title: Increased cortisol awakening response after completing the summer treatment program in children with ADHD.
abstract: OBJECTIVE
  Little is known about the cortisol awakening response (CAR) in children with attention deficit hyperactivity disorder (ADHD). Here, we examined the CAR in children with ADHD and their mothers before, immediately after, and 4months after an intensive summer treatment program (STP).
  
  
  METHODS
  Participants were 37 children aged 7-12years who completed the STP in 2009 and 2010, and their mothers. Daily saliva samples for cortisol measurement were collected twice daily at awakening and 30min afterwards at pre-STP, post-STP, and during a follow-up measurement period. ADHD symptom scores were evaluated by parents, and participants completed the Kid-KINDLRQOL questionnaire.
  
  
  RESULTS
  CAR was low in children with ADHD before the STP, and increased to the control range 4months after STP. Maternal CAR also tended to increase after STP. Changes in the CAR in children tended to correlate with an improved ADHD inattention scores (p=0.091), physical health (p=0.070), and school life subscales scores in the Kid-KINDLR(p=0.079).
  
  
  CONCLUSIONS
  We demonstrated that STP improved the behavior and QOL of children with ADHD. Our results indicate that STP could lead to improvements in HPA axis function, as reflected by increased CAR after STP.
authors.affiliation: Department of Pediatrics & Child Health Kurume University School of Medicine, Kurume, Japan.
authors.forename: Rumiko
authors.initials: R
authors.lastname: Okabe
authors.affiliation: Cognitive and Molecular Research Institute of Brain Diseases, Kurume University School of Medicine, Kurume, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Okamura
authors.affiliation: Faculty of Nursing, Fukuoka Prefectural University, Fukuoka, Japan.
authors.forename: Chiyomi
authors.initials: C
authors.lastname: Egami
authors.affiliation: NPO Kurume STP, Kurume, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tada
authors.affiliation: NPO Kurume STP, Kurume, Japan.
authors.forename: Chizuru
authors.initials: C
authors.lastname: Anai
authors.affiliation: NPO Kurume STP, Kurume, Japan; Graduate School of Psychological Sciences, Hiroshima International University, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Mukasa
authors.affiliation: Department of Pediatrics & Child Health Kurume University School of Medicine, Kurume, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Iemura
authors.affiliation: Department of Pediatrics & Child Health Kurume University School of Medicine, Kurume, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nagamitsu
authors.affiliation: College of Education, Psychology, and Human Studies, Aoyamagakuin University, Tokyo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Furusho
authors.affiliation: Cognitive and Molecular Research Institute of Brain Diseases, Kurume University School of Medicine, Kurume, Japan; Research Center for Children, Research Center for Rett Syndrome, St Mary's Hospital, Kurume, Japan.
authors.forename: Toyojiro
authors.initials: T
authors.lastname: Matsuishi
authors.affiliation: Department of Pediatrics & Child Health Kurume University School of Medicine, Kurume, Japan; Cognitive and Molecular Research Institute of Brain Diseases, Kurume University School of Medicine, Kurume, Japan. Electronic address: yushiro@med.kurume-u.ac.jp.
authors.forename: Yushiro
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000378:metabolism* / Q000628:therapy*; D001521:Behavior Therapy; D002648:Child; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007124:Immunoenzyme Techniques; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers; D009483:Neuropsychological Tests; D011619:Psychotropic Drugs; D012463:Saliva / Q000378:metabolism; D066107:Social Skills; D013177:Sports; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014851:Wakefulness
chemical_list: D011619:Psychotropic Drugs; D006854:Hydrocortisone
keywords: Attention deficit hyperactivity disorder; Cortisol awakening response; Psychosocial treatment; QOL; Summer treatment program