22 results on '"Gignac, Martin"'
Search Results
2. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder
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Faraone, Stephen V., Banaschewski, Tobias, Coghill, David, Zheng, Yi, Biederman, Joseph, Bellgrove, Mark A., Newcorn, Jeffrey H., Gignac, Martin, Al Saud, Nouf M., Manor, Iris, Rohde, Luis Augusto, Yang, Li, Cortese, Samuele, Almagor, Doron, Stein, Mark A., Albatti, Turki H., Aljoudi, Haya F., Alqahtani, Mohammed M.J., Asherson, Philip, Atwoli, Lukoye, Bölte, Sven, Buitelaar, Jan K., Crunelle, Cleo L., Daley, David, Dalsgaard, Søren, Döpfner, Manfred, Espinet (on behalf of CADDRA), Stacey, Fitzgerald, Michael, Franke, Barbara, Gerlach, Manfred, Haavik, Jan, Hartman, Catharina A., Hartung, Cynthia M., Hinshaw, Stephen P., Hoekstra, Pieter J., Hollis, Chris, Kollins, Scott H., Sandra Kooij, J.J., Kuntsi, Jonna, Larsson, Henrik, Li, Tingyu, Liu, Jing, Merzon, Eugene, Mattingly, Gregory, Mattos, Paulo, McCarthy, Suzanne, Mikami, Amori Yee, Molina, Brooke S.G., Nigg, Joel T., Purper-Ouakil, Diane, Omigbodun, Olayinka O., Polanczyk, Guilherme V., Pollak, Yehuda, Poulton, Alison S., Rajkumar, Ravi Philip, Reding, Andrew, Reif, Andreas, Rubia, Katya, Rucklidge, Julia, Romanos, Marcel, Ramos-Quiroga, J. Antoni, Schellekens, Arnt, Scheres, Anouk, Schoeman, Renata, Schweitzer, Julie B., Shah, Henal, Solanto, Mary V., Sonuga-Barke, Edmund, Soutullo, César, Steinhausen, Hans-Christoph, Swanson, James M., Thapar, Anita, Tripp, Gail, van de Glind, Geurt, van den Brink, Wim, Van der Oord, Saskia, Venter, Andre, Vitiello, Benedetto, Walitza, Susanne, and Wang, Yufeng
- Published
- 2021
- Full Text
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3. The Child Behavior Check List Usefulness in Screening for Severe Psychopathology in Youth: A Narrative Literature Review.
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Chavannes, Pascal and Gignac, Martin
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CHILD behavior ,LITERATURE reviews ,MEDICAL screening ,PATHOLOGICAL psychology ,AUTISM spectrum disorders - Abstract
Objective: This article will review the use of the CBCL to diagnose youth with psychopathological disorders focusing on: ADHD, Mood Disorders, Autism Spectrum disorders, and Disruptive Disorders. Method: Using a narrative review approach, we investigate the usefulness of the CBCL as a screening tool to detect childhood onset psychopathology across different diagnostic syndromes. Results: The available literature supports the use of the CBCL for ADHD screening and as a measure of ADHD severity. While some studies support a specific profile linked with childhood bipolar disorder, replication studies for this profile found mixed results. The CBCL was also found to be useful in screening for patients presenting with Autism Spectrum Disorders, Conduct Disorder, and Childhood Bipolar Disorder all of which presents with more severely impaired scores. Conclusion: The CBCL holds promise as a screening tool for childhood psychopathology. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Characteristics of Adolescents and Young Adults with ADHD Who Divert or Misuse Their Prescribed Medications
- Author
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Wilens, Timothy E., Gignac, Martin, and Swezey, Allison
- Abstract
Objective: Little is known about the risks and characteristics of attention-deficit/hyperactivity disorder (ADHD) patients who misuse or divert their stimulant medications. As part of a 10-year longitudinal study of youths with ADHD, the authors evaluated medication diversion or misuse at the last follow-up period. Method: Structured psychiatric interviews for diagnosis and a self-report questionnaire regarding medication use in medicated subjects with ADHD compared with controls without ADHD receiving psychotropics for non-ADHD treatment were employed. Results: Of 98 subjects receiving psychotropic medications (mean age of 20.8 plus or minus 5 years), 55 (56%) were ADHD subjects and 43 (44%) were controls receiving medications for other purposes. The authors found that 11% of the ADHD group reported selling their medications compared with no subjects in the control group (z = 0.00, p less than 0.05). An additional 22% of the ADHD group reported misusing their medications compared with 5% of the control subjects (z = 1.7 p = 0.09) and that those with conduct or substance use disorders accounted for the misuse and diversion. A minority of subjects reported escalating their doses and concomitant use with alcohol and drugs. Conclusions: The data indicate that the majority of ADHD individuals, particularly those without conduct or substance use disorders, use their medications appropriately. The authors' findings also highlight the need to monitor medication use in ADHD individuals with conduct and/or substance use disorders and to carefully select agents with a low likelihood of diversion or misuse in this group. (Contains 1 table.)
