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The Selling of Attention Deficit Disorder

By ALAN SCHWARZ After more than 50 years leading the fight to legitimize attention deficit hyperactivity disorder, Keith Conners could be celebrating. Severely hyperactive and impulsive children, once shunned as bad seeds, are now recognized as having a real neurological problem. Doctors and parents have largely accepted drugs like Adderall and Concerta to temper the traits of classic A.D.H.D., helping youngsters succeed in school and beyond. But Dr. Conners did not feel triumphant this fall as he addressed a group of fellow A.D.H.D. specialists in Washington. He noted that recent data from the Centers for Disease Control and Prevention show that the diagnosis had been made in 15 percent of high school-age children, and that the number of children on medication for the disorder had soared to 3.5 million from 600,000 in 1990. He questioned the rising rates of diagnosis and called them “a national disaster of dangerous proportions.” “The numbers make it look like an epidemic. Well, it’s not. It’s preposterous,” Dr. Conners, a psychologist and professor emeritus at Duke University, said in a subsequent interview. “This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.” The rise of A.D.H.D. diagnoses and prescriptions for stimulants over the years coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable. Few dispute that classic A.D.H.D., historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge. © 2013 The New York Times Company

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 19039 - Posted: 12.16.2013

Premature baby steroids 'may raise risk of ADHD'

By James Gallagher Health and science reporter, BBC News Steroids given to help premature babies develop may also be slightly increasing the risk of mental health disorders, say researchers. The drugs are often given to pregnant mothers at risk of a premature birth to help the baby's lungs prepare for life outside the womb. The study, in the journal PLoS One, showed there was a higher risk of attention disorders at age eight. The charity Bliss said it reinforced the need for regular health checks. Being born too soon can lead to long-term health problems and the earlier the birth the greater the problems. One immediate issue is the baby's lungs being unprepared to breathe air. Steroids can help accelerate lung development. However, the study by researchers at Imperial College London and the University of Oulu in Finland showed the drugs may also be affecting the developing brain. They compared what happened to 37 premature children whose mother was injected with steroids with 185 premature children, of the same weight and gestational age, who were not exposed to the extra dose of steroid. When the children were followed to the age of eight, there was a higher incidence of attention deficit hyperactivity disorder. No difference could be detected at age 16, but this may have been due to the small size of the study. BBC © 2013

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 4: Development of the Brain
Link ID: 18970 - Posted: 11.25.2013

Common Insecticides May Be Linked to Kids' Behavior Problems

By Lindsey Konkel and Environmental Health News Insecticides commonly used in households may be associated with behavior problems in children, according to a new study by researchers in Quebec. The study is one of the first to investigate potential human health effects of pyrethroids, which are used in more than 3,500 commercial products, including flea bombs and roach sprays. The findings raise some questions about the safety of the compounds, which have replaced other insecticides with known risks to children’s brain development. Exposure to pyrethroids, which kill insects by interfering with their nervous systems, is widespread because they are used inside homes and schools, in municipal mosquito control and on farms. In the study, the urine of 779 Canadian children between the ages of 6 and 11 was tested, and their parents answered questions about each child’s behavior. Ninety-seven percent of the children had traces of pyrethroid breakdown products in their urine, and 91 percent had traces of organophosphates, another class of pesticides. A 10-fold increase in urinary levels of one pyrethroid breakdown product, cis-DCCA, was associated with a doubling in the odds of a child scoring high for parent-reported behavioral problems, such as inattention and hyperactivity. Another breakdown product, trans-DCCA, was also associated with more behavior problems, although the association was not statistically significant, meaning the finding could be due to chance. The breakdown product, trans- and cis-DCCA, is specific to certain pyrethroids – namely permethrin, cypermethrin and cyfluthrin. © 2013 Scientific American

