitutive activity, brain with language and work. A discursive point of view enabled us to show up specific processes in aphasic language that affect the speech flow. The data show that aphasics subjects do not have, as before, the expressive resources to mean, but use other ways and the experience in other processes to help them in the translation meaning intra-and inter-semiotics. KEYWORDS: Neurolinguistic. Aphasia. Dyslexia. Attention-deficit hyperactivity disorder. Language practices.

Background Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder with international prevalence estimates of 5 % in childhood, yet significant evidence exists that far fewer children receive ADHD services. In many countries, ADHD is assessed and diagnosed in specialist mental health or neuro-developmental paediatric clinics, to which referral by General (Family) Practitioners (GPs) is required. In such ‘gatekeeper’ settings, where GPs act as a filter to diagnosis and treatment, GPs may either not recognise potential ADHD cases, or may be reluctant to refer. This study systematically reviews the literature regarding GPs’ views of ADHD in such settings. Methods A search of nine major databases was conducted, with wide search parameters; 3776 records were initially retrieved. Studies were included if they were from settings where GPs are typically gatekeepers to ADHD services; if they addressed GPs’ ADHD attitudes and knowledge; if methods were clearly described; and if results for GPs were reported separately from those of other health professionals. Results Few studies specifically addressed GP attitudes to ADHD. Only 11 papers (10 studies), spanning 2000–2010, met inclusion criteria, predominantly from the UK, Europe and Australia. As studies varied methodologically, findings are reported as a thematic narrative, under the following themes: Recognition rate; ADHD controversy (medicalisation, stigma, labelling); Causes of ADHD; GPs and ADHD diagnosis; GPs and ADHD treatment; GP ADHD training and sources of information; and Age, sex differences in knowledge and attitudes. Conclusions Across times and settings, GPs practising in first-contact gatekeeper settings had mixed and often unhelpful attitudes regarding the validity of ADHD as a construct, the role of medication and how parenting contributed to presentation. A paucity of training was identified, alongside a reluctance of GPs to become involved in shared care practice. If access to services is to be improved for possible ADHD cases, there needs to be a focused and collaborative approach to training. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0516-x) contains supplementary material, which is available to authorized users.

The α2-adrenergic receptor agonist guanfacine, in its extended-release formulation (GXR), is the most recent nonstimulant medication approved in several countries for the treatment of attention-deficit hyperactivity disorder (ADHD) as monotherapy and as adjunctive pharmacotherapy to stimulants in children and adolescents. The present paper aims to review comprehensively and critically the pharmacodynamic and pharmacokinetic characteristics and the published evidence on the efficacy and safety profile of GXR in the treatment of ADHD. A comprehensive search of relevant databases (PubMed, Embase, and PsycInfo) was conducted to identify studies published in peer-reviewed journals until January 15, 2015. Though the precise mechanism of action of guanfacine in the treatment of ADHD is not fully understood, it is thought to act directly by enhancing noradrenaline functioning via α2A-adrenoceptors in the prefrontal cortex. Weight-adjusted doses should be used, with a dosing regime on a milligram per kilogram basis, starting at doses in the range 0.05-0.08 mg/kg/day, up to 0.12 mg/kg/day. As evidenced in short-term randomized controlled trials and in long-term open-label extension studies, GXR has been shown to be effective as monotherapy in the treatment of ADHD. Furthermore, GXR has also been found to be effective as adjunctive therapy to stimulant medications in patients with suboptimal responses to stimulants. Many of the adverse reactions associated with GXR, particularly sedation-related effects, were dose-related, transient, mild to moderate in severity, and did not interfere with attention or overall efficacy. There are no reports of serious cardiovascular adverse events associated with GXR alone or in combination with psychostimulants.

