Mateu Servera
Publications
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1.23Impact points
[The influence of different diagnostic criteria and the culture on the prevalence of attention deficit hyperactivity disorder].
Revista de neurologia. 03/2011; 52 Suppl 1:S109-17.
To compare the prevalence of attention deficit disorder and hyperactivity disorder (ADHD) using different diagnostic criteria (DSM-IV-TR versus ICD-10) and two specific scales based on DSM IV (ADHD-IV Rating Scales and SNAP-IV p90) in school-age children (6-12 years). . A population-based study appl... [more] To compare the prevalence of attention deficit disorder and hyperactivity disorder (ADHD) using different diagnostic criteria (DSM-IV-TR versus ICD-10) and two specific scales based on DSM IV (ADHD-IV Rating Scales and SNAP-IV p90) in school-age children (6-12 years). . A population-based study applying stratified multistage sample design (by courses), proportional to the type of school (public, private and enterd) and demographic areas (rural, city). From a target population of approximately 30 000 subjects a sample of 1509 children. The prevalence rates of ADHD were within the expected range: 3.6% (95% CI = 2.6-4.6%) using DSM-IV criteria, 1.2% (95% CI = 0.6-1.8%) using the ICD-10, 4.6% (95% CI = 3.5-5.7%) using ADHD Rating Scales-IV with a cut-off of 90 percentile 4.11% (95% CI = 3.2-5.1%) using the scale SNAP-IV. However, we found some differences in reference to gender and subtype according to the criteria and instrument used. We propose to use standard scales, scale by age, sex and evaluator that includes maturation and sociocultural factors help us draw conclusions about the true prevalence of ADHD.
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1.23Impact points
[Attention deficit disorder and hyperactivity: a pattern of evolution?].
Revista de neurologia. 03/2010; 50 Suppl 3:S143-7.
When the frequency of a gene in the general population exceeds 1%, is not considered a random mutation but a mutation that has been positively selected during evolution. The high prevalence of attention deficit/hyperactivity disorder (ADHD) from 5-10% and its association with the seven-repeat allele... [more] When the frequency of a gene in the general population exceeds 1%, is not considered a random mutation but a mutation that has been positively selected during evolution. The high prevalence of attention deficit/hyperactivity disorder (ADHD) from 5-10% and its association with the seven-repeat allele of DRD4, which is positively selected in evolution, raising the possibility that ADHD increases the reproductive fitness of the individual and/or group. One of the main characteristics of ADHD is its diversity and is a well recognized fact that diversity confers many benefits to a population (eg. immunity). This article discusses the various studies that support this hypothesis and offers further explanations on the prevalence, age distribution and sex distribution of the severity and heterogeneity of ADHD. It is possible that the presence of altered gene combinations, as in ADHD, can bring concrete benefits to society but are detrimental to the individual.
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2.91Impact points
Understanding trait and sources effects in attention deficit hyperactivity disorder and oppositional defiant disorder rating scales: mothers', fathers', and teachers' ratings of children from the Balearic Islands.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 01/2010; 39(1):1-11.
Confirmatory factor analysis was used to model a multitrait (attention deficit hyperactivity disorder [ADHD]-inattention, ADHD-hyperactivity/impulsivity, oppositional defiant disorder [ODD]) by multisource (mothers, fathers, and teachers) matrix to determine the convergent and discriminant validity ... [more] Confirmatory factor analysis was used to model a multitrait (attention deficit hyperactivity disorder [ADHD]-inattention, ADHD-hyperactivity/impulsivity, oppositional defiant disorder [ODD]) by multisource (mothers, fathers, and teachers) matrix to determine the convergent and discriminant validity of ratings by mothers, fathers, and teachers. Participants were 1,749 elementary school children from the island of Majorca in the Balearic Islands. The results showed good convergent validity for the measures for mothers' and fathers' ratings with moderate support for the measures discriminant validity for mothers' and fathers' ratings. There was no convergent and discriminant validity, however, between mothers' and teachers' as well as fathers' and teachers' ratings for the ADHD-IN, ADHD-HI, and ODD measures. The results provide additional evidence that the construct validity of parent and teacher ADHD/ODD rating scales is mostly parent (home) and teacher (school) specific.
