Pub Date : 2022-11-01DOI: 10.3389/frcha.2022.1032559
Yoo-sik Yoon, Matthew Kennis, Elijah W. Hale
ADHD is associated with a number of developmental, emotional, social, academic, and cognitive health risks that can affect the adolescents' quality of life. There have been various guidelines published regarding the management of children with ADHD, however, it has been reported that physicians may not adequately screen for ADHD prior to surgery. To our knowledge, there are no such studies studying post-operative complications and outcome rates in adolescents with ADHD. We conducted a retrospective case-control study through the TriNetX databases. We identified patients with ADHD (ICD-10: F90) undergoing a surgical procedure (CPT: 1003143), and a control group of non-ADHD patients undergoing a surgical procedure. From these two pairs of case-control cohorts we compared outcomes of post-procedural infections, post-procedural shock, and any post-procedural complications. We identified 791,481 matched pairs of subjects undergoing surgery where one of the pair had ADHD and the other did not. Among subjects undergoing a surgical procedure, those with ADHD had a significantly higher risk of post-procedural infection and any post-procedural complication, relative to subjects without ADHD. Furthermore, those with ADHD showed a heightened risk of post-procedural complications in all procedural subcategories. These novel findings suggest that ADHD is a notable factor in surgical care and should be given special consideration by both surgeons and psychiatrists.
{"title":"Post-operative complications and ADHD","authors":"Yoo-sik Yoon, Matthew Kennis, Elijah W. Hale","doi":"10.3389/frcha.2022.1032559","DOIUrl":"https://doi.org/10.3389/frcha.2022.1032559","url":null,"abstract":"ADHD is associated with a number of developmental, emotional, social, academic, and cognitive health risks that can affect the adolescents' quality of life. There have been various guidelines published regarding the management of children with ADHD, however, it has been reported that physicians may not adequately screen for ADHD prior to surgery. To our knowledge, there are no such studies studying post-operative complications and outcome rates in adolescents with ADHD. We conducted a retrospective case-control study through the TriNetX databases. We identified patients with ADHD (ICD-10: F90) undergoing a surgical procedure (CPT: 1003143), and a control group of non-ADHD patients undergoing a surgical procedure. From these two pairs of case-control cohorts we compared outcomes of post-procedural infections, post-procedural shock, and any post-procedural complications. We identified 791,481 matched pairs of subjects undergoing surgery where one of the pair had ADHD and the other did not. Among subjects undergoing a surgical procedure, those with ADHD had a significantly higher risk of post-procedural infection and any post-procedural complication, relative to subjects without ADHD. Furthermore, those with ADHD showed a heightened risk of post-procedural complications in all procedural subcategories. These novel findings suggest that ADHD is a notable factor in surgical care and should be given special consideration by both surgeons and psychiatrists.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86107316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-28DOI: 10.3389/frcha.2022.1027083
L. Tindall, A. Scott, K. Biggs, E. Hayward, Jon Wilson, C. Cooper, R. Hargate, B. Wright, L. Gega
In 2015, The Alleviating Specific Phobias Experienced by Children Trial (ASPECT) was commissioned by the National Institute for Health and Care Research (NIHR) to compare the clinical and cost-effectiveness of multi-session Cognitive Behavioral Therapy (CBT) for specific phobias in children and young people (CYP) (aged 7–16), with a briefer variant called One Session Treatment (OST). From 2016 to 2020, ASPECT recruited n = 274 CYP with specific phobias and their families from across England, including 26 Child and Adolescent Mental Health Services (CAMHS) centres, three voluntary sector centers and one University-based wellbeing service. Whilst the trial successfully reached its recruitment target, the challenges experienced in its delivery highlight the difficulties of embedding child and adolescent research into clinical settings and routine practice. Using ASPECT as a case in point, this paper explores these challenges and provides important insights and considerations of potential benefit to others conducting research within the field of child and adolescent mental health.
