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Entries in ADHD (35)

Monday
Mar042013

Children with ADHD More Likely to Suffer from Mental Health Issues

iStockphoto/Thinkstock(NEW YORK) -- A new study has found that children diagnosed with attention-deficit hyperactivity disorder are more likely to suffer from a number of mental health problems later in life.

According to the study, which is set to be published in the journal Pediatrics, almost thirty percent of children with childhood ADHD continued to deal with the disorder into adulthood.

The study also found that children diagnosed with childhood ADHD had higher rates of alcohol and drug use, anti-social personality disorder, anxiety and depression as compared to children without ADHD. Those children afflicted with ADHD also have a higher rate of suicide when they grow up, according to the study.

In fact, the study showed that just 37 percent of the ADHD afflicted children were free of mental health problems later in life.

The authors of the study say these grim numbers show an urgent need to improve long-term treatment of affected children, as well as working towards improved follow-up care as adults.

Copyright 2013 ABC News Radio

Tuesday
Jan222013

Childhood ADHD on the Rise, Study Suggests

Jupiterimages/Thinkstock(NEW YORK) -- The number of children diagnosed with attention deficit hyperactivity disorder, or ADHD, is on the rise, a new study published on Monday suggests.

Looking at health records from Southern California, insurance provider Kaiser Permanente found that among kids ages 5 to 11, the rate of ADHD rose 24 percent between 2001 and 2010. 

Researchers also noted after examining more than 800,000 children with ADHD that boys were three times more likely to be diagnosed than girls.

Kaiser Permanente said it's likely the spike came from parents and doctors growing more aware of the disorder.

Critics of the study, however, say it is too narrow, focusing on members of one health plan, and that it relies too heavily on doctors' records, which can be inconsistent. 

Copyright 2013 ABC News Radio

Monday
Nov192012

Younger Kids Have Harder Time in Classroom, Study Finds

Stockbyte/Thinkstock(NEW YORK) – MedPage reports that a new study shows that the younger your child is in the classroom, the more difficult it may be for them to focus on schoolwork and learn how to behave properly.

According to study author Helga Zoëga along with colleagues from the Mount Sinai School of Medicine, they analyzed data from the Icelandic school system and discovered that elementary school students in the bottom third of their fourth-grade class for age were almost twice as likely to score low on math and language arts standardized tests.

The study, which is published in the December issue of the medical journal Pediatrics, also found that the same group are 50 percent more likely to be prescribed stimulants for attention-deficit hyperactivity disorder (ADHD) by seventh grade than the oldest kids in their class.

However, the group noticed that this pattern continued in the children until the age of 14. "This should be taken into account when evaluating children's performance and behavior in school to prevent unnecessary stimulant treatment," Zoëga and her team noted in their article.

Copyright 2012 ABC News Radio

Tuesday
Oct092012

Study Links Prenatal Mercury Exposure to ADHD Symptoms

Jupiterimages/Thinkstock(BOSTON) -- A new study highlights the difficulty pregnant women face while eating for two, finding that more mercury exposure leads to a higher incidence of ADHD symptoms, while more fish consumption -- the main source of mercury exposure -- leads to a decreased risk.

"How much fish you eat is not equivalent to how much mercury you are exposed to," said study author Dr. Susan Korrick of Brigham and Women's Hospital.  "I think the public health conclusion that I would come to is that one can benefit from fish consumption, but it's important to try to consume fish that are low in mercury."

Researchers at Brigham and Women's tested more than 400 women for mercury about 10 days after they gave birth between 1993 and 1998, and asked them to fill out a survey about their fish consumption.  They measured the mercury in samples of the mothers' hair.  When the children were eight, researchers tested their cognitive abilities with a parent questionnaire and other tests, searching for symptoms of ADHD.  (It is important to note that these children were not diagnosed with clinical ADHD, but only exhibited some of the symptoms.)

Symptoms of ADHD, or attention deficit hyperactivity disorder, include inattention, hyperactivity and impulsive behavior, according to the National Institutes of Health.

Researchers say cutting fish out of the prenatal diet to avoid mercury exposure entirely is a bad idea, and pregnant women should look for fish that are low in mercury, such as salmon.

"It's elegantly showing the paradoxical paradigm that it's both good for you and bad for you," said Christina Chambers of the Organization of Teratology Information Specialists' Collaborative Research Center in San Diego, who read the study but was not involved in it.  Teratology is the study of abnormalities in physical development.

