Research - Attention Deficit Hyperactivity Disorder
Baseline Omega-3 Index Correlates with Aggressive and Attention Deficit Disorder Behaviours in Adult Prisoners
Barbara J. Meyer , Mitchell K. Byrne, Carole Collier, Natalie Parletta, Donna Crawford, Pia C. Winberg, David Webster, Karen Chapman, Gayle Thomas, Jean Dally, Marijka Batterham, Ian Farquhar, Anne-Marie Martin, Luke Grant
BackgroundThere is emerging evidence that the supplementation of omega-3 contributes to a decrease in aggressive behaviour in prison populations. A challenge of such research is achieving statistical power against effect sizes which may be affected by the baseline omega-3 index. There are no published data on the blood omega-3 index with studies of this kind to assess the variability of the blood omega-3 index in conjunction with aggression and attention deficit assessments.
To determine if the variance of the omega-3 index is correlated with aggressive and attention deficit behaviour in a prison population.
136 adult male prisoners were recruited from South Coast Correctional Centre (SCCC), NSW Australia. A 7 point categorisation was used to quantify levels of aggressive behaviour (4 weeks) from individual SCCC case notes, whereby higher scores correspond to increasingly aggressive behaviour. Study participants completed the Aggression Questionnaire (AQ) and the Brown’s Attention Deficit Disorder Scales (BADDS), provided a blood sample for erythrocyte fatty acid analysis using gas chromatography and the omega-3 index was calculated.
The baseline omega-3 index ranged from 2.3% to 10.3%, indicating that some participants already had substantial omega-3 intake, however a median of 4.7% indicated a lower overall omega-3 intake than the general Australian population. Assessment of aggressive and attention deficit behaviour shows that there were negative correlations between baseline omega-3 index and baseline aggression categorisation scores (r = −0.21, P = 0.016); total AQ score (r = −0.234, P = 0.011); Anger (r = -0.222 p = 0.016); Hostility AQ (r = −0.239, P = 0.009); indirect aggression (r = −0.188 p = 0.042); total BADDS (r = −0.263, p = 0.005); Activation (r = −0.224, p = 0.016); Attention (r = −0.192, p = 0.043); Effort (r = −0.253, p = 0.007); Affect (r = −0.330, p = 0.000) and Memory (r = −0.240, p = 0.010).
There is a high variability in omega-3 status of a NSW prison population, and inmates with lower omega-3 index were more aggressive and had higher ADD scores.
Source : Plos One
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Ginkgo biloba Extract EGb 761® in Children with ADHD Preliminary Findings of an Open Multilevel Dose-Finding Study
Objectives: The side effects, nonresponse, and prejudices against conventional pharmacological treatments call for complementary or alternative medical treatments (CAM) for ADHD. One possible treatment, at least for cognitive problems, might be the administration of Ginkgo biloba, though evidence is currently rare. This study tests the clinical efficacy of a Ginkgo biloba special extract (EGb 761®) and its correlation with brain electrical activity in children with ADHD combined type according to DSM-IV.
Method: In this open clinical pilot study, EGb 761® was administered to 20 children with ADHD over 3 to 5 weeks. Dosage was increased to a maximum of 240 mg daily if attention problems persisted. Possible drug side effects were assessed using the Side Effect Rating Scale. Efficacy was assessed in a multilevel approach including clinical assessment, quality of life (QoL), as well as performance and preparatory brain-electrical activity evoked during a Continuous Performance Test (Cue-CNV in the CPT).
Results: A very low rate of mild adverse effects occurred during the observation period. Following EGb 761® administration, possible improvements in QoL, ADHD core symptoms as well as CPT performance were detected. Improved core symptoms were positively related to elevated CNV amplitude.
Conclusion: This preliminary evidence suggests that EGb 761® at a maximal dosage of 240 mg daily might be a clinically useful alternative treatment for children with ADHD, but further evidence is required before firm conclusions can be made.
