Annales medico-psychologiques最新文献

{"title":"Aging ADHD: Case series of patients reaching 45+ with a recent diagnosis of ADHD","authors":"Margaux Courrèges,&nbsp;Jeremy De Kermadec,&nbsp;Hassan Rahioui","doi":"10.1016/j.amp.2024.07.006","DOIUrl":"10.1016/j.amp.2024.07.006","url":null,"abstract":"<div><div>Attention deficit with hyperactivity disorder is a neurodevelopmental disorder, which first symptoms commonly appear before 12 years of age. Educational impact of focus inconsistencies and impulsive behavior has been heavily researched in children, adolescents, and even young adults. However, late adults have not been described in literature, even if the pathological syndrome does not always disappear over time. It can, as it is of note with the four-presented cases, last over 50 years of age, meaning a lifelong past of inattentive and hyperactive repercussions. Persisting ADHD can be correlated with multiple risk factors and comorbidities, which means more complicated medical care. Dedicated therapies, especially addressing professional difficulties, should be validated through research in order to cease repeating negatives patterns indefinitely.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 292-296"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pourquoi une Société française du TDAH ?","authors":"Diane Purper-Ouakil ,&nbsp;Stéphanie Bioulac-Rogier ,&nbsp;Hervé Caci ,&nbsp;Maëva Roulin ,&nbsp;Benjamin Rolland ,&nbsp;Thiébaut-Noël Willig","doi":"10.1016/j.amp.2024.08.022","DOIUrl":"10.1016/j.amp.2024.08.022","url":null,"abstract":"&lt;div&gt;&lt;div&gt;This document provides an overview of the establishment, objectives, and early activities of the first professional ADHD society in France, the “Société française du TDAH (SF-TDAH)”. The SF-TDAH aims to improve coordination among professionals involved in ADHD treatment and care throughout all ages. There are still significant issues in France for people with ADHD and families, including difficult access to care, a lack of trained healthcare professionals, and long waiting times for diagnosis and treatment. Additionally, concerns were raised about the effectiveness of generic medications and the variability of access to psychoeducation, psychological treatments, and school accommodations. The situation was particularly dire for adults, with limited treatment options and no authorization for ADHD medications. Since then, the French National Authority for Health (HAS) has started developing recommendations for diagnosing and treating ADHD in children and adolescents, expected to be published in 2024. A working group for adult ADHD recommendations will follow. In 2023, the national health authorities formed a group of experts and patient representatives to address ADHD-related issues, including prevalence, care pathways, professional training, and treatment access. The creation of the SF-TDAH is an output of this group with the objective to form a collective of professionals to promote best practices, collaboration, and research. The society's members include recognized professionals in child and adult ADHD from clinical and research backgrounds and representatives from scientific societies, public organizations, and ADHD associations. The SF-TDAH aims to: • Improve care quality through evidence-based and personalized medicine for ADHD and comorbidities. • Disseminate scientifically supported information to healthcare professionals and those involved in ADHD diagnosis and treatment. • Engage in initial and ongoing training for healthcare professionals across various sectors. • Combat stigma and exclusion through scientifically supported information. • Promote interdisciplinary scientific research on ADHD. • Collaborate with national and international scientific societies and research organizations. • Advocate for healthcare system improvements to enhance care accessibility and coordination. • Ensure better recognition and reimbursement for ADHD care in the healthcare system. SF-TDAH plans to achieve its objectives through: • Organizing training sessions, public meetings, conferences, and congresses for healthcare professionals and the public. • Publishing in various media, both print and electronic. • Engaging with the public, healthcare professionals, and authorities to advocate for ADHD-related issues. • Developing a national network of healthcare professionals, psychologists, and patient experts. • Participating in national and international professional associations and user organizations. • Maintaining an informative website for ADHD-","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 205-208"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trouble du Déficit de l’Attention/Hyperactivité et Addictions : concepts et applications cliniques pour une meilleure prise en charge","authors":"Norman Therribout ,&nbsp;Romain Icick ,&nbsp;Emily Karsinti ,&nbsp;Alexandra Dereux ,&nbsp;Frank Bellivier ,&nbsp;Florence Vorspan ,&nbsp;Cora Von Hammerstein ,&nbsp;Lucia Romo","doi":"10.1016/j.amp.2024.08.024","DOIUrl":"10.1016/j.amp.2024.08.024","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Addictive disorders are responsible for a significant morbidity and mortality rates. These disorders often coexist with other psychiatric and neurodevelopmental disorders, explaining some of the severe consequences. The complexity of the mental disorders associated with addiction and the public health issue they represent have led researchers to develop a new field of research: dual disorders, which corresponds to a mental disorder (or several mental