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[What combination of symptoms according to parents and teachers would be more reliable for the diagnosis of ADHD?]
Anales de pediatria (Barcelona, Spain : 2003). 07/2009;
INTRODUCTION: The polythetic method used in the DSM is the one proposed traditionally for the diagnosis of Attention Disorders with or without Hyperactivity (ADHD). However, it is possible that the approach which aggregates any combination of 6 items won't be the optimal method to establish a di... [more] INTRODUCTION: The polythetic method used in the DSM is the one proposed traditionally for the diagnosis of Attention Disorders with or without Hyperactivity (ADHD). However, it is possible that the approach which aggregates any combination of 6 items won't be the optimal method to establish a diagnosis of ADHD, and that the different combinations may not be the same as regards to their ability to predict ADHD. AIM: Determine which combinations of items of DuPaul's inattention and hyperactivity-impulsivity scales (from parent and teacher versions), are the most effective to predict or rule out a diagnosis of ADHD. RESULTS: Not every combination of items from parents and teachers obtained the same predictive value. All of them offered high levels of specificity, but had low sensivity; that is to say, the combinations were more effective and reliable for ruling out the disorder than predicting it. CONCLUSIONS: Data show that not every combination of ADHD items has the same predictive value and, therefore, the well-known polythetic method is disputable. The highest predictive value combinations, limitations of the study, and future lines of investigation are analyzed.
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1.23Impact points
[Oppositional defiant disorder: aspects related to sex differences and informant]
Revista de neurologia. 03/2009; 48 Suppl 2:S17-21.
INTRODUCTION: Oppositional defiant disorder (ODD) is one of the most common externalizing disorders in childhood. ODD prevalence global rates vary from 2% to 16%. Along with conduct disorder and attention deficit disorder, ODD is one of the leading reasons for referral to neuropediatric and psychiat... [more] INTRODUCTION: Oppositional defiant disorder (ODD) is one of the most common externalizing disorders in childhood. ODD prevalence global rates vary from 2% to 16%. Along with conduct disorder and attention deficit disorder, ODD is one of the leading reasons for referral to neuropediatric and psychiatric services. Even though ODD has recognized clinical importance, key aspects of its conceptualization and prevalence in childhood and adolescence remain uncertain. DEVELOPMENT: We examine previous research findings of ODD prevalence and analyze sex differences and differences according to informants. CONCLUSIONS: ODD prevalence rates present high variability. A number of studies suggest that ODD is more common in boys than in girls. Nevertheless, some authors point that this sex differences may be due to methodological bias. We recommend the validation of an ODD scale that has into consideration the following aspects: level of the subject's development (age), gender and environment.
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1.23Impact points
[Soft neurological signs: are they of any value in the assessment and diagnosis of attention deficit hyperactivity disorder?]
Revista de neurologia. 02/2008; 46 Suppl 1:S51-4.
INTRODUCTION: The association between difficulties on motor skills, visual-hand coordination and excess motor activity was described previously of being established the attention-deficit/hyperactivity disorder (ADHD) as a diagnostic category. These disorders have been grouped under different termino... [more] INTRODUCTION: The association between difficulties on motor skills, visual-hand coordination and excess motor activity was described previously of being established the attention-deficit/hyperactivity disorder (ADHD) as a diagnostic category. These disorders have been grouped under different terminologies, being one of them the soft neurological signs (SNS). Traditionally, the European scientific community has put more attention on the SNS than the American one. However, nowadays there are a lot of neuropediatrician and community pediatrician that continue to think that those deficits, together with inattention and hyperactivity, form part of the same disorder. DEVELOPMENT: In this article we have tried to do a neurobiological revision of the movement and the possible relationship between motor problems and cognitive processes from different points of view: neuroanatomical, findings on different clinical examination tests and neuropsychological experimental models. CONCLUSION: Most of the revised articles conclude that the SNS prevalence is greater in ADHD children compared with control. Therefore we recommend to include the SNS in the evaluation and diagnosis protocols of these disorders in order to improve the sensitivity and specificity of the diagnosis and to be able to evaluate the real needs of the ADHD patients.
