1. Charman T, Bazelmans T, Pasco G, Ali JB, Jones EJH, Johnson MH. Developmental Trajectories of Autistic Traits in Infants With Autism and/or ADHD Family History: Predictors and Mid-Childhood Outcomes. J Autism Dev Disord. 2026.

PURPOSE: Autism is both a developmental and heterogeneous condition, with individual variation in the timing and shape of autistic symptom trajectories over time, as recognised by the concept of ‘chronogeneity’. Prospective infant autism family history studies are well-suited to examining developmental trajectory variability, a key aspect of autism trait heterogeneity. METHODS: We examined autistic trait trajectories in a large sample of infants with autism and/or ADHD family history (N = 384) followed from infancy to mid-childhood. Using group-based multi-trajectory modelling, we identified classes with distinct trajectories across three autism trait measures taken at six, five, and four timepoints, respectively, between 5 months and 9 years. RESULTS: A 5-class solution provided the best fit. Three classes included 50-75% children meeting autism diagnostic criteria at 3 years or mid-childhood, with distinct differences in timing, onset, and developmental patterns of autistic traits. Two classes were predominantly typically developing, with one characterised as ‘slow starters’. Background characteristics including autism/ADHD family history, sex, maternal education, and household income (but not ethnicity) predicted class membership. Mid-childhood outcomes-IQ, adaptive function, autism and ADHD traits, anxiety and behavioural difficulties-differed across trajectory classes. CONCLUSION: The timing and developmental course of autistic traits-independent of trait level-relate meaningfully to infant and family characteristics, diagnostic timing, and mid-childhood outcomes. These findings support chronogeneity as a valuable framework for understanding autism heterogeneity in family history studies. The trajectory classes identified here are descriptive; future studies should examine their replicability, and explanatory and mechanistic value.

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2. Christen AL, Sobanski E, Bitto H, Abt-Mörstedt B, Stieglitz RD, Corbisiero S. Emotional Dysregulation, Emotional Lability, Emotional Impulsiveness and Emotion in Adults with ADHD: Do All Scales Define the Same Concept?. J Atten Disord. 2026: 10870547261475724.

BACKGROUND: Various studies highlight emotional symptoms as a crucial component of ADHD in adulthood, suggesting independent diagnostic approaches that incorporate patients’ emotional experiences into the assessment. However, the emotional symptomatology appears to be defined differently within the disorder’s different constructs: Emotional Dysregulation (ED), Emotional Lability (EL), Emotional Impulsiveness (EI) and Emotion (E). Hence, the question arises: Do these symptom domains represent the same psychopathological spectrum? METHOD: A total of 1240 adults seeking diagnostic evaluation at the ADHD specialist consultation in two different clinics (University Psychiatric Clinics (UPK) in Basel and Central Institute of Mental Health in Mannheim) were examined, whereas 611 participants were diagnosed with ADHD. They were further assessed in regard of their emotional symptoms using the following scales: ED, EL, EI and E. Additionally, affective lability was measured as a control using the Affective Lability Scale (ALS-18). RESULTS AND DISCUSSION: The convergent and construct validity using correlations and principal component analysis (PCA) revealed that individuals with ADHD experience distinct emotional symptoms divergent from a general concept of affective lability as assessed by the ALS-18. The PCA shows that the ADHD-specific emotional symptoms may be classified into (1) difficulties with temper control and anger, (2) emotional distress and (3) emotional overreactivity and mood changes.

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3. Cong J, Zhao S, Xu H, Xu X, Li C, Li H, Xu T, Li Y, Yang H, Cui Z. White-matter functional connectivity uniquely predicts brain age, cognition, and psychopathology beyond gray-matter connectivity. Proc Natl Acad Sci U S A. 2026; 123(34): e2604191123.

White-matter pathways form the structural backbone for communication across the human connectome, yet whether functional connectivity (FC) involving white matter carries information beyond gray-matter networks remains unclear. Here, we tested whether white-matter FC (W-M FC) uniquely predicted brain age, cognition, and psychopathology. Across four independent developmental cohorts spanning childhood to young adulthood (total n = 2,370), we showed that W-M FC, including both white-white and gray-white connectivity, robustly predicted individual differences in brain age. Critically, these predictions remained significant after controlling for gray-matter FC, demonstrating that W-M FC captures nonredundant functional information relevant to brain development. We further demonstrated that W-M FC similarly explained unique variance in cognitive performance (n = 4,388) and ADHD symptoms (n = 4,465). Feature-weight analyses revealed prominent contributions from commissural, projection, superficial, and association pathways, indicating a structured white-matter functional architecture that complements, rather than mirrors, gray-matter functional organization. Together, these findings establish W-M FC as a distinct and behaviorally meaningful component of the human connectome, extending models of human neurodevelopment beyond gray-matter FC alone.

