Ongoing Research

At this moment, there are six (6) areas of investigation in Child and Adolescent Program.

If you are interested in having more information, taking part of any of them, or referring your patient to take part (only for mental health professionals), please contact our secretary throught the phone (051) 3359-8094.

  • Study of ADHD - Genetic susceptibility, identification of candidate genes and a farmacogenetic study

    The study of identification of candidate genes integrates an international research network on ADHD genetics (“The ADHD Molecular Genetics Network”), coordinated by Prof. Stephen Faraone from Harvard University. In PRODAH, this research field is coordinated by Prof. Mara Helena Hutz, with collaboration of Prof. Tatiana Roman, both from Genetics Department of Federal University of Rio Grande do Sul (UFRGS). Ana Paula Miranda Guimarães e Júlia Pasqualini Genro, PhD students from Genetics and Molecular Biology Post-Graduation Program (UFRGS), Angélica Oliveira, Biological Sciences under degree student (UFRGS) and Gláucia Chiyoko Akutagava Martins, Biomedicine under degree student (Federal University of Health Sciences of Porto Alegre, UFCSPA) also develop projects related to this research field. Nowadays, many studies have clearly demonstrated a significant participation of genetic factors in ADHD etiology. Thus, it is not uncommon to find the disease also in parents and siblings of ADHD patients. The current effort concentrates mainly in the identification of the genes possibly involved, as well as the exact contribution of each one of these genes.

    The farmacogenetic study is a project related to the above protocol and corresponds to one of the many possible ways genetics could influence clinical aspects of ADHD. Considering that there is a recent interest in evaluating the association between candidate genes and response to medication or adverse effects caused by medications commonly used for ADHD treatment, in this study we evaluate the relation of genes that can be involved in ADHD neurobiology or in drug action in CNS and the response to it. Initially developed in PRODAH by psychiatrists Cristian Zeni and Guilherme Polanczyk.

    What would be the benefits if you join the study?
    The child or adolescent with ADHD and biological parents will have access to a multidisciplinary evaluation through individual interviews with the objective of detecting and / or confirming the presence of ADHD. The patient will also have access to several neuropsychological tests that help to understand possible school problems he/she might be experiencing. In the case of a positive diagnosis, the patient’s attendance in the Program will be assured even if the family decides to quit the study during its course. Finally, your participation will help to acquire new knowledge that could benefit you, your family and other people who face the same problems.

    What will be required from you if you join the study?
    Besides the interviews and tests cited above, it will be necessary to collect a 5 ml blood sample from the patient and from one or both biological parents, to investigate, through DNA analysis, genes probably involved in ADHD.

    Who is able to join the study (inclusion criteria)?
    Children or adolescents with an ADHD diagnosis confirmed through the evaluation previously described who have one or both (preferably) biological parents available and willing to join the study.

  • Bipolar disorder in comorbidity with ADHD: a randomized double blind clinical trial with aripiprazole followed by methylphenidate

    In clinical samples, recent findings suggest that a significant proportion (10%-20%) of patients with ADHD present bipolar disorder (BD) as a comorbidity. BD in children is characterized by periods of irritability, with affective storms, concomitant depressive symptoms, and a more chronic than episodic course. The presence of both disorders at the same time usually determines a more impaired follow-up. Aripiprazole is a new medication that can have a positive effect on symptoms of both disorders. The goal of this research is to evaluate the effectiveness and tolerability of this medication in cases of ADHD-BD comorbidity. In patients with only partial response in ADHD symptoms, the effectiveness and tolerability of the association of aripiprazole and methylphenidate will be evaluated in a two-week crossover study. Dra. Silza Tramontina is the PI for this study (for a review of the protocol, see www.clinicaltrial.gov).

    What do you get by taking part?
    The child or adolescent and his/her biological parents will have access to a multidisciplinary assessment through interviews for detecting and/or confirming both ADHD and BD. In case of positive diagnoses, the enrollment of the child or adolescent in the program is assured, as well as the supply of medication throughout the study. Patients may leave the research at any time, if they wish to do so. Finally, your participation will help the development of new knowledge that may help you and others who suffer from the same problems.

    What do you have to do?
    In addition to the interviews for evaluation, you and your child will need to come weekly – for eight consecutive weeks – to the Hospital de Clínicas de Porto Alegre for the assessment of medication response. Blood tests will be taken before and after medication. The child must take the medications as prescribed by the doctors.

    Who can take part (inclusion criteria)? 
    Children and adolescents who already have a confirmed ADHD and BD diagnosis by the PRODAH outpatient service or who voluntarily come to PRODAH.