"They're finding the kids are slightly above average in the number of symptoms," Richard Gallegher, a professor of child and adolescent psychiatry at NYU Langone, said of the children born to mothers with higher mercury levels in their hair samples.  "They [the ADHD symptoms] can certainly impact how well kids are tending to things in school."

Researchers at Brigham and Women's also learned that pregnant women who ate more than two 6-ounce servings of fish a week were less likely to have children with these symptoms.  This is actually more than the Federal Food and Drug Administration recommends, which is only 12 ounces of fish a week.

Because the fish consumption survey was originally designed to look at organic chlorine contaminants, the fish were grouped by how much chlorine they were likely to contain -- not how much mercury they had, Korrick said.  As a result, the study could not name which fish increased ADHD symptoms and which did not.

Fish high in mercury include shark, swordfish and fresh tuna, Korrick said.  Fish with lower mercury levels -- which are also rich in healthy fats -- include salmon, rainbow trout and herring.  A third group, which has different health benefits but still is low in mercury, includes cod, shrimp and haddock.

Copyright 2012 ABC News Radio

Wednesday
Jun272012

Adderall Use on the Rise for Mothers

iStockphoto/Thinkstock(NEW YORK) -- All over America, moms are turning to the prescription drug Adderall for relief. Adderall is a drug for attention deficit hyperactivity disorder, but these women don't have ADHD; they say they need Adderall to be better mothers.

Between 2002 and 2010, there's been a 750 percent increase in Adderall prescriptions for women between 26 and 39.  Critics say clearly not all of these women need the drug for ADHD.

ABC News spoke with Betsy Degree from suburban Minneapolis, who started taking the prescription drug to keep up with the demands of being a mother of four.

"I grew up in a house where my mom was very neat," she said.  "Everything was really clean, beautiful dinners every night and that didn't come naturally for me."

Several years ago, one of Degree's children was prescribed Adderall, a central nervous system stimulant, for ADHD.  In a moment of desperation she stole a pill from her own child and the addiction was almost immediate.

"I was able to get all the stuff done around the house," Degree said.  "I was able to cook the dinner and have everything perfect."

Degree tells ABC News she felt like supermom and would stay up until 3 a.m. doing loads of laundry.  She says she thought she'd only take it once.

"I couldn't stop," she said.  "I could not stop taking them.  I'd say I'm just going to take them one more time."

When she ran out she resorted to tricking the family doctor into writing more prescriptions.

"I would call and say we lost them.  I would call and say that dose isn't right so can we try a different dose," said Degree.  "[I was trying] every trick in the book."

Addiction doctors say the situation is getting out of control.

"This is a significant problem," said Dr. Marvin Seppala, chief medical officer at Hazelden, an addiction treatment facility.  "We've got an increase in women using drugs like Adderall ending up in our treatment programs. ... We know from a medical perspective it's dangerous and can cause seizures, strokes, heart attacks, even death."

Adderall sent Degree, who admits she struggled with addiction issues all of her life, down a dangerous path.  When she decided she could no longer fool her doctor she switched from Adderall to meth.  She lost her business and she says she nearly lost her kids.

She is now clean and has this simple advice for any mom considering taking Adderall, "don't."

"It's pretty addictive," said Degree.  "It can happen to anybody."

Copyright 2012 ABC News Radio

Monday
Jun252012

Should Kids Be Prescribed ADHD Medications Sooner?

iStockphoto/Thinkstock(NEW YORK) -- Children with attention deficit hyperactivity disorder (ADHD) who start taking medications as early as fourth grade may be more likely to score better academically than those who start taking medication in middle school, according to a study published Monday in the journal Pediatrics.

ADHD is a developmental disorder characterized by problems focusing and erratic behavior.  Since 2007, 5.4 million children ages 4 to 17 have been diagnosed with ADHD, and 66 percent reported taking medication to treat their symptoms, according to the U.S. Centers for Disease Control and Prevention.  A majority of children are diagnosed with ADHD by age 7.

Researchers looked at data of nearly 12,000 Icelandic children born between 1994 and 1996, each of whom began taking medication for ADHD sometime between fourth and seventh grades.  By the time the children reached seventh grade, those who had begun taking medications within the first year of fourth grade showed only a 0.3 percent drop in their math score, compared to a 9 percent drop among children who started medication around sixth or seventh grade.

