Pubmed (TDAH) du 21/03/26
1. Andrew LM, Zhang I, Saldana L, Santoro B, Lohman N, Ryee MY, Gestricht-Thompson W, Russo K, Willing L, Saleh A. Developing a Novel Coding System for Retrospective Chart Review of Attention-Deficit/Hyperactivity Disorder, Anxiety, and Medication Adherence in Pediatric Psychiatry. J Child Adolesc Psychopharmacol. 2026: 10445463261436795.
OBJECTIVES: Pediatric mental health prevalence rates have increased in recent years, while gaps remain in the number of available providers. Ongoing evaluation and understanding of treatment progress and engagement are critical to psychiatric care, and these details are often documented in the electronic health record (EHR). Given the utility of retrospective chart review (RCR) as a tool for psychiatrists, we developed a coding system examining common comorbid conditions (anxiety and attention-deficit/hyperactivity disorder [ADHD]) and adherence and evaluated interrater reliability. METHODS: We created a coding system with a comprehensive manual and coding instructions that explore both symptom severity domains (anxiety, ADHD, and global) and adherence to medication. Codes were rated using Likert scales, and two independent raters coded all data. RESULTS: RCR was completed for 142 patients with a total of 1139 visits over 2 years. Weighted linear kappa statistics ranged between 0.77 and 0.95, and weighted quadratic kappa statistics ranged between 0.74 and 0.96, suggesting substantial to almost perfect agreement. Interrater agreement was highest for anxiety severity. CONCLUSIONS: We created a novel coding system for RCR and found substantial to almost perfect interrater reliability for assessing ADHD severity, anxiety severity, global severity, and medication adherence using psychiatry encounter notes documented in an EHR. Our coding system explores conditions that are often heterogeneous and have waxing and waning presentations, using a continuum that captures the complexity of symptoms. Future directions include utilization of coding systems to explore emotion and behavior change over time to optimize treatment.
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2. Arı P, Büber A, Şenol H. Disruptive behavior in preschoolers: associations with attention deficit hyperactivity disorder and parental psychopathology. BMC Psychiatry. 2026.
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3. Li RL, Shan YD, Lu P, Liu TT, Yu ZF, Lv GG, Liu NN, Zhang W, Zhang JY, Gao WJ, Zhang LM, Miao HT. Exploratory study of plasma GFAP and GAD65-Ab levels in children with ADHD. Ital J Pediatr. 2026.
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4. Tian Y, Xiao Y, Chang H, Zhang M, Liu Y, Lu J, Wang X, Li X. Association of neuroimaging markers with clinical and neuropsychological profiles in pediatric ADHD: A cross-sectional study. Psychiatry Res Neuroimaging. 2026; 359: 112198.
BACKGROUND: Glymphatic-related perivascular processes may influence neurodevelopment, but their role in ADHD remains unclear. This study offers the first integrated assessment of glymphatic MRI markers in pediatric ADHD. METHODS: In this cross-sectional case-control study, children with ADHD (n = 80) and age-matched controls (n = 110) underwent multimodal MRI. Structural glymphatic integrity was measured using the diffusion-derived ALPS index and choroid plexus volume from T1 segmentation, while functional dynamics were assessed via gBOLD-CSF coupling from resting-state fMRI. Cognitive performance and symptom severity were evaluated with standardized neuropsychological and behavioral tests. RESULTS: Children with ADHD showed markedly higher ADHD-RS-IV, anxiety, and depressive symptoms (all P < 0.001). ALPS indices were significantly reduced (1.42 ± 0.18 vs. 1.51 ± 0.17; P = 0.002). CPV exhibited a non-significant trend toward enlargement (P = 0.060), whereas gBOLD-CSF coupling did not differ between groups (P = 0.635). Higher ALPS values correlated with better long-delay recall, recognition and processing speed (all P ≤ 0.006) and fewer inattentive symptoms and lower anxiety (P ≤ 0.020). CONCLUSION: ADHD in children shows mild structural glymphatic alterations, with reduced ALPS linked to deficits in attention and cognition, indicating a potential neurodevelopmental role of perivascular pathways.
