1. Al-Khlaiwi T, Alhakbany M, Aldossary MK, Binsalamh LF, Altamimi LM, Alyahya NI, Aldekhail RW, Alobaid RA, Aljarbaa MO, Iqbal M. Impact of socioeconomic factors and birth-related conditions on autism spectrum disorder, Down syndrome, and attention deficit/hyperactivity disorder. BMC Pediatr. 2026; 26(1).

BACKGROUND AND OBJECTIVE: This study examined the association between socioeconomic factors and maternal birth-related variables in children diagnosed with Autism Spectrum Disorder (ASD), Down Syndrome (DS), and Attention Deficit/Hyperactivity Disorder (ADHD). METHODS: A retrospective analysis was conducted using data from King Khalid University Hospital Riyadh between 2015 and 2024. The sample included 269 children: 185 with ASD, 51 with DS, and 33 with ADHD. Multivariable logistic regression was used to identify significant predictors. RESULTS: Maternal use of medications during pregnancy (excluding dietary supplements) was significantly associated with a higher likelihood of ASD (OR = 4.253, p = 0.012). Child age was also significant, with each additional year increasing ASD odds by about 5% (OR = 1.054, p = 0.040). Child birth order played a role, as first- or second-born children were less likely to be diagnosed with ASD compared to later-born children (OR = 0.660, p = 0.002). For DS, higher socioeconomic status index (SESi) was linked to a reduced risk, with each unit increase in SESi score, DS odds decreased significantly (OR = 0.578, p = 0.018). Maternal employment during pregnancy was associated with increased DS odds (OR = 1.535, p = 0.024). In contrast, maternal vitamin D supplementation was associated with reduced odds of DS (OR = 0.452, p = 0.028). Regarding ADHD, assisted conception was the only factor significant predictor. Children conceived through assisted reproductive methods had more than twice the likelihood of ADHD compared to those conceived naturally (OR = 2.401, p = 0.040). CONCLUSION: Maternal medication use during pregnancy was associated with increased ASD risk, while birth order and child age also played roles. For DS, higher socioeconomic status reduced risk, whereas maternal employment increased it and vitamin D supplementation was less associated with the disorder. Assisted conception was the only factor linked to increased ADHD risk. Overall, maternal, socioeconomic, and perinatal factors showed distinct associations across ASD, DS, and ADHD.

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2. Grønvik CKU, Mundal I, Laake P, Lara-Cabrera ML. Structural validity and internal consistency of the Client Satisfaction Questionnaire-8 among parents of children with ADHD: a cross-sectional study. BMJ Open. 2026; 16(10): e123542.

ABSTRACT: OBJECTIVES: This study aimed to examine the structural validity and internal consistency of the eight-item Client Satisfaction Questionnaire (CSQ-8) among parents of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), attending and evaluating a psychoeducational programme. Based on previous research, we hypothesised that the CSQ-8 would demonstrate a unidimensional factor structure and high internal consistency in this population. DESIGN: A cross-sectional study was conducted, using analytical methods appropriate for ordinal data. Structural validity was evaluated using exploratory and confirmatory factor analyses based on polychoric correlations and internal consistency was assessed using ordinal alpha and McDonald’s omega. SETTING: Participants were recruited from four outpatient clinics within Norwegian Child and Adolescent Mental Health Services. PARTICIPANTS: Of the 239 parents who participated in the psychoeducational programme, 178 responded and 157 parents completed all items of the CSQ-8 questionnaire. Data were collected between May 2019 and February 2020. RESULTS: Item responses indicated generally high levels of parent satisfaction (mean total score 26.2 out of possible 32, SD 3.51), with distributions skewed towards the upper response categories. Polychoric correlations showed moderate to strong inter-item associations. Parallel analysis, supported by scree plot inspection, and factor loadings ranging from 0.73 to 0.90 supported a unidimensional factor structure. Confirmatory factor analysis indicated good model fit for the one-factor model. Internal consistency was excellent, with both ordinal α and McDonald’s ω equal to 0.94. CONCLUSIONS: The findings provide preliminary evidence supporting the structural validity and internal consistency of the CSQ-8 among Norwegian parents of children newly diagnosed with ADHD who participated in a psychoeducational programme. Further research is needed to evaluate other measurement properties before broader conclusions can be drawn about the validity and reliability of the instrument.

