1. Babinski DE, Tuan WJ. Obstetric Risk Associated With Stimulant Versus Nonstimulant Treatment During Pregnancy. J Clin Psychiatry. 2026; 87(3).

Objective: To evaluate and compare the obstetric risks associated with stimulant and nonstimulant medication use during pregnancy. Methods: This retrospective cohort study used TriNetX electronic health records from 894,986 pregnancies recorded between 2010 and 2023. Women aged 18-45 years were grouped by attention-deficit/hyperactivity disorder (ADHD) medication exposure during pregnancy: stimulant (n=3,465), nonstimulant (n=575), or no ADHD medication (n=890,946). Propensity score-based inverse probability of treatment weighting balanced demographic, substance use, medical, and mental health factors, including ADHD. Weighted logistic regression compared adverse pregnancy outcomes across groups. Results: Stimulant and nonstimulant use during pregnancy were both associated with increased risk for several obstetric complications compared to no medication, with increased-risk odds ratios ranging from 1.21 to 1.85 for stimulants and 1.12 to 5.70 for nonstimulants. Compared with nonstimulants, stimulants were associated with higher odds of placenta previa and large for gestational age but lower odds of gestational diabetes, placental abruption, intrauterine growth restriction, and preterm delivery. Conclusion: Stimulant and nonstimulant use during pregnancy were associated with increased obstetric risk. Given the observational electronic health record design, lack of an ADHD-unmedicated comparison group, and lack of adjustment for concomitant medication exposures, findings should be interpreted as potential safety signals rather than definitive causal estimates. Findings support individualized risk-benefit assessment and further research on ADHD treatment during pregnancy.

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2. Barbini CM, Merino D, Manera V, Fabre R, Quaderi A, Askenazy F, Thümmler S. Biofeedback for Attention Deficit and Hyperactivity Disorder in children: A pilot study of a multimodal approach of respiratory biofeedback to improve functional impact. Encephale. 2026.

Defined as a complex syndrome combining attentional and behavioral difficulties, Attention Deficit Hyperactivity Disorder (ADHD) is a widespread condition affecting approximately 5.3% of children worldwide. Treatments mainly include psychotherapy and amphetamine derivative-based pharmacotherapy. Respiratory biofeedback may represent an additional, promising non-pharmacological approach for ADHD, in addition to neurofeedback, biofeedback’s actual main application protocol based on cerebral activity. However, to date, there are few studies regarding other physiological rhythms, such as breathing. This study explored the potential effects of a therapeutic intervention based on respiratory, haptic and visual biofeedback, aiming to reduce the intensity of attentional dysfunction symptoms in children with ADHD aged 8 to 11 years. In this crossover protocol, we set two intervention groups: an immediate group and a delayed group. The intervention phase consisted of five weekly respiratory biofeedback sessions focused on attention processes, along with the monitoring of symptomatic manifestations using validated psychometric tools. Among the 17 participants, the results showed a significant overall decrease in ADHD evaluation scale scores both immediately after the intervention and at the 30-day follow-up, indicating short-term benefits from the sessions. However, these benefits were attenuated in the medium term, possibly due to the limited number of biofeedback sessions. In conclusion, respiratory biofeedback was well accepted, and few sessions decreased in the short term symptomatic manifestations and functional impacts related to ADHD. However, treatment effects, permanence and acceptability need to be assessed in larger and longer cohort studies. Thus, a multimodal biofeedback approach based on respiratory feedback is an innovative preliminary but promising emerging perspective for children presenting ADHD.

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3. Cohen JM. ADHD Medication Safety in Pregnancy: Precise Estimates, Uncertain Causal Inference. J Clin Psychiatry. 2026; 87(3).

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4. Egsgaard S, Brown HK, Zipursky J, Munk-Olsen T, Babujee A, Patrikar A, Lu M, Vigod SN. Time Trends in Maternal Attention-Deficit/Hyperactivity Disorder and Medication Use in Pregnancy. J Clin Psychiatry. 2026; 87(3).