"Performance of kids with ADHD tends to decline over time, especially if medication is delayed," said Helga Zoega, an epidemiologist at the Institute for Translational Epidemiology at Mount Sinai School of Medicine in New York, and lead author of the study.  "Starting medication earlier may halt this decline."

The girls among the group only showed improvement in math after starting medication.  The boys showed improvement in both math and language arts.

A majority of kids are diagnosed with ADHD by age 7, Zoega said.

Besides medication, treatments for ADHD include behavioral interventions, education plans and parental training.  The interventions may be the first line of treatment before medication, or may be used in combination with medication.

The study data did not show whether the children received other forms of treatment besides medication, and whether these additional treatments may have influenced their performance.

Copyright 2012 ABC News Radio

Monday
Jun182012

Prescriptions for ADHD Drugs Increasing, Says New FDA Research

Comstock/Thinkstock(WASHINGTON) -- The number of children who received prescriptions for drugs used to treat attention deficit hyperactivity disorder (ADHD) increased over an eight-year period while the number of antibiotic prescriptions declined, according to a new study by the Food and Drug Administration.

Using a large national database, FDA researchers analyzed prescription drug trends among children up to age 17 between 2002 and 2010 on an outpatient basis.

The study, published in the journal Pediatrics, found that the number of overall prescriptions for this age group decreased by 7 percent, in contrast to the 22 percent increase in prescriptions given to adults over the same period.  However, the authors noted that their research did not track whether the drugs were actually used, only that they were prescribed.

There were also significant decreases in the number of antibiotics, allergy medicines, pain medicines, drugs used to treat depression and certain cough and cold medications prescribed for children. But ADHD prescriptions increased by 46 percent, and there were also higher numbers of medications prescribed for asthma and birth control.

"Identification of drugs with the highest numbers of patients exposed can help focus research efforts on those drugs that could have a large impact on the pediatric population, " wrote the authors, led by Grace Chai of the FDA's Center for Drug Evaluation and Research.

Contraceptive prescriptions also skyrocketed, increasing among adolescents by 93 percent. The study did not offer in-depth analysis of reasons behind these trends, but the authors did suggest that birth control use could actually be explained by a number of factors.  Recent surveys did not find much of an increase in the number of girls using birth control, so the trend may be the result of longer use or using these medications for other reasons, such as acne.

They also found that a considerable number of infants less than 1 year old were prescribed acid reflux-controlling proton pump inhibitors -- particularly Prevacid -- although these medications are not FDA-approved for use in children this young.

On the other hand, antibiotic use decreased by 14 percent, and the authors suggest that large-scale efforts by the American Academy of Pediatrics and other children's health experts to decrease antibiotic use "by educating parents about the futility of treating viral infections with antibiotics and about concerns of antibiotic resistance" have been successful.

Similarly, the number of antidepressant prescriptions for children declined.

Copyright 2012 ABC News Radio

Friday
May112012

Childhood Bipolar Boom: More Cases or Misdiagnoses?

Digital Vision/ValueLine(NEW YORK) -- Dr. Avram H. Mack, a child and adolescent psychiatrist in Washington, D.C., wonders if an explosion in childhood bipolar disorder reflects a true increase in the condition, or the inappropriate labeling of some youngsters that potentially could hold them back the rest of their lives.

"I often encounter kids who have been called bipolar where I suspect that bipolar is not the accurate diagnosis," said Mack, an associate professor of psychiatry at Georgetown University School of Medicine.

Bipolar disorder, sometimes called manic depressive illness, is classically characterized by mood swings between depression and mania, and notoriously tricky to diagnose in children. That's partly because symptoms frequently overlap with those of such disorders as ADHD, anxiety, depression, obsessive compulsive disorder (OCD), and oppositional defiant disorder (ODD).

Children tend to have more angry outbursts or tantrums than adults, and those episodes of poorly controlled behavior have led to a school of thought that irritability and tantrums are key components of bipolar disorder in children and teens. Diagnoses in children began to take off in the late 1990s.

Although there have been scant studies quantifying the increase in diagnoses, a 2007 study in the Archives of General Psychiatry led by Columbia University researchers found a 40-fold rise in office visits among youth diagnosed with bipolar disorder between 1994-95 and 2002-3. The estimated annual number of office visits for people 19 and below skyrocketed from 25 per 100,000 to 1,003 per 100,000 during the period.