Despite years of ADHD research, diagnosis remains tricky and treatment, more so

By Amanda Mascarelli, When my son was in preschool, I did what many parents of excessively energetic and impulsive preschoolers have surely done: I worried whether his behavior might be a sign of attention-deficit hyperactivity disorder (ADHD). Then I sought input from two pediatricians and a family therapist. The experts thought that his behavior was developmentally normal but said it was still too early to tell for sure. They offered some tips on managing his behavior and creating more structure at home. One pediatrician worked with my son on self-calming techniques such as breathing deeply and pushing on pressure points in his hands. He also suggested an herbal supplement, Valerian Super Calm, for him to take with meals and advised us on dietary adjustments such as increasing my son’s intake of fatty acids. Studies have shown that a combination of omega-3 (found in foods such as walnuts, flaxseed and salmon) and omega-6 fatty acids (from food oils such as canola and flax) can reduce hyperactivity and other ADHD symptoms in some children. In the couple of years since trying these techniques, my son has outgrown most of those worrisome behaviors. I had just about written off the possibility of ADHD until a few weeks ago, when his kindergarten teacher mentioned that she was going to keep an eye on him for possible attention issues. Hearing that left me worried and heavy-hearted. Why is it still so hard to diagnose ADHD? And why is there so much emotional baggage associated with treating it? There are no firm numbers for the number of children with ADHD in the United States. The Centers for Disease Control and Prevention estimates that 9 percent of U.S. children ages 5 to 17 had received diagnoses of ADHD as of 2009. © 1996-2013 The Washington Post

Extra gene makes mice manic

Amanda Mascarelli Duplication of a single gene — and too much of the corresponding protein in brain cells — causes mice to have seizures and display manic-like behaviour, a study has found. But a widely used drug reversed the symptoms, suggesting that it could also help some people with hyperactivity who do not respond to common treatments. Smooth functioning at the synapses, the junctions between brain cells, is crucial to functions that control everything from social etiquette to everyday decision-making. It is increasingly thought that some neuropsychiatric disorders are caused by function of the synapses going awry1, and indeed researchers have found that neuropsychiatric conditions such as schizophrenia and autism can sometimes be traced to missing, mutated or duplicated copies of SHANK32, a gene that encodes one of the 'architectural' proteins that help to ensure that messages are relayed properly between cells. Some people with attention deficit hyperactivity disorder (ADHD), Asperger's syndrome or schizophrenia have an extra copy of a wider region of DNA that contains SHANK33. To explore the role of SHANK3, Huda Zoghbi, a neurogeneticist at Baylor College of Medicine in Houston, Texas, and her colleagues created mice with duplicate copies of the gene. “The mouse was remarkably hyperactive, running around like mad,” says Zoghbi. But the animals did not respond to stimulant medications typically used to treat ADHD. Instead, their hyperactivity grew much worse. “That’s when we knew this was not typical ADHD,” says Zoghbi. The study is published today in Nature4. © 2013 Nature Publishing Group

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 14: Attention and Higher Cognition
Link ID: 18829 - Posted: 10.24.2013

The Not-So-Hidden Cause Behind the A.D.H.D. Epidemic

By MAGGIE KOERTH-BAKER Between the fall of 2011 and the spring of 2012, people across the United States suddenly found themselves unable to get their hands on A.D.H.D. medication. Low-dose generics were particularly in short supply. There were several factors contributing to the shortage, but the main cause was that supply was suddenly being outpaced by demand. The number of diagnoses of Attention Deficit Hyperactivity Disorder has ballooned over the past few decades. Before the early 1990s, fewer than 5 percent of school-age kids were thought to have A.D.H.D. Earlier this year, data from the Centers for Disease Control and Prevention showed that 11 percent of children ages 4 to 17 had at some point received the diagnosis — and that doesn’t even include first-time diagnoses in adults. (Full disclosure: I’m one of them.) That amounts to millions of extra people receiving regular doses of stimulant drugs to keep neurological symptoms in check. For a lot of us, the diagnosis and subsequent treatments — both behavioral and pharmaceutical — have proved helpful. But still: Where did we all come from? Were that many Americans always pathologically hyperactive and unable to focus, and only now are getting the treatment they need? Probably not. Of the 6.4 million kids who have been given diagnoses of A.D.H.D., a large percentage are unlikely to have any kind of physiological difference that would make them more distractible than the average non-A.D.H.D. kid. It’s also doubtful that biological or environmental changes are making physiological differences more prevalent. Instead, the rapid increase in people with A.D.H.D. probably has more to do with sociological factors — changes in the way we school our children, in the way we interact with doctors and in what we expect from our kids. © 2013 The New York Times Company

