Search Results (171)

Background: Non-medical use of prescription stimulants is increasing among college students worldwide. While intended for ADHD treatment, many students use these substances to improve their concentration and academic performance. Despite global research, little is known about the psychological and attitudinal factors influencing such use in the Israeli academic context. Objectives: We wished to examine the relationship between self-efficacy, attitudes toward stimulant use, and actual use among Israeli college students, aiming to uncover the mechanisms behind non-medical stimulant consumption. Methods: A cross-sectional online survey was conducted among 598 students from two Israeli academic institutions. The participants completed validated questionnaires assessing their demographic characteristics, stimulant use patterns, self-efficacy, and attitudes. Results: A total of 22% of students reported using stimulants, 17% of them without a prescription. Positive attitudes significantly increased the likelihood of use (Exp(B) = 3.31, p < 0.001), while higher self-efficacy reduced it (Exp(B) = 0.69, p < 0.01). A negative correlation was found between self-efficacy and favorable attitudes (r = −0.17, p < 0.001). The mediation analysis revealed that self-efficacy influences stimulant use entirely through its effect on attitudes toward stimulants. Additionally, stimulant use was significantly more common among Jewish students (25%) compared to non-Jewish students (11%; p < 0.05) and among smokers (36%) compared to non-smokers (20%; p < 0.001). Conclusions: Positive attitudes and low self-efficacy are key risk factors for stimulant misuse. These findings underscore the need for educational interventions aimed at strengthening self-efficacy and promoting healthier coping strategies in academic settings. Full article

The growing influence of technology in the healthcare industry has led to the creation of innovative applications that improve convenience, accessibility, and diagnostic accuracy. However, health applications face significant challenges concerning user privacy and data security, as they handle extremely sensitive personal and medical information. Privacy-Enhancing Technologies (PETs), such as Privacy-Attribute-based Credentials, Differential Privacy, and Federated Learning, have emerged as crucial tools to tackle these challenges. Despite their potential, PETs are not widely utilized due to technical and implementation obstacles. This research introduces a comprehensive framework for protecting health applications from privacy and security threats, with a specific emphasis on gamified mental health apps designed to manage Attention Deficit Hyperactivity Disorder (ADHD) in children. Acknowledging the heightened sensitivity of mental health data, especially in applications for children, our framework prioritizes user-centered design and strong privacy measures. We suggest an identity management system based on blockchain technology to ensure secure and transparent credential management and incorporate Federated Learning to enable privacy-preserving AI-driven predictions. These advancements ensure compliance with data protection regulations, like GDPR, while meeting the needs of various stakeholders, including children, parents, educators, and healthcare professionals. Full article

Background: Individuals with ADHD may perform poorly on tasks targeting executive functioning skills such as the ImPACT, which requires the test-taker to employ judgement in non-routine situations Objective: To determine whether ADHD serves as a mediating variable for increasing the likelihood of an invalid score. Materials and Methods: A total of 39,140 collegiate athletes and United States military cadets consented to the Concussion Assessment, Research, and Education (CARE) Consortium study. Participants completed the CARE Baseline Packet which included various sections through which study participants provide self-report data, including demographic, personal, and family history sections. The personal history portion of the CARE Baseline Packet addressed the participant’s neurological history, including self-reported diagnosis of ADHD and history of traumatic brain injury. Variables utilized for the current study included age, gender, race, ethnicity, the participant’s primary college sport, use of mouthguards for athletes competing in sports requiring them, and the presence of an ADHD diagnosis. Participants responded to a question, inquiring if they had ever been diagnosed by a medical professional with ADHD, ultimately producing a dichotomous yes/no response. Results: We found that participants with ADHD were more likely to produce invalid baseline scores (ß = −0.884; p < 0.001). Similar results were found when controlling for sex, race, age, sport played, mouthguard use, and number of previous concussions (ß = −0.786; p < 0.001). Sex, race, sport played, and mouthguard use each played a significant role in determining profile validity, independent of ADHD diagnosis. With ADHD removed from the model, age negatively affected the likelihood of a valid score (ß = −0.052; p = 0.048). Conclusions: Our study suggests that the relationship between age and ImPACT validity is explained by the presence of ADHD. Results support adjusting ImPACT’s validity thresholds for individuals with ADHD. Full article