Telling children and teens that they suffer from bipolar disorder – especially if that's not firmly established -- can lessen their self-esteem, expose them to side effects of powerful antipsychotic and mood-altering drugs and land them in special education classes or even a residential setting "that may do more harm than good," Mack said. Some say some of these children might be better served with a proposed diagnosis of "disruptive mood dysregulation disorder."

"Bipolar disorder is real, and I have seen it among toddlers," said Mack. "The number of youth diagnosed with bipolar clearly has risen, but should "bipolar" have been diagnosed in all of those additional cases? Many psychiatrists feel the answer is 'no.'"

"I'm not denying there is bipolar disorder, and there are some whose severe temper tantrums and outbursts are deserving of care," he said. Mack said the key question is what you call those outbursts, "because what we call it influences how we treat it and the patient's expectations for the future."

Many psychiatrists aren't yet ready to embrace DMDD, although the condition, which is more likely to be limited in duration than bipolar disorder--a lifetime affliction--could reduce a patient's sense of being disabled and increase "their hope for the future."

Mack's caution reflects some of the concerns currently being aired as the American Psychiatric Association continues reviewing criteria for diagnoses to be included in the upcoming revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) due out in May 2013. That book, often referred to as the Bible of psychiatry, defines mental health disorders for diagnosis, treatment and research. Its diagnostic codes are the basis of health insurance reimbursements for treatment.

The proposed new diagnosis of "disruptive mood dysregulation disorder" follows studies led by Dr. Ellen Leibenluft, at the National Institute of Mental Health in which she and colleagues have made physiologic distinctions between youngsters with strictly defined bipolar disorder and those with what they call "severe mood dysregulation" (a term that isn't yet officially part of the manual). Her work has found, for example, that few youngsters diagnosed with severe mood dysregulation subsequently are diagnosed with bipolar disorder.

Although some people say that giving a youngster a diagnosis of "disruptive mood dysregulation disorder" might be less stigmatizing than bipolar disorder, Mack said there's no data yet to show if that might be the case.

"It is unknown what would be the medical or social effect of a new diagnosis like DMDD," he said. "It certainly needs to be vetted as to its utility in psychiatry's classification of disorders. We don't want to miss kids who have true bipolar disorder, and we don't want to ignore kids with severe mood problems… We just want to know what is the right diagnosis."

Revising the DSM is a years-long project that includes comment periods and intermediate changes in proposed diagnostic criteria for psychiatric disorders. APA announced earlier this month that results of field trials at 11 medical centers for two proposed diagnoses, "attenuated psychosis syndrome," which was meant to identify people at risk of psychosis, and "mixed anxiety depression disorder," which combines anxiety and depression, weren't reliable enough to put them into broader use. As a result, they will be included in a special section of the manual for conditions requiring further research before APA determines whether they should be recognized as formal disorders.

Among other conditions to be further studied are "Internet use disorder," "caffeine use disorder," and "hypersexual disorder."

The committee also recently changed some language within criteria for major depressive disorder to acknowledge that sadness, insomnia and other symptoms while grieving a significant personal loss don't in themselves constitute a mental disorder.

Field trials at pediatric medical centers demonstrated that the proposed disruptive mood dysregulation disorder diagnosis worked in clinical settings, APA said. Similarly, field trials with 322 youngsters support a controversial proposal to narrow the definition of autism spectrum disorder and excluded very few children who meet the current definition. Critics and parents, however, fear that the new definition, which eliminates Asperger's syndrome and "pervasive developmental disorder" as related conditions, would shrink the number of children eligible for medical, social and school-based services for autism spectrum disorders.

The process of revising the manual for the first time since the DSM-4 came out in 1994 "is about compromise," said Dr. Liza Gold, a clinical and forensic psychiatrist in Arlington, Va. "The question is: how do you do science by consensus?"

Copyright 2012 ABC News Radio

Monday
Apr302012

Study: Some Teens May Be Pre-Wired for Addiction

(BURLINGTON, Vt.) -- Babies instinctively clutch on fingers and seek out their mother’s voice.  For many, it takes little effort to understand the difference between laughter and anger.

But how instinctive is a teen’s desire to snort a line of coke?

In the largest functional brain imaging study ever performed, researchers report findings that suggest that poor impulse control is pre-wired in some individuals. Specifically, they say that they have identified specific brain networks linked to impulse control and drug addiction — and that these differences exist even before an individual is exposed to drugs or alcohol.

