Background. Numerous clinical trials demonstrate the efficacy of medication and behavioral treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) in children, but provision of behavioral treatment for ADHD is limited in community clinics and only the pharmacological treatment is the standard care for children with ADHD. The current study evaluated the treatment effectiveness of combining psychosocial treatment to methylphenidate and to compare this combined treatment with medication alone in treating ADHD in children of a community mental health center in Hong Kong. Psychosocial treatment consisted of parent training and child intervention. The treatment group for children was a 24-week problem solving, anger coping, and social skills training program. Parent training consisted of 18 weekly sessions, highlighting parenting as an integration of elements of cognition, emotion, and behavior, as well as introducing effective parenting techniques based on social learning principles. Method. A group of 146 consecutive child patients with ADHD symptoms attending Yaumatei Child Psychiatric Center were invited for screening their eligibility of participating in this study. A randomized group comparison design was used with two treatment conditions (medication-only; combined medication and psychosocial treatment) and four assessment time points. Ninety eligible child-parent dyads were randomly allocated to the combined treatment condition or medication-only condition. Treatment outcomes were assessed in multiple domains at pre-intervention and post-intervention, and at 6-month and 12-month follow-ups. Data was analyzed through intent-to-treat mixed-effects regression model. / Conclusions. The combined treatment condition not only yielded significantly greater benefits than the medication-only condition on primary ADHD symptoms, but also other advantages in terms of conduct problem and adaptive functioning outcomes. / Results. Regarding ADHD symptoms, children in combined treatment condition showed significantly greater improvement than those given medication alone at post-treatment assessment. Combined treatment also proved better than medication alone in several other domains, such as oppositional behavior, a child's performance on computerized test, parenting behavior, and parental accurate knowledge of ADHD. Parental treatment-related attributions were also found to be changing over the course of treatment. Follow-up assessments revealed that children in the combined treatment condition maintained greater reduction in oppositional behavior one year after the completion of psychosocial treatment. / So Yuk-chi. / "May 2005." / Adviser: Patrick W. L. Leung. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 4119. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 222-247). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

The catechol-O-methyltransferase (COMT) gene is the predominant means of dopamine deactivation within the prefrontal cortex (PFC), a brain locus implicated in Attention deficit/hyperactivity disorder (ADHD). Dopamine dysregulation is a significant contributor to the pathophysiology of ADHD and Methylphenidate (MPH), an effective treatment for ADHD, and acts at least in part, through modulation of dopamine levels in the PFC. Thus, we tested the hypothesis that the Catechol-O-Methyltransferase (COMT) Val108/158 Met polymorphism modulates behavioral dimensions relevant for ADHD and/or response of these behavioral dimensions to MPH and/or neuropsychological functions considered relevant for ADHD. No genotype or genotype by treatment interaction effects were observed for behavioral response to MPH. No genotype effects were observed using the family-based approach. Marginal genotype effects were observed between the Met/Met genotype and some but not all aspects of executive functioning. Overall, these results do not support the implication of the COMT Val108/158 Met polymorphism in ADHD, ADHD relevant behaviours or response to methylphenidate, but weakly implicate COMT gene in some aspects of executive functions in children with ADHD. Given that gene effects on behaviours are likely to be very small, a much large sample would be needed in order to establish these results, both negative and positive, with better confidence.

No description available.