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- 2006
5. The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder
- Author
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Faraone, Stephen V, Banaschewski, Tobias, Coghill, David, Zheng, Yi, Biederman, Joseph, Bellgrove, Mark A, Newcorn, Jeffrey H, Gignac, Martin, Al Saud, Nouf M, Manor, Iris, Rohde, Luis Augusto, Yang, Li, Cortese, Samuele, Almagor, Doron, Stein, Mark A, Albatti, Turki H, Aljoudi, Haya F, Alqahtani, Mohammed M J, Asherson, Philip, Atwoli, Lukoye, Bölte, Sven, Buitelaar, Jan K, Crunelle, Cleo L, Daley, David, Dalsgaard, Søren, Döpfner, Manfred, Espinet, Stacey, Fitzgerald, Michael, Franke, Barbara, Haavik, Jan, Steinhausen, Hans-Christoph, Walitza, Susanne, et al, University of Zurich, and Faraone, Stephen V
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3206 Neuropsychology and Physiological Psychology ,2805 Cognitive Neuroscience ,2802 Behavioral Neuroscience ,610 Medicine & health ,10058 Department of Child and Adolescent Psychiatry - Published
- 2021
6. Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP.
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Tourjman, Valerie, Louis-Nascan, Gill, Ahmed, Ghalib, DuBow, Anaïs, Côté, Hubert, Daly, Nadia, Daoud, George, Espinet, Stacey, Flood, Joan, Gagnier-Marandola, Emilie, Gignac, Martin, Graziosi, Gemma, Mansuri, Zeeshan, and Sadek, Joseph
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COGNITIVE therapy ,CAREGIVERS ,HYPERACTIVITY ,EXERCISE therapy ,PSYCHOTHERAPY - Abstract
Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind–Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Further evidence of an association between adolescent bipolar disorder with smoking and substance use disorders: A controlled study
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Wilens, Timothy E., Biederman, Joseph, Adamson, Joel J., Henin, Aude, Sgambati, Stephanie, Gignac, Martin, Sawtelle, Robert, Santry, Alison, and Monuteaux, Michael C.
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- 2008
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8. Characteristics of adolescents and young adults with ADHD who divert or misuse their prescribed medications
- Author
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Wilens, Timothy E., Gignac, Martin, Swezey, Allison, Monuteaux, Michael C., and Biederman, Joseph
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Attention-deficit hyperactivity disorder -- Research ,Attention-deficit hyperactivity disorder -- Care and treatment ,Young adults -- Research ,Young adults -- Psychological aspects ,Family and marriage ,Psychology and mental health - Published
- 2006
9. Morbidities and mortality of diagnosed attention deficit hyperactivity disorder (ADHD) over the youth lifespan: A population‐based retrospective cohort study.
