Edmund Sonuga-Barke

The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder : association signals in DRD4, DAT1 and 16 other genes

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples.

Assessing expressed emotion in mothers of preschool AD/HD children: psychometric properties of a modified speech sample

OBJECTIVE To examine the reliability and validity of a modified coding measure of expressed emotion (Preschool Five Minute Speech Sample [PFMSS]), suitable for parents of preschool AD/HD children. DESIGN Mothers of preschool AD/HD children identified through a three-stage screening programme were compared with mothers of non-AD/HD children on the PFMSS. METHOD Mothers of 80 AD/HD and 20 non-AD/HD children participated in the PFMSS. They had 10 mins of play interaction with their child and completed the Feelings on Parenting scales from the Family Impact Questionnaire. RESULTS With the exception of emotional over-involvement, the PFMSS demonstrated acceptable code-recode and inter-rater reliability, and adequate test-retest reliability. It also demonstrated acceptable validity, being associated with less affection and greater maternal direction during play interaction and discriminated between the parents of preschool AD/HD and non-AD/HD children. CONCLUSION This study shows that in a revised form, the Five Minute Speech Sample can provide a useful measure of expressed emotion during the preschool period.

[Long-acting medications for the treatment of hyperkinetic disorders - a systematic review and European treatment guideline. Part 1: overview and recommendations].

Langwirksame Medikamente zur Behandlung der hyperkinetischen St?rungen. Teil 1: ?bersicht und EmpfehlungenA panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorders, on the basis of which practical recommendations for the application of these medications have been developed. The current article outlines results of this analysis, comparing the effect sizes and numbers-needed to-treat for extended-release stimulant preparations and atomoxetine (ATX). It is concluded (1) that long-acting preparations should be licensed and used. (2) However, they should not completely replace short-acting medications, in view of costs as well as the greater flexibility of dosing. Individual choices of therapy are necessary. (3) Both ATX and retarded-release stimulants should be available.Zusammenfassung: Ein Expertengremium aus mehreren europaischen Landern hat samtliche verfugbaren veroffentlichten und unveroffentlichten Studienergebnisse zum Einsatz von langwirksamen Medikamenten bei ADHS und hyperkinetischer Storung analysiert und auf dieser Grundlage Empfehlungen zur praktischen Anwendung dieser Arzneimittel entwickelt: Auf der Grundlage der Analyse wurde gefolgert: (1) Langwirksame Praparate sollten zugelassen sein und eingesetzt werden; (2) Sie sollen kurzwirksame Arzneimittel (aus Kostengrunden und wegen der hoheren Flexibilitat der Dosierung) nicht vollstandig ersetzen. Individuelle Therapieoptionen sind erforderlich. (3) Sowohl ATX als auch Stimulanzien mit retardierter Freisetzung sollten zur Verfugung stehen. Zusatzlich werden ausfuhrliche Empfehlungen gegeben, nach welchen Kriterien ein spezifisches Praparat fur den individuellen Patienten ausgewahlt werden sollte.A panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder. Based on this analysis detailed recommendations about the use of these drugs in practice have been developed: (1) Long-acting preparations should be licensed and used; (2) They should not completely replace short-acting drugs (which will be the initial treatment for many children in view of cost and the greater flexibility of dosing). Individual clinical choices are necessary. (3) Both ATX and extended-release stimulants should be available. In addition, detailed recommendations will be made with regard to the criteria to be applied in choosing a preparation for the individual patient.

[Long-acting medications for the treatment of hyperkinetic disorders - a systematic review and European treatment guidelines. Part 2: a quantitative evaluation of long-acting medications]

A panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorders, on the basis of which practical recommendations for the application of these medications have been developed. The current article outlines results of this analysis, comparing the effect sizes and numbers-needed to-treat for extended-release stimulant preparations and atomoxetine (ATX). It is concluded (1) that long-acting preparations should be licensed and used. (2) However, they should not completely replace short-acting medications, in view of costs as well as the greater flexibility of dosing. Individual choices of therapy are necessary. (3) Both ATX and retarded-release stimulants should be available.Langwirksame Medikamente zur Behandlung der hyperkinetischen Storungen. Teil 2: Ein quantitativer Vergleich der langwirksamen Praparate

