Recent quotes:

African-American mothers rate boys higher for ADHD: Maternal race may impact racial differences in ADHD diagnosis more than child race, researchers report -- ScienceDaily

"Differences in ADHD symptom ratings were influenced almost entirely by maternal race."

How attention orchestrates groups of nerve cells to enrich the brain's symphony -- ScienceDaily

Silence in the concert hall. The conductor raises the baton and the strings begin. They play the first four bars of Mozart's "A Little Night Music." All together they play a single melody, which is probably one of the best known in the music world. Then the voices divide. Different string instruments play separate melodies and the "Little Night Music" thus becomes a complex work of art. Scientists from the German Primate Center (DPZ) -- Leibniz Institute for Primate Research in Göttingen and Institute for Research in Fundamental Sciences in Tehran, Iran, recently discovered in a study with rhesus monkeys that nerve cells assume the role of musicians in visual perception in our brain. Usually many cells are active together (synchronously) when they process simple stimuli from our environment. The researchers were able to show that visual attention desynchronizes these nerve cells' activity and thus enables more complex information processing. Such insights into the neural mechanisms of attention in the healthy state may provide evidence of mechanisms underlying neuronal diseases such as attention deficit hyperactivity disorder (ADHD) or autism (BMC Biology).

What you don't look for can't hurt your share price...

Only nine of 185 randomized clinical trials and 23 of 259 non-randomized studies and patient reports of methylphenidate in children and adolescents with ADHD reported assessment of psychotic symptoms.

Study identifies distinct origin of ADHD in children with history of brain injury -- ScienceDaily

The researchers also looked for hallmark abnormalities in brain structure associated with the disorder. The association between volumes of ADHD-related brain structures and ADHD symptom severity was similar between the two groups. However, an analysis of the connections bridging the two brain hemispheres revealed opposite relationships with ADHD symptoms between the groups. The structural findings indicate the presence of both similar and distinct neural mechanisms that cause ADHD after TBI.

ADHD drugs do not improve cognition in healthy college students -- ScienceDaily

Results of the new study, published last month in the journal Pharmacy, show that the standard 30 mg dose of Adderall did improve attention and focus -- a typical result from a stimulant -- but that effect failed to translate to better performance on a battery of neurocognitive tasks that measured short-term memory, reading comprehension and fluency. Weyandt has a theory about why working memory would be adversely affected by the medication. Brain scan research shows that a person with ADHD often has less neural activity in the regions of the brain that control executive function -- working memory, attention, self-control. For people with ADHD, Adderall and similar medications increase activity in those regions and appear to normalize functioning. "If your brain is functioning normally in those regions, the medication is unlikely to have a positive effect on cognition and my actually impair cognition. In other words, you need to have a deficit to benefit from the medicine," Weyandt said. Participants in the study also reported their perceived effects of the drug and its impact on their emotions, with students reporting significant elevation of their mood when taking Adderall. In contrast to the small, mixed effects on cognition, the drug had much larger effects on mood and bodily responses, increasing positive mood, emotional ratings of the drug effect, heart rate and blood pressure. "These are classic effects of psychostimulants," said White. "The fact that we see these effects on positive emotion and cardiovascular activity, in the same individuals for whom cognitive effects were small or negative in direction, is important. It indicates that the cognitive and the emotional impact of these drugs are separate. How you feel under the drug does not necessarily mean that there is an improvement in cognition; there can be a decrease, as seen here in young adults without ADHD."

Therapy dogs effective in reducing symptoms of ADHD, study finds -- ScienceDaily

Results from Schuck's research indicate children with ADHD who received canine assisted intervention (CAI) experienced a reduction in inattention and an improvement in social skills. And, while both CAI and non-CAI interventions were ultimately found to be effective for reducing overall ADHD symptom severity after 12 weeks, the group assisted by therapy dogs fared significantly better with improved attention and social skills at only eight weeks and demonstrated fewer behavioral problems. No significant group differences, however, were reported for hyperactivity and impulsivity. "Our finding that dogs can hasten the treatment response is very meaningful," said Schuck. "In addition, the fact that parents of the children who were in the CAI group reported significantly fewer problem behaviors over time than those treated without therapy dogs is further evidence of the importance of this research."

Nonprescription use of Ritalin linked to adverse side effects, UB study finds - University at Buffalo

“We saw changes in the brain chemistry in ways that are known to have an impact on the reward pathway, locomotor activity, and other behaviors, as well as effects on body weight,” Thanos says. “These changes in brain chemistry were associated with serious concerns such as risk-taking behaviors, disruptions in the sleep/wake cycle and problematic weight loss, as well as resulting in increased activity and anti-anxiety and antidepressive effects.” Further research indicated that female subjects were more sensitive to the behavioral effects of methylphenidate than the males. Thanos hopes that studying the effects of methylphenidate on those without ADHD may lead to a greater understanding of how the drug works on the brain and behavior, and can help researchers understand the impact of the drug on young people throughout development. “Understanding more about the effects of methylphenidate is also important as people with ADHD show greater risk to be diagnosed with a drug dependency problem,” Thanos says. “In addition, this study highlights the potential long-range risks college students take in using Ritalin for a quick study boost.”