disorders) coexisting with addiction. Attention Deficit Hyperactivity Disorder (ADHD) is receiving an increasing attention from the clinical and scientific community. In France, ADHD has finally been fully considered a public health issue over the past decade, leading to a growing demand for training among health professionals. This neurodevelopmental disorder is common in the population suffering from addiction and pose major diagnostic and therapeutic issues. Addiction and ADHD have bidirectional causal links, which maintain and worsen the symptoms. ADHD population represents a key element for the treatment. However, screening and diagnosing ADHD in patients suffering from addictions pose serious challenges for clinicians because of the effect of substance use and gambling/gaming on executive functions and of other common psychiatric comorbidities, which can mimic or hide ADHD symptoms. Treatment strategies for this dual disorder remain understudied.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To describe recent data concerning the diagnosis and management of the dual pathology of ADHD and addictions, eventually leading clinicians to better implement the most up-to-date and relevant diagnostic and therapeutic strategies relevant to their practice&lt;em&gt;.&lt;/em&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;A narrative review of the international literature was carried out via MEDLINE for articles in English or French published without date limit, concerning the identification, diagnosis and management of ADHD comorbid with substance and non-substance addictions (gambling, video games)&lt;em&gt;.&lt;/em&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;ADHD is identified in 23% of substance addicts and up to 40% of non-substance addicts. Similarly, the prevalence of substance and non-substance addictions reached 50% among ADHD sufferers. In these cases, the clinical picture is more severe. Identifying this dual pathology requires a specific diagnostic process. Standardized screening and diagnostic tools are useful, but not all of them have been validated. Medication and non-medication management must target both aspects in an integrated way. Some promising dedicated therapeutic strategies (psycho-education, cognitive-behavioral therapy) have been developed, based on their efficacy in each disorder alone. Unfortunately, their level of evidence remains low to date.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;As in other dual disorders, the reasons for the high co-occurrence of ADHD and addictions are m","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 249-258"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact professionnel du Trouble Déficit de l’Attention avec ou sans Hyperactivité (TDAH)","authors":"Bénédicte Jullian ,&nbsp;Jérémie Pariente ,&nbsp;Antoine Yrondi ,&nbsp;Fabrice Herin","doi":"10.1016/j.amp.2024.11.004","DOIUrl":"10.1016/j.amp.2024.11.004","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that manifests in childhood and can persist into adulthood, affecting various aspects of daily life, including the professional environment. The prevalence of ADHD in adults is estimated to be between 1.5% and 3.2%. In France, the 2023–2027 national strategy for Neurodevelopmental Disorders (NDD) highlights the importance of managing adult ADHD, including medication prescriptions. The article is based on a literature review examining the impact of ADHD on the professional lives of adults. The review methodology focuses on identifying the main symptoms of ADHD in adults, associated comorbidities, and specific impacts on the professional environment. Adults with ADHD exhibit attention and concentration difficulties, emotional regulation problems, often accompanied by manifestations of psychic or physical hyperactivity. These symptoms can vary depending on the context and professional constraints. Frequent comorbidities include mood disorders, anxiety disorders, and substance use disorders, complicating the diagnosis and management of ADHD. ADHD has a significant impact on professional life, with studies showing decreased productivity, lower qualification levels, and higher absenteeism rates. For instance, a global survey by the WHO revealed that workers with ADHD lost an average of 22 days of productivity per year compared to their non-ADHD colleagues. Adults with ADHD may experience difficulties in organization, time management, punctuality, and interpersonal relationships at work. These challenges can be exacerbated by stressful and poorly adapted work environments. Specific adaptations can mitigate the negative effects of ADHD on the professional environment. These include creating an adapted work environment, regular breaks, and using specific organizational tools. A stimulating and supportive work environment can help adults with ADHD maximize their strengths, such as creativity, dynamism, and effective crisis management. For example, avoiding noisy open spaces, allowing standing work options, and providing access to resource spaces can improve well being and performance. The risk of professional burnout is high among adults with ADHD, particularly those working in stressful environments like the healthcare sector. Studies show a correlation between ADHD symptoms and burnout, emphasizing the need for tailored management to prevent exhaustion. Healthcare professionals are particularly at risk, with factors such as stress, irregular hours, and high responsibilities increasing their vulnerability to burnout. It is crucial to raise awareness and train healthcare