Background: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized among women of reproductive age. Little is known about time trends in maternal ADHD, and treatment utilization in this group. Methods: We conducted a cross-sectional time series analysis of all obstetrical deliveries in Ontario, Canada, from 2002-2023 (medication data available from 2014). Maternal ADHD was defined by inpatient or outpatient diagnosis within 10 years preconception. Stimulant medication use (amphetamine, dextroamphetamine, lisdexamfetamine, methylphenidate) was assessed via prescription fills in the year before pregnancy, during pregnancy, and stratified by trimester. We described the annual proportions of pregnancies with preconception maternal ADHD diagnoses and stimulant use patterns in this group. Results: Of 2,327,110 included pregnancies, the proportion of pregnancies with maternal ADHD rose from 0.5% to 2.5% from 2002 to 2023. Between 2014 and 2023, stimulant use increased from 21.8% to 39.8% in the year prior to pregnancy and from 10.1% to 20.9% during pregnancy among those with ADHD. Methylphenidate predominated early in the study period, but increases over time were largely driven by lisdexamfetamine. Approximately 75% of those prescribed a stimulant in the year prior to conception discontinued it prior to, or in, the first trimester of pregnancy, with stable time trends. Conclusions: The 4-fold increase in maternal ADHD in pregnancy over a 20-year period and 2-fold increase in the use of stimulant medication before and during pregnancy in this group underline the need for clinical guidance on managing ADHD in pregnancy.

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5. Friedman LM, Fabrikant-Abzug G, Chromik LC. Barriers Associated With the Implementation of Homework in Behavioral Parent Training Among Parents With ADHD Symptoms. J Atten Disord. 2026: 10870547261483443.

PURPOSE: Behavioral Parent Training (BPT) is a front-line intervention for childhood ADHD, yet its effectiveness is reduced in families where parents also experience ADHD. Prior research suggests this attenuation stems from reduced BPT skill use among parents with ADHD symptoms. Beyond simply recognizing its occurrence, identifying the factors that contribute to poor skill use is essential for enhancing BPT effectiveness among parents with ADHD symptoms. The current study is the first, to our knowledge, to qualitatively examine barriers to BPT skill use in multiplex ADHD families. METHODS: Parents with ADHD symptoms who recently completed a BPT program (n = 16) and BPT clinicians (n = 4) participated in focus groups or interviews. Qualitative data were analyzed to identify common and impairing barriers to consistent skill implementation at home. RESULTS: Four primary themes emerged: (a) executive functioning and ADHD symptoms; (b) intervention fit (e.g., fast pace, poor skill understanding); (c) emotion regulation and motivation; and (d) child and family factors (e.g., multiple children, family communication). CONCLUSIONS: Findings highlight the unique cognitive, emotional, and contextual challenges that parents with elevated ADHD symptoms face when applying BPT skills. Addressing these barriers through intervention modifications, such as cognitive-behavioral strategies for parents, digital tools, and program delivery adaptations, may improve parents’ skill use and, in turn, child outcomes.

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6. Gul MK, Hudayioglu B, Demirci E, Ozmen S. A Retrospective Study Examining Predictors of Treatment Response in Over 1,300 Children and Adolescents with Attention-deficit Hyperactivity Disorder. Clin Psychopharmacol Neurosci. 2026; 24(3): 490-500.

OBJECTIVE: This study aimed to examine the predictors of treatment response in children and adolescents with attention-deficit hyperactivity disorder (ADHD). METHODS: The study included 1,314 patients with ADHD who came to the child psychiatry department over a 5-year period. The 276 patients whose treatment was changed due to treatment non-response or side effects were included twice for the first and second treatment, so a total of 1,590 patient data were used. Age, sex, initial ADHD severity, ADHD treatment, treatment response, comorbidities, additional treatments, and chronic disease status of the cases were recorded. RESULTS: One thousand twenty-seven (78.16%) of the patients were male and 287 (21.84%) were female. Using the combination therapy of methylphenidate (MPH) and atomoxetine (ATX) as the reference category, ATX monotherapy showed a significantly lower likelihood of responding to treatment. Moderate and marked disorder severity were associated with higher odds compared with severe disorder. Borderline intellectual functioning (BIF), mild intellectual disability, conduct disorder (CD), autism spectrum disorder (ASD), and adjustment disorder (AD) showed significantly lower odds. Older age was significantly associated with response to treatment. In the MPH monotherapy and ATX monotherapy groups, compared to moderate disorder, severe disorder was associated with significantly lower odds. BIF, CD, ASD, enuresis, communication disorders, and AD showed significantly lower odds in MPH group, while only ASD had significantly lower odds in ATX group. Higher ATX dosage was significantly associated with treatment response in this group. CONCLUSION: Knowing the factors affecting treatment response can be used to predict prognosis.