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Diallo, Fatoumata Binta, Pelletier, Éric, Vasiliadis, Helen‐Maria, Rochette, Louis, Vincent, Annick, Palardy, Sylvain, Lunghi, Carlotta, Gignac, Martin, and Lesage, Alain
- Subjects
ATTENTION-deficit hyperactivity disorder ,TIC disorders ,HEALTH insurance ,MENTAL health services ,COHORT analysis ,YOUNG adults - Abstract
Objectives: To estimate the prevalence of ADHD, and related comorbidities, mortality, and type of health service use among children and young adults, using different case definitions. Methods: We conducted a population‐based retrospective cohort study between 2000 and 2018, using the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database. All residents aged less than 25 years eligible for health insurance coverage were included. We compared outcomes of three indicators (morbidity, services use and mortality) according two different algorithms of ADHD definitions, to the general population. Results: The cumulative prevalence of ADHD has risen steadily over the past decade, reaching 12.6% in 2017–2018. People with ADHD have a higher prevalence of psychiatric comorbidities, make greater use of medical, mental health services, and are hospitalized more often. The comparison of prevalence between the two algorithms and the general population for the three indicators showed that the cohort having one claim was very close to that with two or more, and statistically significant higher to that of people without ADHD. Conclusion: This finding support that a single claim algorithm for ADHD can be used for case definition. More research is needed on the impact of potentially effective treatments in improving consequences of ADHD. [ABSTRACT FROM AUTHOR]
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- 2022
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10. 2.2 Pharmacology of Conduct Disorder
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Gignac, Martin
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- 2022
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11. Treatment Options for the Cardinal Symptoms of Disruptive Mood Dysregulation Disorder
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Tourian, Leon, LeBoeuf, Amélie, Breton, Jean-Jacques, Cohen, David, Gignac, Martin, Labelle, Réal, Guile, Jean-Marc, and Renaud, Johanne
- Subjects
Research Article - Abstract
DSM-5 has added a new developmentally appropriate child and adolescent mood disorder subtype called disruptive mood dysregulation disorder (DMDD). The core features of DMDD are temper outbursts (manifested by either verbal rages and/or physical aggression) and unrelenting irritability or anger. Currently, the literature is lacking a thorough review of the possible treatment options for the cardinal symptoms constituting DMDD. The objective of this article is to provide a thorough review of peer-reviewed studies on the subject of pharmacological treatment options for children and adolescents with the cardinal symptoms of DMDD.Relevant articles for this study were obtained through Pubmed, Medline, PsychINFO and PsychINDEXplus using the key words: "adolescents," "children," "paediatric," "youth," "irritability," "temper outbursts," "aggression," "rage," "disruptive behaviour," "treatment," "dysphoria," "autism," "mental retardation/intellectual disability," "impulsivity," "ADHD," "oppositional defiant disorder," and "conduct disorder." A total of 823 studies were generated; only English studies focusing on pharmacological treatment were retained.Currently there are no established guidelines or thorough reviews summarizing the treatment of DMDD. Pharmacotherapeutic treatment options of both aggression and chronic irritability include: antidepressants/selective norepinephrine reuptake inhibitors, mood stabilizers, psychostimulants, antipsychotics, and alpha-2 agonists.Treatment options of severe, persistent irritability in youth are numerous, and a consensual treatment algorithm has not yet emerged from the literature. Further studies and clinical trials are warranted to determine efficacious and safe treatment modalities.Le DSM-5 a ajouté un nouveau sous-type de trouble de l’humeur adapté au développement des enfants et des adolescents qui porte le nom de trouble disruptif avec dysrégulation de l’humeur (TDDH). Les principales caractéristiques du TDHE sont des accès de colère (manifestés soit par des rages verbales et/ou une agression physique) et une irritabilité ou une colère persistante. À l’heure actuelle, la littérature ne présente pas de revue approfondie des options de traitement possibles des symptômes cardinaux constituant le TDHE. L’objectif de cet article est d’offrir une revue approfondie des études révisées par des pairs sur le sujet des options de traitement pharmacologique pour les enfants et les adolescents présentant les symptômes cardinaux du TDHE.Les articles pertinents pour cette étude ont été obtenus dans Pubmed, Medline, PsychINFO et PsychINDEXplus à l’aide des mots clés: « adolescents », « enfants », « pédiatrie », « jeunesse », « irritabilité », « accès de colère », « agressivité », « rage », « comportement perturbateur », « traitement », « dysphorie », « autisme », « retard mental/déficience intellectuelle », « impulsivité », « TDAH », « trouble oppositionnel avec provocation », et « trouble des conduites ». Au total, 823 études ont été relevées; seulement les études en anglais portant sur le traitement pharmacologique ont été retenues.À l’heure actuelle, il n’y a pas de lignes directrices établies ou de revues approfondies qui résument le traitement du TDHE. Les options de traitement pharmacologique de l’agressivité et de l’irritabilité chronique sont notamment: les antidépresseurs/inhibiteurs spécifiques du recaptage de la noradrénaline, les stabilisateurs de l’humeur, les psychostimulants, les antipsychotiques, et les agonistes alpha-2.Les options de traitement de l’irritabilité grave et persistante chez les adolescents sont nombreuses, et un algorithme de traitement consensuel n’a pas encore été dégagé de la littérature. D’autres études et essais cliniques sont nécessaires pour déterminer des modes de traitement efficaces et sûrs.