professionals in recognizing and managing ADHD. Better understanding can improve early detection and appropriate management, thereby reducing the negative impact on professional life. Innovative initiatives, such as support programs, psychoeducation, and specific workplace adaptations, can promote be","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 234-241"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’épidémiologie du TDAH à tous les âges","authors":"Cédric Galera ,&nbsp;Hervé Caci","doi":"10.1016/j.amp.2024.07.014","DOIUrl":"10.1016/j.amp.2024.07.014","url":null,"abstract":"<div><div>Epidemiology studies diseases and the factors influencing their onset and progression. It also examines disease prevention and control strategies. Epidemiology has three dimensions: descriptive, analytical and evaluative. These three dimensions are used to guide public health decisions and conduct research to better understand diseases. In descriptive epidemiology, the prevalence of ADHD is estimated at around 5% in children and 2.5% in adults. Studies show that this prevalence is stable across time and geographical regions. ADHD is more common in boys than in girls during childhood, but this ratio tends to even out in adulthood. Comorbidities with other psychiatric and physical disorders are frequent, making ADHD a complex condition to treat. Analytical epidemiology examines the genetic and environmental risk factors for ADHD. Studies show high genetic heritability, with contributions from many genes. Environmental factors include prenatal influences, psychosocial conditions and exposure to pollutants. Gene-environment interactions and gene-environment correlations also play an important role in the development of ADHD. Analytical epidemiology also enables us to study the long-term consequences of ADHD, highlighting its possible negative impact in terms of academic, social, mental and physical health, as well as excess mortality. Finally, evaluative epidemiology focuses on the effectiveness of interventions, such as medication and behavioral therapies. Meta-analyses, notably those carried out by Cochrane, provide evidence on the efficacy and safety of treatments used for ADHD, helping to optimize therapeutic strategies.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 215-222"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approche historique du trouble déficit de l’attention hyperactivité et de sa prise en charge","authors":"Erica Martins ,&nbsp;Manuel P. Bouvard","doi":"10.1016/j.amp.2024.08.023","DOIUrl":"10.1016/j.amp.2024.08.023","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder affecting 5% of children and nearly 3% of adults. This frequent disorder, often associated with comorbidities, is part of a developmental trajectory from childhood to adulthood, and can have repercussions in various areas of individual functioning. We present a non-exhaustive narrative review, focusing on the evolution of the concept of ADHD and its management in children and adolescents. On the 18th century, the first European clinical descriptions, by Melchior A. Wiekard and Cornelius A. Kloekhof and later Alexander Crichton, focus on attention deficit using the term of “attentio volubilis”. A century later, Désiré Magloire Bourneville introduced the concept of “mental instability”; he formalized his models of education and advocated the creation of “special classes” in ordinary schools. By the beginning of the 20th century, Alfred Binet writes “Le portrait de l’instable” (The portrait of the unstable) and already highlights the value of positive reinforcement in the school context. Then, Georges Still, a pediatrician, described the syndrome of “loss of moral control”, in children with no impairment of “general intelligence”, with no identifiable somatic cause; which he associated with “Minimal Brain Damage” referring to minor brain lesions. This theory is taken up in studies on Van Economo-Cruchet encephalitis, which in its hyperkinetic form is similar to ADHD as we know it today. American psychiatrist Charles Bradley publishes his first study on the administration of benzedrine sulfate. Bradley supports a multi-factorial model of behavioural disorders and insists on a global management strategy, combining a psychological and a biological dimension. In 1963, Conners and Eisenberg published the first article on the effect of methylphenidate on children's behaviour and learning. Efficacity of treatements on ADHD symptoms both attested of the neurological underpinnings of this behavioral disorder. Then, two theoretical currents evolved: a neuroanatomical and neurobiological approach on the one hand, and a psychoanalytical current on the other. Polemics about the recognition of the disorder and its causality emerged, contributing to poor identification, delayed access to diagnosis and specific care in France. Wood et al., published a preliminary study on the evolution of “Minimal Brain Dysfunction” in adulthood, representing the beginnings of the developmental perspective of ADHD. Over the last forty years, the contribution of neuroscience (cognition, imaging, electrophysiology, genetics, epigenetics, etc.) has enabled us to develop integrative theoretical models of understanding that describe the complexity of the disorder: a multi-path model was proposed by Sonuga-Barke and Fairchild in 2012. Taken together, these empirical data aim to establish a model for understanding ADHD, and neuroscientists agree that multimodal approaches and “big data” analyses tha","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 