 |
Faculty |
 |
Statement of Need |
 |
Activity Goal |
 |
Learning Objectives |
 |
Target Audience |
 |
Financial Support |
 |
Credit Information |
neuroscienceCME Journal Club
Premiere Date: Monday, November 16, 2009
Click here to access additional resources mentioned in the live broadcast.This activity offers CE credit for:
All other clinicians will either receive a CME Attendance Certificate or may choose any of the types of CE credit being offered.
- Physicians (ACCME/AMA PRA Category 1)
- Nurses (CNE)
- Pharmacists (ACPE)
- Psychologists (APA)
Credit Expiration Date:
Tuesday, November 16, 2010
Faculty
Robert L. Findling, MD (Guest Host)
Professor of Psychiatry & Pediatrics
Case Western Reserve University
Director, Child and Adolescent Psychiatry
University Hospitals Case Medical Center
Cleveland, OH
Matthew Parvin, MD (Featured Author)
ABPN Board-Certified Psychiatrist
Clinical Assistant Professor
University of Illinois Chicago Medical School
Department of Psychiatry
Medical Director Family Behavioral Health
Chicago, ILStatement of Need
Attention-deficit hyperactivity disorder (ADHD) affects 8% of school age children. It presents with symptoms of inattention, hyperactivity/impulsivity, or both. Currently, three subtypes of ADHD are defined: ADHD inattentive (ADHD/I), ADHD hyperactive/impulsive (ADHD/H) and ADHD combined (ADHD/C). However, in the last decade heated debate has emerged that questions how this disorder should be conceptualized, defined, and categorized. Key questions have been: Is it a category or a continuum? and How do comorbidities relate to currently defined subtypes? In these interactive, evidence-based neuroscienceCME Journal Club sessions, the faculty will explore new data that may re-focus how we view ADHD subtypes. Such exploration will allow clinicians to anticipate how developers of the DSM-V might revise ADHD diagnostic criteria. As a result, clinicians will be in a position of opportunity to achieve better individualization of therapy.
- Faraone SV, Biederman J, Friedman D. Validity of DSM-IV subtypes of attention-deficit/hyperactivity disorder: a family study perspective. J Am Acad Child Adolesc Psychiatry 2000;39:300-307.
- Thapar A, Lewis G. Should we be rethinking how we assess and manage ADHD? J Am Acad Child Adolesc Psychiatry 2009;48:1051-1052.
Featured Article: Mayes SD, Calhoun SL, Bixler EO, et al. ADHD subtypes and comorbid anxiety, depression, and oppositional-defiant disorder: differences in sleep problems. J Pediatr Psychol 2009;34(3):328-337.
View Abstract
Summary:
The Clinical Questions
How does ADHD subtype, presence of comorbid conditions, and ADHD medication use influence sleep in children with ADHD-C and ADHD-I?
Why We Asked It
Parent-reported sleep complaints are common among parents of children with ADHD and can represent a clinical challenge. These sleep problems are often ascribed by parents to their child being on ADHD medications. Neuropsychiatric comorbid conditions are common among children with ADHD and may impact sleep. Other groups have investigated sleep in children with ADHD; however very few have employed a larger sample size and assessed the contribution of comorbid conditions.
How We Approached the Question
We looked at 681 consecutive referrals to our child psychiatry clinic who were diagnosed with ADHD-C or ADHD-I, had normal intelligence, and may or may not have had a neuropsychiatric comorbidity. This ADHD sample was compared with 135 control children who were recruited via questionnaires sent to parents of children enrolled at elementary schools local to our child psychiatry clinic. Data on sleep was collected using parent ratings on the sleep problems subscale of the Pediatric Behavior Scale (PBS).
What We Found
Increased ADHD severity was associated with increased sleep problems. ADHD-C was associated with more sleep problems that ADHD-I, which was similar to controls. Daytime sleepiness was less in ADHD-C, even though those children slept less and had more sleep problems. Comorbid anxiety and depression worsened sleep problems; while ODD and enuresis did not. Medication-treated children had more trouble falling asleep, compared to untreated children, but this can be explained by the fact they had more severe ADHD.