- Published
- 2015
12. The CBCL dysregulated profile: An indicator of pediatric bipolar disorder or of psychopathology severity?
- Author
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Mbekou, Valentin, Gignac, Martin, MacNeil, Sasha, Mackay, Pamela, and Renaud, Johanne
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- 2014
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13. DOES CONDUCT DISORDER MEDIATE THE DEVELOPMENT OF SUBSTANCE USE DISORDERS IN ADOLESCENTS WITH BIPOLAR DISORDER? A FAMILY CASE-CONTROL STUDY
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Wilens, Timothy E., Martelon, MaryKate, Kruesi, Markus J.P., Parcell, Tiffany, Westerberg, Diana, Schillinger, Mary, Gignac, Martin, and Biederman, Joseph
- Subjects
Conduct Disorder ,Male ,Bipolar Disorder ,Adolescent ,Substance-Related Disorders ,Smoking ,Comorbidity ,Article ,Alcoholism ,Massachusetts ,Risk Factors ,Case-Control Studies ,Interview, Psychological ,Humans ,Female ,Genetic Predisposition to Disease ,Child - Abstract
Recent work has highlighted important relationships among conduct disorder (CD), substance use disorders (SUD), and bipolar disorder in youth. However, because bipolar disorder and CD are frequently comorbid in the young, the impact of CD in mediating SUD in bipolar disorder youth remains unclear.105 adolescents with DSM-IV bipolar disorder (mean +/- SD age = 13.6 +/- 2.50 years) and 98 controls (mean +/- SD age = 13.7 +/- 2.10 years) were comprehensively assessed with a structured psychiatric diagnostic interview for psychopathology and SUD. The study was conducted from January 2000 through December 2004.Among bipolar disorder youth, those with CD were more likely to report cigarette smoking and/or SUD than youth without CD. However, CD preceding SUD or cigarette smoking did not significantly increase the subsequent risk of SUD or cigarette smoking. Adolescents with bipolar disorder and CD were significantly more likely to manifest a combined alcohol plus drug use disorder compared to subjects with bipolar disorder without CD (chi(2) = 11.99, p.001).While bipolar disorder is a risk factor for SUD and cigarette smoking in a sample of adolescents, comorbidity with preexisting CD does not increase the risk for SUD. Further follow-up of this sample through the full risk of SUD into adulthood is necessary to confirm these findings.
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- 2009
14. Expert Opinion and Recommendations for the Management of Attention-Deficit/Hyperactivity Disorder in Correctional Facilities.
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Scott, Duncan A., Gignac, Martin, Kronfli, Risk N., Ocana, Anthony, and Lorberg, Gunter W.
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ATTENTION-deficit hyperactivity disorder ,AWARDS ,BIOAVAILABILITY ,CORRECTIONAL institutions ,INTERVIEWING ,MEDICAL care of prisoners ,SURVEYS ,DISEASE prevalence ,SYMPTOMS - Abstract
There has been considerably less research on the management of adult attention-deficit/hyperactivity disorder (ADHD) among the inmates of correctional facilities than in the general community. While the successful identification and management of ADHD in the adult correctional setting offer potential benefits to the individuals themselves, to institutional staff, and to wider society, their implementation represents significant challenges. These include high prevalence rates, the low level of ADHD recognition, the high incidence of comorbid psychiatric disorders, and the high risk of abuse and diversion of prescribed medications. Here, the authors provide an overview of current recommendations for the identification and management of adults with ADHD in correctional settings and discuss possible strategies for their further development. [ABSTRACT FROM AUTHOR]
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- 2016
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15. Parent-Youth Agreement on Self-Reported Competencies of Youth With Depressive and Suicidal Symptoms.
- Author
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Mbekou, Valentin, MacNeil, Sasha, Gignac, Martin, and Renaud, Johanne
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DEPRESSION in adolescence ,PARENT participation in adolescent psychotherapy ,TEENAGE suicide ,SELF-evaluation ,PARENT-child relationships & psychology ,YOUTH Self-Report ,CHILD Behavior Checklist ,GENDER differences (Psychology) - Abstract
Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
16. Does Conduct Disorder Mediate the Development of Substance Use Disorders in Adolescents With Bipolar Disorder? A Case-Control Family Study.