Source : Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie
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Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar, schizophrenia, and impulsive behavior
Rhonda P. Patrick1 and Bruce N. Ames1
Nutrition and Metabolism Center, Children’s Hospital Oakland Research Institute, Oakland, California, USA
Serotonin regulates a wide variety of brain functions and behaviors. Here, we synthesize previous findings that serotonin regulates executive function, sensory gating, and social behavior and that attention deficit hyperactivity disorder, bipolar disorder, schizophrenia, and impulsive behavior all share in common defects in these functions. It has remained unclear why supplementation with omega-3 fatty acids and vitamin D improve cognitive function and behavior in these brain disorders. Here, we propose mechanisms by which serotonin synthesis, release, and function in the brain are modulated by vitamin D and the 2 marine omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Brain serotonin is synthesized from tryptophan by tryptophan hydroxylase 2, which is transcriptionally activated by vitamin D hormone. Inadequate levels of vitamin D (∼70% of the population) and omega-3 fatty acids are common, suggesting that brain serotonin synthesis is not optimal. We propose mechanisms by which EPA increases serotonin release from presynaptic neurons by reducing E2 series prostaglandins and DHA influences serotonin receptor action by increasing cell membrane fluidity in postsynaptic neurons. We propose a model whereby insufficient levels of vitamin D, EPA, or DHA, in combination with genetic factors and at key periods during development, would lead to dysfunctional serotonin activation and function and may be one underlying mechanism that contributes to neuropsychiatric disorders and depression. This model suggests that optimizing vitamin D and marine omega-3 fatty acid intake may help prevent and modulate the severity of brain dysfunction.--
Source : The FASEB Journal
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ADHD Brains Are the Most Creative: Why Do We Treat It Like a Disability?
Research shows that people who have ADHD are often extremely creative. Yet our schools and society fail them.
In his 2004 book “Creativity is Forever“, Gary Davis reviewed the creativity literature from 1961 to 2003 and identified 22 reoccurring personality traits of creative people. This included 16 “positive” traits (e.g., independent, risk-taking, high energy, curiosity, humor, artistic, emotional) and 6 “negative” traits (e.g., impulsive, hyperactive, argumentative). In her own review of the creativity literature, Bonnie Cramond found that many of these same traits overlap to a substantial degree with behavioral descriptions of Attention Deficit Hyperactive Disorder (ADHD)– including higher levels of spontaneous idea generation, mind wandering, daydreaming, sensation seeking, energy, and impulsivity.
Research since then has supported the notion that people with ADHD characteristics are more likely to reach higher levels of creative thought and achievement than people without these characteristics (see here, here, here, here, here, here, here, here,here, and here). Recent research by Darya Zabelina and colleagues have found that real-life creative achievement is associated with the ability to broaden attention and have a “leaky” mental filter– something in which people with ADHD excel.
Recent work in cognitive neuroscience also suggests a connection between ADHD and creativity (see here and here). Both creative thinkers and people with ADHD show difficulty suppressing brain activity coming from the “ Imagination Network“:
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Hyperactivity, concentration difficulties and impulsiveness improve during seven weeks’ treatment with valerian root and lemon balm extracts in primary school children
Jürgen Gromballa,Frank Beschornerb, Christian Wantzenc, Ute Paulsend, Martin Burkartd
- a Dombühler Strasse 8, D-90449 Nürnberg, Germany
- b Spenglersruh 1b, D-36381 Schlüchtern, Germany
- c Gartenstraße 10, D-54470 Bernkastel-Kues, Germany
- d Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, D-76227 Karlsruhe, Germany
Valerian root and lemon balm extracts have previously shown efficacy and excellent tolerability in children < 12 years suffering from restlessness and insomnia. We now examined whether treatment with a fixed combination of both may also improve concentration, hyperactivity and impulsiveness.