{"title":"The alleviating specific phobias in children trial: Challenges and solutions to implementing a randomized controlled trial in clinical services","authors":"L. Tindall, A. Scott, K. Biggs, E. Hayward, Jon Wilson, C. Cooper, R. Hargate, B. Wright, L. Gega","doi":"10.3389/frcha.2022.1027083","DOIUrl":"https://doi.org/10.3389/frcha.2022.1027083","url":null,"abstract":"In 2015, The Alleviating Specific Phobias Experienced by Children Trial (ASPECT) was commissioned by the National Institute for Health and Care Research (NIHR) to compare the clinical and cost-effectiveness of multi-session Cognitive Behavioral Therapy (CBT) for specific phobias in children and young people (CYP) (aged 7–16), with a briefer variant called One Session Treatment (OST). From 2016 to 2020, ASPECT recruited n = 274 CYP with specific phobias and their families from across England, including 26 Child and Adolescent Mental Health Services (CAMHS) centres, three voluntary sector centers and one University-based wellbeing service. Whilst the trial successfully reached its recruitment target, the challenges experienced in its delivery highlight the difficulties of embedding child and adolescent research into clinical settings and routine practice. Using ASPECT as a case in point, this paper explores these challenges and provides important insights and considerations of potential benefit to others conducting research within the field of child and adolescent mental health.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78009796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-28DOI: 10.3389/frcha.2022.971743
C. Dow, E. Lorthe, C. Galéra, M. Tafflet, L. Marchand-martin, P. Ancel, Marie-Aline Charles, B. Heude
Background Peer relationships are an important aspect of child development that are often overlooked. Maternal pre-pregnancy body mass index (BMI) may influence peer relationships through intrauterine mechanisms affecting fetal neurodevelopment or through postnatal mechanisms including social discrimination of the obese mother/child. This study aimed to determine the relationship between maternal pre-pregnancy BMI and child peer-relationship problems around 5 years old, including preterm and term-born children. Methods and findings Maternal BMI and offspring peer-relationship problems were assessed in participants of three French birth cohorts: EDEN (n = 1,184 children born at term), ELFE (n = 10,889 children born ≥33 weeks of gestation) and EPIPAGE-2 (n = 2,646 children born 23–34 weeks of gestation). Reported or measured pre-pregnancy weight (kg) and height (m) were collected from mothers and used to calculate BMI (kg/m2). Offspring peer-relationship problems were assessed using the Strengths and Difficulties Questionnaire at 5.5 years. Logistic regression was used to estimate odds ratios (OR) of a high peer-relationship problem score (≥3) in EDEN and ELFE, and generalized estimated equations were used in EPIPAGE-2 to account for the large number of multiple births. Paternal BMI was used as a negative control in sensitivity analyses. Maternal pre-pregnancy obesity was associated with increased odds of a high peer-relationship problem score in all three cohorts, independent of confounding factors [adjusted OR 2.27 (1.32, 3.88); 1.52 (1.29, 1.78); 1.44 (1.04, 1.99); for EDEN, ELFE and EPIPAGE-2, respectively]. Additional analysis based on negative controls (i.e., adjusting for paternal BMI) showed the same pattern of associations. Conclusion High maternal pre-pregnancy BMI is associated with greater likelihood of a high peer-relationship trouble score in offspring around 5 years of age in both children born preterm and at term.