  • Food ingestion and the levels of iron serum –n children and teens with attention deficit hyperactivity disorder - ADHD

    The treatment of ADHD includes a multiple approach, comprehending psychosocial and psychopharmacological interference. Moreover, it has been suggested the importance of nutritional interferences due to the possibility of deficiency of some specific nutrients in children with ADHD. In special, it is suggested the possibility of ADHD children showing iron deficiency, which may contribute to the occurrence of behavioural problems. Iron is present in a series of extremely important biochemical functions which include the transport of oxygen, the glucose metabolism and the synthesis of neurotransmitters, like dopamine. So, according to studies using animals, the iron storage in the brain may influence the children behavior.

    What do you get as a participant of this study?
    The child or teenage will be nutritionally evaluated through four individual interviews under an individualized diet, suggestions for adequate food habits and nutritional advices. Besides, the laboratorial exams will detect possible iron nutritional shortage. The child and teenage from Control Group still be beneficial to QI evaluation and detect psychiatric disorder. Our aim will be to offer information for healthy nourishment, with the essential quantities of nutrients and the necessary calories to prevent deficiency or excess of nutrients. The balanced food is important to health maintenance, preventing the appearance of several illnesses.

    What will you have to do?
    Besides the interviews, a parasitological examination of feces (PEF) and a blood exam for a biochemical analysis of blood iron will be necessary.

    Who can participate?
    Children and Teens from 6 to 18 years old:
    1. with a diagnostic of ADHD and in treatment with methylphenidate (Ritalin®, Ritalin LA® or Concert®) for at least 3 months;
     or
    1. with a diagnostic of ADHD and not in treatment with medication;
    or
    1. without ADHD or another psychiatric disorder.

    Children and Teens under the following aspects are not allowed to participate:
    - illiterate parents or responsible (as they are supposed to fill in the food control done at home);
    - with mental retardness, depression and/or bipolar confusion;
    - present situations which interfere in the iron serum levels, such as the use of iron supplement in the last 2 months; parasites by Ancylostoma duodenal and Necator americanus; chronical infections; history of blood lost; diagnostic of chronical diarrhea.

  • Association between motoboys accidents, attention-deficit/hyperactivity disorder

  • The role of adverse environmental factors, family functioning and parental psychopathology in the response to methylphenidate in child and adolescent with attention-deficit hyperactivity/disorder

    There is a association between social adversity and psychopathology in general. Regarding child and adolescent ADHD, adverse environmental factors are associated with co morbidity and higher levels of impairment. Until now, there are no studies of factors that mediate or modulate methylphenidate response in ADHD in our population. The purpose of this study is to evaluate the association between adverse environmental factors, family functioning and parental psychopathology and response to methylphenidate in child and adolescents with ADHD.

  • Teaching strategies for children and adolescents with attention-deficit/hyperactivity disorder (ADHD): possibilities of pedagogical intervention in arithmetic

    This project is developed in a partnership with the School of Education, UFRGS. This study aims at assessing the efficacy of a teaching program of basic facts. Storage and retrieval of basic facts have been pointed as a specific difficulty in children with arithmetic difficulties and with ADHD (inattentive and combined subtypes), which can be worsened when both disorders overlap. However, there are still doubts as to the validity of a teaching focused on this aspect of mathematics.

    What do I get by participating?
    The child/adolescent and his/her biological parents will have access to a multidisciplinary evaluation, through individual interviews for detection and/or confirmation of the ADHD diagnosis. In addition to the multidisciplinary assessment for detection and/or confirmation of presence of ADHD, the child or adolescent will participate in a pedagogical support focused on arithmetic (basic facts) for a 10-week period. Your participation will also help to improve further knowledge on pegadogical interventions for ADHD, which may benefit you and others who have the same problem. You can dropout from the research project while it is still ongoing, if you wish to do so.

    What will you have to do?
    In addition to interviews and neuropsychological tests for ADHD assessment, patients will be tested as to their mathematical knowledge. In case there is indication for pedagogical support, the patient needs to go to HCPA once a week for a 10-week period.

    Who can take part (inclusion criteria)?
    Children and adolescents who (1) are attending the six first grades of Elementary School; (2) have a diagnosis of inattentive and combined ADHD subtypes, confirmed by the PRODAH staff according to the APA guidelines (2003); (3) have estimated IQ (WISC-III, 2002) between 80 and 120; (4) use an immature counting strategy to solve arithmetic calculations; (5) are not having psychopedagogical support or any pedagogical help besides that provided by their school.

    There are three (3) areas of investigation in Adults Program. To take part of any of these investigations, take special attention for the inclusion and exclusion criteria. If you decide to join us, contact our program throught the phone (051) 3359-8268 on fridays from 4PM to 8PM (Dr. Grevet).