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1.23Impact points
[The predictive value of DSM-IV criteria in the diagnosis of attention deficit hyperactivity disorder and its cultural differences]
Revista de neurologia. 04/2007; 44 Suppl 2:S19-22.
INTRODUCTION: The most common method used to diagnose attention deficit/hyperactivity disorder (ADHD) is based on the Diagnostic and statistic manual of mental disorders, 4th edition (DSM-IV) criteria. Nevertheless, it is more likely that the categorical system postulated by DSM-IV is not the most a... [more] INTRODUCTION: The most common method used to diagnose attention deficit/hyperactivity disorder (ADHD) is based on the Diagnostic and statistic manual of mental disorders, 4th edition (DSM-IV) criteria. Nevertheless, it is more likely that the categorical system postulated by DSM-IV is not the most appropriate method as it does not consider the possible differences between the diagnostic capacity of the 18 proposed criteria. AIM. To analyze the predictive power of each DSM-IV diagnostic symptoms/criteria for ADHD using DuPaul's ADHD Parent and Teacher Rating Scales. PATIENTS AND METHODS: In a prospective, poblational study to evaluate the prevalence of ADHD the positive predictive power of each item was analyzed for each subtype and informant. A kappa index was applied for positive predictive power to correct the number of accurate predictions based on chance factors, and a ranking of items was established to determinate which ones offered the highest predictive power, comparing parent and teacher ratings. RESULTS: The results suggest that not all DSM-IV criteria are equal with regard to their ability to predict ADHD. The predictive power varies as a function of the informant. Parent and teachers agreed more on hyperactivity and impulsivity items, and showed more significant differences with regard to the American sample. CONCLUSIONS: The approach that aggregates any combination of items will not be the more effective strategy for ruling in a diagnosis of ADHD. To improve the clinical value of these scales making item combinations is recommended, the ones that will have attached a higher clinical weight for ruling in a diagnosis of ADHD.
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Análisis de dos estrategias de enseñanza-aprendizaje en la docencia de Terapia de Conducta
International Journal of Clinical and Health Psychology. 01/2007;
Este estudio cuasi-experimental analiza la eficacia de una metodología docente basada en seminarios y evaluación continua (grupo S) respecto a la basada en clases magistrales y una única prueba de evaluación final (grupo M), y la disposición del alumnado a seguir estas metodologías y su grado de imp... [more] Este estudio cuasi-experimental analiza la eficacia de una metodología docente basada en seminarios y evaluación continua (grupo S) respecto a la basada en clases magistrales y una única prueba de evaluación final (grupo M), y la disposición del alumnado a seguir estas metodologías y su grado de implicación en la asignatura Terapia de Conducta de los estudios de Psicología. Los alumnos del grupo S obtuvieron un mayor rendimiento académico que los estudiantes que no optaron por esa metodología docente, tanto en lo que respecta a la calificación media obtenida como al porcentaje de aprobados. La distribución del alumnado en la selección de grupo fue bastante homogénea aunque un porcentaje importante de alumnos no completó el curso con la metodología elegida inicialmente. Los alumnos del grupo S dedicaron más tiempo a la preparación de la asignatura. No se encontró relación significativa entre el tiempo de estudio y el rendimiento académico. Los resultados se discuten en el marco de la adaptación al Espacio Europeo de Educación Superior.