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3. İlgen Uslu F, Özyalçın M, Kizek Ö, Elmalı AD, Bebek N. ADHD symptom positivity and its association with medication adherence and psychiatric burden in adults with epilepsy. Epilepsy Behav. 2026; 186: 111315.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) symptoms are increasingly recognized in adults with epilepsy (AwE) and may contribute to psychiatric burden, seizure-related outcomes, and treatment adherence. We therefore investigated the frequency of ADHD symptom positivity and its associations with medication adherence, psychiatric symptoms, seizure burden, and neurophysiological findings. METHODS: This cross-sectional study included 100 AwE and 94 healthy controls. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS-v1.1). Anxiety and depressive symptoms were evaluated using the Beck Anxiety Inventory and Beck Depression Inventory, respectively. Medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS-8). Participants were classifiedas ASRS-positive or ASRS-negative according to the six-item ASRS Part A screener. Clinical, psychiatric, electroencephalographic, and magnetic resonance imaging findings were compared between groups. Multivariable logistic regression analyses were performed to identify factors independently associated with ADHD-symptom-positivity. RESULTS: ADHD-symptom-positivity was significantly more frequent in AwE than in healthy controls (50.0% vs. 25.5%, p = 0.001). Within the epilepsy cohort, ASRS-positive participants demonstrated lower medication adherence (p = 0.010), higher rates of poor adherence (70.0% vs. 48.0%, p = 0.042), higher anxiety (p = 0.002), and depression scores (p < 0.001). Clinically significant anxiety and depression were also more common among ASRS-positive participants (p = 0.027 and p < 0.001, respectively). In multivariable analysis, depression score was independently associated with ADHD-symptom-positivity (OR = 1.147, 95% CI 1.039-1.267, p = 0.007). CONCLUSIONS: ADHD-symptom-positivity is common in AwE and is associated with poorer medication adherence in the between-group analysis, but this association did not remain statistically significant after multivariable adjustment, while greater psychiatric symptom burden was observed. Routine screening for ADHD-related symptoms may facilitate identification of adults with epilepsy at increased riskfor adverse clinical outcomes and support more comprehensive epilepsy care.

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4. Kalkbrenner AE, Ketzel M, Kuhlwein T, Zheng C, Yu J, Jenson T, Pedersen CB, Grove J, Khan J, Brandt J, Ladd-Acosta C, Mortensen PB, Closter AM, Dalsgaard S, Schendel D. Traffic-related air pollution links with attention deficit hyperactivity disorder in Denmark: Developmental periods of susceptibility and sex-specificity. Environ Res. 2026: 125900.

Literature supports that higher early life exposure to air pollution arising from combustion, e.g., traffic exhaust and electric power generation, is associated with attention deficit hyperactivity disorder (ADHD). However, little is known about whether certain periods of exposure during fetal or childhood brain development are more important, i.e. whether there are critical windows of exposure, or whether associations differ by child sex. To address these gaps, we performed a population-based case-cohort study including singletons born 1981-2008 using Danish national registry data resources. We included 21,860 persons diagnosed with ADHD (ICD10 F90.0) and 32,041 persons randomly selected from the eligible population. Daily fine particulate matter (PM(2.5)) and elemental carbon (EC) exposure corresponded to complete residential addresses from pre-conception through the 12th year of life, using the multi-level Danish air model, DEHM/UBM/AirGIS, at the address level. We estimated hazard ratios (HR) and 95% confidence intervals for pollutants and ADHD, adjusting for urbanicity, Danish region, birth year, sex assigned at birth, socio-demographic factors, and polygenic scores for ADHD. To account for correlation structure of pollutants across time, we adjusted pollutant exposure in one time period for other periods, finding that HRs in the second-year of life were larger than during pregnancy or other postnatal years: EC > 1.13 vs. EC < 0.49 μg/m(3) HR: 1.24 (1.12, 1.36); these associations were not attenuated after adjusting for PM(2.5). For females, the EC HR in the 2 nd year of life: 1.44 (1.21, 1.72) was larger than for males: 1.18 (1.00, 1.40) (modification test p = 0.000), suggesting increased vulnerability in females. Critical period and sex modification results were similar for PM(2.5). These results add to growing literature that major air pollutants increase ADHD risk and add important new insights that early childhood may be an important period of exposure and links may be stronger in females.

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5. Oliaro T, Amianto F. Emerging Therapeutic Strategies for Child and Adolescent Obesity: A Narrative Review. Nutrients. 2026; 18(20).