Forget the meds and special schools: The best cure for my son’s learning issues is time off

By Rebecca Lanning, Everywhere I went, people asked me about my son Will. They knew he’d graduated from high school, and they wanted to know what he was doing. Smiling politely, I told them that Will had been accepted to his first-choice college. But, I always added — in case someone saw him around town — that he had deferred enrollment. He was taking a gap year, I’d say. “So what’s your son doing with his windfall of free time? Traveling abroad? Doing research?” My cheeks burned as I played along, offering sound bites. A start-up venture. A film project. Independent study. Anything to avoid the truth: that my handsome, broad-shouldered son was, probably, at that very moment, home in bed with the shutters drawn, covers pulled over his head. Officially, Will was taking a gap year. But after 13 years of school, what he needed, what he’d earned, was a nap year. Will has long suffered from learning difficulties. It took years to pinpoint a diagnosis — and even when we did, figuring out how to manage it wasn’t easy. He needed a break. So did I. Will’s problems began to surface when he was in kindergarten. “He’s not where the other children are,” his teacher whispered to me one morning. I knew what she meant. Clumsy and slow to read, Will rested his head on his desk a lot. His written work, smudgy from excessive erasing, looked like bits of crumpled trash. School was torture for Will. He couldn’t take notes, failed to turn in homework, forgot when tests were coming up. Yet on standardized tests, his verbal scores consistently exceeded the 99th percentile. I wondered why he struggled, when clearly he was bright. © 1996-2013 The Washington Post

Inner ear disorders 'linked to hyperactivity '

Inner-ear problems could be a cause of hyperactive behaviour, research suggests. A study on mice, published in Science, said such problems caused changes in the brain that led to hyperactivity. It could lead to the development of new targets for behaviour disorder treatments, the US team says. A UK expert said the study's findings were "intriguing" and should be investigated further. Behavioural problems such as ADHD are usually thought to originate in the brain. But scientists have observed that children and teenagers with inner-ear disorders - especially those that affect hearing and balance - often have behavioural problems. However, no causal link has been found. The researchers in this study suggest inner-ear disorders lead to problems in the brain which then also affect behaviour. The team from the Albert Einstein College of Medicine of Yeshiva University in New York noticed some mice in the lab were particularly active - constantly chasing their tails. They were found to be profoundly deaf and have disorders of the inner ear - of both the cochlea, which is responsible for hearing, and the vestibular system, which is responsible for balance. The researchers found a mutation in the Slc12a2 gene, also found in humans. Blocking the gene's activity in the inner ears of healthy mice caused them to become increasingly active. BBC © 2013

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 9: Hearing, Balance, Taste, and Smell
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 6: Hearing, Balance, Taste, and Smell
Link ID: 18613 - Posted: 09.07.2013

The "Right" Treatment for ADHD: Revealed

Posted by Dr. Sushrut Jangi The child's family and physician were making decisions about how to treat this disease. Many readers voted that starting an ADHD medication and behavioral therapy together might be a good way forward. Her doctor agrees with this approach. "A lot of judgement happens the day I talk about starting medicines for young children," Dr. Chan says. Most parents have already tried numerous other routes, such as behavioral therapy which is frequently recommended first. But behavioral therapy alone is hard to implement. "It's hard to access and there's not too many families who can actually carry it out," Chan says. "If you're a single parent working multiple jobs, its really hard to fit the time to take your child regularly. It's a huge time investment." J's parents tried the behavioral therapy route and they worked hard at it. But he wasn't improving. Dr. Chan is more than familiar with the culture of fear that surrounds ADHD medications, but she feels these fears are overinflated. Consequently, children who might benefit from being on medicine get delayed treatments, which can have harmful social effects. "Children in his class already know that he's different, so they react to him differently. Children with ADHD start getting negative feedback from their peers early on." Dr. Chan feels that this is one potential justification for starting medications early. "These medicines can help children get out of cycles of negative-feedback. And we're not condemning children to medicine for the rest of their lives. They can be started as a trial, and then stopped down the line." © 2013 NY Times Co.