  • Study of genetic susceptibility and identification of candidate genes in ADHD adults patients

    This study investigates the ADHD adult patient’s genetics bases. Many studies have shown the role of genetic factors in the vulnerability to ADHD. It is usual to find the presence of ADHD in parents and siblings of children and adolescents with ADHD. The recent research focus is on identifying which genes are involved in the susceptibility to the disorder.

    What do I get participating in this study?
    The adult patient will have access to a multidisciplinary evaluation, through individual interviews for detection and/or confirmation of the ADHD diagnosis. The patient will also have access to a battery of neuropsychological tests, which will help in understanding life difficulties that he/she may present. In case of a positive diagnose, treatment is guaranteed. Your participation will also help to improve further knowledge on ADHD, which may benefit you and others who have the same problem.

    What do I have to do?
    Besides the interviews and tests mentioned above, 10 ml of blood is collected for the evaluation of genes potentially involved, through DNA analysis.

    Who can participate (inclusion criteria)?
    Adult patients with 18 years or older with confirmed diagnose of ADHD through the evaluation procedures described above.

  • Pharmacogenetics study of the Methylphenidate response in ADHD adult patients ADHD

    The goal of these projects is to better understand the participation of dopamine and norepinephrine genes in the response to Methylphenidate used in the treatment of ADHD and their side effects.

    What do I have to do?
    Besides the interviews and tests mentioned above, 10 ml of blood is collected for the evaluation of genes potentially involved, through DNA analysis.

    Who can participate (inclusion criteria)?
    Adult patients with 18 years or older with confirmed diagnose of ADHD through the evaluation procedures described above.

  • Association between candidate genes and response patterns to Neuropsychological tests in ADHD

    A new area of research in ADHD genetics is the search for hearable characteristics by groups of individuals with ADHD. Since the disorder has a broad clinically presentation (heterogeneity), the identification of these hearable characteristics might reduce the clinical variability helping in advancing the understanding of ADHD causes. One way of reducing clinical heterogeneity is by assessing specific responses in neuropsychological tests. Our group are working with some candidate genes and response to a neuropsychological battery including factor of distractibility from the WAISS, Stroop Test, Wisconsin Sorting Card Test, and CPT.

    What do I get participating in this study?
    The adult patient will have access to a multidisciplinary evaluation, through individual interviews for detection and/or confirmation of the ADHD diagnosis. The patient will also have access to a battery of neuropsychological tests, which will help in understanding life difficulties that he/she may present. In case of a positive diagnose, treatment is guaranteed. Your participation will also help to improve further knowledge on ADHD, which may benefit you and others who have the same problem.

    What do I have to do?
    Besides the interviews and tests mentioned above, 10 ml of blood is collected for the evaluation of genes potentially involved, through DNA analysis.

    Who can participate (inclusion criteria)?
    Adult patients with 18 years or older with confirmed diagnose of ADHD through the evaluation procedures described above.

  • Association between Temperament Types and ADHD subtypes in adult ADHD

    There is a growing concern in the scientific community to find the relationship between different patterns of temperaments present in the different ADHD subtypes. It is know that same temperament traits could led to a higher impulsivity and restless, as well as specific ADHD subtypes. To clarify those relationships we idealized this study.

    What do I get participating in this study?
    The adult patient will have access to a multidisciplinary evaluation, through individual interviews for detection and/or confirmation of the ADHD diagnosis. The patient will also have access to a battery of neuropsychological tests, which will help in understanding life difficulties that he/she may present. In case of a positive diagnose, treatment is guaranteed. Your participation will also help to improve further knowledge on ADHD, which may benefit you and others who have the same problem.

    What do I have to do?
    Besides the interviews and tests mentioned above, 10 ml of blood is collected for the evaluation of genes potentially involved, through DNA analysis.

    Who can participate (inclusion criteria)?
    Adult patients with 18 years or older with confirmed diagnose of ADHD through the evaluation procedures described above.

  • Environmental effects associated to adult ADHD

    In this study we are interested in studying the effects of environmental (life events) factor on the severity, response to treatment and clinical presentation of adult ADHD patients.

    What do I get participating in this study?
    The adult patient will have access to a multidisciplinary evaluation, through individual interviews for detection and/or confirmation of the ADHD diagnosis. The patient will also have access to a battery of neuropsychological tests, which will help in understanding life difficulties that he/she may present. In case of a positive diagnose, treatment is guaranteed. Your participation will also help to improve further knowledge on ADHD, which may benefit you and others who have the same problem.

    What do I have to do?
    Besides the interviews and tests mentioned above, 10 ml of blood is collected for the evaluation of genes potentially involved, through DNA analysis.

    Who can participate (inclusion criteria)?
    Adult patients with 18 years or older with confirmed diagnose of ADHD through the evaluation procedures described above.