BACKGROUND/OBJECTIVES: Childhood obesity is a chronic, multifactorial disease requiring attention to biological, behavioral, psychological, family, and socioeconomic factors. This narrative review examined the integration of lifestyle, family-based, psychological, and pharmacological approaches, focusing on treatment engagement, eating disorders, attention-deficit/hyperactivity disorder (ADHD), and treatment durability. METHODS: A single search interface covering PubMed/MEDLINE, Scopus, and Web of Science (the University of Turin library discovery platform) was used to identify studies published primarily from 2010 to August 2026. Pediatric trials, observational studies, systematic reviews, meta-analyses, guidelines, and public-health reports were prioritized. RESULTS: Intensive family-based, multicomponent behavioral treatment remains the best-supported foundation of care, although psychological outcomes are infrequently assessed. Psychiatric comorbidity is heterogeneous; loss-of-control eating, emotional symptoms, ADHD, and executive-function difficulties may impair engagement in selected patients, and untreated ADHD has been associated with a slower BMI response to weight management. Professionally supervised obesity treatment containing a dietary component did not, on average, worsen eating psychopathology and reduced several related symptoms. Family participation improved outcomes, whereas logistical, socioeconomic, and psychological barriers reduced attendance. Across randomized trials, adding anti-obesity medication to behavioral treatment produced an additional, although on average modest, reduction in BMI. Semaglutide, liraglutide, and phentermine/topiramate produced larger numerical reductions than older agents in separate trials, but heterogeneity and the absence of head-to-head comparisons preclude formal ranking. Gastrointestinal adverse events were frequent with glucagon-like peptide-1 (GLP-1) receptor agonists. Pediatric trials and real-world evidence indicate partial weight regain after discontinuation, while prescribing remains limited and unequal. CONCLUSIONS: Pediatric obesity care should be phenotype-informed, multidisciplinary, and longitudinal. Pharmacotherapy can enhance BMI reduction but should complement rather than replace behavioral, psychological, and family care. Outcomes should extend beyond BMI to metabolic, psychological, functional, and long-term measures.

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6. Rafiei S, Cartwright G, Atkins B, Toro C. From backlog to blind spots: improving data visibility across autism and ADHD pathways in England. BJPsych Bull. 2026: 1-5.

All-age autism and attention-deficit hyperactivity disorder pathway reform in England is often framed around waiting lists and capacity. However, backlog data alone cannot show how people move through referral, triage, assessment, support and follow-up, or where inequities and unmet need are hidden. Current data also struggle to distinguish confirmed diagnosis, suspected diagnosis, disclosure, self-identification and co-occurring needs. This creates pathway blindness: systems can see pressure, but not flow, fairness or diagnostic visibility. We argue that reform should begin with structured system mapping, agreed definitions and a realistic minimum data-set before dashboards or predictive analytics are used to guide service change.

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7. Summerfield D. Critiquing the ‘epidemic’ of ‘adult ADHD’. Br J Psychiatry. 2026: 1-2.

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8. Törnhage CJ, Robertz AC, Kantzer AK, Nilsson S. Methodological Considerations for Using Hair Cortisol as a Biomarker Following No Measurable Effects of Tactile Massage in Adolescents With ADHD. Int J Pediatr. 2026; 2026: 5891199.

AIMS: Dysregulation of the hypothalamic-pituitary-adrenal axis has been proposed as a mechanism in attention-deficit/hyperactivity disorder (ADHD). Tactile massage is suggested to influence long-term cortisol secretion in adolescents with ADHD, although it remains unclear whether such an effect occurs. This study examined whether tactile massage alters hair cortisol in adolescents with ADHD. METHODS: Fourteen adolescents aged 15-17 with ADHD received 10 weekly 60-min standardised tactile massage sessions. Hair samples were collected at five time points and analysed for cortisol using a competitive radioimmunoassay. Perceived stress (the Stress in Children questionnaire), heart rate and blood pressure were assessed. Non-parametric statistics (Friedman’s ANOVA, Wilcoxon matched-pairs tests and Spearman’s correlation) evaluated time-dependent changes and associations. RESULTS: Hair cortisol showed no significant differences between baseline, intervention and follow-up (p = 0.63). After six sessions, boys had higher cortisol levels than girls (p = 0.029). No significant correlations emerged between hair cortisol and heart rate, blood pressure or total stress, although a negative correlation was found with frustration (p = 0.028). CONCLUSIONS: Because the intervention did not alter long-term cortisol output, and hair cortisol shows limited sensitivity to short-term effects, it does not appear suitable for detecting tactile-massage effects in adolescents with ADHD.

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