T. I. Anisimova

Family Problems and Family Therapy in Attention Deficit Hyperactivity Disorder

occurs in quite large numbers of children and in all socioeconomic groups, though it is somewhat more frequent in the poorer layers of society in children of low-paid and poorly educated parents. ADHD has also been noted to be more common in areas with higher population density [8]. Genetic mechanisms play a role in the origination of ADHD, as do organic brain lesions and psychosocial factors, though several mutually interacting factors may be involved. Unfavorable social-economic and psychological conditions can increase the occurrence of disorders arising as a result of inherited pathology or brain damage during the perinatal period. Suslova [6] identified the following psychological and social factors influencing the occurrence of ADHD: lack of preparation of parents for family life, tension and frequent conflicts in the family, and bias against and intolerance of children. Exacerbating unfavorable effects are also produced by factors such as income levels, cramped living conditions, alcohol abuse by family members, and use of physical methods for upbringing. Investigation of children with ADHD showed that negative family factors operated in 63% of cases [2]. Upbringing in broken families, frequent family conflicts, parental alcoholism, and different approaches to childrearing were the most common of these. In children with genetic predisposition to ADHD, conflicts within the family can increase the severity of impairments to the clinical level. It is particularly important that the parents of children with ADHD, sometimes themselves suffering from this disorder, are often characterized by lack of self-control and impaired relationships with their children. Families with children with ADHD experience an increased psychological loading. The traits of children with this illness, such as impulsivity, difficulty with self-organization, reduced self-control, emotional lability, and speech motor disinhibition, have negative effects on the family microclimate. Not only are relationships between the parents and children damaged, but conflicts between family members are exacerbated and there is often a risk that married couples will divorce; the neuropsychological state of the mother, who bears most of the childrearing load, undergoes decompensation. Characteristic features of families with children with ADHD include: lack of expressivity (lack of openness and expression of feelings), tendency to conflicts, and decreased encouragement to be independent. The study group was dominated by rigid and chaotic levels of family adaptation, as well as a fragmented and interlocking level of family social cohesion. Impairments to the process of rearing in the family were manifest as ignorance of the child’s needs, extreme demands and prohibitions, sanctions for disobedience, in some cases with ill treatment and emotional rejection. The parents of children with ADHD were impulsive, Neuroscience and Behavioral Physiology, Vol. 41, No. 4, May, 2011

A dyad approach to the treatment of attention deficit hyperactivity disorder

AIM To study anxiety in adolescents with attention deficit hyperactivity disorder (ADHD) and their mothers and to evaluate the efficacy of a dyad approach (simultaneous treatment of the mother and the child) to ADHD treatment. MATERIAL AND METHODS Thirty-four adolescents, aged 12-15 years, with ADHD and their mothers were studied. All participants of the study received anxiolytic treatment: children were treated with noophen (500 mg per day 45 days) and their mothers received adaptol (1500 mg per day 45 days). In the comparison group with the same clinical/psychological characteristics, anxiolytic therapy with noophen was used only in adolescents. RESULTS Symptoms of anxiety were found in 61.7% of adolescents with ADHD and in 79.4% of the mothers. After the dyad therapy, an improvement was noted in 73.5% of adolescents and 69.7% of the mothers. There was an improvement in 63.3% of patients in the comparison group. CONCLUSION The results demonstrate the high efficacy of the dyad approach in treatment of ADHD with comorbid anxiety disorders.

Treatment of Anxiety Disorders in School Maladaptation with Adaptol

A total of 336 children aged 7–14 years with signs of school maladaptation (SMA) were studied. Anxiety disorders were detected in 167 (49.7%) of the cohort: generalized anxiety disorder in 87 (25.9%), phobic disorders in 40 (11.3%), separation-associated anxiety disorder in 14 (4.2%), and social anxiety disorder in 26 (7.7%). These rates were significantly different from a reference group (children without SMA). Children with generalized anxiety disorder (n = 32) were treated with Adaptol at a dose of 1000 mg/day for 30 days. Adaptol was found to be highly effective in terms of both clinical and psychological investigations, had good tolerance, and produced virtually no side effects.

Syndrome of autonomic dysfunction in children and adolescents

AIM To study clinical and pathophysiological symptoms of autonomic dysfunction syndrome in children and adolescents and assess the efficacy of its treatment with nooclerin. MATERIAL AND METHODS Fifty-three patients, aged from 10 to 15 years, with autonomic dysfunction syndrome were examined. All patients underwent neurological examination, assessment with the A.M. Veins questionnaire of autonomic disorders, the 10 point Visual Analogous scale for headache and fatigue, the Spielberger-Khanin scale for anxiety, Kerdo index, Hildebrandts coefficient, electrocardiography with clinoorthostatic test, electroencephalography, and TOVA psychophysiological test. RESULTS AND CONCLUSION The signs of the asthenic-autonomic syndrome were characteristic of the clinical picture of disease. EEG results demonstrated the deficit of activation effects, predominance of synchronized effects of thalamic structures which led to the insufficient activation of cortical structures. These data support the high efficacy of nooclerin.