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Children Sustained Attention Task (CSAT): Normative, reliability, and validity data
International Journal of Clinical and Health Psychology. 01/2006;
La atención sostenida ha demostrado estar relacionada con diferentes problemas clínicos, tales como el trastorno por déficit de atención e hiperactividad (TDAH) y los trastornos de aprendizaje. La atención sostenida puede estudiarse desde dos paradigmas relacionados pero independientes representados... [more] La atención sostenida ha demostrado estar relacionada con diferentes problemas clínicos, tales como el trastorno por déficit de atención e hiperactividad (TDAH) y los trastornos de aprendizaje. La atención sostenida puede estudiarse desde dos paradigmas relacionados pero independientes representados por los tests de ejecución continua (CPT) y las tareas de vigilancia. La Tarea de Atención Sostenida en la Infancia (CSAT) es una tarea de vigilancia. El propósito de este estudio instrumental es analizar algunas de sus propiedades psicométricas, relacionadas con la estandarización, fiabilidad y validez de constructo. La CSAT se administró a una muestra de 584 niños de entre 6 y 11 años, que fueron clasificados en cuatro grupos de edad. Las variables dependientes fueron el rendimiento académico y las medidas de inatención y sobreactividad de la Edelbrock¿s Child Attention Problems Scale. Los resultados muestran que con la edad mejoran todas las puntuaciones de la CSAT, sin que se observen diferencias por género. La fiabilidad test-retest fluctuó entre 0,59 y 0,88. Las medidas de la CSAT (especialmente los aciertos, d¿ y A¿), tal y como se hipotetizó, mostraron más implicaciones con la inatención y el rendimiento que con la sobreactividad. En resumen, la CSAT ha demostrado buenos índices psicométricos y se propone su utilización en futuros estudios clínicos o aplicados. KEYWORDS. Atención sostenida. Tests de ejecución continua. Niños. Estudio instrumental. RESUMO. Tem sido demonstrado que a atenção sustentada está relacionada com diferentes problemas clínicos, tais como a perturbação por défice de atenção e hiperactividade (TDAH) e as perturbações de aprendizagem. A atenção continuada pode estudar-se a partir dos paradigmas relacionados mas independentes representados pelos testes de execução contínua (CPT) e as tarefas de vigilância. A tarefa de Atenção Continuada na Infância (CSAT) é uma tarefa de vigilância. O propósito deste estudo instrumental é analisar algumas das suas propriedades psicom
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1.23Impact points
[The prevalence of attention deficit hyperactivity disorder]
Revista de neurologia. 02/2005; 40 Suppl 1:S11-5.
INTRODUCTION: Hyperactivity is a common, genetically-based disorder in childhood in which a number of neurological and psychological factors that give rise to attentional disorders, impulsiveness and motor overactivity are involved. DEVELOPMENT: The prevalence rate of attention deficit hyperactivity... [more] INTRODUCTION: Hyperactivity is a common, genetically-based disorder in childhood in which a number of neurological and psychological factors that give rise to attentional disorders, impulsiveness and motor overactivity are involved. DEVELOPMENT: The prevalence rate of attention deficit hyperactivity disorder (ADHD) is a controversial matter. Although the DSM-IV gives an interval of between 3 and 5%, which is probably the value that is most widely accepted by the scientific community, there is in fact a very high degree of variability. According to different authors, an interval of 2-30% is obtained in the general population. In Anglo-Saxon countries the most commonly accepted prevalence of this entity is 5%, but few studies have been conducted in our country. In an epidemiological study with a community-based sample extracted by multistage, stratified sampling in school-age children on the island of Majorca, the estimated prevalence of ADHD was 4.7%. The authors consider aspects concerning the prevalence of ADHD and subtypes by ages, sex, in both the clinical and community environments. CONCLUSIONS: The analysis of these data will enable us to compare the different evaluation methods used and to draw conclusions about screening and early detection methods.
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[Attention deficit disorder and hyperactivity. An overview]
Anales de pediatría (Barcelona, Spain : 2003). 10/2003; 59(3):225-8.
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1.23Impact points
[ADHD Rating Scale-IV in a sample of Spanish schoolchildren: normative data and internal consistency for teachers and parents]
Revista de neurologia. 45(7):393-9.