Napping and teenage learning

Routine nappers, who napped five to seven days in a week, had sustained attention, better nonverbal reasoning ability and spatial memory. How long to nap is also an important question? The sweet spot is between 30 to 60 minutes. A nap longer than one hour interferes with circadian rhythm. Participants who slept between 30 to 60 minutes produced better accuracy in attention tasks as well as faster speed. She recommends not to nap after 4 p.m., nor over-nap. Researchers were surprised to find a positive relationship between midday napping and nighttime sleep, which is different than the literature. Habitual nappers (who napped more often) tended to have a better nighttime sleep. “That’s different than the findings in the United States, where napping may serve as a function to replace sleep lost from the previous night. Consequently, that may interfere with the following night’s sleep,” Ji said. “In China, a midday nap is considered a healthy lifestyle. Routine nappers are more likely to experience healthy nighttime sleep. So routine nappers are essentially trained to sleep well and sleep more at night.”

Prevalence | ADHD | NCBDDD | CDC

Percent of Youth Aged 4-17 Ever Diagnosed with Attention-Deficit/Hyperactivity Disorder by State: National Survey of Children's Health

Geographic variation in the prevalence of attention-deficit/hyperactivity disorder: the sunny perspective. - PubMed - NCBI

The preventative effect of high SI might be related to an improvement of circadian clock disturbances, which have recently been associated with ADHD. These findings likely apply to a substantial subgroup of ADHD patients and have major implications in our understanding of the etiology and possibly prevention of ADHD by medical professionals, schools, parents, and manufacturers of mobile devices.

The Selling of Attention Deficit Disorder - The New York Times

In an interview last month, Dr. Dodson said he makes a new diagnosis in about 300 patients a year and, because he disagrees with studies showing that many A.D.H.D. children are not impaired as adults, always recommends their taking stimulants for the rest of their lives. He said that concern about abuse and side effects is “incredibly overblown,” and that his longtime work for drug companies does not influence his opinions. He said he received about $2,000 for the 2002 talk for Shire. He earned $45,500 in speaking fees from pharmaceutical companies in 2010 to 2011, according to ProPublica, which tracks such payments. “If people want help, my job is to make sure they get it,” Dr. Dodson said. Regarding people concerned about prescribing physicians being paid by drug companies, he added: “They like a good conspiracy theory. I don’t let it slow me down.”

OCD after three weeks on ADHD drugs – henry copeland – Medium

One boy spent 36 hours playing with legos. Another had a similar experience with video games. Another child spent seven straight hours raking leaves, “after which he still felt compelled to rake individual leaves as they fell.”

Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. - PubMed - NCBI

We analyzed data from 49 randomized, controlled clinical trials in the pediatric development programs for these products. A total of 11 psychosis/mania adverse events occurred during 743 person-years of double-blind treatment with these drugs, and no comparable adverse events occurred in a total of 420 person-years of placebo exposure in the same trials. The rate per 100 person-years in the pooled active drug group was 1.48.

Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

Mosholder et al.21 reviewed and analysed data from the medication manufacturers on ADHD drugs from 49 randomised controlled clinical trials. They identified a total of 11 psychosis/mania adverse events during 743 person-years of follow-up in 5717 individuals (1.48 events per 100 person-years or one event in every 70 years of treatment) compared with none reported with placebo, giving a number needed to harm of 526.

1 in 6 adults getting Adderall experience acute anxiety in 4 months

Acute anxiety symptoms occurred in 4 of 7 patients with a comorbid anxiety diagnosis. CONCLUSION:

Chapter 5—Medical Aspects of Stimulant Use Disorders - Treatment for Stimulant Use Disorders - NCBI Bookshelf

Some researchers and clinicians describe the development of stimulant-induced psychosis as an evolving process. Panel members depicted MA users as having brief and transient psychotic episodes before a full-blown psychosis emerges after more extensive chronic use. MA users often recognize these early psychotic effects and try to stave them off by self-medicating with alcohol or decreasing drug use. In several articles, Ellinwood and colleagues describe the evolution of MA-induced psychosis as progressively abnormal behaviors--beginning at moderately high doses--with intense feelings of curiosity about the environment and patterns of exploration that result, for example, in examining the punctuation periods in a magazine text for evidence of a secret code (Ellinwood et al., 1973).

Ritalin Use in Childhood Has Long-Term Effects on the Brain

The initial scans revealed that the brains of subjects who began taking Ritalin before the age of 16 (the “early treatment” group) had lower levels of GABA — a neurotransmitter linked to inhibition control and often implicated in the neurological makeup of ADHD — than did those who started stimulants later or never took them all. After Ritalin was administered, however, and the patients re-scanned, only the early treatment group saw any increase in GABA levels.

Goodman: Did Fetal Alcohol Exposure Help Create Mass Murderer Nikolas Cruz? – Respvblica

I believe that Nikolas Cruz has a form of fetal alcohol/drug syndrome, a diagnosis that can be readily made by his facial characteristics. I am an experienced neuropsychiatrist.

