1) Assessment of Working Memory in Children With Attention-Deficit/Hyperactivity Disorder

Lucinete de Freitas Messina, Klaus Bruno Tiedemann (University of São Paulo)
Enio Roberto de Andrade (Hospital das Clínicas de São Paulo)
Ricardo Primi (University São Francisco)

Objective: This research investigated the cognitive abilities and the working memory in children and youngsters with three different types of attention-deficit/hyperactivity disorder (ADHD): (a) mainly with attention-deficit, (b) hyperactive and impulsive, and (c) combined. Method: A computerized test called Infant Cognitive Abilities Test, which measures five cognitive abilities based on the Cattell-Horn-Carroll model, was used. Thirty-two children from both sexes, aged 7 to 15 years, from the Hospital das Clínicas, suffering from ADHD and a control group with 30 children from a state elementary school (first through eighth grades) were submitted to the test. Results: The results showed that there were significant differences with regard to the reaction time of the working memory of the different types of ADHD. Conclusion: Children suffering from ADHD had high test scores for the visual memory items of the test, when compared with the results in the auditory memory items.

2) Positive effects of methylphenidate on inattention and hyperactivity in pervasive developmental disorders: an analysis of secondary measures.


Posey DJ, Aman MG, McCracken JT, Scahill L, Tierney E, Arnold LE, Vitiello
B, Chuang SZ, Davies M, Ramadan Y, Witwer AN, Swiezy NB, Cronin P, Shah B,
Carroll DH, Young C, Wheeler C, McDougle CJ.
Department of Psychiatry, Indiana University School of Medicine,
Indianapolis, Indiana.

Biol Psychiatry. 2007 Feb 15;61(4):538-44.

BACKGROUND: Methylphenidate has been shown elsewhere to improve hyperactivity in about half of treated children who have pervasive developmental disorders (PDD) and significant hyperactive-inattentive symptoms. We present secondary analyses to better define the scope of effects of methylphenidate on symptoms that define attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), as well as the core autistic symptom domain of repetitive behavior.
METHODS: Sixty-six children (mean age 7.5 y) with autistic disorder, Asperger's disorder, and PDD not otherwise specified, were randomized to varying sequences of placebo and three different doses of methylphenidate during a 4-week blinded, crossover study. Methylphenidate doses used approximated .125, .25, and .5 mg/kg per dose, twice daily, with an
additional half-dose in the late afternoon. Outcome measures included the Swanson, Nolan, and Pelham Questionnaire revised for DSM-IV (ADHD and ODD scales) and the Children's Yale-Brown Obsessive Compulsive Scales for PDD.

RESULTS: Methylphenidate was associated with significant improvement that was most evident at the .25- and .5-mg/kg doses. Hyperactivity and impulsivity improved more than inattention. There were not significant effects on ODD or stereotyped and repetitive behavior.

CONCLUSIONS: Convergent evidence from different assessments and raters confirms methylphenidate's efficacy in relieving ADHD symptoms in some children with PDD. Optimal dose analyses suggested significant interindividual variability in dose response.

3) Fibromylagia,Chronic fatigue, and adult attention deficit hyperactivity disorder in the adult: a case study.


Young JL, Redmond JC.
Rochester Center for Behavioral Medicine, Rochester Hills, MI.
Psychopharmacol Bull. 2007 Winter;40(1):118-26.

Adult attention deficit hyperactivity disorder (ADHD) may share common features with fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS). In an outpatient psychiatric clinic, a number of adult patients who presented primarily with symptoms of ADHD, predominately inattentive type, also reported unexplained fatigue, widespread musculoskeletal pain or a
pre-existing diagnosis of CFS or FMS. As expected, ADHD pharmacotherapy usually attenuated the core ADHD symptoms of inattention, distractibility, hyperactivity, and impulsivity. Less expected was the observation that some patients also reported amelioration of pain and fatigue symptoms. The utility of ADHD medications in FMS and CFS states may be their innate
arousal and enhanced filtering properties. This model supposes that FMS and CFS are central processing problems rather than peripheral disorders of muscles and joints.

4) ADHD and achievement: meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students.


Frazier TW, Youngstrom EA, Glutting JJ, Watkins MW.
Section of Behavioral Medicine, The Cleveland Clinic, Shaker Medical Campus,
OH 44104, USA. fraziet2@ccf.org
J Learn Disabil. 2007 Jan-Feb;40(1):49-65.

This article presents results from two interrelated studies. The first study conducted a meta-analysis of the published literature since 1990 to determine the magnitude of achievement problems associated with attention-deficit/hyperactivity disorder (ADHD). Effect sizes were significantly different between participants with and without ADHD (sample
weighted r = .32, sample weighted d = . 71; p = .001). Effects were also examined according to the moderators of age, gender, achievement domain (reading, math, spelling), measurement method (standardized tests vs.
grades, parent/teacher ratings, etc.), sample type (clinical vs. nonclinical), and system used to identify ADHD (DSM-III-R vs. DSM-IV). Significant differences emerged from the moderator comparisons. The second study, using averaged effect sizes from the first study as a baseline for comparison, investigated achievement levels for an understudied age group with ADHD, namely, college students. Unlike previous studies at the college level, the sample incorporated both student and parent ratings (N = 380
dyads). The results were comparable to outcomes from the meta-analysis for college students and adults. Analyses demonstrated modest (R = .21) but meaningful predictive validity across 1 year to end-of-first-year grades.
However, unlike earlier studies with children and adolescents, student ratings were as predictive as parent ratings. Findings are discussed in terms of the impact of moderator variables on ADHD and achievement.`

5) Differentiating major depressive disorder in youths with attention deficit hyperactivity disorder.

Diler RS, Daviss WB, Lopez A, Axelson D, Iyengar S, Birmaher B.
Division of Child Psychiatry, Western Psychiatric Institute and Clinic,
Pittsburgh, Pennsylvania, United States.

J Affect Disord. 2007 Feb 2; [Epub ahead of print]

BACKGROUND: Youths with attention deficit hyperactivity disorders (ADHD) frequently have comorbid major depressive disorders (MDD) sharing overlapping symptoms. Our objective was to examine which depressive symptoms
best discriminate MDD among youths with ADHD.

METHODS: One-hundred-eleven youths with ADHD (5.2-17.8 years old) and their parents completed interviews with the K-SADS-PL and respective versions of the child or the parent Mood and Feelings Questionnaire (MFQ-C, MFQ-P).
Controlling for group differences, logistic regression was used to calculate odds ratios reflecting the accuracy with which various depressive symptoms on the MFQ-C or MFQ-P discriminated MDD. Stepwise logistic regression then
identified depressive symptoms that best discriminated the groups with and without MDD, using cross-validated misclassification rate as the criterion.

RESULTS: Symptoms that discriminated youths with MDD (n=18) from those without MDD (n=93) were 4 of 6 mood/anhedonia symptoms, all 14 depressed cognition symptoms, and only 3 of 11 physical/vegetative symptoms. Mild
irritability, miserable/unhappy moods, and symptoms related to sleep, appetite, energy levels and concentration did not discriminate MDD. A stepwise logistic regression correctly classified 89% of the comorbid MDD
subjects, with only age, anhedonia at school, thoughts about killing self, thoughts that bad things would happen, and talking more slowly remaining in the final model.

LIMITATIONS: Results of this study may not generalize to community samples because subjects were drawn largely from a university-based outpatient psychiatric clinic.

CONCLUSIONS: These findings stress the importance of social withdrawal, anhedonia, depressive cognitions, suicidal thoughts, and psychomotor retardation when trying to identify MDD among ADHD youths.