Atomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorder.

Objective: In this study we examined the effectiveness of atomoxetine for the treatment of oppositional defiant disorder comorbid with attention-deficit/hyperactivity disorder.

Methods: Patients were aged 6 to 12 years and met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for attention-deficit/hyperactivity disorder with a Swanson, Nolan, and Pelham Rating Scale-Revised attention-deficit/hyperactivity disorder subscale score above age and gender norms; Clinical Global Impressions-Severity Scale score of > or = 4; and Swanson, Nolan, and Pelham Rating Scale-Revised oppositional defiant disorder subscale score of > or = 15. Patients were randomly assigned in a 2:1 ratio to receive 1.

Heterogeneity in the pharmacodynamics of two long-acting methylphenidate formulations for children with attention deficit/hyperactivity disorder. A growth mixture modelling analysis.

Objectives: To use growth mixture modelling (GMM) to identify subgroups of children with attention deficit hyperactive disorder (ADHD) who have different pharmacodynamic profiles in response to extended release methylphenidate as assessed in a laboratory classroom setting.

Methods: GMM analysis was performed on data from the COMACS study (Comparison of Methylphenidates in the Analog Classroom Setting): a large (n = 184) placebo-controlled cross-over study comparing three treatment conditions in the Laboratory School Protocol (with a 1.5-h cycle of attention and deportment assessments).

The neuropsychological effects of chronic methylphenidate on drug-naive boys with attention-deficit/hyperactivity disorder.

Background: The reported neuropsychological effects of methylphenidate (MPH) in attention-deficit/hyperactivity disorder (ADHD) are inconsistent. The assumed relationships between these neuropsychological effects and clinical efficacy have not been substantiated. We therefore investigated the effects of chronic MPH administration on neuropsychological functioning.

Sex differences in the response of children with ADHD to once-daily formulations of methylphenidate.

Objectives: Studies of sex differences in methylphenidate response by children with attention-deficit/hyperactivity disorder have lacked methodological rigor and statistical power. This paper reports an examination of sex differences based on further analysis of data from a comparison of two once-daily methylphenidate formulations (the COMACS study), which addresses these shortcomings.

Method: Children (184: 48 females; mean [SD] age, 9.

Validity of the health-related quality of life assessment in the ADORE study: Parent Report Form of the CHIP-Child Edition.

Objectives: To examine the cross-sectional reliability and validity of the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE), a generic measure of health-related quality of life (HRQoL), in children with ADHD in the pan-European ADHD Observational Research in Europe (ADORE) study.

Methods: Parents of children with ADHD (aged 6-18 years) in 10 European countries completed the CHIP-CE at the baseline visit (n=1,477; data missing for one patient). Analyses included determination of internal consistency reliability, ceiling and floor effects, factor analysis, and Pearson's correlations between CHIP-CE and other scales used to measure ADHD severity, problems and family strain.

Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study.

Objectives: To provide psychometric information on the Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV (ADHD-RS-IV) in a large population of children with ADHD.

Methods: Patients aged 6-18 years (n=1,478 in baseline analysis) were rated by 244 physicians on the ADHD-RS-IV based on a semi-structured interview with the patient's parent. Physicians additionally rated functional impairment (CGAS) and health status (CGI-S), and parents rated their child's behavioural and emotional problems (SDQ) and quality of life (CHIP-CE).

Study design, baseline patient characteristics and intervention in a cross-cultural framework: results from the ADORE study.

Objective: To describe the methodology and to present the baseline findings of the Attention-deficit/hyperactivity Disorder Observational Research in Europe (ADORE) study, the primary objective of which is to describe the relationship between treatment regimen prescribed and quality of life of children with ADHD in actual practice.

Methods: In this 2-year prospective observational study, data on diagnosis, prescribed treatment and outcomes of ADHD were collected at seven time points by paediatricians and child psychiatrists on 1,573 children recruited in 10 European countries. The data presented here from the 1,478 patients included in the analyses describe the baseline condition, initial treatment regimen prescribed and quality of life of families with children with ADHD.

Factors related to health-related quality of life (HRQoL) among children with ADHD in Europe at entry into treatment.

Objective: To describe the associations between a range of baseline factors (demographic, family and clinical) and parent-reported health-related quality of life (HRQoL) of children with ADHD taking part in the ADORE study.

Methods: HRQoL was rated using the Parent Report Form of the Child Health and Illness Profile-Child Edition (CHIP-CE). Forward-stepwise linear regression models were used to investigate associations with 26 independent variables.

Which factors impact on clinician-rated impairment in children with ADHD?

Objectives: To describe the associations between a range of demographic, family and clinical factors and clinician-rated measures of global impairment in children with ADHD symptoms obtained at the baseline assessment in the ADHD Observational Research in Europe (ADORE) study.

Methods: Global impairment was measured by clinicians using the Clinical Global Impression-Severity (CGI-S) scale and the Children's Global Assessment Scale (CGAS). Associations with independent variables were investigated using forward-stepwise regression models.

Acute neuropsychological effects of methylphenidate in stimulant drug-naïve boys with ADHD II--broader executive and non-executive domains.

Background: Accumulating evidence supports methylphenidate-induced enhancement of neuropsychological functioning in attention deficit hyperactivity disorder (ADHD). The present study was designed to investigate the acute effects of the psychostimulant drug, methylphenidate (MPH), on neuropsychological performance in stimulant naïve boys with ADHD.

Methods: Seventy-three drug-naïve boys (age 7-15) with ADHD (combined type) completed neuropsychological tasks from the CANTAB battery under randomised, placebo controlled, double-blind conditions following an acute challenge with either placebo (n = 24), .

Effect of extended release stimulant-based medications on neuropsychological functioning among adolescents with Attention-Deficit/Hyperactivity Disorder.