Impulsivity in Adolescents with Attention Deficit Hyperactivity Disorder

Objectives. To study impulsivity in adolescents with attention deficit hyperactivity disorder (ADHD) and to evaluate the efficacy of Noofen (500 mg/day for 45 days) in the treatment of this pathology. Materials and methods. The results of clinical, psychological, and psychophysiological studies of 60 adolescents aged 12–15 years with ADHD are presented. The clinical pictures of illness and data from psychophysiological studies in ADHD with a predominance of hyperactivity (ADHD-H) and the combined type of illness (ADHD-C) were compared. Results and conclusions. Significantly higher levels of impulsivity and anxiety were found in children with ADHD-H. Treatment with Noofen was shown to have high clinical efficacy: status improved in 63.3% of patients.

Исследование эффективности цитофлавина в лечении соматоформных расстройств

AIM To study the efficacy of cytoflavin in patients with somatoform disorders (SD). MATERIAL AND METHODS The study included 60 patients with SD, aged from 27 to 43 years. The efficacy was assessed by the results of psychological and neurophysiological examinations. RESULTS AND CONCLUSION The higher efficacy of cytoflavin (the improvement of patients condition in 63,3% of cases) compared to that of ethylmethylhydroxypyridine succinate (56,7% of cases) was found. Patients state was more stable after treatment with cytoflavin.

Emotional impairments and their correction in patients with migraine

AIM To study emotional impairments in patients with migraine and to evaluate the efficiency of Noophen therapy for this pathology. SUBJECTS AND METHODS 63 patients aged 18 to 45 years with migraine without aura were examined. 56 patients used prophylactic antimigraine therapy: Group 1 (n = 26) received metoprolol and Group 2 took metoprolol in combination with Noophen. RESULTS The patients with migraine had a significantly higher level of alexithymia than the controls. Concomitant anxiety disorders were found in 47 (74.6%) cases. The study provided evidence that the treatment was highly effective in Group 2 that exhibited a more pronounced decrease in pain intensity, a greater reduction in the levels of anxiety, and more vital activity. CONCLUSION The results of this study allow a conclusion that emotional impairments are implicated in the pathogenesis and clinical presentations of migraine and that it is appropriate to use Noophen for the treatment of this pathology.

Impulsivity in adolescents with attention deficit hyperactivity disorder

AIM To study impulsivity in adolescents with attention deficit hyperactivity disorder (ADHD) and evaluate the efficacy of noophen in dosage 500 mg daily for 45 days in the treatment of this disorder. MATERIAL AND METHODS The results of the clinical, psychological and psycho-physiological study of 60 adolescents with ADHD, aged 12 to 15 years, have been analyzed. A comparative analysis of the clinical picture of the disease and the data of psychophysiological examination of ADHD predominantly hyperactive (ADHD-H) and the combined type of the disease are presented as well. The study shows significantly higher levels of anxiety and impulsivity in children with ADHD-H. The efficacy of noophen in the treatment of this group of patients has been evaluated. RESULTS AND CONCLUSION The high clinical efficacy of noophen is shown. After treatment, the improvement has been obtained in 63.3% of patients.

Clinical and neurophysiological heterogeneity of attention deficit hyperactivity disorder

AIM To determine clinical/neurophysiological characteristics of different forms of attention deficit hyperactivity disorder (ADHD) and the efficacy of treatment with cerebrolysin. MATERIAL AND METHODS Sixty children, aged 9 to 12 years, with ADHD were examined using clinical and electroencephalographic methods. Idiopathic and residual-organic forms were compared. RESULTS AND CONCLUSION The study shows significantly higher levels of impulsivity and hyperactivity in children with residual-organic form of the disease. There were significant differences in the amplitude component of engaging in action (P3 Go) and the amplitude of the action suppression component (P3 NOGO) in patients with different forms of ADHD. The high clinical efficacy (improvement in 70.0% of patients with idiopathic form of ADHD and 86.7% of patients with residual-organic form of the disease) was found.

Attention Deficit Disorder in Adults: Clinical and Psychophysiological Features and Treatment

We present here the results of studies of 34 patients aged 18–30 years with attention deficit hyperactivity disorder (ADHD) (ICD-10 F90.0). The form of ADHD with predominance of inattention was more frequent in adults (50% of patients), while the form with predominance of hyperactivity (11.7%) and the combined form (38.3%) were less common. The status of adult patients with ADHD was characterized by high levels of anxiety and asthenia. The efficacy and safety of Adaptol at a dose of 1500 mg/day for eight weeks were studied in the treatment of this group of patients. Clinical, psychological, and neurophysiological data demonstrated the high efficacy (improvements in 64.7% of cases) and safety of Adaptol.