209-214"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les interventions psychologiques dans la prise en charge du TDAH chez l’adulte","authors":"Maëva Roulin ,&nbsp;François Radiguer ,&nbsp;Sébastien Henrard ,&nbsp;Johanna Guinet ,&nbsp;Sophie Bayard","doi":"10.1016/j.amp.2024.06.010","DOIUrl":"10.1016/j.amp.2024.06.010","url":null,"abstract":"<div><div>Managing difficulties for people suffering from attention deficit hyperactivity disorder (ADHD) is a complex task that goes beyond the application of pharmacotherapy alone. Although stimulant medications are frequently used to treat the core symptoms of ADHD, they are not always sufficient to manage other important aspects of this disorder. The aim of this study is to complete the systematic review carried out in 2017 by the Cochrane Database of Systematic Reviews concerning psychological approaches to ADHD. To do this, we analyzed data published since 2017 in PubMed, Embase, PsycInfo and MEDLINE databases. We grouped our data by type of approach to highlight the most effective therapies for improving behavioral and functional symptoms associated with ADHD. The data collected highlights that cognitive-behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT) and psychoeducation are particularly effective, providing short-term benefits by reducing ADHD symptoms and improving associated disorders such as depression and anxiety. We conclude that there is significant evidence to support the use of specific psychological approaches in the management of ADHD in adults. Future research should examine more rigorously the lack of methodology and further integrate transdiagnostic approaches to psychopathology.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 301-307"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidités et diagnostics différentiels du Trouble Déficit de l’Attention Hyperactivité (TDAH) en fonction de l’âge","authors":"Diane Purper-Ouakil ,&nbsp;Sébastien Weibel","doi":"10.1016/j.amp.2024.09.006","DOIUrl":"10.1016/j.amp.2024.09.006","url":null,"abstract":"<div><div>Attention Deficit Hyperactivity Disorder (ADHD) is associated with neurodevelopmental and psychiatric comorbidities throughout life, with a profile of co-occurring disorders that tend to become more complex over time. This article synthesizes the main comorbidities and differential diagnoses of ADHD to provide guidance and facilitate the diagnostic and therapeutic process. In adolescents and adults, it is common for ADHD symptoms to be difficult to spot amid substance abuse disorders or mood disorders. However, diagnosing ADHD is crucial because its treatment can decisively improve social functioning and prognosis for individuals with comorbidities. Most comorbid disorders also serve as differential diagnoses for ADHD, with several symptoms that can be shared across multiple diagnostic categories. This is the case with difficulties in concentration, impulsivity, and irritability, for example. Comorbidities of ADHD in children and adolescents include neurodevelopmental disorders such as autism spectrum disorder (ASD), intellectual developmental disorder (IDD), communication disorders, specific learning disorders, and motor development disorders. A meta-analysis found a lifetime prevalence of ADHD in ASD to be 40,2%, and in children with ADHD, a co-occurrent diagnosis of ASD is found in 20 to 30% <span><span>[1]</span></span>, <span><span>[2]</span></span>. The diagnostic process can be delayed in people with both ADHD and ASD. While treatment of ADHD has documented efficacy in this population, a slow titration is recommended to minimise the risk of side effects <span><span>[3]</span></span>. The prevalence of ADHD in children with Intellectual Disability is 39%, with higher figures in syndromic conditions such as fragile X <span><span>[4]</span></span>. Externalizing disorders such as oppositional defiant disorder (ODD) and conduct disorder (CD) associated with ADHD strongly influence psychosocial functioning and prognosis. Oppositional defiant disorder (ODD) is frequent in children and adolescents with ADHD, about 40 to 60% in clinical samples and 20 to 30% in the general population. Internalizing and stress-related disorders are also frequent in persons with ADHD at different ages. The presence of ADHD increases the risk of being exposed to accidents and other potentially traumatising life events. ADHD is a risk factor for post-traumatic stress disorder, with rates four times higher compared with controls <span><span>[5]</span></span>. Anxiety disorders can begin at a young age with separation anxiety disorder or generalised anxiety disorder and affect about 50% adults with ADHD <span><span>[6]</span></span>. In adults with ADHD, depressive disorders are 3 to 5 times more likely than in controls <span><span>[7]</span></span>. The association between a mood disorder and impulsivity increases the risk of suicidal behaviours <span><span>[8]</span></span>. Bipolar disorder is found in 15% of adults with ADHD and is likely to be associated ","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 242-248"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TDAH : quels sont les effets cardiovasculaires du méthylphénidate et quelles sont les conséquences éventuelles pour la pratique clinique ?","authors":"Antoine Faure ,&nbsp;Laurence Bonelli ,&nbsp;Mélanie Guagenti","doi":"10.1016/j.amp.2024.08.021","DOIUrl":"10.1016/j.amp.2024.08.021","url":null,"abstract":"<div><h3>Context</h3><div>Methylphenidate is the first-line pharmacological treatment for ADHD, and its prevalence continues to grow, with an increase of 116% over the last ten years in France. Its use in hospitals has been extended to neurologists, psychiatrists and pediatricians, and its prescription can be renewed by a general practitioner. Cardiovascular complications are rare, but life-threatening. Management practices currently vary widely from one medical center or doctor to another.