Validation of the post-traumatic stress disorder subscale of the child behaviour checklist (PTSD-CBCL): screening for post-traumatic stress disorder or attention deficit/hyperactivity disorder?

Article

作者: Butjosa, Anna ; Aizpitarte, Alazne ; Albiac, Natalia ; Alvarez-Segura, Mar ; Camprodon-Rosanas, Ester ; Lacasa, Fernando

PURPOSE:

Almost 20% of children and adolescents who attend in mental health centres are witnesses of domestic violence (WDVs). It would therefore be clinically useful to have an appropriate screening instrument for this population, such as the PTSD-CBCL. Our aim here was thus to assess the psychometric properties of relevant tools by determining their internal consistency, sensitivity/specificity, and positive/negative predictive values in our centre's population.

METHODS:

We recruited 194 parents of children aged 4-16 at the Child and Adolescent Mental Health Service of the Hospital Sant Joan de Déu and Els Pins primary school. This sample was divided into: (1) a WDV group (n = 104); (2) an ADHD diagnosis group (n = 28); and (3) a general population (GP) primary school group (n = 62).

RESULTS:

The PTSD-CBCL total reliability score was high (Cronbach's alpha = 0.87). We found significant mean difference for WDV vs. GP (MD = 8.57; p < 0.001) with significantly higher mean scores in WDV than in GP. We also found significant differences for ADHD vs. GP (MD = 6.91; p < 0.001) with higher mean scores in ADHD than in GP. We observed good discriminatory power indices in the following group comparisons: WDV vs. GP, ADHD vs. GP, WDV vs. ADHD + GP, and GP vs. WDV + ADHD. Nevertheless, the PTSD-CBCL did not discriminate WDV vs. ADHD.

CONCLUSIONS:

Thus, we conclude that the PTSD-CBCL instrument has good discriminatory power in general and clinical populations, and could be implemented in the context of prevention and early intervention after trauma.

2023-05-01·Journal of child and adolescent psychopharmacology

Comparison of Fidgeting in Adolescents with Attention-Deficit/Hyperactivity Disorder Between Before and After Stimulant Medication Intake.

Article

作者: Moore, Alexandra ; Nagao, Kyoko ; Sydenstricker, Shelby

Objective: Fidgeting is a common symptom in patients with attention-deficit hyperactivity disorder (ADHD). The current study investigated ADHD stimulant medication effects on fidgeting in adolescents with ADHD during a short research study session using wrist-worn accelerometers. Method: Adolescents with ADHD who had been taking stimulant medications (ADHD group) and adolescents without ADHD (control group) participated in the study. Accelerometer data were obtained from both wrists of each participant to track their hand movements during two hearing testing sessions. All subjects in the ADHD group abstained from their stimulant medications for at least 24 hours before their first session (off-med session). The second session (on-med session) was conducted about 60-90 minutes after medication intake. The control group participated in two sessions in a similar time frame. Results: The current study focuses on relationships between hand movements and stimulant medication in adolescents with ADHD. Both conditions were compared to evaluate the relationship of hand movements and stimulant medication. We hypothesized the ADHD group will exhibit less hand movements during the on-medication session in comparison to off-medication session. Conclusion: Wrist-worn accelerometer measures obtained during nonphysical tasks in a short duration may not provide hand movement differences between on-med and off-med conditions in adolescents with ADHD. ClinicalTrials.gov Identifier: NCT04577417.

2022-05-01·Journal of clinical psychopharmacology4区 · 医学

Acute Hyperkinetic Movement Disorders as a Multifactorial Pharmacodynamic Drug Interaction Between Methylphenidate and Risperidone in Children and Adolescents

4区 · 医学

Article

作者: Mohamoud, Mohamed ; Chen, Qi ; Volpe, Donna A ; Cheng, Carmen ; Demczar, Dorothy ; Stone, Marc ; Kortepeter, Cindy ; Burkhart, Keith ; Croteau, David

Abstract:

Purpose/Background:

Acute hyperkinetic movement disorders have been reported with the concomitant use of attention-deficit/hyperactivity disorder (ADHD) stimulants and antipsychotics in children and adolescents. We analyzed postmarketing reports of suspected acute hyperkinetic movement disorder associated with concomitant use of ADHD stimulants and antipsychotics.