Eunethydis: a statement of the ethical principles governing the relationship between the European group for ADHD guidelines, and its members, with commercial for-profit organisations

The Eunethydis ADHD Guidelines group set out here the ethical principles governing the relationship between the group and industry. The principles set out here are provided to ensure that this is both done and seen to be done. The impetus for these guidelines comes from within the Group and is linked to the recognition for the need for an open and transparent basis for Group-industry relations, especially in the light of the present concern that the pharmaceutical industry may be exerting a growing influence on the actions of researchers and clinicians in the ADHD field.The Eunethydis ADHD Guidelines group set out here the ethical principles governing the relationship between the group and industry. The principles set out here are provided to ensure that this is both done and seen to be done. The impetus for these guidelines comes from within the Group and is linked to the recognition for the need for an open and transparent basis for Group-industry relations, especially in the light of the present concern that the pharmaceutical industry may be exerting a growing influence on the actions of researchers and clinicians in the ADHD field.

Langwirksame Medikamente zur Behandlung der hyperkinetischen St?rungen. Teil 1: ?bersicht und Empfehlungen

Langwirksame Medikamente zur Behandlung der hyperkinetischen St?rungen. Teil 1: ?bersicht und EmpfehlungenA panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorders, on the basis of which practical recommendations for the application of these medications have been developed. The current article outlines results of this analysis, comparing the effect sizes and numbers-needed to-treat for extended-release stimulant preparations and atomoxetine (ATX). It is concluded (1) that long-acting preparations should be licensed and used. (2) However, they should not completely replace short-acting medications, in view of costs as well as the greater flexibility of dosing. Individual choices of therapy are necessary. (3) Both ATX and retarded-release stimulants should be available.Zusammenfassung: Ein Expertengremium aus mehreren europaischen Landern hat samtliche verfugbaren veroffentlichten und unveroffentlichten Studienergebnisse zum Einsatz von langwirksamen Medikamenten bei ADHS und hyperkinetischer Storung analysiert und auf dieser Grundlage Empfehlungen zur praktischen Anwendung dieser Arzneimittel entwickelt: Auf der Grundlage der Analyse wurde gefolgert: (1) Langwirksame Praparate sollten zugelassen sein und eingesetzt werden; (2) Sie sollen kurzwirksame Arzneimittel (aus Kostengrunden und wegen der hoheren Flexibilitat der Dosierung) nicht vollstandig ersetzen. Individuelle Therapieoptionen sind erforderlich. (3) Sowohl ATX als auch Stimulanzien mit retardierter Freisetzung sollten zur Verfugung stehen. Zusatzlich werden ausfuhrliche Empfehlungen gegeben, nach welchen Kriterien ein spezifisches Praparat fur den individuellen Patienten ausgewahlt werden sollte.A panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorder. Based on this analysis detailed recommendations about the use of these drugs in practice have been developed: (1) Long-acting preparations should be licensed and used; (2) They should not completely replace short-acting drugs (which will be the initial treatment for many children in view of cost and the greater flexibility of dosing). Individual clinical choices are necessary. (3) Both ATX and extended-release stimulants should be available. In addition, detailed recommendations will be made with regard to the criteria to be applied in choosing a preparation for the individual patient.

Langwirksame Medikamente zur Behandlung der hyperkinetischen Störungen. Teil 2: Ein quantitativer Vergleich der langwirksamen Präparate

A panel of experts from several European countries has accomplished a systematic review of published and unpublished data on the use of long-acting medications in ADHD and hyperkinetic disorders, on the basis of which practical recommendations for the application of these medications have been developed. The current article outlines results of this analysis, comparing the effect sizes and numbers-needed to-treat for extended-release stimulant preparations and atomoxetine (ATX). It is concluded (1) that long-acting preparations should be licensed and used. (2) However, they should not completely replace short-acting medications, in view of costs as well as the greater flexibility of dosing. Individual choices of therapy are necessary. (3) Both ATX and retarded-release stimulants should be available.Langwirksame Medikamente zur Behandlung der hyperkinetischen Storungen. Teil 2: Ein quantitativer Vergleich der langwirksamen Praparate