The Clinical Application
Be cautious to avoid underestimating the significance of sleep problems in children with ADHD.
Diligent evaluation of parent-reported sleep problems in children with ADHD is warranted and addressing these may enhance compliance and adherence.
Parents and teachers should recognize that daytime sleepiness and daydreaming, especially in school-aged girls, is a reason to think about the possibility of ADHD.Activity Goal
To translate new evidence in the literature into improved diagnosis of ADHD in children and adolescents.
Learning Objectives
At the end of this CE activity, participants should be able to:
- Interpret data supporting that sleep problems in children with ADHD vary in incidence and severity based on ADHD subtype and associated comorbidities.
- Identify clinical implications associated with variable sleep problems in children with ADHD.
The following learning objectives pertain only to those requesting CNE credit:
- Review data supporting sleep problems in children with ADHD vary in incidence and severity based on ADHD subtype and associated comorbidities.
- Identify clinical implications associated with variable sleep problems in children with ADHD.
- Review conclusion from the study presented by the faculty.
Target Audience
Physicians, physician assistants, nurse practitioners, nurses, psychologists, pharmacists, and other healthcare professionals interested in diagnosis and management of ADHD in children and adolescents.
Financial Support
This educational activity is supported by an independent medical educational grant from Shire.
Credit Information
CME Credit (Physicians):
CME Outfitters, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. CME Outfitters, LLC, designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Note to Physician Assistants: AAPA accepts Category I credit from AOACCME, Prescribed credit from AAFP, and AMA Category I CME credit for the PRA from organizations accredited by ACCME.CNE Credit (Nurses):
This continuing nursing education activity was approved by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
It has been assigned approval code 7ZDT2R-10. 1.0 contact hours will be awarded upon successful completion.CEP Credit (Psychologists):
CME Outfitters is approved by the American Psychological Association to sponsor continuing education for psychologists. CME Outfitters maintains responsibility for this program and its content. (1.0 CE credits)
CPE Credit (Pharmacists):
CME Outfitters, LLC, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. 1.0 contact hours (0.1 CEUs)
Universal Program Number: 376-000-09-030-L01-P (Live) 376-000-09-030-H01-P (Recorded)
Activity type: Knowledge-based
Post-tests, credit request forms, and activity evaluations can be completed online at www.neuroscienceCME.com (click on the Testing/Certification link under the Activities tab–requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neuroscienceCME.com/technical.asp.Disclosure Declaration
It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.
Dr. Findling has disclosed that he receives or has received research support, acted as a consultant and/or served on a speaker's bureau for Abbott Laboratories, Addrenex Pharmaceuticals, Inc., AstraZeneca Pharmaceuticals LP, Biovail Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Forest Laboratories, Inc., GlaxoSmithKline, Johnson & Johnson Pharmaceutical Research & Development, L.L.C., KemPharm Inc., Eli Lilly and Company, H. Lundbeck A/S, Neuropharm Group plc, Novartis Pharmaceuticals Corporation, Organon Pharmaceuticals USA Inc., Otsuka America Pharmaceutical, Inc., Pfizer Inc., Sanofi-Aventis, Sepracor Inc., Shire Pharmaceuticals, Solvay Pharmaceuticals, Inc., Supernus Pharmaceuticals, Inc., Validus, and Wyeth Pharmaceuticals.
Dr. Parvin has no disclosures to report.
Unlabeled Use Disclosure
Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.
CME Outfitters, LLC, the faculty, and Shire, do not endorse the use of any product outside of the FDA labeled indications. Medical professionals should not utilize the procedures, products, or diagnosis techniques discussed during this activity without evaluation of their patient for contraindications or dangers of use.Questions about this activity? Call us at 877.CME.PROS (877.263.7767).
JC-012-111609-19