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with diminished neuropsychological functioning. This randomized, double-blind, placebo controlled, study is the first comparison of two extended release stimulant-based medications (Adderall XR and Concerta) and placebo on ADHD neuropsychological functioning. Adolescents diagnosed with ADHD (n=35, 19 males) completed three separate assessments (5, 8, 11 p.

Osmotic, controlled-release methylphenidate for the treatment of ADHD.

Methylphenidate (MPH) is the most commonly used and best-studied stimulant medication for attention-deficit hyperactivity disorder. However, its short duration of action usually results in a requirement to administer multiple daily doses in order to achieve optimal clinical benefit. Although a wax-matrix-based SR formulation of MPH has been available since the 1990s, it was not well accepted into clinical practice.

Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline.

A systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder is reported, giving effect sizes and numbers-to-treat for extended-release stimulant preparations and atomoxetine (ATX). A panel of experts from several European countries used the review to make recommendations about the use of these drugs in practice, and conclusions are reported: (1) Long-acting preparations should be available and used; (2) They should not replace short-acting drugs (which will be the initial treatment for many children for reasons of cost and flexibility of dosing). Individual clinical choice is needed.

Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder.

Background: Although children with hyperkinetic disorder and/or attention deficit hyperactivity disorder (ADHD) show disordered executive neuropsychological functioning, the nature of these changes remains controversial. Additionally, impairments in non-executive neuropsychological functioning have been relatively unexplored. Here, the authors describe the neuropsychological functioning of a sample of stimulant drug-naive boys with hyperkinetic disorder on a battery of neuropsychological tasks sensitive to impairments of both executive and non-executive functions.

Whither causal models in the neuroscience of ADHD?

In this paper we examine the current status of the science of ADHD from a theoretical point of view. While the field has reached the point at which a number of causal models have been proposed, it remains some distance away from demonstrating the viability of such models empirically. We identify a number of existing barriers and make proposals as to the best way for these to be overcome in future studies.

Use of stimulants for attention deficit hyperactivity disorder: FOR.

Definitive diagnosis of attention deficit hyperactivity disorder is complex. David Coghill believes the condition is undertreated, but Harvey Markovitch argues that current uncertainties about diagnosis and treatment mean doctors should be cautious

Efficacy of two once-daily methylphenidate formulations compared across dose levels at different times of the day: preliminary indications from a secondary analysis of the COMACS study data.

Background: Methylphenidate (MPH) is commonly prescribed in the treatment of Attention-Deficit/Hyperactivity Disorder or ADHD. Concerta and Metadate CD are once-daily formulations of MPH using different delivery mechanisms resulting in different pharmacokinetic profiles. A recent study (COMACS) showed that for near-milligram (mg) equivalent daily doses, Metadate CD provides greater symptom control in the morning (1.

European clinical guidelines for hyperkinetic disorder -- first upgrade.

Background: The validity of clinical guidelines changes over time, because new evidence-based knowledge and experience develop.

Objective: Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified.

Method: Discussions at the European Network for Hyperkinetic Disorders (EUNETHYDIS) and iterative critique of each clinical analysis.

Methylphenidate restores visual memory, but not working memory function in attention deficit-hyperkinetic disorder.

Rationale: Dysfunction of executive neuropsychological performance, mediated by the prefrontal cortex, has been the central focus of recent attention deficit/ hyperkinetic disorder (AD-HKD) research. The role of other potential neuropsychological "risk factors", such as recognition memory, remains understudied. Further, the impact of methylphenidate (MPH) on key neuropsychological processes in AD-HKD remains poorly understood.

Genital gonorrhoea in women: a serovar correlation with concomitant rectal infection.

Strains of gonococci isolated from 383 episodes of infection in women were classified serologically by means of two independently developed panels (Pharmacia (Ph) and Genetic Systems (GS] of monoclonal coagglutination reagents. Strains isolated from two groups of patients-those with concomitant genital and rectal infection (Group R) and those with genital infection in the absence of rectal infection (Group G)-were compared in order to determine whether certain strains of gonococci are isolated more often from women with concomitant rectal infection. Group R patients accounted for 126 (33%) episodes and Group G patients accounted for 223 (58%) episodes.

Serological classification of Neisseria gonorrhoeae with monoclonal antibody coagglutination reagents.

A total of 357 clinical isolates of Neisseria gonorrhoeae from 286 patients were classified serologically using two independently developed panels of monoclonal coagglutination reagents. The Pharmacia (Ph) Diagnostics panel comprised 14 reagents, five specific for serogroup WI strains and nine specific for serogroup WII/III strains, whereas the Genetic Systems (GS) panel comprised 14 reagents, seven specific for serogroup WI strains and seven specific for serogroup WII/III strains. Serogroup WI represented 45% and WII/III represented 55% of the patients.

Evaluation of a direct immunofluorescence test for diagnosing gonorrhoea.

A new direct immunofluorescence reagent (Syva and Genetic Systems Inc) was evaluated for its ability to detect Neisseria gonorrhoeae in specimens from populations with a high prevalence of the infection. Gonorrhoea was diagnosed by culture in 45 of 105 (43%) urethral specimens from men and 17 of 90 (28%) urethral and 25 of 60 (42%) cervical specimens from women. In men the immunofluorescence test had a sensitivity of 84.

A comparison of erythrocyte glutathione S-transferase activity from human foetuses and adults.

Glutathione S-transferase activity was measured in partially purified haemolysates of erythrocytes from human foetuses and adults. Enzyme activity was present in erythrocytes obtained between 12 and 40 weeks of gestation. The catalytic properties of the enzyme from foetal cells were similar to those of the enzyme from adult erythrocytes, indicating that probably only one form of the erythrocytes enzyme exists throughout foetal and adult life.