{"title":"High maternal pre-pregnancy BMI is associated with increased offspring peer-relationship problems at 5 years","authors":"C. Dow, E. Lorthe, C. Galéra, M. Tafflet, L. Marchand-martin, P. Ancel, Marie-Aline Charles, B. Heude","doi":"10.3389/frcha.2022.971743","DOIUrl":"https://doi.org/10.3389/frcha.2022.971743","url":null,"abstract":"Background Peer relationships are an important aspect of child development that are often overlooked. Maternal pre-pregnancy body mass index (BMI) may influence peer relationships through intrauterine mechanisms affecting fetal neurodevelopment or through postnatal mechanisms including social discrimination of the obese mother/child. This study aimed to determine the relationship between maternal pre-pregnancy BMI and child peer-relationship problems around 5 years old, including preterm and term-born children. Methods and findings Maternal BMI and offspring peer-relationship problems were assessed in participants of three French birth cohorts: EDEN (n = 1,184 children born at term), ELFE (n = 10,889 children born ≥33 weeks of gestation) and EPIPAGE-2 (n = 2,646 children born 23–34 weeks of gestation). Reported or measured pre-pregnancy weight (kg) and height (m) were collected from mothers and used to calculate BMI (kg/m2). Offspring peer-relationship problems were assessed using the Strengths and Difficulties Questionnaire at 5.5 years. Logistic regression was used to estimate odds ratios (OR) of a high peer-relationship problem score (≥3) in EDEN and ELFE, and generalized estimated equations were used in EPIPAGE-2 to account for the large number of multiple births. Paternal BMI was used as a negative control in sensitivity analyses. Maternal pre-pregnancy obesity was associated with increased odds of a high peer-relationship problem score in all three cohorts, independent of confounding factors [adjusted OR 2.27 (1.32, 3.88); 1.52 (1.29, 1.78); 1.44 (1.04, 1.99); for EDEN, ELFE and EPIPAGE-2, respectively]. Additional analysis based on negative controls (i.e., adjusting for paternal BMI) showed the same pattern of associations. Conclusion High maternal pre-pregnancy BMI is associated with greater likelihood of a high peer-relationship trouble score in offspring around 5 years of age in both children born preterm and at term.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"209 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76576785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-17DOI: 10.3389/frcha.2022.1033822
S. Evans, Elijah W. Hale, Matt S. Silverman
Objectives We sought to perform a review of emergency department data to illuminate whether there is a difference in the prevalence of severe injuries in patients with ADHD compared to patients without ADHD. We hope to illuminate whether providers should consider inquiring whether their pediatric patients have ADHD to improve long term outcomes. Methods This study is a retrospective cohort study of patient records contained in the TriNetX database, specifically of pediatric patients in this database who presented to an emergency department. We specifically looked at the risk difference in patients <25 years of age with ADHD, no ADHD, inattentive type ADHD, hyperactive type ADHD, and combined type ADHD who presented with any fracture, a central fracture, an upper limb fracture, a lower limb fracture, an accidental overdose, a burn injury, a drowning incident, a gunshot wounds, suffocation, and a suicide attempt. Results Comparison between the no-ADHD cohort and the inattentive, hyperactive/impulsive, combined, and overall ADHD cohorts revealed differences in the majority of outcomes studied. Patients with overall ADHD had significant differences in rates of all outcomes aside from the upper limb fracture. Patients with combined or hyperactive/impulsive ADHD had significant differences in all but drowning, and the inattentive cohort had significance all events. Conclusion The stark difference between severe injury presentations in the pediatric emergency department between children with ADHD and without ADHD suggests that providers should consider inquiring whether patients have ADHD to educate them on their risk for severe injuries.
{"title":"Mechanisms of bodily harm in emergency department youths with ADHD","authors":"S. Evans, Elijah W. Hale, Matt S. Silverman","doi":"10.3389/frcha.2022.1033822","DOIUrl":"https://doi.org/10.3389/frcha.2022.1033822","url":null,"abstract":"Objectives We sought to perform a review of emergency department data to illuminate whether there is a difference in the prevalence of severe injuries in patients with ADHD compared to patients without ADHD. We hope to illuminate whether providers should consider inquiring whether their pediatric patients have ADHD to improve long term outcomes. Methods This study is a retrospective cohort study of patient records contained in the TriNetX database, specifically of pediatric patients in this database who presented to an emergency department. We specifically looked at the risk difference in patients <25 years of age with ADHD, no ADHD, inattentive type ADHD, hyperactive type ADHD, and combined type ADHD who presented with any fracture, a central fracture, an upper limb fracture, a lower limb fracture, an accidental overdose, a burn injury, a drowning incident, a gunshot wounds, suffocation, and a suicide attempt. Results Comparison between the no-ADHD cohort and the inattentive, hyperactive/impulsive, combined, and overall ADHD cohorts revealed differences in the majority of outcomes studied. Patients with overall ADHD had significant differences in rates of all outcomes aside from the upper limb fracture. Patients with combined or hyperactive/impulsive ADHD had significant differences in all but drowning, and the inattentive cohort had significance all events. Conclusion The stark difference between severe injury presentations in the pediatric emergency department between children with ADHD and without ADHD suggests that providers should consider inquiring whether patients have ADHD to educate them on their risk for severe injuries.","PeriodicalId":73074,"journal":{"name":"Frontiers in child and adolescent psychiatry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74467047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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