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4. Durak FS, Ocakoğlu FT, Özaydın Y, Ercan ES. Longitudinal transitions, remission predictors, symptom network structure, and classification accuracy in childhood ADHD: a four-year prospective study. Appl Neuropsychol Child. 2026: 1-12.

OBJECTIVE: To examine four-year longitudinal transitions in ADHD diagnostic status and DSM-IV subtypes, identify predictors of remission, characterize changes in symptom network structure, and evaluate the classification performance of network-derived indices. METHOD: This secondary analysis included children with ADHD (n = 89) and matched controls (n = 82) from a prospective four-wave school-based cohort (2008-2011). Participants were assessed annually using the Turgay DSM-IV-Based Scale and structured clinical interviews. Multivariable logistic regression with bootstrap resampling identified predictors of remission. Regularized partial correlation networks were estimated at year 1 and year 4 and compared using the network comparison test. Receiver operating characteristic analyses evaluated the classification accuracy of network-derived indices. RESULTS: Among participants reassessed at year 4 (94.7% retention), 32.1% achieved remission, and 67.9% showed persistent ADHD. Greater early reduction in teacher-rated inattention and lower baseline inattention independently predicted remission. Symptom network structure remained highly stable over time, whereas global connectivity increased significantly (p = 0.024). An inattention-dominant composite AI index showed high apparent classification accuracy (AUC = 0.94), although external validation is required. CONCLUSION: Early inattention trajectory predicts ADHD remission better than baseline severity. Stable but increasingly connected symptom networks and network-derived indices may improve clinical stratification pending independent replication.

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5. El-Farargy SH, Fawzy AM, Elgammal AS, Mostafa HA, Husain MA, Ali HT, Abdelmonim GA. Prevalence of attention-deficit/hyperactivity disorder symptoms and associated factors among university students in Egypt: a cross-sectional study. Sci Rep. 2026; 16(1).

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that persists in adulthood, affecting academic performance and daily functioning. Despite its significance, limited research has explored the prevalence of ADHD-like symptoms among university students in Egypt. This study aims to estimate the prevalence of ADHD Symptoms among Egyptian university students and identify associated factors. A cross-sectional study was conducted using an online self-administered questionnaire among students aged ≥ 18 years or older from various Egyptian universities. The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms. A non-probability convenience sampling technique was applied, and multivariable logistic regression was performed to determine associated risks of ADHD positivity. A total of 3,136 responses were collected, with 2,383 valid responses included in the final analysis. The estimated prevalence of ADHD SYMPTOMS was 37.9% (95% CI: 36.0%-39.9%), obesity (OR = 2.09, 95% CI: 1.14-3.95, p = 0.019), smoking (OR = 1.93, 95% CI: 1.25-3.01, p = 0.003), sleep disorders (OR = 2.12, 95% CI: 1.77-2.55, p < 0.001), childhood trauma (OR = 1.42, 95% CI: 1.18-1.71, p < 0.001), and history of mental health conditions (OR = 1.71, 95% CI: 1.34-2.18, p < 0.001). Regular exercise was associated with lower odds of ADHD (OR = 0.55, 95% CI: 0.44-0.70, p < 0.001). Prevalence of ADHD-like symptoms among Egyptian university students is notably high, with multiple lifestyle and psychosocial factors showing significant associations with its occurrence. These findings highlight the need for increased awareness, early screening, and targeted interventions to support affected students. Future research should further investigate the cultural and educational influences on ADHD in Egypt.

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6. Farahvash A, Naseh E, Morovvati M, Shamabadi A, Fard MM, Zamani Z, Mobini B, Akhondzadeh S. Ropinirole adjunct to methylphenidate versus placebo adjunct to methylphenidate for attention-deficit/hyperactivity disorder: a randomized, double-blind, placebo-controlled trial. Eur Child Adolesc Psychiatry. 2026.

