Oligoantigenic Diet Improves Children’s ADHD Rating Scale Scores Reliably in Added Video-Rating

Frontiers in Psychiatry

Philip Heiser¹  Hans-Willi Clement²  Christian Fleischhaker²  Reinhold Rauh²  Eberhard Schulz²  Christina Clement²  Katja Schneider-Momm²  Anna Dölp² 

[1] Clinic of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, SuedharzHospital Nordhausen, Nordhausen, Germany;Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;

关键词: attention-deficit/hyperactivity disorder;    children;    adolescent;    ADHD rating scale IV;    brain-gut axis;    oligoantigenic diet;   

DOI  :  10.3389/fpsyt.2020.00730

来源: DOAJ

【 摘 要 】

ObjectivesThe influence of food intake on behavioural disorders was already described in the early 20th century. Elimination of individually allergenic food items from individual diets [“oligoantigenic diet” (OD)] showed promise to improve attention-deficit/hyperactivity disorder (ADHD) symptoms. However, only few of the positive results were evaluated by blinded symptom rating. Therefore the present study’s purpose was to evaluate the reliability of a non-blinded rating of the ADHD Rating Scale IV (ARS) for the assessment of OD effects in comparison to a blinded rating of the ARS based on pseudonymized video recordings.MethodsTen children (8m/2f) aged 8 to 14 with ADHD according to ICD-10 participated in an uncontrolled, open-label dietary intervention study. Food items, commonly related to intolerances, were eliminated for four weeks. Participants with > 40% improvement in the ARS between T1 (before the diet) and T2 (after the diet) were defined as responders. Nutrients with individual relevance to ADHD symptoms were identified in a following reintroduction phase (T3–T4) lasting 8–16 weeks. The ARS was completed by a non-blinded child and adolescent psychiatrist (T0-T4). Sessions were recorded on video, pseudonymized, and evaluated by three blinded raters. Complete data were captured for eight children. The inter-rater reliability between the non-blinded therapist and every blinded rater was determined by the intra-class correlation coefficient (ICC). Correlations according to Pearson and Spearman between the non-blinded and blinded rating were calculated for each rater.ResultsTwo blinded raters and the non-blinded rater considered 5 of 8 (62.5%) children as responders, whereas one blinded rater disagreed as to the success of one case thus considering only 4 of 8 children as responders to the diet. Inter-rater reliability was assessed after each rater having scored 33 videos: The intra-class coefficients were >.9 for all raters (rater 1: ICC=.997, rater 2: ICC=.996, rater 3: ICC=.996) and the Spearman rho between the raters were high (n=33; rater 1: rho =.989, p<.0001, rater 2: rho=.987, p<.0001, rater 3: rho=.984, p<.0001), respectively.DiscussionAs both, blinded and non-blinded ratings of the ARS, revealed relevant significant improvement of ADHD scores in children following an OD in this uncontrolled trial, Randomized controlled trials appear as highly desirable in order to replicate these improvements and to establish reliable and unbiased effect sizes thereby fostering further more objective confirmatory measurements.

【 授权许可】

Unknown