Is methylphenidate beneficial or harmful for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents? Methods Electronic databases were searched up to February 2015 for parallel and crossover randomised clinical trials comparing methylphenidate with placebo or no intervention in children and adolescents with ADHD. Meta-analyses and trial sequential analyses (TSA) were conducted. Quality was assessed using GRADE. Teachers, parents, and observers rated ADHD symptoms and general behaviour. Study answer and limitations The analyses included 38 parallel group trials (n=5111, median treatment duration 49 days) and 147 crossover trials (n=7134, 14 days). The average age across all studies was 9.7 years. The analysis suggested a beneficial effect of methylphenidate on teacher rated symptoms in 19 parallel group trials (standardised mean difference (SMD) −0.77, n=1698), corresponding to a mean difference of −9.6 points on the ADHD rating scale. There was no evidence that methylphenidate was associated with an increase in serious adverse events (risk ratio 0.98, nine trials, n=1532; TSA adjusted intervention effect RR 0.91). Methylphenidate was associated with an increased risk of non-serious adverse events (1.29, 21 trials, n=3132; TSA adjusted RR 1.29). Teacher rated general behaviour seemed to improve with methylphenidate (SMD −0.87, five trials, n=668) A change of 7 points on the child health questionnaire (CHQ) has been deemed a minimal clinically relevant difference. The change reported in a meta-analysis of three trials corresponds to a mean difference of 8.0 points on the CHQ (range 0-100 points), which suggests that methylphenidate may improve parent reported quality of life (SMD 0.61, three trials, n=514). 96.8% of trials were considered high risk of bias trials according to the Cochrane guidelines. All outcomes were assessed very low quality according to GRADE. What this study adds The results suggest that among children and adolescents with a diagnosis of ADHD, methylphenidate may improve teacher reported symptoms of ADHD and general behaviour and parent reported quality of life. However, given the risk of bias in the included studies, and the very low quality of outcomes, the magnitude of the effects is uncertain. Methylphenidate is associated with an increased risk of non-serious but not serious adverse events. Funding, competing interests, data sharing Region Zealand Research Foundation and Copenhagen Trial Unit. Competing interests are given in the full paper on bmj.com. Full data are available in the version of this review published in The Cochrane Library., peer-reviewed

Recent increases in attention deficit hyperactivity disorder (ADHD) diagnoses, and the escalation of stimulant prescriptions, has raised concern about diversion and abuse of stimulants, as well as the ethics of using these drugs as “cognitive enhancers.”Such concern appears misplaced in the face of substantial evidence that stimulant drugs do not improve the academic performance of ADHD-diagnosed students. Moreover, numerous studies have found little or no benefit of stimulants on neuropsychological tests of ADHD-diagnosed as well as normal, individuals. This paper examines the apparent paradox: why don't drugs that improve “attention,” produce better academic outcomes in ADHD-diagnosed students? We found that stimulant drugs significantly improved impairment of episodic memory in ADHD-diagnosed undergraduate students. Nevertheless, we also found consistent academic deficits between ADHD students and their non-ADHD counterparts, regardless of whether or not they used stimulant medications. We reviewed the current literature on the behavioral effects of stimulants, to try to find an explanation for these conflicting phenomena. Across a variety of behavioral tasks, stimulants have been shown to reduce emotional reactions to frustration, improve the ability to detect errors, and increase effortful behavior. However, all of these effects would presumably enhance academic performance. On the other hand, the drugs were also found to promote “risky behavior” and to increase susceptibility to environmental distraction. Such negative effects, including the use of drugs to promote wakefulness for last minute study, might explain the lack of academic benefit in the “real world,” despite their cognitive potential. Like many drugs, stimulants influence behavior in multiple ways, depending on the environmental contingencies. Depending on the circumstances, stimulants may, or may not, enhance cognition.

The exclusion of children from school, either on a fixed-term or a permanent basis, is a disciplinary tool used in primary and secondary schools throughout the United Kingdom. Students with special educational needs (SEN) are more likely to be permanently excluded than pupils without SEN (Department for Children, Schools and Families 2009). In this review paper, I will examine the role of underlying behavioural difficulties in school exclusion and specifically explore the potential role of ADHD in disruptive behaviours. Finally, with a view to initiating a discussion that emphasizes early recognition and proactive management of the causes of disruptive behaviour, I will use the evidence from this review to identify areas for further consideration. The overarching intent of this effort is to encourage continued debate among all stakeholders in this important issue that impacts children’s potential and incurs a significant societal cost., peer-reviewed