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7. Kim S, Kim YC, Um YH, Kim TW, Seo HJ, Hong SC, Yoon SH, Jeong JH. Patterns of Lateral Frontal Delta Asymmetry in Adult Attention-deficit/Hyperactivity Disorder with Comorbid Depression: A Quantitative Electroencephalography Study. Clin Psychopharmacol Neurosci. 2026; 24(3): 580-8.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and is frequently comorbid with depression, complicating diagnosis and treatment. Quantitative electroencephalography (qEEG) may aid in distinguishing ADHD alone from ADHD with depression by identifying neurophysiological markers. METHODS: This retrospective study included 45 adults with ADHD, 24 with comorbid depression and 21 without. Diagnoses were confirmed through structured Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-based interviews and neuropsychological testing. Resting-state EEGs were recorded with 19 electrodes under eyes-closed conditions. Data underwent artifact rejection and independent component analysis, and spectral power was calculated for delta, theta, alpha, beta, high beta, and gamma bands. Frontal regions and asymmetry indices (Fp2-Fp1, F4-F3, and F8-F7) were analyzed using ranked ANCOVA, adjusting for age, sex, Full-Scale IQ, and current medication status. RESULTS: Demographic factors did not differ between groups. However, the ADHD-only group showed a difference delta asymmetry in the lateral frontal region (F8-F7) compared with the comorbid group (p = 0.024). Additional findings included a tendency toward higher absolute delta power at F8 in the ADHD-only group (p = 0.060), and a pattern of greater left centro-temporal delta power in the comorbid group (p = 0.051). CONCLUSION: In this pilot study, adults with ADHD with and without comorbid depression showed distinct patterns of frontal delta asymmetry, suggesting that depressive comorbidity may be associated with variability in qEEG features. Further well-powered, longitudinal studies are needed to determine the clinical utility of qEEG as an adjunctive tool in ADHD.

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8. Oliva HNP, Pulido-Saavedra A, Paredes Naveda AM, Forselius E, Potenza MN, Jegede OO, Angarita GA. Pharmacotherapies for Co-Occurring Stimulant Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Network Meta-Analysis. J Clin Psychiatry. 2026; 87(4).

Objective: To evaluate the benefit of pharmacotherapies for adults with co-occurring stimulant use disorder (StUD) and attention-deficit/hyperactivity disorder (ADHD) using network meta-analysis. Data Sources: Searches were conducted of PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to February 2026, without language restrictions. Study Selection: Of 4,152 studies retrieved, 6 were included. These evaluated pharmacologic treatments in co-occurring StUD and ADHD, reporting stimulant use parameters and ADHD symptom-related outcomes. We excluded studies not including both disorders, reviews, and abstracts. Data Extraction: Data extracted included continuous abstinence from stimulants, negative urine toxicologies, and ADHD severity. Pharmacotherapies included methylphenidate (MPH), mixed amphetamine salt (MAS), and bupropion. Standardized mean differences (SMDs) or odds ratios (ORs) were calculated; treatment ranking probabilities were assessed using P-scores. Results: Higher-dose MPH and MAS were associated with superior outcomes. For continuous abstinence, MAS produced the greatest benefit versus placebo (OR=8.45; 95% CI, 2.55-27.98; P=.0005), with the 80-mg dose ranking highest in the network analysis (P-score=0.846). Similarly, pharmacotherapy increased the odds of negative urine tests (OR=1.65; 95% CI, 1.01-2.71; P=.05), and the highest MAS dose again ranked first (P-score=0.890). Regarding improvement in ADHD symptom severity (SMD=-0.59; 95% CI, -0.94 to -0.23; P=.001), the greatest reduction was observed with MPH 180 mg (P-score=0.899). Safety profiles for pharmacotherapies were comparable with placebo. Conclusions: Stimulant-based pharmacotherapies, particularly higher-dose MPH and MAS, were associated with superior outcomes for both stimulant-use indicators and ADHD symptoms. These findings support consideration of optimized stimulant dosing when treating co-occurring StUD and ADHD, though further trials are warranted to refine clinical recommendations.

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9. Skodvin VA, Skjåkødegård HF, Molde H, Wilfley D, Conlon RPK, Júlíusson PB, Danielsen YS. Among Multiple Mental Health Symptoms, Only Attention Deficit/Hyperactivity Problems Predict Poorer BMI Outcomes in Family-Based Behavioural Treatment for Youth With Severe Obesity. Pediatr Obes. 2026; 21(9): e70147.