Methods/Procedures:

We searched for postmarketing reports of acute hyperkinetic movement disorders associated with concomitant use of ADHD stimulants-antipsychotics in the US Food and Drug Administration Adverse Event Reporting System through December 6, 2019. PubMed and EMBASE were also searched for acute hyperkinetic movement reports with the concomitant use of ADHD stimulants-antipsychotics through January 13, 2020.

Findings/Results:

We identified 36 cases resulting in acute hyperkinetic movement disorder associated with the concomitant use of ADHD stimulants-antipsychotics, 19 of which were also identified in the medical literature. From an ADHD stimulant perspective, methylphenidate products accounted for the largest number of cases (n = 23 [64%]), followed by amphetamine products (n = 9 [25%]) and atomoxetine (n = 4 [11%]). From an antipsychotic perspective, all 36 cases were reported with second-generation antipsychotics, particularly risperidone (n = 20 [56%]). Most of the cases were reported in boys (n = 31 [86%]) aged 6 to 12 years (n = 27 [75%]). Approximately 53% of the cases reported a time to onset within 24 hours of the drug change. Acute dystonic reactions (n = 27 [75%]) were the most frequently reported movement disorder.

Implications/Conclusions:

As outlined in changes to the US prescribing information for all methylphenidate and risperidone products, health care professionals should be aware that changes to this combination may be associated with a pharmacodynamic drug-drug interaction resulting in acute hyperkinetic movement disorder.

项与 EG-P119 相关的新闻（医药）

2023-10-05

·FiercePharma

Drugmaker KVK Tech pulls batch of beta blockers after finding opioid tablet on packaging line

For patients, an opioid tablet would be tough to distinguish from the intended betaxolol prescription. After workers at Pennsylvania-based KVK Tech found a stray Oxycontin tablet on the packaging line for a batch betaxolol tablets, the company is recalling the batch as a precautionary measure. The Oxycontin pill was found during a line clearance procedure after the beta blockers were already packed up. So far, the generics maker hasn’t heard reports of a foreign tablet appearing in its medicine, according to an FDA statement on the recall. Beta blockers are prescribed for heart problems such as rhythm disorders, angina and hypertension. The meds slow down a patient’s heart rate, making for a dangerous situation if a patient were to accidentally consume an opioid in addition to their beta blockers. The two tablets look almost identical, featuring only minor differences that a patient likely wouldn’t catch, the FDA said. The affected batch has an expiration date of June 2027. The company has notified its distributors and customers and believes that a “small number” of bottles may have been sent out to retail pharmacies. While the Oxycontin mix-up is unique, the company has run into manufacturing issues before. In 2020, the FDA issued KVK Tech a warning letter after finding the company failed to meet testing standards for a weight loss medicine. The same letter detailed issues with the plant’s investigation of foreign particles found in a lot of an ADHD drug. Later that year, KVK received another letter for skirting cleaning protocols, among other shortfalls.

