Methylphenidate and atomoxetine are efficacious in Indian children with ADHD at lesser doses than previously used. Their efficacy and tolerability are comparable. TRIAL REGISTRATION NO.: CTRI/2011/08/001981.

Background:Oppositional defiant disorder (ODD) is frequently comorbid with attention deficit hyperactivity disorder (ADHD) and is associated with substantial functional impairments. Methylphenidate and atomoxetine are well-established drugs for the management of ADHD. Some studies from Western countries have reported these drugs to be effective in the management of ODD comorbid with ADHD. This study aimed to assess if methylphenidate and atomoxetine are efficacious in treating Indian children with ODD comorbid with ADHD.Subjects and Methods:In this prospective, open-label study, 37 patients of age 6–14 years with a diagnosis of ODD comorbid with ADHD randomly received either methylphenidate (dose 0.2–1 mg/kg/day) or atomoxetine (dose 0.5–1.2 mg/kg/day) for 8 weeks. Improvements in ADHD and ODD symptoms were assessed using Vanderbilt ADHD diagnostic parent rating scale (VADPRS).Results:At 8 weeks, there were statistically significant improvements in both ADHD and ODD symptoms in both methylphenidate and atomoxetine groups, as per VADPRS. The improvements produced and tolerability was comparable in the two groups. 80% of the patients from methylphenidate group and 64.3% patients from atomoxetine group ceased to fulfill the criteria for the presence of ODD at 8 weeks.Conclusions:Methylphenidate and atomoxetine are effective in the treatment of ODD comorbid with ADHD in short duration.

Background:Existence of attention deficit hyperactivity disorder (ADHD) in adults is scantily researched in India. There is dearth of information on prevalence of ADHD in college students worldwide. Further, fewer studies in the past have evaluated the impact of ADHD on the psychological well-being of college students.Aims:To study the prevalence of ADHD among college students and psychological problems related to ADHD.Design:Cross-sectional study.Subjects and Methods:A total of 237 students were recruited from various medical, engineering, and commerce and arts colleges of Chandigarh, India. They were administered the Adult ADHD Self Report Scale v1.1(ASRS) and the Wender Utah Rating Scale (WURS) to diagnose adult ADHD. To assess comorbidities; General Health Questionnaire-12 (GHQ); Zung Depression Rating Scale (ZDRS); Rosenberg's Self-Esteem Scale (RSES);and questions on emotional stability, social problems, and substance use (alcohol, tobacco, and cannabis) were administered on all participants.Results:A total of 13 students (5.48%) fulfilled the criteria for adult ADHD. These students experienced significantly higher emotional instability and low self-esteem than those without ADHD (N = 224). The occurrence of psychological problems, depression, social problems, and substance abuse was comparable in students with and without ADHD.Conclusions:ADHD is prevalent among the college students studying in the most competitive institutes as well. Students with ADHD experience higher emotional instability and poor self-esteem than others. It has little effect on their psychological well-being and social adjustment. Prompt detection and management of ADHD in college students may help them deal with these problems effectively.

Objectives: The present study was aimed to assess the level of perceived stress among doctors working in COVID-19 ward in a tertiary care medical college and hospital of North India and to find the association of stress with time spent in ward, age, and designation of the doctors. Material and Methods: It was a cross-sectional, Google-based survey conducted in October and November 2020. The form was circulated and recorded the sociodemographic data, time spent in the COVID-19 ward, etc. The perceived stress scale (PSS) was used to assess the level of stress. Appropriate statistical analysis was used and all ethical considerations were followed. Results: Mean PSS score of the sample was 22.22 ± 7.13. Twenty-five (10%) doctors reported low stress (mean PSS score 0–13). Moderate (mean PSS score 14-26) and high stress (mean PSS score >26) were found among 156 (62.4%) and 69 (27.6%) doctors, respectively. Perceived stress showed significant negative correlation with age and significant positive correlation with hours spent in COVID ward in a week. Senior residents and junior residents had significantly higher perceived stress than faculty (P - 0.001**). Nearly 50% of doctors (fairly often or very often) felt nervous and stressed, angered because they felt out of control, unable to control important things in their lives, and have been upset because of something that happened unexpectedly. About 40% felt (fairly often or very often) that they could not cope with all the things they had to do. Nearly one-third of doctors felt (fairly or very often) that difficulties were piling up so high that they could not overcome them. Conclusion: Doctors working in COVID-19 wards perceive considerable stress. Stress management should be an integral part of the curriculum of doctors so that they can serve the humanity efficiently and effectively during the pandemic and in future.

Background:Attention deficit hyperactivity disorder (ADHD) persists in a majority of adolescents. It has been reported that ADHD patients have poor social functioning and risk for developing co-morbid psychiatric illnesses.Aims:To determine the retention of diagnosis of ADHD and to assess social adjustment, academic functioning and co-morbidities at follow-up.Design:Retrospective cohort study.Materials and Methods:ADHD patients of 5-14 years of age who came to the out-patient department from 2005 to 2008 were contacted telephonically. Fifty one patients could be contacted. Parents of patients were interviewed using Vanderbilt ADHD Diagnostic Parent Rating Scale for diagnosing ADHD and co-morbidities. Social Adjustment Inventory for Children and Adolescent was administered for assessing their academic and social functioning. Chi square test, Mann–Whitney Test, Kruskal–Wallis Test, and Pearson's product moment correlations were used for statistical analysis.Results:At current assessment, out of 51 patients, 38 were still fulfilling diagnosis of ADHD. Of these, 21 were of inattention type, 3 were hyperactive, and 14 were of combined type. Social functioning and academic functioning were significantly better in those who currently did not fulfill the criteria for ADHD (N=13). Twelve patients developed features of oppositional defiant disorder (ODD)/conduct disorder (CD) at follow-up.Conclusions:ADHD persists in the majority of adolescents. Decline with age is seen more in hyperactive/impulsive symptoms than inattentive symptoms. Several adolescents also develop features of ODD/CD in addition to poorer functioning. Continuation of treatment is crucial to prevent such consequences.