Background: Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that continues into adulthood and is linked to significant academic, occupational, and psychological challenges. Medical students may be at heightened risk due to the cognitive and emotional demands of their training. However, regional data on adult ADHD symptoms in this population, particularly in northern Saudi Arabia, remain limited. Objective: to estimate the prevalence of probable adult ADHD symptoms among medical students at the University of Tabuk and to examine the associated sociodemographic, academic, and health-related factors. Methods: A cross-sectional, web-based survey was conducted between 15 May and 5 June 2025 among randomly selected Saudi medical students (years 2–6) at the University of Tabuk. The validated Arabic version of the WHO Adult ADHD Self-Report Scale (ASRS-v1.1) was used to screen for probable ADHD. A positive screen was defined as ≥4 flagged items. Descriptive and bivariate analyses were performed using SPSS v29. Results: Of the 219 respondents (60.3% male; mean age: 21.6 years), 23.3% screened positive for probable adult ADHD. Symptom frequency peaked in the third (40.0%) and fourth (35.6%) academic years and was lowest among sixth-year students (11.4%) (p = 0.012). A strong association was observed between positive ADHD screening and self-reported psychiatric disorders (p < 0.001). No statistically significant associations were found for gender, income, GPA, marital status, or academic phase. Conclusions: Nearly one in four medical students at the University of Tabuk exhibited symptoms suggestive of adult ADHD, a prevalence markedly higher than global estimates and consistent with regional trends. The association with psychiatric morbidity and the mid-programme peak suggests a need for proactive screening, mental health support, and academic accommodations. Universities can translate these findings into practice by instituting routine ADHD screening, offering flexible assessment accommodations, embedding peer-mentoring programmes, and strengthening on-campus mental-health referral pathways. Full article

Cerebral malaria (CM) is a life-threatening disease that affects mainly children in sub-Saharan Africa. Studies have shown that children who survive CM are often left with neurological disabilities after recovery, such as behavioral changes similar to attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). However, diagnosis and treatments for ADHD are limited in many places in Africa. The purpose of this study was to assess behavioral changes following CM infection in Children in Malawi and parents’ acceptability of behavioral treatments. Twenty-one parents of children who had survived CM were compared to forty parents from the general population. Assessment instruments included the Disruptive Behavior Rating Scale (DBRS), Treatment Evaluation Inventory-Short Form (TEI-SF), and ADHD symptom checklist. The results showed that the most acceptable treatments among parents in Malawi were interrupt/redirect, discussion, and medication. Parents of CM-surviving children were significantly more accepting of medication (F(1,59) = 7.92, p < 0.007). The majority of the children who survived CM were rated above the clinical cut-off for ADHD and ODD symptoms. Full article

Objective: This observational cross-sectional study aimed to comprehensively evaluate sensory–cognitive performance in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), with a focus on auditory processing, visual–perceptual abilities, visual–motor integration, and oculomotor function. The study further examined how hyperactivity, age, and gender may influence these domains. Methods: A total of 70 non-medicated children with clinically diagnosed ADHD (mean age = $9.1\pm 2.4$ years; 67.1% male), all with normal visual acuity, were assessed using four standardized instruments: the Test of Auditory Processing Skills, Third Edition (TAPS-3), the Test of Visual Perceptual Skills, Fourth Edition (TVPS-4), the Beery–Buktenica Developmental Test of Visual–Motor Integration, Sixth Edition (VMI-6), and the Developmental Eye Movement (DEM) Test. Statistical analyses included one sample and independent samples t-tests, one-way ANOVA, and Pearson correlation coefficients. Results: Participants demonstrated significantly above-average performance in auditory processing (TAPS-3: $\mu =108.4$, $std=7.8$), average visual–perceptual abilities (TVPS-4: $\mu =100.9$, $std=7.2$), slightly below-average visual–motor integration (VMI-6: $\mu =97.1$, $std=9.0$), and marked deficits in oculomotor efficiency (DEM ratio: $\mu =87.3$, $std=18.1$). Statistically significant differences were observed across these domains (t-values ranging from 2.9 to 7.2, $p<0.01$). Children with hyperactive-impulsive presentations exhibited lower horizontal DEM scores ($\mu =73.4$, $std=12.3$) compared to inattentive counterparts ($\mu =82.9$, $std=16.2$; $p=0.009$). Age and sex influenced specific subtest scores, with boys and children aged 8–9 years achieving higher outcomes in word memory ($p=0.042$) and visual discrimination ($p=0.034$), respectively. Moderate correlations were identified between auditory and visual–perceptual skills ($r=0.32$, $p=0.007$), and between visual–perceptual and oculomotor performance ($r=0.25$, $p=0.035$). Conclusions: The findings from this sample reveal a distinct sensory–cognitive profile in children with ADHD, characterized by relatively preserved auditory processing and pronounced oculomotor deficits. These results underscore the value of a multimodal assessment protocol that includes oculomotor and visual efficiency evaluations. The conclusions pertain specifically to the cohort studied and should not be generalized to all populations with ADHD without further validation. Full article

