1. Attention Deficit Hyperactivity Disorder Symptoms Predict Nicotine
Dependence and Progression to Regular Smoking from Adolescence to Young
Adulthood.

Fuemmeler BF, Kollins SH, McClernon FJ.
Community and Family Medicine, University Medical Center, Department of
Psychiatry, Duke University Medical Center.

J Pediatr Psychol. 2007 Jun 30; [Epub ahead of print]

OBJECTIVE: To examine the association between retrospectively reported
attention deficit hyperactivity disorder (ADHD) symptoms and progression to
smoking and the association with nicotine dependence.

METHODS: Study sample consisted of a nationally representative cohort of
U.S. adolescents (n = 13,494). Logistic regression was used to examine ADHD
symptoms from both the inattentive (IN) and hyperactive-impulsive (HI)
domains and smoking trajectories. Linear regression was used to examine
nicotine dependence.

RESULTS: HI symptoms were associated with progression from nonsmoking to
regular smoking (OR = 1.14, 95% CI = 1.07-1.21), and with progression from
experimentation to regular smoking (OR = 1.16, 95% CI = 1.08-1.26). IN and
HI symptoms were associated with nicotine dependence among current smokers
(IN: beta = 0.17, SE = 0.03, p < 0.0001; HI: beta = 0.10, SE = 0.04., p <
.001).

CONCLUSIONS: These results have important implications for the development
of prevention and treatment modalities.

2. Prevalence of attention deficit hyperactivity disorder in school children in
the city of Salvador, Bahia, Brazil.

Pondé MP, Freire AC.
Bahia School of Medicine and Public Health, Salvador, BA, Brazil.

Arq Neuropsiquiatr. 2007 Jun; 65(2A):240-244.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most
common neuropsychiatric disorder of infancy and one of the most prevalent
chronic diseases found in schoolchildren.

OBJECTIVE: To evaluate the prevalence of ADHD in schoolchildren through the
use of a questionnaire responded by school-teachers.

METHOD: A total of 774 children enrolled in the public and private school
systems were evaluated. The diagnostic instrument used was a Teacher ADHD
scale.

RESULTS: Results showed that 6.7% of children were considered highly likely
to have the disorder. Of the more severe cases of ADHD, the
hyperactive-impulsive subtype was more frequently identified in girls, while
the inattentive subtype was more prevalent among boys.

CONCLUSION: The symptoms of attention deficit in hyperactive children may be
underestimated by teachers since the symptoms of hyperactivity are more
noticeable and disruptive.

3. Behavior Ratings of Executive Function among Preschoolers with ADHD.

Mahone EM, Hoffman J.
Kennedy Krieger Institute and Johns Hopkins University School of Medicine.
Baltimore, MD.

Clin Neuropsychol. 2007 Jul;21(4):569-86.

The Behavior Rating Inventory of Executive Function-Preschool Version
(BRIEF-P; Gioia, Espy, & Isquith, 2003) was developed to assess executive
function (EF) behaviors in children aged 2 to 5 years.

We compared parent ratings of 25 preschool children with ADHD to 25 age-, sex-, and SES-matched
controls from the BRIEF-P standardization sample.

Children with ADHD wererated significantly higher than controls (p < .01) on all five primary scales (Inhibit, Shift, Emotional Control, Working Memory, Plan/Organize),
and on all four indices (Inhibitory Self Control, Flexibility, Emerging Metacognition, General Executive Composite).

The largest effect size was on the Working Memory scale. All five BRIEF-P clinical scales were significantly intercorrelated in the control group, and seven of ten scale intercorrelations were significant in the ADHD group. Within the ADHD group,
the BRIEF-P Index scores were significantly correlated with ratings on the Conners" Parent Rating Scale, but only moderately correlated with an estimate of Verbal IQ.

The BRIEF-P had low, non-significant correlations with performance-based measures of EF, and patterns of correlations were not significantly different than those between the BRIEF-P and non-EF measures (sensorimotor, receptive vocabulary).

Similar to its predecessor, the BRIEF-P is sensitive to symptoms of ADHD, but appears to measure different elements of EF than those tapped by performance-based measures.

4. Long-Acting Methylphenidate Does Not Adversely Affect Laboratory Values

Pediatrics 2007;120:e120-e128. Jul 03

Will Boggs, MD

Long-term methylphenidate treatment of children with attention-deficit/hyperactivity disorder (ADHD) does not adversely affect laboratory values, according to a study in the July online issue of Pediatrics.

"In medically healthy children receiving methylphenidate, little data exist in longer term studies indicating any major deleterious effects on hematology or blood chemistries," Dr. Sharon B. Wigal from University of California, Irvine, told Reuters Health. "Some of the "concerns" or "monitoring recommendations" in the package insert of medications are vestigial and may not be representative of current data in the area."

Dr. Wigal and colleagues analyzed blood biochemistry values, including hematology, measured during the course of a trial of extended-release methylphenidate (Concerta, McNeil Pediatrics, Fort Washington, Pennsylvania) in children with ADHD who were treated for up to 24 months.

None of the mean values for hematologic or blood biochemistry parameters showed clinically significant changes from baseline, the authors report.

Among the handful of tests whose values changed more than 5% from baseline, the report indicates, most of the absolute changes were less than or approximately the same as the standard deviation for baseline values.

In fact, the researchers note, none of the 407 children developed a clinically significant laboratory value during the course of the study which necessitated their discontinuation from the trial.

"Most physicians do not currently obtain routine laboratory studies on children receiving methylphenidate," Dr. Wigal said. "This study will highlight the relative safety of that practice and reassure physicians as to the hematological and blood chemistry safety of these medications over a two-year period of treatment in medically healthy children (i.e., the children in the study were screened and evaluated to be healthy prior to entering the study)."

5. Long-term effects of methylphenidate transdermal delivery system treatment of ADHD on growth.

J Am Acad Child Adolesc Psychiatry. 2007 Sep; 46(9):1138-47.
Faraone SV, Giefer EE.

OBJECTIVE:: To examine the long-term effects of the methylphenidate transdermal system (MTS) on the growth of children being treated for attention-deficit/hyperactivity disorder.

METHOD:: Height, weight, and body mass index (BMI) were measured in 127 children ages 6 to 12 at longitudinal assessments for up to 36 months of treatment with MTS. These data were compared with norms provided by the Centers for Disease Control and Prevention.

RESULTS:: MTS treatment was associated with small but significant delays in growth for height, weight, and BMI. The latter two indices were affected in a dose-dependent manner. Children who had not received prior stimulant therapy and children who entered the study with above-average height, weight, and BMI were most likely to experience growth deficits during the trial. Effects on all parameters of growth were most apparent during the first year of treatment, and attenuated over time.

CONCLUSIONS:: Consistent with prior studies of methylphenidate, our results suggest that treatment with MTS can lead to reductions in expected height, weight, and BMI that show some attenuation over the course of treatment. Growth of patients with attention-deficit/hyperactivity disorder treated with MTS should be closely monitored, but in this study, deficits in growth in relation to MTS treatment were not a significant clinical concern for most children.