Addictive gaming more common with autism and ADHD

Andrew M. Seaman, Reuters Children with an autism spectrum disorder spend about twice as much time playing video games as kids who don't have a developmental disability, according to a new study. Researchers also found that children with an autism spectrum disorder or attention deficit/hyperactivity disorder (ADHD) are at an increased risk of gaming addictions, compared to children without the disabilities. "What we found is that it looks like (addictive gaming) was largely driven by inattention," Christopher Engelhardt, one of the study's authors from the University of Missouri in Columbia, told Reuters Health. Previous studies have found that children with an autism spectrum disorder or ADHD spend more time playing video games and are at increased risk for gaming addictions than other children, write the researchers in the journal Pediatrics. No single study, however, has looked at the three groups to see whether shared features of autism and ADHD - such as inattention or hyperactivity - seem to drive video game use. For the new study, Engelhardt and his colleague surveyed the parents of 141 boys between the ages of 8 and 18 years old. Of those, 56 had an autism spectrum disorder, 44 had ADHD and 41 were developing normally. Overall, they found that kids with an autism spectrum disorder played - on average - 2.1 hours of video games per day. Children with ADHD spent about 1.7 hours per day playing video games and normally developing kids played about 1.2 hours per day.

Related chapters from BN: Chapter 17: Learning and Memory; Chapter 4: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Related chapters from MM:Chapter 13: Memory and Learning; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 18442 - Posted: 08.01.2013

Brain Test to Diagnose A.D.H.D. Is Approved

By SABRINA TAVERNISE WASHINGTON — The Food and Drug Administration announced on Monday that it had approved the first brain wave test to help diagnose attention deficit hyperactivity disorder in children. The test uses an electroencephalogram, or EEG, with sensors attached to a child’s head and hooked by wires to a computer to measure brain waves. It traces different types of electrical impulses given off by nerve cells in the brain and records how many times those impulses are given off each second. The test takes 15 to 20 minutes, and measures two kinds of brain waves — theta and beta. Certain combinations of those waves tend to be more prevalent in children with A.D.H.D., the Food and Drug Administration said in a news release. The disorder is one of the most common behavioral disorders in children. About 9 percent of adolescents have A.D.H.D. and the average age of diagnosis is 7, the drug agency said, citing the American Psychiatric Association. Children who have it tend to be hyperactive, impulsive and exhibit behavioral problems. The maker of the testing device, NEBA Health of Augusta, Ga., gave the F.D.A. data from a study of 275 children and adolescents, ages 6 to 17, with attention or hyperactivity problems. Clinicians used the device, called a Neuropsychiatric EEG-Based Assessment Aid, in combination with traditional testing methods, like listing the criteria in the Diagnostic and Statistical Manual of Mental Disorders, behavioral questionnaires and I.Q. testing. An outside group of researchers then reviewed the data and decided whether the child had the disorder. The results showed that the device helped doctors make a more accurate diagnosis than using traditional methods alone, the F.D.A. said. An agency spokeswoman said it did not release the study’s data. © 2013 The New York Times Company