Bacopa monnieri, also known as Brahmi or Waterhyssop, is a plant used in Ayurveda for its memory-enhancing properties and control of blood sugar levels. It contains active compounds such as alkaloids, saponins, and cucurbitacins, which have various biological activities. The plant has been studied for its potential in treating Alzheimer’s disease, Parkinson’s disease, attention deficit hyperactivity disorder (ADHD), and depression. Animal studies have shown promising results in reducing symptoms and protecting against neurodegeneration. Concerning safety, Bacopa monnieri has been found to be generally non-toxic, with no serious side effects reported. However, interactions with certain medications and contraindications in conditions like hyperthyroidism should be considered. Further research is needed to determine optimal dosages and ensure safety, especially for pregnant and breastfeeding women. Full article

Narrative therapy generally avoids medical language and diagnostic labels, instead emphasizing collaborative dialogue centered on values and strengths. How does this approach apply to children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), the most common neurodevelopmental condition? This study presents the first scoping review on this topic. A systematic search of five databases (APA PsycNET, PubMed, Web of Science, ProQuest, and Google Scholar) identified 24 records meeting the inclusion criteria. Four key insights emerged relating to the therapies: (1) philosophical foundations; (2) unique perspective on ADHD; (3) practical interventions (e.g., externalizing and separating the problem from the child, identifying ‘sparkling moments’); (4) reported effectiveness. Further research is recommended to evaluate the therapy’s empirical impact and explore its potential to empower children by co-creating a ‘health-side story’ that shifts focus from problems to strengths, relationships, and values. Full article

Background: Externalizing, internalizing and social problems are frequent comorbidities for children with ADHD. This study explored the effects of methylphenidate versus a child and parents’ parallel mindfulness program (MYmind) on children’s internalizing, externalizing and social problems. Data came from our RCT investigating treatment effects on the primary outcome of children’s ADHD symptoms. Methods: Children followed their ascribed course of treatment for 4 months: 46 children were in the mindfulness group and 42 in the medication group. Multilevel modeling analyzed the responses of four informants (mothers, fathers, children and teachers) across three follow-up points: short-term (2 months), medium-term (4 months) and long-term (10 months). Results: Both treatment groups improved from the baseline across all outcomes. No differences were found between groups on improvement of mindful awareness as reported by children at any time point. At the short-term follow-up, children in the medication group showed greater reductions as compared to those in the mindfulness group on internalizing problems (as observed by mothers), externalizing problems (mothers; fathers) and social problems (mothers; teachers). At the medium-term follow-up, children in the medication group still showed larger reductions in externalizing problems as observed by fathers, but on all other outcomes, informants’ reports did not differ between groups. At the long-term follow-up, none of the informants reported any differences between treatment groups in effects on internalizing, externalizing or social problems. Conclusions: Given the observations of similar improvements at short-, medium- and long-term, mindfulness might be a viable option for families of children with ADHD who are seeking an alternative to medication to reduce comorbid externalizing, internalizing and/or social problems. Full article