INTRODUCTION: The ADHD Rating Scale-IV (ADHD RS-IV) is one of the most use scales for attention deficit hyperactivity disorder (ADHD), because has cut-off point regarding age, gender and setting, but the normalization data is based on American school samples. AIM: Evaluation of cut-off point of ADHD... [more] INTRODUCTION: The ADHD Rating Scale-IV (ADHD RS-IV) is one of the most use scales for attention deficit hyperactivity disorder (ADHD), because has cut-off point regarding age, gender and setting, but the normalization data is based on American school samples. AIM: Evaluation of cut-off point of ADHD-RS-IV for parents and teachers in a Spanish sample. SUBJECTS AND METHODS: The study used the score of ADHD-RS-IV from a prevalence study of ADHD in school children of 6-12 years. Using an intrasubject design between the three evaluators (parents and teachers) and the results of each subscale (IN, H/I, and TOT) according to gender and age factors. Then, we analyzed the reliability and internal consistency for each subscale and evaluator. RESULTS: There are no significant differences between the father and the mother; but there are between teachers, and father and/or mother scores. In relation to gender factor, boys' score is higher on inattention and hyperactivity-impulsivity than girls'. Our results show a reversal tendency in comparison with the American samples, in our case parents' scores were significantly higher than teachers'. CONCLUSION: The use and normalization of the ADHD RS-IV will need to account not only for age, gender and setting but also for socio-cultural aspects.
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1.23Impact points
[Methylphenidate in the treatment of attention-deficit/hyperactivity disorder: are we achieving an adequate clinical practice?]
Revista de neurologia. 43(12):705-14.
INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is the most frequent behavioural disorder in infancy and methylphenidate is the most widely used medication. AIM. To analyze if the use of methylphenidate allows a good clinical practice in ADHD in terms of efficacy, effectiveness, effici... [more] INTRODUCTION: Attention-deficit/hyperactivity disorder (ADHD) is the most frequent behavioural disorder in infancy and methylphenidate is the most widely used medication. AIM. To analyze if the use of methylphenidate allows a good clinical practice in ADHD in terms of efficacy, effectiveness, efficiency and safety. MATERIALS AND METHODS: Systematic review of the articles about therapeutic management of ADHD with methylphenidate published in secondary and primary publications and critical appraisal by means of methodology of the Evidence-Based Medicine Working Group. RESULTS: The main secondary information is found in the Cochrane Library, but we also detect relevant articles in Pubmed, mainly published in Journal of the American Academy of Child and Adolescent Psychiatry and Pediatrics. There are many randomized clinical trials with methylphenidate (immediate-release and extended-release methylphenidate) and some systematic review and/or meta-analysis, but these trials have some limitations (in relation to patients, interventions and outcomes) and publication bias. CONCLUSIONS: From the evidence-based analysis (and from the experience) we detect good scientific evidence that methylphenidate improve target outcomes in ADHD in the short and half-term in children (mainly 6-12 years). The treatment algorithm advises to start with methylphenidate (immediate or extended-release methylphenidate, in relation to cost-benefit parameters); when there is not response (between 10-30% of patients) or evidence of relevant secondary effects, we could consider the use of atomoxetine. There are many questions to solve based on better clinical trials: the efficacy and safety of methylphenidate in very young children and adolescents, long-term effects and the duration of the treatment.
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1.23Impact points
[Estimation of the prevalence of attention deficit hyperactivity disorder among the standard population on the island of Majorca]
Revista de neurologia. 44(1):10-4.
