Anxiety and depression in family pracitce

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Medical Schools University Maribor and University Ljubljana, Nursing Science University Primorska

Santé & Médecine Formation

EPIDEMIOLOGY OF MENTAL PROBLEMS IN FAMILY PRACTICE ATTENDERS JANKO KERSNIK Department of family medicine, University Ljubljana

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REVIEW published: 24 June 2015 doi: 10.3389/fnhum.2015.00359 Pathophysiology of ADHD and associated problems—starting points for NF interventions? Björn Albrecht*, Henrik Uebel-von Sandersleben, Holger Gevensleben and Aribert Rothenberger Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany Edited by: Martijn Arns, Research Institute Brainclinics, Netherlands Reviewed by: Roumen Kirov, Institute of Neurobiology, Bulgarian Academy of Sciences, Bulgaria Leon Kenemans, Utrecht University, Netherlands *Correspondence: Björn Albrecht, Department of Child and Adolescent Psychiatry, University Medical Center Göttingen, von Siebold Straße 5, 37075 Göttingen, Germany [email protected] Received: 06 October 2014 Accepted: 02 June 2015 Published: 24 June 2015 Citation: Albrecht B, Uebel-von Sandersleben H, Gevensleben H and Rothenberger A (2015) Pathophysiology of ADHD and associated problems—starting points for NF interventions? Front. Hum. Neurosci. 9:359. doi: 10.3389/fnhum.2015.00359 Attention deficit hyperactivity disorder (ADHD) is characterized by severe and age-inappropriate levels of hyperactivity, impulsivity and inattention. ADHD is a heterogeneous disorder, and the majority of patients show comorbid or associated problems from other psychiatric disorders. Also, ADHD is associated with cognitive and motivational problems as well as resting-state abnormalities, associated with impaired brain activity in distinct neuronal networks. This needs to be considered in a multimodal treatment, of which neurofeedback (NF) may be a promising component. During NF, specific brain activity is fed-back using visual or auditory signals, allowing the participants to gain control over these otherwise unaware neuronal processes. NF may be used to directly improve underlying neuronal deficits, and/or to establish more general self- regulatory skills that may be used to compensate behavioral difficulties. The current manuscript describes pathophysiological characteristics of ADHD, heterogeneity of ADHD subtypes and gender differences, as well as frequently associated behavioral problems such as oppositional defiant/conduct or tic disorder. It is discussed how NF may be helpful as a treatment approach within these contexts. Keywords: Neurofeedback (NF), ADHD, ODD/CD, tic disorder, comorbidity, children, neurobiology Introduction Difficulties with Inattention or Hyperactivity and Impulsivity as the core symptoms of Attention deficit Hyperactivity disorder (ADHD) are a frequent psychosocial burden. With an early onset during childhood, ADHD is often persisting throughout life. It is a heterogeneous disorder, and a challenge to treat. In light of this heterogeneity, the most promising treatment approach should be multimodal in nature (Taylor et al., 2004; Swanson et al., 2008). Pharmacological interventions particularly with stimulants such as methylphenidate and amphetamine sulfate, as well as non- s.

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