Current therapeutics for attention-deficit/hyperactivity disorder (ADHD) have significant limitations, necessitating innovative therapies. This study aimed to investigate the efficacy and safety of ropinirole, a dopamine agonist with anti-inflammatory and neuroprotective properties, as an add-on to methylphenidate for children with ADHD. In this eight-week, randomized, double-blind trial, 66 outpatients aged 6-17 with a diagnosis of ADHD were randomized to receive methylphenidate plus either ropinirole 0.25 mg or a matching placebo twice daily. ADHD-related symptoms were assessed using the ADHD Rating Scale-IV (ADHD-RS-IV) reported by teachers and parents at baseline and weeks 4 and 8. Inattention and hyperactivity-impulsivity subscale scores were also recorded. Additionally, adverse effects were monitored throughout the study. Data from 65 participants were used for analyses. Baseline demographic and clinical characteristics were comparable between the arms. Significant time-by-treatment interaction was observed for the ADHD-RS-IV total scores as rated by teachers ([Formula: see text]= 0.051) and parents ([Formula: see text]= 0.153). The ropinirole group demonstrated significantly greater reductions in ADHD-RS-IV total scores from baseline to the endpoint as reported by teachers (Cohen’s d = 0.530) and parents (Cohen’s d = 0.504). Also, the ropinirole group achieved higher rates of response to treatment (69.7% versus 34.4%) and robust improvement (60.6% versus 25.0%). The incidence of adverse effects was comparable. In conclusion, methylphenidate + ropinirole was safe and beneficial compared to methylphenidate + placebo for reducing inattentive, hyperactive-impulsive, and total symptoms in children with ADHD. Further studies are required.

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7. Hu L. Centanafadine (Simtriyo®): a first-in-class triple reuptake inhibitor approved for attention-deficit/hyperactivity disorder (ADHD). Med Chem Res. 2026.

Centanafadine (Simtriyo(®), 3) is a recently approved therapy for attention-deficit/hyperactivity disorder (ADHD) that introduces a first-in-class triple reuptake inhibition mechanism. Featuring a naphthyl group and a rigid azabicyclic scaffold, centanafadine functions as a norepinephrine, dopamine, and serotonin reuptake inhibitor (NDSRI) with a potency profile of NET > DAT > SERT. Unlike flexible phenethylamine stimulants such as (meth)amphetamine (1), which enter presynaptic neurons and actively trigger monoamine release, or piperidine derivatives like methylphenidate (2), which selectively block dopamine and norepinephrine reuptake, centanafadine inhibits all three monoamine transporters without inducing neurotransmitter release. Centanafadine represents a modern medicinal chemistry strategy aimed at managing ADHD symptoms through combined catecholaminergic and serotonergic mechanisms, offering sustained efficacy while potentially mitigating the abuse liability, insomnia, and cardiovascular risks typical of traditional psychostimulants.

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8. Larsson I, Svedberg P, Jarbin H, Nygren J, Lindholm A, Aili K, Malmborg JS. Implementation and real-world effectiveness of a weighted blanket intervention and standard melatonin treatment for children with ADHD and sleep problems: protocol for a pragmatic longitudinal cohort study. BMC Psychiatry. 2026; 26(1).

BACKGROUND: Sleep problems are common in children with attention-deficit/hyperactivity disorder (ADHD), yet the real-world use, implementation, and long-term outcomes of weighted blankets and standard melatonin treatment remain understudied. This study protocol describes a research project evaluating the real-world effectiveness and implementation of a weighted blanket intervention and standard melatonin treatment for children with ADHD and sleep problems in routine clinical practice. The project focuses on (1) changes over time in sleep, health-related outcomes, and resource utilization within and across treatment arms, and (2) barriers and facilitators to implementation in routine clinical practice. METHODS: The research project uses: (1) a pragmatic longitudinal cohort design to investigate real-world changes over time in sleep, health-related outcomes, and healthcare resource utilization among children receiving either a weighted blanket intervention or standard melatonin treatment, and (2) a process evaluation design to evaluate implementation in routine clinical practice. Approximately 150 child-parent dyads will be included in each treatment arm. Children aged 6-14 years and one of their parents will each complete questionnaires at baseline, before treatment starts, at 1, 3, 6, and 12 months, and then annually for an additional nine years. The questionnaires assess sleep problems using the Children’s Sleep Habits Questionnaire (CSHQ) total score as the primary sleep outcome, treatment adherence and treatment changes, additional sleep-related measures, everyday function, lifestyle habits, worry and anxiety, ADHD-related symptoms, health-related quality of life, pain, resource utilization, and treatment use and implementation. Child-parent dyads and clinical staff members will be interviewed at 6 and 12 months. Appropriate parametric and non-parametric statistical tests will be performed. Interviews will be analyzed using qualitative content analysis. The implementation process will be analyzed using a convergent parallel mixed methods approach. DISCUSSION: The project has the potential to inform clinical guidelines and decision-making frameworks for personalized care for children with ADHD. By evaluating patterns of treatment use and treatment change, real-world outcomes, and implementation in routine clinical practice, the project may contribute knowledge about the role of weighted blankets as a non-pharmacological treatment option alongside standard melatonin treatment. TRIAL REGISTRATION: http://ClinicalTrials.gov , NCT06808425; registered 29 January 2025.