- Author
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Wilens, Timothy E., Martelon, Mary Kate, Kruesi, Markus J. P., Parcell, Tiffany, Westerberg, Diana, Schillinger, Mary, Gignac, Martin, and Biederman, Joseph
- Subjects
CONDUCT disorders in adolescence ,SUBSTANCE abuse ,BIPOLAR disorder in adolescence ,CASE-control method ,ALCOHOLISM ,YOUTH & alcohol - Abstract
The article focuses on a case-control family study on whether conduct disorder (CD) affect the development of substance use disorders (SUD) in adolescents with bipolar disorder. It was found that bipolar disorder youth with CD were more likely to report cigarette smoking and SUD compared with youth without CD. The most common substance misused by adolescents suffering from bipolar disorder is alcohol. The methodological limitations of the study were cited, including limited sample size.
- Published
- 2009
- Full Text
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17. Expert consensus statement for telepsychiatry and attention-deficit hyperactivity disorder.
- Author
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Hong J, Mattingly GW, Carbray JA, Cooper TV, Findling RL, Gignac M, Glaser PE, Lopez FA, Maletic V, McIntyre RS, Robb AS, Singh MK, Stein MA, and Stahl SM
- Abstract
Changing practice patterns caused by the pandemic have created an urgent need for guidance in prescribing stimulants using telepsychiatry for attention-deficit hyperactivity disorder (ADHD). A notable spike in the prescribing of stimulants accompanied the suspension of the Ryan Haight Act, allowing the prescribing of stimulants without a face-to-face meeting. Competing forces both for and against prescribing ADHD stimulants by telepsychiatry have emerged, requiring guidelines to balance these factors. On the one hand, factors weighing in favor of increasing the availability of treatment for ADHD via telepsychiatry include enhanced access to care, reduction in the large number of untreated cases, and prevention of the known adverse outcomes of untreated ADHD. On the other hand, factors in favor of limiting telepsychiatry for ADHD include mitigating the possibility of exploiting telepsychiatry for profit or for misuse, abuse, and diversion of stimulants. This Expert Consensus Group has developed numerous specific guidelines and advocates for some flexibility in allowing telepsychiatry evaluations and treatment without an in-person evaluation to continue. These guidelines also recognize the need to give greater scrutiny to certain subpopulations, such as young adults without a prior diagnosis or treatment of ADHD who request immediate-release stimulants, which should increase the suspicion of possible medication diversion, misuse, or abuse. In such cases, nonstimulants, controlled-release stimulants, or psychosocial interventions should be prioritized. We encourage the use of outside informants to support the history, the use of rating scales, and having access to a hybrid model of both in-person and remote treatment.
- Published
- 2024
- Full Text
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18. Treatment Options for the Cardinal Symptoms of Disruptive Mood Dysregulation Disorder.
- Author
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Tourian L, LeBoeuf A, Breton JJ, Cohen D, Gignac M, Labelle R, Guile JM, and Renaud J
- Abstract
Objective: DSM-5 has added a new developmentally appropriate child and adolescent mood disorder subtype called disruptive mood dysregulation disorder (DMDD). The core features of DMDD are temper outbursts (manifested by either verbal rages and/or physical aggression) and unrelenting irritability or anger. Currently, the literature is lacking a thorough review of the possible treatment options for the cardinal symptoms constituting DMDD. The objective of this article is to provide a thorough review of peer-reviewed studies on the subject of pharmacological treatment options for children and adolescents with the cardinal symptoms of DMDD., Methods: Relevant articles for this study were obtained through Pubmed, Medline, PsychINFO and PsychINDEXplus using the key words: "adolescents," "children," "paediatric," "youth," "irritability," "temper outbursts," "aggression," "rage," "disruptive behaviour," "treatment," "dysphoria," "autism," "mental retardation/intellectual disability," "impulsivity," "ADHD," "oppositional defiant disorder," and "conduct disorder." A total of 823 studies were generated; only English studies focusing on pharmacological treatment were retained., Results: Currently there are no established guidelines or thorough reviews summarizing the treatment of DMDD. Pharmacotherapeutic treatment options of both aggression and chronic irritability include: antidepressants/selective norepinephrine reuptake inhibitors, mood stabilizers, psychostimulants, antipsychotics, and alpha-2 agonists., Conclusion: Treatment options of severe, persistent irritability in youth are numerous, and a consensual treatment algorithm has not yet emerged from the literature. Further studies and clinical trials are warranted to determine efficacious and safe treatment modalities.