AIM: To determine the rate of prevalence of attention-deficit/ hyperactivity disorder (ADHD) in children of school age (6-11 years) in the Island of Mallorca. SUBJECTS AND METHODS: The epidemiological study was conducted using a community sample extracted by means of multi-stage stratified sampling ... [more] AIM: To determine the rate of prevalence of attention-deficit/ hyperactivity disorder (ADHD) in children of school age (6-11 years) in the Island of Mallorca. SUBJECTS AND METHODS: The epidemiological study was conducted using a community sample extracted by means of multi-stage stratified sampling according to areas (rural, city and touristy) and schooling (public, private and concerted) and consisted in 1,509 children of both sexes. The ADHD Rating Scales-IV (ADHD RS-IV) for home and school setting were used to collect data. The optimal approach to do a diagnostic evaluation, according with the literature, was using a cut-off point of 90 centil. RESULTS: The estimated prevalence of ADHD was 4.57% (CI at 99%: 3.0-5.8%) and we also obtained 1.26% for the hyperactive subtype, 1.06% for the disattentional subtype, and 2.25% for the combined subtype. Contrary to what was expected, prevalence was higher for females but no statistically significant. There were no statistically significant differences between levels, schools or areas. CONCLUSIONS: The estimates for prevalence found in this study are consistent with those reported in the literature (between 3-5%). Using the ADHD rating scale which has different cut-off point regarding age, sex and setting and the fact that it was a poblational based study could explain the higher prevalence in the females. We propose a normalization of the scales in our area in other to confirm our findings.
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L'avaluació de la qualitat docent a la Universitat de les Illes Balears
Arc, L' : quadern informatiu de l'Institut de Ciències de l'Educació de la Universitat de les Illes Balears; Vol.: 2.
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Evaluación de procesos cognitivos a lo largo de la escolarización
Educació i Cultura : revista mallorquina de pedagogia; Vol.: 7.
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1.23Impact points
[Attention deficit hyperactivity disorder: the state of the matter and further research approaches]
Revista de neurologia. 46(6):365-72.
AIM: This paper is a review on the state of affairs of attention deficit hyperactivity disorder. DEVELOPMENT: In the first section, the authors review the limitations and controversies in the fields of the prevalence, etiology, diagnostic criteria and comorbidities. In the second part, there is an u... [more] AIM: This paper is a review on the state of affairs of attention deficit hyperactivity disorder. DEVELOPMENT: In the first section, the authors review the limitations and controversies in the fields of the prevalence, etiology, diagnostic criteria and comorbidities. In the second part, there is an update of the latest findings in the field of the neurobiological bases, the genetic etiology, the relevance of the evaluation of the executive functions and the effectiveness of drug therapies, behavioral and others alternatives therapies. The authors have selected the most relevant recently published bibliography and addressed in a schematic way, disputes or outstanding issues with a greater emphasis on the lines of research more relevant in the near future.
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1.23Impact points
[Barkley's model of self-regulation applied to attention deficit hyperactivity disorder: a review]
Revista de neurologia. 40(6):358-68.
AIM: The aim of this study was to carry out a review of Barkley's model of self-regulation and executive functions (EF) applied to attention deficit hyperactivity disorder (ADHD). DEVELOPMENT AND CONCLUSIONS: Our starting point was the discrepancy between the description and the explanation of t... [more] AIM: The aim of this study was to carry out a review of Barkley's model of self-regulation and executive functions (EF) applied to attention deficit hyperactivity disorder (ADHD). DEVELOPMENT AND CONCLUSIONS: Our starting point was the discrepancy between the description and the explanation of the disorder; that is to say, on the one hand important advances have been made from the applied point of view, but on the other hand we still do not have an overall explanation of the problem. The causes of ADHD are then reviewed as regards both specific aetiological factors and the wider reaching explanatory models. In this latter case, as antecedents and contributions prior to the model of self-regulation, we examine Douglas's attentional model and three models based on the concept of behavioural inhibition: Quay's neurobehavioural, Schachar's competitive, and Sergeant and van deer Meere's energetic models. Barkley's model was initially based on 'behavioural inhibition', but eventually the limitations that were detected and new lines of research led him to advance towards self-regulation. The main components of the model are reviewed: behavioural inhibition processes, the very concept of self-regulation/self-control, the EF involved, and motor control. The model is applied to the behaviour and characteristics of children with ADHD, and its implications in the fields of evaluation and treatment are discussed. Finally, we outline some of its main controversies and, in the conclusions, its strong and weak points are highlighted.
Following (3)
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Jordi Llabres
Universidad de las Islas Baleares -
Josep A. Pérez Castelló
Universidad de las Islas Baleares