No Link Seen Between Child Stimulant Use and Later Drug Abuse

By ALAN SCHWARZ An analysis published Wednesday by the American Medical Association said children with attention deficit hyperactivity disorder who take stimulant medication do not have a lower risk over all for later substance abuse, contradicting the longstanding and influential message that such medicines tend to deter those with the disorder from abusing other substances. The paper, written by three researchers at the University of California, Los Angeles, examined data from 15 previous studies on the subject and determined that, on average, medications like Adderall and Ritalin had no effect one way or the other on whether children abused alcohol, marijuana, nicotine or cocaine later in life. A 2003 study in the journal Pediatrics had concluded that the introduction of stimulant medication to children with A.D.H.D. reduced the risk of such abuse later in life, a finding that has been repeated by doctors and pharmaceutical companies not only to assuage parents’ fears of medication but also to suggest that the pills would protect their children from later harm. “I always doubted the whole ‘protection’ argument, and I wasn’t the only one, but that message was really out there,” said Liz Jorgensen, an adolescent addiction specialist at Insight Counseling in Ridgefield, Conn. “Hopefully, this message will be heard loud and clear.” The study comes amid growing concern about the persistent rise in A.D.H.D. diagnoses and prescriptions for medication among children. A recent New York Times analysis of data collected by the Centers for Disease Control and Prevention found that 11 percent of all children ages 4 through 17 — 6.4 million over all — had received a diagnosis of A.D.H.D. from a medical professional. The diagnosis rate rose to 19 percent for boys of high school age. © 2013 The New York Times Company

Childhood ADHD Linked to Obesity in Adulthood

By Tara Haelle Identification and treatment issues surrounding attention deficit hyperactivity disorder (ADHD) are challenging enough. Now research is shedding light on long-term outcomes for people with ADHD. A recent study in Pediatrics reports that men who had ADHD in childhood are twice as likely to be obese in middle age, even if they no longer exhibit symptoms of ADHD. ADHD is a mental disorder characterized by hyperactivity, impulsivity, inattention and inability to focus. It affects approximately 6.8 percent of U.S. children ages 3 to 17 in any given year, according to a recent report by the CDC. Medications used to treat ADHD, such as Ritalin (methylphenidate) or Adderall (dextroamphetamine and amphetamine), are stimulants that can suppress appetite, however, a couple recent retrospective studies have pointed to a possible increased risk for obesity among adults diagnosed with ADHD as children. The new 33-year prospective study started with 207 healthy middle-class white boys from New York City between 6 and 12 years old, who had been diagnosed with ADHD. When the cohort reached an average age of 18, another 178 healthy boys without ADHD were recruited for comparison. At the most recent follow-up when the participants were an average age of 41, a total of 222 men remained in the study. A troubling pattern emerged: A comparison of the men’s self-reported height and weight revealed that twice as many men with childhood ADHD were obese than those without childhood ADHD. The average body mass index (BMI) of the men with childhood ADHD was 30.1 and 41.4 percent were obese, whereas those without the condition as kids reported an average BMI of 27.6 and an obesity rate of 21.6 percent. The association held even after the researchers controlled for socioeconomic status, depression, anxiety and substance abuse disorders. © 2013 Scientific American

Related chapters from BN: Chapter 18: Attention and Higher Cognition; Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 14: Attention and Higher Cognition; Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 18174 - Posted: 05.20.2013

Are Doctors Diagnosing Too Many Kids with ADHD?

By Scott O. Lilienfeld and Hal Arkowitz A German children's book from 1845 by Heinrich Hoffman featured “Fidgety Philip,” a boy who was so restless he would writhe and tilt wildly in his chair at the dinner table. Once, using the tablecloth as an anchor, he dragged all the dishes onto the floor. Yet it was not until 1902 that a British pediatrician, George Frederic Still, described what we now recognize as attention-deficit hyperactivity disorder (ADHD). Since Still's day, the disorder has gone by a host of names, including organic drivenness, hyperkinetic syndrome, attention-deficit disorder and now ADHD. Despite this lengthy history, the diagnosis and treatment of ADHD in today's children could hardly be more controversial. On his television show in 2004, Phil McGraw (“Dr. Phil”) opined that ADHD is “so overdiagnosed,” and a survey in 2005 by psychologists Jill Norvilitis of the University at Buffalo, S.U.N.Y., and Ping Fang of Capitol Normal University in Beijing revealed that in the U.S., 82 percent of teachers and 68 percent of undergraduates agreed that “ADHD is overdiagnosed today.” According to many critics, such overdiagnosis raises the specter of medicalizing largely normal behavior and relying too heavily on pills rather than skills—such as teaching children better ways of coping with stress. Yet although data point to at least some overdiagnosis, at least in boys, the extent of this problem is unclear. In fact, the evidence, with notable exceptions, appears to be stronger for the undertreatment than overtreatment of ADHD. © 2013 Scientific American,