- Published
- 2015
19. Is oppositional defiant disorder a meaningful diagnosis in adults? Results from a large sample of adults with ADHD.
- Author
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Harpold T, Biederman J, Gignac M, Hammerness P, Surman C, Potter A, and Mick E
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- Adaptation, Psychological, Adult, Age Factors, Age of Onset, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity psychology, Attention Deficit and Disruptive Behavior Disorders epidemiology, Attention Deficit and Disruptive Behavior Disorders psychology, Child, Cognition Disorders diagnosis, Cognition Disorders epidemiology, Cognition Disorders psychology, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders, Educational Status, Female, Humans, Male, Neuropsychological Tests, Prevalence, Psychiatric Status Rating Scales, Social Adjustment, Wechsler Scales, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit and Disruptive Behavior Disorders diagnosis
- Abstract
We examined the prevalence and clinical characteristics of oppositional defiant disorder (ODD) in a sample of clinically referred adults with attention deficit hyperactivity disorder (ADHD). Subjects were consecutively referred adults with a DSM-III R/IV diagnosis of ADHD with or without ODD. Nearly half of subjects (43%) had a history of ODD. Subjects with a childhood history of ODD had increased risk for bipolar disorder, multiple anxiety disorders, and substance use disorders relative to the ADHD subjects without ODD. We concluded, as in children with ODD, adults with a childhood history of ODD have high rates of psychiatric comorbidity and more impaired psychosocial functioning than those without this condition. A better understanding of the course, phenomenology, and clinical significance of ODD in adults is needed to better understand therapeutic approaches for this disorder.
- Published
- 2007
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20. An open-label study of the tolerability of mixed amphetamine salts in adults with attention-deficit/hyperactivity disorder and treated primary essential hypertension.
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Wilens TE, Zusman RM, Hammerness PG, Podolski A, Whitley J, Spencer TJ, Gignac M, and Biederman J
- Subjects
- Adult, Age Factors, Amphetamines adverse effects, Amphetamines pharmacology, Antihypertensive Agents therapeutic use, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity epidemiology, Blood Pressure Determination, Central Nervous System Stimulants adverse effects, Central Nervous System Stimulants pharmacology, Comorbidity, Delayed-Action Preparations, Drug Therapy, Combination, Electrocardiography statistics & numerical data, Female, Heart Rate drug effects, Humans, Hypertension epidemiology, Male, Mental Disorders diagnosis, Mental Disorders epidemiology, Psychiatric Status Rating Scales, Treatment Outcome, Amphetamines therapeutic use, Attention Deficit Disorder with Hyperactivity drug therapy, Blood Pressure drug effects, Central Nervous System Stimulants therapeutic use, Hypertension drug therapy
- Abstract
Objective: To evaluate the short-term tolerability of an extended-release preparation of the stimulant medication mixed amphetamine salts (MAS XR) in adults with attention-deficit/hyperactivity disorder (ADHD) whose hypertension has been successfully treated with antihypertensive medications., Method: An 8-week, 2-phase, open-label study design was implemented. All adults had ADHD (DSM-IV diagnosis) and essential hypertension and were required to be normotensive (blood pressure < 135/85 mm Hg, treated) for at least 4 weeks at entry into the study. MAS XR was given for a 6-week period, titrated once each week to a target maximum dose of 60 mg/day given once daily in the morning (phase 1), and then discontinued for 2 weeks at the end of the study (phase 2). At baseline, subjects underwent a comprehensive clinical assessment, medical history, vital signs assessment, and electrocardiogram (ECG). Rating scales were used throughout the study to assess response to treatment, and blood pressure was measured manually at each study visit. The primary outcome was the effect of MAS XR on blood pressure and the development of hypertension., Results: Thirteen subjects receiving antihypertensive therapy were entered and placed on MAS XR treatment and completed the trial. There were no serious adverse events. No sustained elevated blood pressure (> 140/90 mm Hg at 2 consecutive visits) was observed in the subjects treated with MAS XR. Similar rates of single episodes of hypertension were observed in phases 1 and 2. Similarly, there was no group mean increase in systolic or diastolic blood pressure or pulse during treatment with MAS XR. No clinically significant changes in the ECG were observed. During the 6-week medication phase, significant improvement was found on rating scales assessing ADHD symptoms and severity that reversed with discontinuation of MAS XR., Conclusion: The results of this open study suggest that adults with ADHD and controlled hypertension can be safely treated with MAS XR.
