<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-0754</journal-id>
<journal-title><![CDATA[Nascer e Crescer]]></journal-title>
<abbrev-journal-title><![CDATA[Nascer e Crescer]]></abbrev-journal-title>
<issn>0872-0754</issn>
<publisher>
<publisher-name><![CDATA[Centro Hospitalar do Porto]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-07542021000100012</article-id>
<article-id pub-id-type="doi">10.25753/birthgrowthmj.v30.i1.18910</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Pica and attention deficit hyperactivity disorder: is there a link? Comorbidity and treatment outcomes with methylphenidate]]></article-title>
<article-title xml:lang="pt"><![CDATA[Pica e perturbação de hiperatividade e défice de atenção: existe ligação? Comorbilidade e resultados do tratamento com metilfenidato]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[Daniela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte]]></surname>
<given-names><![CDATA[Luísa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinto]]></surname>
<given-names><![CDATA[Vanessa Fonseca]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cartaxo]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra Hospital Pediátrico de Coimbra Department of Child and Adolescent Psychiatry]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>30</volume>
<numero>1</numero>
<fpage>12</fpage>
<lpage>17</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-07542021000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-07542021000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-07542021000100012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Pica is the persistent ingestion of non-nutritive substances. It is common during childhood and may be related to nutritional deficits, intellectual disability, stress, and psychosis. However, no causative biological condition is identified in most cases and there is limited evidence to support pharmacological intervention. As several authors describe pica as an impulse control disorder and impulsive symptoms are a core aspect of the diagnostic criteria of attention deficit hyperactivity disorder (ADHD), this study reviews literature data on pica, ADHD, and treatment response during childhood and adolescence and adds two case reports to this body of evidence.  Methods:  Systematic literature review using the key terms &#8220;pica&#8221;, &#8220;attention deficit&#8221;, &#8220;hyperactivity&#8221;, &#8220;child&#8221;, and &#8220;adolescent&#8221;. A retrospective analysis of clinical data of two patients with pica and ADHD followed at the Child and Adolescent Psychiatry Department of Hospital Pediátrico was also conducted.  Results: As far as the authors are aware, only three cases are currently reported in the literature describing comorbid pica and ADHD in children. Of these, two reported complete pica symptom remission after methylphenidate treatment. Two other cases of children with pica and ADHD observed at the Child and Adolescent Psychiatry Department of our institution were reported in this study, one of which had complete symptom remission after psychostimulant treatment optimization.  Discussion: The suggested association between pica and ADHD may have underlying etiology in poor impulse control and dopaminergic system dysfunctions. Therefore, a pharmacological approach capable of improving dopaminergic functioning may be an alternative treatment for pica. Psychostimulants may improve pica by eliciting an increase in brain dopamine levels and a decrease in impulsivity.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: Pica é uma condição caracterizada pela ingestão persistente de substâncias não nutritivas. É comum durante a infância e pode estar associada a défices nutricionais, perturbações do desenvolvimento intelectual, stress e psicose. No entanto, na maior parte dos casos não é possível identificar uma causa orgânica e existem poucas evidências que sustentem intervenção farmacológica. Dado que vários autores descrevem a pica como uma perturbação do controlo dos impulsos e os sintomas impulsivos fazem parte dos critérios chave da perturbação de hiperatividade e défice de atenção (PHDA), o presente estudo pretende rever os dados disponíveis na literatura sobre pica, PHDA e resposta ao tratamento durante a infância e adolescência.  Métodos:  Revisão sistemática da literatura utilizando os termos chave &#8220;pica&#8221;, &#8220;défice de atenção&#8221;, &#8220;hiperatividade&#8221;, &#8220;criança&#8221; e &#8220;adolescente&#8221;. Foi também conduzida uma análise retrospetiva dos dados clínicos de dois doentes com pica e PHDA seguidos no Serviço de Pedopsiquiatria do Hospital Pediátrico.  Resultados: Existem atualmente na literatura apenas três relatos de casos de crianças com pica e PHDA. Destas, duas apresentaram remissão completa dos sintomas de pica após tratamento com metilfenidato. Os autores reportam outros dois casos de crianças com pica e PHDA observados no seu serviço hospitalar, uma das quais alcançou remissão completa dos sintomas após otimização do tratamento com psicoestimulante.  Discussão: A associação sugerida entre pica e PHDA pode ter por base um controlo inadequado dos impulsos e disfunção do sistema dopaminérgico. Consequentemente, uma abordagem farmacológica capaz de melhorar o funcionamento dopaminérgico pode ser um tratamento alternativo para a pica. Ao produzir um aumento dos níveis cerebrais de dopamina e diminuição da impulsividade, os psicoestimulantes podem associar-se a uma melhoria dos sintomas de pica.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[attention deficit hyperactivity disorder]]></kwd>
<kwd lng="en"><![CDATA[methylphenidate]]></kwd>
<kwd lng="en"><![CDATA[pica]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="pt"><![CDATA[metilfenidato]]></kwd>
<kwd lng="pt"><![CDATA[perturbação de hiperatividade e défice de atenção]]></kwd>
<kwd lng="pt"><![CDATA[pica]]></kwd>
<kwd lng="pt"><![CDATA[tratamento]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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