This study suggests that atomoxetine is non-inferior to methylphenidate in the improvement of ADHD symptoms in paediatric outpatients. Although both of the drugs were well tolerated, atomoxetine was associated with a higher incidence of TEAEs than methylphenidate.
IntroductionDuring the last decade, an increase in children and adolescents' completed suicide has been reported nationally and internationally. Psychiatric disorders, family circumstances and sociocultural influences are associated risk factors. ObjectiveTo describe suicidal tendency in children and adolescents during 1998-2011 in Mexico. MethodNational Data Health Records on mortality in children and adolescents younger than 20 years between from the year 1998 to 2011 were analyzed. Rates and indices were calculated using population projections from the National Population Council. The Truncated Trend of Standardized Mortality, change rate and the Years of Life Lost Index were calculated. ResultsIn the 5 to 19 year group population, the completed suicide deaths accounted for 7% of the external cause injuries; the male-female ratio was 2.2:1. Overall, the tendency increased from 18.5 to 31.9 by 10 6 . Hanging was the method most often employed. The percentage of change was greater in women with 6%. The county with the highest trend was Hidalgo with 17.2%. In 2011, Tabasco was the county with the highest index of years lost by suicide with 67%. Discussion and conclusionThe increase in completed suicide in the adolescent's group, the hanging method, the low socioeconomic status and the problems with the registry's death system are data that have also been reported by other authors. The suicide mortality trend has increased. Hanging was the preferred method nationally. A deficient recording system remains an unresolved issue.Key words: Suicide, adolescent, trends, methods, Mexico. RESUMEN IntroducciónDurante la última década se ha reportado un incremento de suicidios en niños y adolescentes a nivel nacional e internacional. Los factores de riesgo asociados son trastornos psiquiátricos, circunstancias familiares e influencias socioculturales. ObjetivoDescribir el comportamiento del suicidio consumado en menores de 20 años en el periodo 1998-2011 en México.
We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6–15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: “Lower Cognitive Profile” (LCP), “Lower Working Memory” (LWM), “Higher Working Memory” (HWM), “Higher Cognitive Profile” (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.
Objective. This study aims to generate evidence on intellectual development disorders (IDD) in Mexico. Materials and methods. IDD disease burden will be estimated with a probabilistic model, using population-based surveys. Direct and indirect costs of catastrophic expenses of families with a member with an IDD will be evaluated. Genomic characterization of IDD will include: sequencing participant exomes and performing bioinformatics analyses to identify de novo or inherited variants through trio analysis; identifying genetic variants associated with IDD, and validating randomly selected variants by polymerase chain reaction (PCR) and sequencing or real-time quantitative PCR (qPCR). Delphi surveys will be done on best practices for IDD diagnosis and management. An external evaluation will employ qualitative case studies of two social and labor inclusion programs for people with IDD. Conclusions. The results will constitute scientific evidence for the design, promotion and evaluation of public policies, which are currently absent on IDD. ResumenObjetivo. Esta investigación busca generar evidencia sobre trastornos del desarrollo intelectual (TDI) en México. Material y métodos. La carga de la enfermedad por TDI se estimará con un modelo probabilístico usando encuestas poblacionales. Se estimarán costos directos e indirectos de gastos catastróficos de familias con un integrante con TDI. La caracterización genómica de TDI incluirá secuenciar exomas, realizar análisis bioinformático para identificar variantes de novo o heredadas a través de análisis de tríos, identificar variantes genéticas asociadas con TDI, y validar variantes aleatoriamente seleccionadas con reacción en cadena de polimerasa y secuenciación o qPCR. Se harán encuestas Delphi sobre mejores prácticas de diagnóstico y manejo de TDI. Una evaluación externa empleará estudios cualitativos de caso de dos programas de inclusión social y laboral para personas con TDI. Conclusiones. Los resultados serán evidencia científica que podrá ser la base para el diseño, promoción y evaluación de políticas públicas, actualmente ausentes para TDI.Palabras clave: trastornos del desarrollo intelectual; TDAH; trastorno autista; gasto; México
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