</div></div><div><h3>Objectives</h3><div>Reviewing the cardiovascular effects of methylphenidate in adults and children with ADHD, aiming to propose a practical management plan without intending to replace existing recommendations.</div></div><div><h3>Methods</h3><div>The subject under study aimed to answer the following PICO question “What are the cardiovascular consequences (outcomes) when using MPH (intervention) for an ADHD population (population) regardless of age”. We carried out systematic review of international reviews and meta-analyses, selected using the PRISMA methodology via the PubMed, Cochrane Library and Google Scholar databases. Their methodological quality was assessed using the AMSTAR-2 scale. Cardiovascular events considered were the adrenergic effects of MPH on the cardiovascular system, looking for changes in blood pressure and heart rate, and the serious cardiovascular effects represented by sudden death/arrhythmia, myocardial infarction and stroke. A total of 17 systematic reviews and meta-analyses met the eligibility criteria.</div></div><div><h3>Results</h3><div>Of the 734 articles found, twelve were finally selected. Four concerned a population of children, five a mixed population of adults and children and three a population of adults only. They included two systematic reviews and ten meta-analyses. Three reviews included cohort studies and nine included randomized controlled trials. Three clinical situations can be distinguished depending on the age of the patient and the length of exposure to methylphenidate. The first, on initiation of treatment, there was a marked by a short-term increase in blood pressure and heart rate. The second involves a patient under the age of 35 with short- to medium-term exposure to MPH. A persistent adrenergic effect tends to increase the risk of sudden death by 12% (if the resting heart rate increases by ten beats per minute). This risk is further increased if the patient has psychiatric comorbidities and their associated treatments, congenital heart disease and uses recreational substances. Finally, the last situation involves a patient exposed to MPH for several years and aged over 35, whose main risk is the onset of atheromatous disease with myocardial infarction and ventricular arrhythmia. In this case, a comprehensive approach is required, identifying risk factors and behavioral factors likely to exacerbate the risk of CV disease.</div></div><div><h3>Conclusions</h3><div>The short-term cardiovasc","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 338-345"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between pediatric extremity fractures and attention deficit hyperactivity disorder","authors":"Merve Yazıcı ,&nbsp;Rıfat Şahin ,&nbsp;Mehmet Sabri Balık ,&nbsp;Ahmet Tunahan Yılmaz","doi":"10.1016/j.amp.2024.09.005","DOIUrl":"10.1016/j.amp.2024.09.005","url":null,"abstract":"<div><h3>Context</h3><div>Attention deficit hyperactivity disorder is one of the most common mental disorders of childhood, characterized by inattention, hyperactivity, and impulsive behaviors. Fractures are a common cause of hospitalization, especially in children. Recognizing fracture risk factors can aid in injury prevention and provide information for determining the appropriate interventions.</div></div><div><h3>Objectives</h3><div>This study examined whether a diagnosis of fracture is associated with the diagnosis and symptoms of attention deficit hyperactivity disorder, as well as with symptoms of oppositional defiant disorder, conduct disorder and sluggish cognitive tempo.</div></div><div><h3>Materials and methods</h3><div>The study groups consisted of children with and without extremity fractures who applied to the orthopedics and traumatology outpatient clinic. A semi-structured interview was conducted by a child psychiatrist and the scales were applied. The results obtained were compared and analyzed between patient and control groups. In addition, in patient group, fracture-related characteristics were detailed and their relationship with attention deficit hyperactivity disorder was invastigated.</div></div><div><h3>Results</h3><div>A total of 200 children and adolescents, 65 males and 35 females diagnosed with fractures, and 56 males and 46 females in the control group, were included. The mean ages of the patient with fractures and control groups were 11.74<!--> <!-->±<!--> <!-->3.40 and 11.46<!--> <!-->±<!--> <!-->3.66, respectively. Results showed that the symptoms of inattention and hyperactivity were associated with the risk of fracture. However, there was no relationship between with symptoms of other diseases and fracture.</div></div><div><h3>Conclusions</h3><div>This study is important in terms of revealing the possible relationship between attention deficit hyperactivity disorder and fracture. Questioning the symptoms of attention deficit hyperactivity disorder by surgeons and identifying children at-risk will contribute to the early diagnosis and treatment of attention deficit hyperactivity disorder.</div></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":"183 3","pages":"Pages 265-271"},"PeriodicalIF":0.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}