Attention-Deficit Drugs Face New Campus Rules

By ALAN SCHWARZ FRESNO, Calif. — Lisa Beach endured two months of testing and paperwork before the student health office at her college approved a diagnosis of attention deficit hyperactivity disorder. Then, to get a prescription for Vyvanse, a standard treatment for A.D.H.D., she had to sign a formal contract — promising to submit to drug testing, to see a mental health professional every month and to not share the pills. “As much as it stunk, it’s nice to know, ‘O.K., this is legit,' ” said Ms. Beach, a senior at California State University, Fresno. The rigorous process, she added, has deterred some peers from using the student health office to obtain A.D.H.D. medications, stimulants long abused on college campuses. “I tell them it takes a couple months,” Ms. Beach said, “and they’re like, ‘Oh, never mind.’ ” Fresno State is one of dozens of colleges tightening the rules on the diagnosis of A.D.H.D. and the subsequent prescription of amphetamine-based medications like Vyvanse and Adderall. Some schools are reconsidering how their student health offices handle A.D.H.D., and even if they should at all. Various studies have estimated that as many as 35 percent of college students illicitly take these stimulants to provide jolts of focus and drive during finals and other periods of heavy stress. Many do not know that it is a federal crime to possess the pills without a prescription and that abuse can lead to anxiety, depression and, occasionally, psychosis. Although few experts dispute that stimulant medications can be safe and successful treatments for many people with a proper A.D.H.D. diagnosis, the growing concern about overuse has led some universities, as one student health director put it, “to get out of the A.D.H.D. business.” © 2013 The New York Times Company

All in the ADHD family: Diagnosis in kids can spotlight parents' own condition

By Linda Carroll, Kate Snow and Meghan Frank, NBC News As a little girl, Bonnie Ihme had big plans. Bright and artistically talented, she dreamed of becoming an architect. But the older she got, the more distant that dream seemed. By third grade, school had become a struggle. She felt easily distracted and found it impossible to focus in class. Eventually she abandoned her plan to be an architect. Ihme got married, had two kids and began cleaning houses and helping her husband with his business. But even that simpler life felt impossibly difficult. The Michigan mom had trouble keeping track of all the threads of her life. She’d send her kids to school without sneakers on gym day. She’d forget to bring library books back. She felt more overwhelmed than ever before. “I really would try hard to pull it all together,” Ihme told NBC’s Kate Snow in an interview airing on Rock Center Friday. “But when … you’re late for a Christmas concert that your daughter was really looking forward to going to and we get there and her class is walking back to the classroom and the tears in her eyes… you try harder.” Ihme saw history repeating itself in her 10-year-old son, Jacob, who began struggling with school, just as she had. Jacob would spend hours doing his homework, only to forget to bring it to school the next morning. Ihme’s heart ached for her son. © 2013 NBCNews.com

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 18001 - Posted: 04.08.2013

A.D.H.D. Seen in 11% of U.S. Children as Diagnoses Rise

By ALAN SCHWARZ and SARAH COHEN Nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. These rates reflect a marked rise over the last decade and could fuel growing concern among many doctors that the A.D.H.D. diagnosis and its medication are overused in American children. The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 53 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis. “Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.” And even more teenagers are likely to be prescribed medication in the near future because the American Psychiatric Association plans to change the definition of A.D.H.D. to allow more people to receive the diagnosis and treatment. A.D.H.D. is described by most experts as resulting from abnormal chemical levels in the brain that impair a person’s impulse control and attention skills. © 2013 The New York Times Company

ADHD in adults? It’s more common, studies suggest, and often undiagnosed.