Objective: to assess the association between attention-deficit/hyperactivity disorder (ADHD), type 1 diabetes mellitus (T1D), and cardiovascular comorbidities in adults. Methods: The Adult Self-Report Scale V1.1 (ASRS) for ADHD symptoms was electronically sent to 2069 adults with T1D. Cardiometabolic conditions, laboratory measurements, and PHQ-2/PHQ-9 depression scores were obtained from the electronic medical record. Results: In total, 292 (14.1%) individuals responded and 279 consented to medical records extraction. The average age was 47.4 years (SD: ±18.9), 64.2% were women, 95.7% were non-Hispanic white, and the mean HbA1c level was 7.7% (±1.5%). Of 273 completing ASRS, 87 med ADHD criteria (ASRS positive, 31.9%), and 42 (15.4%) had an ADHD diagnosis or medication. Women had higher scores than men. ADHD symptoms decreased with age, but remained significantly higher than the general population levels. HbA1c levels were positively associated with the ASRS scores (Spearman’s r = 0.28, p < 0.0001). ASRS positive individuals had worse glycemic control (HbA1c ≥ 8.0%, adjusted OR 2.3, 95%CI: 1.3–4.1, p < 0.0001) and higher PHQ-9 scores (10 ± 7.3 vs. 6.1 ± 6, χ²₍₁₎ = 9.2, p = 0.002) than the ASRS negative group. No associations were found between ASRS scores and cardiometabolic diseases, or other laboratory or clinical measurements. Conclusions: Many adults with T1D exhibit undiagnosed ADHD symptoms, which correlate with poorer glycemic control and depression. Further research with larger samples is needed to investigate ADHD prevalence and impacts in this group. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent condition etiologically related to suboptimal levels of dopamine (DA) and norepinephrine (NE) that is typically treated with psychostimulant medication. In individuals with ADHD, divergent thinking abilities have been shown to improve with the use of psychostimulants. Furthermore, psychostimulants affect autonomic nervous system (ANS) functioning, which can impact creative cognition. However, it is not known how DA and NE affect creative cognition in this setting and how this effect is related to autonomic activity in ADHD. Therefore, our objective was to elucidate ANS function and its relationship with divergent creativity gains related to psychostimulant treatment in ADHD. Method: Seventeen individuals diagnosed with ADHD (age 27.9 ± 6.7 sd) participated in two counterbalanced sessions—one while on their prescribed stimulant medication and another after abstaining for at least 24 h. During each session, participants completed convergent (anagrams) and divergent (Torrance Test of Creative Thinking) thinking tasks. An 8 min electrocardiogram prior to cognitive testing was taken to measure heart rate variability (HRV), which is an index of ANS functioning. Results: The hypothesized baseline pNN50 HRV measure was not predictive of enhanced creativity gains on convergent anagrams or divergent creativity on the Torrance when taking stimulants. Conclusions: In this pilot study, the relationship between baseline HRV and the impact of stimulants on anagram performance suggests the noradrenergic system may not play a role in the effect of stimulants on convergent or divergent creativity. The lack of a relationship between baseline HRV and stimulant-related changes in TTCT and anagram scores lends some support to the hypothesis that dopaminergic effects may be the predominant factor in the effect of stimulants on creativity in ADHD. Future research should further investigate the interaction between hypoactive neurotransmitter systems, particularly dopamine in divergent and norepinephrine in convergent creativity, using neuroimaging techniques to assess neurotransmitter dynamics during creativity-based tasks. Full article

First-line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) is pharmacological but is associated with poor success rates in adults. The potential to discontinuously use stimulants may confound adherence assessment. Approximately 30–50% of adults with ADHD will experience depressive episodes, and associated treatment with antidepressants is generally recommended. It can therefore be expected that patients with a formal F90 diagnosis would show higher medication adherence than patients without a diagnosis and that the simultaneous use of antidepressants would increase adherence to ADHD medication. The primary aim was to explore the influence of factors of ADHD diagnosis and comorbid antidepressant use on stimulant adherence. A retrospective, longitudinal pharmacoepidemiological study was conducted on South African community pharmacy dispensing records for 2012–2016 for all patients aged between 18 and 40 years with any record of receiving a drug classified as “Central nervous system other” by the MIMS in 2015. Patients endorsed with an ADHD-linked diagnostic code (F90) were identified and contrasted with those receiving ADHD-indicated medication in the absence of a confirmatory diagnostic code. Two methods were applied to assess adherence to ADHD and/or depression treatment drugs: monthly medicine plotting and Proportion of Days Covered (PDC). Patients were classified as being more or less adherent based on monthly medicine plotting criteria. A study population of 89 patients was identified: 50 had F90 diagnostic codes and 39 were classified as “Non F90”. Adherence as measured based on PDC was generally higher for antidepressant use than for methylphenidate for patients classified as being more adherent. A trend towards higher consumption of antidepressants was shown for the treatment-adherent group. Diagnostic code distinction revealed significantly higher adherence rates to methylphenidate for F90 code patients. Adherence rates to antidepressants appeared to be generally higher for non-F90 patients. Many factors may influence adherence to ADHD-indicated drugs; however, the impact of a confirmed diagnosis may be a strong determinant of motivation to be adherent to ADHD pharmacotherapy. Full article