- Published
- 2006
- Full Text
- View/download PDF
21. Assessing cannabis use in adolescents and young adults: what do urine screen and parental report tell you?
- Author
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Gignac M, Wilens TE, Biederman J, Kwon A, Mick E, and Swezey A
- Subjects
- Adolescent, Adult, Comorbidity, Female, Humans, Interviews as Topic, Male, Marijuana Abuse urine, Parents, Marijuana Abuse diagnosis, Substance Abuse Detection
- Abstract
Objectives: Our analysis compares three approaches to detect the most common drug abused in early adulthood, cannabis: (1) report on direct structured interview; (2) indirect parental report; and (3) urine toxicology screen., Methods: We examined data on 207 subjects (36% also met criteria for alcohol abuse; 9% for alcohol dependence) derived from two prospective and ongoing family studies of boys and girls with or without attention-deficit/hyperactivity disorder (ADHD). Assessments relied on the Schedule for Affective Disorders and Schizophrenia (K-SADS-E; under 18 years of age) and on the Structured Clinical Interview for DSM-IV (SCID-IV; over 18 years of age). Urine samples were analyzed with Auccusign DOA5 (on-site screening assay)., Results: Ninety-seven percent (97%) of individuals, who reported no use of cannabis within the past month, had a negative urine screening and 79% of individuals, who endorsed cannabis abuse/dependence, had a positive urine screening. The sensitivity of the direct structured interview report was 91%, the specificity 87%, the positive predicting value 67%, and the negative predictive value 97%. Indirect parental reports were found to be less informative on cannabis use than direct report., Conclusion: Direct report of cannabis use, abuse, or dependence during the structured interview is both sensitive and specific when compared to urine toxicology screens and indirect parental reports.
- Published
- 2005
- Full Text
- View/download PDF
22. The clinical dilemma of using medications in substance-abusing adolescents and adults with attention-deficit/hyperactivity disorder: what does the literature tell us?
- Author
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Wilens TE, Monuteaux MC, Snyder LE, Moore H, Whitley J, and Gignac M
- Subjects
- Adolescent, Adult, Clinical Trials as Topic, Humans, Attention Deficit Disorder with Hyperactivity drug therapy, Substance-Related Disorders drug therapy
- Abstract
Objective: Adolescents and adults with attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUD) are increasingly recognized in clinical practice. The role of pharmacological treatment for ADHD in these comorbid individuals remains unclear., Methods: A systematic review of the medical literature was conducted through PubMed, supplemented with data from scientific presentations, to evaluate the role of medication treatment of ADHD in substance abusing individuals with ADHD. Meta-analysis was used to evaluate the effects of medication therapy on ADHD and SUD outcomes in general, while specifically addressing trial design, trial duration, retention, class of medication, age group, concurrent psychotherapy, and outcome in both SUD and ADHD domains., Results: Four studies in adolescents and five studies in adults with ADHD plus SUD were identified (two controlled and seven open studies; n = 222 subjects). The standard mean difference (SMD) indicated statistically significant improvements in ADHD and SUD that were not maintained when evaluating controlled studies only. Albeit limited by power, trial duration, retention rate, and age group did not influence outcome. No worsening of SUD or drug-drug interactions were observed in any of the studies. The results could not be accounted for by any single study or by publication bias., Conclusion: Treating ADHD pharmacologically in individuals with ADHD plus SUD has a moderate impact on ADHD and SUD that is not observed in controlled trials and does not result in worsening of SUD or adverse interactions specific to SUD. Further controlled trials evaluating the effect of novel combinations of psychotherapy and ADHD pharmacotherapy on SUD relapse in these groups are warranted.
- Published
- 2005
- Full Text
- View/download PDF
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