To determine this, the researchers used a scan called a functional MRI, which allowed them to examine how different parts of the brain work together in real time. They “peeked into” the brains of nearly 1,900 14-year-olds while they asked them to perform repetitive tasks, and then measured their ability to stop mid-task.  Called “stop-signal reaction time,” it is a measure that is used to gauge inhibitory control. Patients who abuse drugs or alcohol perform poorly on this test.  So do children with ADHD.

“These networks are not working as well for some kids as they are for others,” says Dr. Robert Whelan of the University of Vermont, the lead researcher in this investigation.  

Whelan explains how they were able to break down how different brain networks were involved with specific types of impulses.

Interestingly, they were able to identify teens who had prior exposure to alcohol, nicotine, or other illicit drugs and were able to identify specific brain patterns associated with early experimentation with these substances.  Furthermore, teens with poor impulse control, but no prior substance use had brain images similar to those who had already admitted use.

The findings suggest that there may be an opportunity to identify teens at risk before they indulge. “While identifying those at greatest risk of addiction is a complex process with many different factors involved, identifying brain networks specific to impulse control represents the first step” says Whelan.

According to the National Institute of Health, more than 40 percent of U.S. high-school seniors report drinking alcohol, 21 percent have used marijuana, and 8 percent have used Vicodin unrelated to a medical condition.

The study also looked at brain images of teens suffering from ADHD.  Two million American children are affected with ADHD, and a disproportionate number become alcohol or drug abusers.  The cause-and-effect literature regarding ADHD and substance abuse is mixed.   Many with ADHD also suffer with various other psychiatric disturbances, such as depression, bipolar disorder or conduct disorder, increasing their substance abuse risk.  Both ADHD and substance abusers have impulse-control issues at their core.

In agreement with prior studies, both adolescents with a history of ADHD or a history of alcohol or drug use had poor impulse control scores.  But researchers found that the brain networks activated in teens with ADHD were different than the ones associated with early drug use.

Copyright 2012 ABC News Radio

Thursday
Mar222012

Prenatal Pollutants Linked to Childhood Anxiety, ADHD

Jupiterimages/Thinkstock(NEW YORK) -- Inner-city women who breathe powerful airborne pollutants called polycyclic aromatic hydrocarbons while pregnant are more likely to have children who develop behavioral problems by the time they reach school age, researchers report.

The findings bolster what's known about the influence of prenatal conditions on later health.

In recent years, scientists have found that in utero exposure to a host of toxins including pesticides, outdoor air pollutants, secondhand tobacco smoke and prescription drugs influence a child's susceptibility to many conditions for years to come.  The brain and nervous system of a fetus, still too immature to eliminate toxins or repair damaged DNA, may be particularly sensitive to these assaults.

The research team behind the latest findings, led by Frederica Perera, director of the Center for Children's Environmental Health at Columbia University's Mailman School of Public Health, previously linked prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) from fossil fuels including gasoline, diesel and coal, to impaired fetal growth and development, possible chromosomal changes, developmental delays at age 3 and reduced IQ at age 5.

Their newest study, published Wednesday in the journal Environmental Health Perspectives, expands on the previous finding that breathing air fouled by PAHs during pregnancy boosts the risk of giving birth to children with signs of anxiety and depression or ADHD by ages 6 or 7 years.

The scientists knew that PAHs inhaled by the mother can pass through her bloodstream, through the placenta and into the fetus' tissues.  In the new study, they gauged the mothers' exposure by measuring PAH concentrations in home air samples collected during the third trimesters of their pregnancies. 

The scientists assessed how much of those pollutants got into their bodies by measuring blood levels of a chemical formed when PAHs interact with blood cells.  They similarly gauged the newborns' exposure to PAHs by measuring levels of the marker in their umbilical cord blood.

"This study provides evidence that prenatal exposure to environmental PAH at levels encountered in the air of New York City may influence child behavior," the authors wrote.  They said the PAH exposure "could impact cognitive development and the ability to learn."

PAHs are such a ubiquitous component of urban air pollution that air samples for 100 percent of the women contained detectable PAH levels, the researchers reported.  At the same time, 40 percent of the women reported being exposed to second-hand smoke during their pregnancies.

Perera and her colleagues have been following a group of 253 African-American and Dominican women, all non-smokers, living in New York City, who gave birth between 1999 and 2006.  They plan to follow their children to age 12.

Copyright 2012 ABC News Radio







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