Objective: This review aims to assess the efficacy and safety of different supplements, such as L-theanine, caffeine, Ginkgo biloba L., and Bacopa monnieri for improving ADHD symptoms, to determine the most effective supplement and provide insight for medical practice. Methods: International databases (PubMed/MEDLINE and Scopus) were searched for English-language RCTs, open-label studies, and cross-sectional studies. Results: Studies on L-theanine, caffeine, Ginkgo biloba L., and Bacopa monnieri have shown various effects on ADHD symptoms. L-theanine improved sleep efficiency but not other sleep parameters. Caffeine showed no significant benefits, although its combination with L-theanine may enhance attention. Bacopa monnieri consistently improved inattention, hyperactivity, and memory, whereas Ginkgo biloba L. reduced ADHD symptoms, particularly inattention, but was less effective than methylphenidate. Conclusions: The evidence revealed the potential use of supplements as complementary ADHD treatments under clinical guidance. The limited effect of supplements cannot replace the well-documented efficacy of stimulants for ADHD treatment. Additional studies are needed to ascertain the most effective dosages and the safety of these supplements as adjunctive treatments for ADHD. Full article

Background/Objective: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in Saudi Arabia, yet challenges remain in diagnosis and treatment accessibility. This study examined healthcare practitioners’ clinical approaches to ADHD diagnosis and management in Saudi Arabia and identified gaps in practice. Methods: This cross-sectional study included healthcare practitioners working in various healthcare settings across Saudi Arabia. The sample included psychiatrists, pediatricians, psychologists, and other relevant specialists. Clinical practices regarding ADHD diagnosis, the use of ADHD screening tools, adherence to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, treatment strategies, medication prescription protocols, and reported challenges were investigated. Results: A total of 43 licensed healthcare practitioners with a minimum of 2 years of clinical experience managing ADHD participated. Among participants, 81.4% were psychiatrists, and 53.5% managed ADHD cases in children/adolescents exclusively. Approximately 86.0% of the sample used screening tools, with the Vanderbilt Assessment Scale being the most used (67.6%). However, only 55.8% addressed all 18 DSM-5 ADHD symptoms during the evaluation. Combined pharmacological and non-pharmacological treatment approaches (74.4%) were preferred. Interestingly, only 7.0% prescribed amphetamine-based stimulants due to the lack of clear guidelines. Key barriers included a lack of early screening programs (65.1%), limited ADHD medication option availability (51.2%), and extended referral waiting lists (44.2%). Conclusions: Significant variability in ADHD diagnosis and treatment practices was evident among healthcare providers in Saudi Arabia. Specifically, a large proportion of healthcare providers do not fully comply with the standard DSM-5 diagnosis criteria. Major barriers to ADHD diagnosis and treatment in Saudi Arabia include extended referral waiting lists, limited availability of psychostimulant medications, and standardized clinical guidelines. A national ADHD protocol must be advocated, and access to diverse treatment options should be improved. Full article

Background/Objectives. Central nervous system (CNS)-related diseases such as Alzheimer’s and Parkinson’s, Attention Deficit Hyperactive Disorder (ADHD), stroke, epilepsy, and migraines are leading causes of morbidity and disability worldwide. New solutions for drug delivery are increasingly needed. In this context, three-dimensional (3D) printing technology has introduced innovative alternatives to produce more efficient medicines with diverse features, patterns, and consistencies, particularly oral medications. Even though research in this area is growing rapidly, no study has thoroughly analyzed 3D printing oral drug delivery progress for the CNS. To fill this gap this study pursues to determine a technological landscape in this field. Methods. For this aim, a Competitive Technology Intelligence (CTI) methodology was applied, examining 747 publications from 1 January 2019 to 20 May 2024 published in the Scopus database. Results. The main advances identified comprise six categories: 3D printing techniques, characteristics and applications, materials, design factors, user acceptance, and quality processes. FDM was identified as the main technique for pharmaceutical use. The main applications include pills, polypills, caplets, gel caps, multitablets, orodispersible films, and tablets, featuring external patterns and internal structures with one or more active substances. Insights show that the most utilized materials are thermoplastic polymers like PLA, PVA, PCL, ABS, and HIPS. A novel design factor involves release patterns using compartments of varying thicknesses and volumes in the core. Additionally, advances in specialized software have enabled the creation of highly complex designs. In the user acceptance category, oral drugs dosages are tailored to the specific needs and preferences of neurological patients. Finally, for the quality aspect, the precision in Active Pharmaceutical Ingredient (API) dosage and controlled-release mechanisms are critical, given the narrow margin between therapeutic doses and toxicity for CNS diseases. Conclusions. Revealing these advancements in 3D printing for oral drug delivery allows researchers, academics, and decision-makers to identify opportunities and allocate resources efficiently, promising enhanced oral medicaments for the health and well-being of individuals suffering from CNS disorders. Full article