By Jan Brogan Paula Driscoll had a hard time sitting still as a kid, doodled a lot, and often wrestled with the feeling that she should be accomplishing more. But she made it through high school and college and became an elementary school teacher. With three small children at home, she did not feel she had trouble managing her life. But when her youngest child went to school, she found herself with what felt like too much time on her hands. “I couldn’t get anything done,” she said. “I had one room I started to paint, another I was going to reorganize, and I could never complete a task. I couldn’t stay in the house. I went out on one errand after the next.” Driscoll was 45 when she was diagnosed with attention deficit hyperactivity disorder, or ADHD. ADHD, a neurobiological disorder that makes it difficult to focus and can also include hyperactivity and impulsivity, has historically been viewed as a childhood disease. Over the last couple decades, research has shown that many of those afflicted carry symptoms into adulthood. The latest study, led by a Boston Children’s Hospital researcher and published Monday in the journal Pediatrics, suggests that nearly 30 percent of those with childhood ADHD still have the condition as adults — often after discontinuing treatment. The researchers followed hundreds of children with ADHD into adulthood and reported that the majority had mental health problems such as alcohol or drug dependence, anxiety, depression, or a personality disorder. © 2012 NY Times Co.

ADHD Doesn't Go Away

by Sheila M. Eldred Picture someone with attention deficit hyperactivity disorder, or ADHD, and you probably conjure up an image of an elementary school-age boy. But an analysis of data from the first large, population-based study to follow kids through to adulthood shows that the neurobehavioral disorder rarely goes away with age. Indeed, as ADHD patients make the transition to adulthood, the issues they face often multiply: they are more likely to have other psychiatric disorders and even commit suicide, reports a new study published online today in Pediatrics. NEWS: ADHD Linked to Missing Genes In fact, researchers found that only 37.5 percent of the adults who had been diagnosed with the disorder as a child were free of other psychiatric disorders, including alcohol and drug dependence, in their late 20s. Very few of the children with ADHD were still being treated as adults -- although neuropsychiatric interviews confirmed that 29 percent still had it. “I think there has been a view that ADHD is a childhood disorder, and it’s only relatively recently that people have been trained to detect it in adults,” said Nathan Blum, a developmental-behavioral pediatrician at Children’s Hospital in Philadelphia, who was not involved in the study. Among the adults who’d had ADHD as a child, 57 percent had at least one other psychiatric disorder, compared with 35 percent of the controls. Just under 2 percent percent had died; of the seven deaths, three were suicides. Of the controls, less than 1 percent had died. Of those 37 deaths, five were from suicide. And 2.7 percent were incarcerated at the time of recruitment for the study. © 2013 Discovery Communications, LLC.

Related chapters from BN: Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 14: Attention and Higher Cognition
Link ID: 17865 - Posted: 03.04.2013

Yet Another Harrowing Story of White Collar Addiction

By melody Yesterday, Alan Schwarz, reporting for the Sunday edition of The New York Times, published an alarmist piece on Adderall abuse. The story chronicles the short life of Richard Fee, a popular young pre-med who, after dabbling in fast-acting stimulants in college, faked his way into an ADHD diagnosis and, within months of filling his first prescription, began heavily abusing the drug, leading to severe addiction and psychosis, and ultimately to his suicide, two years ago, at the age of twenty-four. The story of Richard Fee is a tragic one, and one that highlights both the dangers of prescribing ADHD drugs to neurotypical adults and some of the problems endemic in psychiatric diagnosis. Regrettably, the reporter seems to believe that these problems are somehow specific to amphetamines, signaling “widespread failings in the system through which five million Americans take medication for ADHD”, and that Richard’s harrowing case, while undoubtedly rare, “underscores aspects of ADHD treatment that are mishandled every day with countless patients”. Schwarz is a Pulitzer-prize nominated journalist, renowned for exposing the danger of concussive head injuries in football. More recently, he has cast that same critical eye on how attention-deficit disorder is diagnosed. The question is – to what end? Presumably – in the case of this story – to tighten the restrictions on how amphetamines are prescribed to adults, and to ward against the kind of negligence and lack of oversight that characterized Richard’s case. But there is a delicate balance to be struck here between serving the needs of the ADHD population, many of whom benefit tremendously from the regulated use of stimulants, and potential drug addicts, like Richard. It is also far from clear, given the nature of psychiatric nosology, that there are any surefire ways of stopping con-artists and addicts from gaming the system. © 2013 Scientific American

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