2023-08-31

·Pharmaceutical Technology

Zerva acquires Acer Therapeutics to bolster rare disease portfolio

Phalguni Deswal @Phalguni_GD The news caused Acer’s stock to skyrocket by 140% when the markets opened on 31 August. Image Credit: 3rdtimeluckystudio / Shutterstock. Zerva Therapeutics, formerly KemPharm, has announced a strategic acquisition of Acer Therapeutics to expand its rare therapies portfolio. The biggest Acer assets include the marketed rare therapy Olpruva (sodium phenylbutyrate formulation), and late-stage drug celiprolol. Recommended Reports Reports LOA and PTSR Model - Rozanolixizumab in Demyelinating Diseases GlobalData Reports LOA and PTSR Model - Satralizumab in Demyelinating Diseases GlobalData View all Companies Intelligence Zevra Therapeutics Inc Acer Therapeutics Inc View all The acquisition is expected to be worth up to $91m in stock and cash payments, of which $76m is contingent upon milestone-based payments for Olpruva and celiprolol. Additionally, Zerva purchased Acer’s secured debt at a discounted value of $35.3m from its creditor, Nantahala Capital. The news caused Acer’s stock to skyrocket by 140% when the markets opened on 31 August. Zerva has a market cap of $165.25m, with a reported Q1 2023 revenue of $2.9m, as per the company’s financial report . Whilst Acer reported a loss of $8.1m in Q2 2023, as per the company’s Q2 financials . Olpruva is an oral suspension approved for the treatment of urea cycle disorders by the US Food and Drug Administration (FDA) in 2022. Urea cycle disorders are a type of rare genetic metabolic disorder that causes a build-up of toxic levels of ammonia. Celiprolol is a beta-1 selective adrenoceptor antagonist with partial beta-2 agonist activity currently in Phase III (NCT05432466) clinical development for the rare connective tissue disorder, vascular Ehlers-Danlos syndrome. Another Acer pipeline drug is the menopausal therapy, ACER-801 (osanetant), which was licensed from Sanofi. However, the drug development was paused after a Phase IIa trial failed to meet its primary endpoint. Zerva’s marketed portfolio consists of Azstarys (serdexmethylphenidate and dexmethylphenidate), an attention-deficit/hyperactivity disorder (ADHD) drug for children aged six years or older. Zerva has a licensing agreement with Corin for marketing Azstarys in the US. The pipeline portfolio of Zerva includes arimoclomol for treating Niemann-Pick Disease Type C , and KP1077 for rare sleep disorders such as idiopathic hypersomnia and narcolepsy.

上市批准并购引进/卖出临床3期临床2期

2023-07-07

·Pharmaceutical Technology

Antidepressant prescriptions continue to steadily grow in England

Robert Barrie There has been an overall longer-term trend of an increase in antidepressant prescriptions, with their use now up 25% compared to the 2017-18 period. Image credit: Shutterstock/Yau Ming Low The number of antidepressant drugs being prescribed on the UK’s National Health Service (NHS) rose again, according to a quarterly report by the NHS Business Services Authority (NHSBSA). The report, which covers the months from October 2022 to December 2022, lists the number of mental health medicines prescribed in England according to the five British National Formulary (BNF) drug groups. This includes drugs that could have been dispensed in England, Scotland, Wales, Isle of Man of the Channel Islands. Recommended Reports Reports LOA and PTSR Model - Amylin Agonist Long Acting GlobalData Reports Big Data in Pharmaceuticals - Thematic Research GlobalData View all Companies Intelligence National Health Service GPS, L.L.C. BNF Corporation Ltd View all The British National Formulary classifies mental health medications into different groups based on their use. They are antidepressants, hypnotics and anxiolytics, central nervous system (CNS) stimulants and attention-deficit/hyperactivity disorder (ADHD) drugs, dementia medication, and antipsychotics. In the Q3 2022-2023, period antidepressant drugs were the most prescribed drug class, totalling nearly 22 million items, a 2.67% increase compared to the same period in the previous year. The rise is part of an overall longer-term trend of an increase in antidepressant prescriptions, with their use now up 25% compared to the 2017-18 period. The biggest percentage change in mental health medications in the last five years has been with prescriptions for CNS stimulants and ADHD drugs, in line with a gradual upward trend. Since the Q3 2017-18 period, there has been nearly a 70% increase in prescribed items in that drug class. Dementia medication and antipsychotic prescriptions have also increased. The only downward trend in prescribing habits was seen in drugs classified as hypnotics and anxiolytics. Mental health is a key focus of the NHS Long Term Plan, which involves an increase of funding for the sector to £2.3bn ($2.9m) per year . In addition, in January 2023, the UK government announced a further £150m ($191m) to help build mental healthcare facilities . Amidst rising use of antidepressants and high-strength painkillers in general, the NHS issued guidance to general practitioners (GPs) to explore alternative treatments. With the aim of reducing patient reliance on such medication, GPs have been encouraged to follow a more personalised treatment plan for patients. Whilst opioid prescriptions have dropped by nearly half a million , antidepressant use is still climbing.