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9. Martinez-Perez C, Oliveira AP, Baltazar I. Visual Function and Potential Neurodevelopmental Ocular Markers in ADHD: A Systematic Review and Meta-Analysis. J Atten Disord. 2026: 10870547261478340.

PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) has been associated with ocular and visual abnormalities, although findings across studies remain inconsistent. This systematic review and meta-analysis aimed to quantify differences in structural and functional ocular parameters between individuals with ADHD and healthy controls. MATERIALS AND METHODS: PubMed, Web of Science, and Scopus were searched for cross-sectional and cohort studies evaluating ocular or visual parameters in children, adolescents, or adults with ADHD. The review was conducted in accordance with PRISMA guidance, informed by AMSTAR 2 methodological standards, and registered in PROSPERO (CRD420251090876). Eligible outcomes included visual acuity, refraction, ocular biometry, retinal structure, accommodative and binocular function, contrast sensitivity, color perception, and pupillary measures. Pooled mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models, as appropriate. RESULTS: Twenty-seven studies including 888 participants with ADHD and 1,172 controls were included, of which 21 contributed to the quantitative synthesis. No significant between-group differences were found in visual acuity (MD = 0.01; 95% CI [-0.02, 0.03]), cycloplegic spherical equivalent (MD = -0.11 D; 95% CI [-0.32, 0.11]), axial length (MD = 0.50 mm; 95% CI [-0.61, 1.62]), macular thickness (MD = -2.57 μm; 95% CI [-6.49, 1.34]), color perception, or pupil diameter (MD = -0.23 mm; 95% CI [-0.76, 0.31]). Keratometry values were slightly lower in participants with ADHD (MD = -0.37 D; 95% CI [-0.62, -0.12]), and amplitude of accommodation was slightly higher (MD = 0.34 D; 95% CI [0.09, 0.59]). Contrast sensitivity was lower in participants with ADHD at 1.5, 3, 12, and 18 cycles per degree, although these analyses were based on only two studies each and showed substantial heterogeneity at several spatial frequencies. RNFL thickness did not differ significantly in the primary analysis (MD = -2.42 μm; 95% CI [-5.48, 0.64]); however, a sensitivity analysis excluding one influential study showed modest thinning in the ADHD group (MD = -3.69 μm; 95% CI [-5.96, -1.42]). The certainty of evidence was very low across the assessed outcomes. CONCLUSIONS: Current evidence does not indicate consistent or clinically meaningful differences in ocular anatomy, refraction, or most binocular and accommodative measures in individuals with ADHD. Some small group-level differences were observed in contrast sensitivity, keratometry, amplitude of accommodation, and RNFL thickness in sensitivity analysis, but their clinical significance remains uncertain. These findings should be considered exploratory because of the observational study designs, methodological heterogeneity, and very low certainty of evidence.

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10. Russell A, Holt S, Wellaway I, Hirst A, Heaney L, Hanna R, Wenger J, Hampton L, Sullivan B, Townsend F, Ford T, Dunn BD, Moore D, Sonuga-Barke E, Pfiffner L, Kidger J, Hayes R, Gudka R, Bryant E, Cordwell K. Co-design of a complex school-based intervention for attention deficit/hyperactivity disorder using the Intervention Mapping approach. JCPP Adv. 2026: e70169.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental condition, comprising varying difficulties in attention and/or impulsive and overly active behaviours, with knock on effects for health, learning, social and emotional functioning, self-esteem and quality of life. There is little implementation of school-based intervention for ADHD in UK mainstream primary schools, due to resource constraints and implementation challenges of existing, multi-component complex interventions. METHODS: This study describes the co-design of a novel, personalised school-based intervention for ADHD, delivered by teachers to primary school students. The Intervention Mapping approach was used to structure intervention development. Co-design with a Planning Group of 33 adults and children with ADHD, school and health professionals is described in detail, as well as an overview of the resultant intervention: the Flex toolkit. RESULTS: Co-design was woven throughout the intervention development and evaluation process, leading to a novel digital health intervention for ADHD suitable for delivery in UK mainstream school settings, by classroom teachers. The Flex toolkit contains some core components applicable to every child, then becomes personalised depending on each child’s areas of strength and challenge. CONCLUSION: This novel digital intervention builds on the existing evidence base whilst ensuring that the content, format and design as well as implementation and evaluation plan are suitable for the UK mainstream primary school context.

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