PsycNET Record Display - PsycNET

amphetamine psychosis can, in some cases, almost exactly replicate endogenous schizophrenia.

Florida Agency Investigated Nikolas Cruz After Violent Social Media Posts - The New York Times

Agency investigators identified Mr. Cruz, who had turned 18 a few days earlier, as a “vulnerable adult due to mental illness.” In addition to depression, Mr. Cruz had autism and attention-deficit hyperactivity disorder, the report said. He was regularly taking medication for the A.D.H.D. It was unclear whether he was taking anything for the depression, according to the report.

12 of 14

A large dose of intravenous methamphetamine hydrochloride reproduced the amphetamine psychosis in 12 of 14 patients dependent on amphetamine sulfate and failed to produce a psychosis in two patients who were eventually found to have not used amphetamine regularly above the therapeutic dose range. The psychosis was the facsimile of the disorder observed during drug abuse—a schizophrenic-like state of paranoia in a setting of clear consciousness accompanied by auditory or visual hallucinations, or both, but without thought disorder. Since in some cases the onset of the psychosis was sudden and occurred within one hour of commencing the intravenous injection, hypotheses about depletion of catecholamines and long term metabolites may need to be reconsidered.

Frontiers | The Role of Infection and Immune Responsiveness in a Case of Treatment-Resistant Pediatric Bipolar Disorder | Psychiatry

P’s behavior appeared treatment resistant with minimal improvement despite multiple medication trials prior to and during hospitalizations.

Amid ADHD spike, doctors urge closer look at sleep issues -- ScienceDaily

D-diagnosed children whose behavior only improves after better sleep quality and duration. Occasionally, he has found that ADHD medications are the root of the sleep issues.

Long-term ADHD Med Use: No Benefit, Negative Impact on Growth

Moreover, individuals in the consistent/inconsistent groups were significantly shorter than those in the negligible group, at an average height reduction of 2.55 ± 0.73 cm (P < .0005). Those in the consistent group were on average 2.36 ± 1.13 cm shorter than those in the inconsistent group, a difference that was again significant (P = .04).

Researchers 'dismantle' mindfulness intervention to see how each component works -- ScienceDaily

As health interventions based on mindfulness have grown in popularity, some of the field's leading researchers have become concerned that the evidence base for such practices is not yet robust enough. A new study shows how a rigorous approach to studying mindfulness-based interventions can help ensure that claims are backed by science. One problem is that mindfulness-based interventions (MBIs) sometimes blend practices, which makes it difficult to measure how each of those practices affects participants. To address that issue, the researchers took a common intervention for mood disorders -- mindfulness-based cognitive therapy (MBCT) -- and created a controlled study that isolated, or dismantled, its two main ingredients. Those include open monitoring (OM) -- noticing and acknowledging negative feelings without judgment or an emotional secondary reaction to them; and focused attention (FA) -- maintaining focus on or shifting it toward a neutral sensation, such as breathing, to disengage from negative emotions or distractions. "It has long been hypothesized that focused attention practice improves attentional control while open-monitoring promotes emotional non-reactivity -- two aspects of mindfulness thought to contribute its therapeutic effects," said study lead and corresponding author Willoughby Britton, an assistant professor of psychiatry and human behavior in the Warren Alpert Medical School of Brown University. "However, because these two practices are almost always delivered in combination, it is difficult to assess their purported differential effects. By creating separate, validated, single-ingredient training programs for each practice, the current project provides researchers with a tool to test the individual contributions of each component and mechanism to clinical endpoints." In the study, the researchers randomized more than 100 individuals with mild-to-severe depression, anxiety and stress to take one of three eight-week courses: one set of classes provided a standardized MBCT that incorporated the typical blend of OM and FA. The two other classes each provided an intervention that employed only OM or only FA. In every other respect -- time spent in class, time practicing at home, instructor training and skill, participant characteristics, number of handouts -- each class was comparable by design. At the beginning and end of the classes, the researchers asked the volunteers to answer a variety of standardized questionnaires, including scales that measure their self-reported ability to achieve some of the key skills each practice is assumed to improve. If the researchers saw significant differences between the FA group and the OM group on the skills each was supposed to affect, then there would be evidence that the practices uniquely improve those skills as intervention providers often claim. Sure enough, the different practices engaged different skills and mechanisms as predicted. The FA-only group, for example, reported much greater improvement in the ability to willfully shift or focus attention than the OM-only group (but not the MBCT group, which also received FA training). Meanwhile, the OM-only group was significantly more improved than the FA-only group (but not the MBCT group) in the skill of being non-reactive to negative thoughts.

Is ADHD really a sleep problem? -- ScienceDaily

"There is extensive research showing that people with ADHD also tend to exhibit sleep problems. What we are doing here is taking this association to the next logical step: pulling all the work together leads us to say that, based on existing evidence, it looks very much like ADHD and circadian problems are intertwined in the majority of patients. We believe this because the day and night rhythm is disturbed, the timing of several physical processes is disturbed, not only of sleep, but also of temperature, movement patterns, timing of meals, and so on. If you review the evidence, it looks more and more like ADHD and sleeplessness are 2 sides of the same physiological and mental coin."