Large variability exists in outcome following Family-based treatment (FBT) for severe obesity in youth. In the present study, we aimed to expand our understanding of how mental health impacts FBT outcomes. In total, 90 participants (58.9% girls) 5.9-18.6 years (mean ± SD: 13.2 ± 3.1) were enrolled in a 17-session FBT-programme. Baseline mean percentage above the IOTF threshold for overweight (%IOTF25) was 146 ± 13, and Body Mass Index standard deviation score (BMIz) was 3.02 ± 0.52. Mental health predictors were assessed using the Self-Perception Profile for Children and the Child Behaviour Checklist. A multivariate multilevel Bayesian linear mixed-effects model with repeated measures was utilized to estimate the effects of mental health predictors on BMI outcomes. Average change in BMI during FBT was -3.80 (%IOTF25) and -0.08 (BMIz) units. Higher scores of Attention Deficit/Hyperactivity (ADH) Problems were associated with a smaller reduction in BMI (0.31 units for %IOTF25 (p = 0.02), 0.01 units for BMIz (p = 0.03) for each one-unit T-score increase on the ADH problem scale). Self-Worth, Emotional Dysregulation, Internalizing- and Externalizing problems were not associated with differences in BMI outcomes. Identifying children with higher ADH problems and incorporating additional family support strategies within FBT should be a focus for further treatment development.

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10. Sürig L, Fongaro E, Kerbage H, Blanc JP, Desgrez V, Mayer SS, Purper-Ouakil D, Willig TN. A script concordance test to implement 2024 HAS ADHD guidelines in primary care. Encephale. 2026.

BACKGROUND: The 2024 French Haute Autorité de santé (HAS) guidelines introduced the concept of an « ADHD-specialized physician » calling for competency-based models to support broader, evidence-based ADHD care for children and adolescents. However, no standardized assessment currently exists to evaluate the clinical reasoning required for this role. OBJECTIVE: This study describes the development and initial validation of a Script Concordance Test (SCT) designed to assess clinical reasoning in ADHD management, with potential applications as both a pedagogical and certification tool. METHODS: Following international standards for SCT design, the test was constructed using a structured blueprint aligned with HAS 2024 guidelines. A panel of 25 national experts completed the full version (72 items); after reviewing the items and excluding those with low consensus, 43 items were retained. Inter-rater agreement was analyzed using Kendall’s coefficient of concordance (W=0.67). Qualitative validation was achieved through iterative expert consensus ensuring clarity, relevance, and representativeness. RESULTS: The expert panel demonstrated substantial concordance (Kendall’s W=0.67) consistent with previous SCT validation studies in psychiatry and pediatrics. Qualitative reviews confirmed the clarity, representativeness, and clinical relevance of the retained items. CONCLUSIONS: This SCT provides a valid and adaptable method to assess higher-order clinical reasoning in ADHD care. By operationalizing the competencies implied in the HAS 2024 guidelines, it may support the emerging role of the « ADHD-specialized physician » and contribute to competency-based certification models similar to those used in other regulated medical practices.

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11. Xu X, Fu Z, Xu H, Zhang K, Cong J, Yang H, Li Y, Zhao Y, Zheng X, Keller AS, Xu T, Chen R, Cai W, Cao Q, Yang L, Cui Z. Developmental deviations of association-network structural connectivity in youths with ADHD predict symptom and treatment outcomes. Nat Biomed Eng. 2026.

Attention deficit hyperactivity disorder (ADHD) lacks validated biomarkers for tracking symptom trajectories or guiding treatment selection in youth. Here we quantify individual deviations from normative age-related trajectories of white-matter structural connectivity across two independent datasets: 6,687 typically developing and 1,114 ADHD scans from a longitudinal developmental cohort, and 355 typically developing and 477 ADHD participants from an independent cohort. Youths with ADHD showed pronounced structural connectivity deviations enriched towards the association end of the sensorimotor-association connectional axis. A subset of higher-order association connections showed ADHD-specific developmental reductions in deviations beyond typical developmental patterns, and these changes mediated age-related declines in ADHD symptoms. Within-individual decreases in deviation over 2 years tracked symptom improvement. Baseline deviations predicted 12-week treatment response to atomoxetine but not methylphenidate, and follow-up imaging revealed treatment-related reductions in deviation. Together, these findings identify structural connectivity deviation as a developmental biomarker with prognostic relevance for ADHD, supporting precision care through symptom monitoring and treatment stratification.

