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- Bejerot, Susanne, 1955-, et al.
(författare)
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Two-year outcome of treatment with central stimulant medication in adult attention-deficit/hyperactivity disorder : a prospective study
- 2010
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Ingår i: Journal of Clinical Psychiatry. - Memphis, USA : Physicians Postgraduate Press, Inc.. - 0160-6689 .- 1555-2101. ; 71:12, s. 1590-1597
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Tidskriftsartikel (refereegranskat)abstract
- Background: Given that adults with ADHD continue to use stimulants for extended periods of time, studies on the long-term effectiveness and adverse events are warranted. The aims of this study were to investigate factors associated with persistence in treatment in an exploratory manner and to document side effects and reasons for discontinuation.Method: The current study describes the systematic follow-up of 133 psychiatric patients with DSM-IV-diagnosed ADHD treated with central stimulants at a specialized outpatient unit between January 1, 2001, and August 31, 2006. A standardized questionnaire, derived from the Targeted Attention-deficit Disorder Symptoms Rating Scale, was used in order to measure improvement of the following target symptoms: hyperactivity, impulsivity, irritability, distractibility, structure/organization problems, inattention, and restlessness.Results: Eighty percent of the patients were successfully treated with stimulants at the 6- to 9-month follow-up. Fifty percent remained in treatment after 2 years or more. Forty-five percent were treated for comorbid anxiety and/or depression during the study period. Only 15% dropped out because of lack of efficacy. The amount of clinical response over the first 6 to 9 months (but not at 6 weeks) predicted adherence to treatment at 2 years. The patients' heart rate increased from a least squares mean ± SE of 70 ± 2.2 to 80 ± 2.1 bpm (P = .00003) while blood pressure remained unchanged at the ≥ 2-year follow-up. Severe side effects or drug abuse were not detected in this cohort.Conclusions: The long-term treatment outcome shows that stimulants are effective in adult ADHD and side effects tend to be mild.
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| 2. |
- Del Peso-Santos, Teresa, et al.
(författare)
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Pr is a member of a restricted class of σ70-dependent promoters that lack a recognizable -10 element
- 2012
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Ingår i: Nucleic Acids Research. - : Oxford University Press (OUP). - 0305-1048 .- 1362-4962. ; 40:22, s. 11308-11320
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Tidskriftsartikel (refereegranskat)abstract
- The Pr promoter is the first verified member of a class of bacterial σ(70)-promoters that only possess a single match to consensus within its -10 element. In its native context, the activity of this promoter determines the ability of Pseudomonas putida CF600 to degrade phenolic compounds, which provides proof-of-principle for the significance of such promoters. Lack of identity within the -10 element leads to non-detection of Pr-like promoters by current search engines, because of their bias for detection of the -10 motif. Here, we report a mutagenesis analysis of Pr that reveals strict sequence requirements for its activity that includes an essential -15 element and preservation of non-consensus bases within its -35 and -10 elements. We found that highly similar promoters control plasmid- and chromosomally- encoded phenol degradative systems in various Pseudomonads. However, using a purpose-designed promoter-search algorithm and activity analysis of potential candidate promoters, no bona fide Pr-like promoter could be found in the entire genome of P. putida KT2440. Hence, Pr-like σ(70)-promoters, which have the potential to be a widely distributed class of previously unrecognized promoters, are in fact highly restricted and remain in a class of their own.
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| 3. |
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| 4. |
- Rydén, Eleonore
(författare)
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Attention-deficit hyperactivity disorder in bipolar disorder
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder, i.e., it is by definition present from childhood. The main features characterizing ADHD are the difficulties to regulate attention, activity level, and impulses. The hallmark of bipolar disorder is episodic mood alterations with restitution between episodes. Although debut in childhood may occur, bipolar disorder typically debuts in late adolescence or early adulthood. The overarching aim with this thesis was to study the importance of ADHD symptoms in adult bipolar disorder. The first study assessed the prevalence of childhood and current ADHD in a cohort of adult bipolar patients. Childhood ADHD was a significant predictor for more frequent hypomanic, depressive, and mixed episodes, as well as more violent incidents, regardless of whether ADHD criteria were fulfilled in adulthood or not. It is suggested that bipolar disorder with a history of childhood ADHD might represent a developmental subtype of bipolar disorder. The second study examined adult personality traits and affective regulation in euthymic bipolar patients with and without a history of childhood ADHD, as well as in a group of pure ADHD patients. Those with childhood ADHD had more affective dysregulation than bipolar patients without childhood ADHD. Childhood ADHD was a significant predictor for the development of affective dysregulation in terms of anxiety, stress-susceptibility, irritability, aggression, and impulsivity in bipolar patients. Whereas the personality profile in bipolar patients with childhood ADHD differed from pure bipolar patients, it closely resembled patients with pure ADHD. The third study compared the levels of cerebrospinal fluid monoamine metabolites in euthymic patients with bipolar disorder type 1, with and without a history of childhood ADHD. The results demonstrated significantly lower levels of dopamine (HVA) and serotonin metabolites (5-HIAA) in those with a history of childhood ADHD, compared to those without ADHD. This lends biological support for the notion that bipolar disorder type 1 with childhood ADHD represents a specific subtype of bipolar disorder. The fourth population-based study examined the risk for bipolar disorder and schizophrenia in ADHD probands and their relatives in comparison with matched controls. The aim was to test the hypothesis that ADHD is familially associated to bipolar disorder, but not to schizophrenia. The results showed that persons with ADHD were at considerably increased risk for bipolar disorder, and more importantly, so were their parents and siblings. Contrary to the hypothesis, however, persons with ADHD, along with their parents and siblings, had an equally increased risk for schizophrenia. Our results suggest that ADHD is familially associated with both bipolar disorder and schizophrenia.
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