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12. Zhou Y, Yao H, Xie T, Gillies MB, Zhang-James Y, Brikell I, Engeland A, Gao L, Semark BD, Wimberley T, Astrup A, Dong Z, Sarsembayeva D, Vos M, Yuen ASC, Dalsgaard S, Faraone SV, Klungsøyr K, Larsson H, Man KKC, Wong ICK, Zoega H, Snieder H, Chang Z, Hartman CA. The association of ADHD and ADHD medication with adherence to pharmacotherapy for type 2 diabetes: a population-based cohort study from seven countries. EClinicalMedicine. 2026; 99: 104182.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) may compromise adherence to pharmacotherapy in adults with type 2 diabetes, but the relationship is unknown. We investigated the association of ADHD and ADHD medication with antidiabetic medication adherence in multinational cohort data. METHODS: Using a common analytical protocol and population-based databases from seven countries, we identified adults initiating non-insulin antidiabetic medication between 2010 and 2020. ADHD was identified by diagnosis or ADHD medication use. We used the proportion of days covered (PDC) to measure antidiabetic medication adherence and defined the primary outcome, poor adherence, as PDC <80% over 1-, 2-, and 5-year follow-up periods. Time-to-first-discontinuation was the secondary outcome. Country-specific estimates were obtained using logistic and Cox regression and pooled using random-effects meta-analyses. FINDINGS: Among 3,643,197 individuals included, 1,871,870 (51.4%) were female and 88,339 (2.4%) had ADHD (76,973 [87.1%] received ADHD medication). Overall, ADHD was not associated with poor adherence to antidiabetic medication (1-, 2-, and 5-year pooled odds ratios [OR]: 1.01 [95% CI 0.90-1.14], 1.03 [0.91-1.17], and 1.12 [0.95-1.31]); country-specific estimates ranged from 0.79 to 1.32, 0.80 to 1.35, and 0.80 to 1.47 at 1, 2, and 5 years, respectively. Among males, ADHD was associated with poorer adherence (1.09 [95% CI 1.00-1.20], 1.12 [1.00-1.24], and 1.23 [1.11-1.37] at 1, 2, and 5 years). Similar results were found for discontinuation. Among individuals with ADHD, ADHD medication use was consistently associated with better adherence over 1-, 2-, and 5-year follow-up periods (e.g., 5-year pooled OR 0.45 [0.30-0.67]); associations were directionally consistent across countries. INTERPRETATION: Among adults with type 2 diabetes, ADHD may not necessarily compromise antidiabetic medication adherence when appropriately managed in routine care. ADHD pharmacological treatment may support adherence among adults with comorbid ADHD and type 2 diabetes, although its causal effect requires further evaluation. FUNDING: EU Horizon 2020 Research and Innovation Programme.

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13. Zhu L, Wang L, Gu T, Chen W. Plasma polyunsaturated fatty acids and amino acids in children with attention-deficit hyperactivity disorder: correlations with clinical and cognitive features. Transl Pediatr. 2026; 15(8): 344.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity and impulsivity. Metabolic profiles of polyunsaturated fatty acids (PUFAs) and amino acids have been linked to neurodevelopmental processes associated with ADHD. This cross-sectional study aimed to compare plasma levels of PUFAs and amino acids between medication-naive children with ADHD and typically developing (TD) children, after adjusting for multiple confounding factors, and explore their correlations with clinical symptoms and cognitive function. METHODS: A total of 102 medication-naive children with ADHD and 91 TD children were enrolled. Plasma concentrations of four PUFAs and seven neuroactive amino acids were measured using liquid chromatography-tandem mass spectrometry. Group comparisons were performed using analysis of covariance adjusted for age, gender, body mass index (BMI), paternal education level, maternal education level, family annual income, only child status, and main caregiver of children. Correlation analyses and multiple testing corrections were also conducted. RESULTS: After adjustment for confounding factors, ADHD group had higher plasma glutamate (Glu) (median: 103.08 vs. 102.25 µmol/L, P=0.043). Tryptophan (Try) was positively correlated with the Swanson, Nolan, and Pelham rating scale version IV (SNAP-IV) inattention scores (r=0.209, P=0.03). γ-aminobutyric acid (GABA) was negatively correlated with full scale intelligence quotient (IQ) (r=-0.198, P=0.04), and eicosapentaenoic acid (EPA) was negatively correlated with Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) processing speed (r=-0.212, P<0.05). Glu and arachidonic acid (ARA) levels differed significantly across groups defined by hyperactivity-impulsivity severity (H=6.695, P=0.04; H=8.616, P=0.01). Boys had higher WISC-IV verbal comprehension (P=0.04). CONCLUSIONS: This study provides exploratory evidence of weak but significant correlations among plasma PUFAs, amino acids, clinical symptoms, and cognitive function in medication-naive children with ADHD. These preliminary findings support further investigation of peripheral metabolic profiles as potential phenotypic correlations rather than established biomarkers for ADHD.

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