169 primary school children suffering from hyperactivity and concentration difficulties but not meeting ADHS criteria were treated in an observational study by 27 office based pediatricians with a recommended daily dose of 640 mg valerian root extract WS® 1014 and 320 mg lemon balm extract WS® 1303 (Sandrin®), and evaluated by pediatricians and parents using standardized questionnaires at baseline, weeks 2 and 7.
The fraction of children having strong/very strong symptoms of poor ability to focus decreased from 75% to 14%, hyperactivity from 61% to 13%, and impulsiveness from 59% to 22%. Parent rated social behavior, sleep and symptom burden showed highly significant improvements. Only in two children mild transient adverse drug reactions were observed.
In primary school children with restlessness, concentration difficulties and impulsiveness treatment with WS® 1014 and WS® 1303 (Sandrin®) provides a viable option in addition to counseling and education.
Source : Journal Phytomedicine
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Dietary Patterns in Children with Attention Deficit/Hyperactivity Disorder (ADHD)
Hae Dong Woo 1, Dong Woo Kim 1, Young-Seoub Hong 2,3, Yu-Mi Kim 2,3, Ju-Hee Seo 3, Byeong Moo Choe 4, Jae Hong Park 4, Je-Wook Kang 5, Jae-Ho Yoo 6, Hee Won Chueh 6, Jung Hyun Lee 7, Min Jung Kwak 8 and Jeongseon Kim 1,*
Abstract: The role of diet in the behavior of children has been controversial, but the association of several nutritional factors with childhood behavioral disorders has been continually suggested. We conducted a case-control study to identify dietary patterns associated with attention deficit hyperactivity disorder (ADHD). The study included 192 elementary school students aged seven to 12 years. Three non-consecutive 24-h recall (HR) interviews were employed to assess dietary intake, and 32 predefined food groups were considered in a principal components analysis (PCA). PCA identified four major dietary patterns: the “traditional” pattern, the “seaweed-egg” pattern, the “traditional-healthy” pattern, and the “snack” pattern. The traditional-healthy pattern is characterized by a diet low in fat and high in carbohydrates as well as high intakes of fatty acids and minerals. The multivariate-adjusted odds ratio (OR) of ADHD for the highest tertile of the traditional-healthy pattern in comparison with the lowest tertile was 0.31 (95% CI: 0.12–0.79). The score of the snack pattern was positively associated with the risk of ADHD, but a significant association was observed only in the second tertile. A significant association between ADHD and the dietary pattern score was not found for the other two dietary patterns. In conclusion, the traditional-healthy dietary pattern was associated with lower odds having ADHD
Source : Journal Nutritents
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Increase in ADHD Runs Parallel With Decrease in Physical Activity
Recent coverage drawing attention to the likely over-treatment of Attention Deficit Hyperactivity Disorder (ADHD) in the United States is very concerning. Data from the Centers for Disease Control and Prevention (CDC) show the diagnosis being made in 11 percent of youth by the time they finish high school, which amounts to a near six-fold increase since 1990. There is much to question about the stark rise in this largely-subjective diagnosis, particularly given the medications used to treat ADHD carry significant side-effects for patients (e.g., insomnia, appetite loss, hallucinations) and come at a hefty financial cost to society.
Experts suggest far more children are taking meds for ADHD than really need to. While severe cases of ADHD require medication, the estimated prevalence of these cases is considerably less than the number being treated today. The majority of reporting on the over-treatment of ADHD focuses on the pharmaceutical industry's comprehensive sales and marketing toolkit, which has no doubt played a large role in the rise of the diagnosis. Makers of drugs for ADHD have strategically targeted parents and teachers for the past two decades, selling their drugs as quick fixes for hyperactive kids that are "safer than aspirin," a questionable assertion at best.
Yet there may be an additional force underlying the surge in ADHD and one that is rarely mentioned if at all. America has seen an extensive reduction in physical activity, a trend that has run in lock-step with the rise of ADHD.
Kids have lots of energy and are losing opportunities to expel it naturally. According to the CDC, less than 30 percent of adolescents meet the guidelines for daily physical activity. The reasons for this are many, ranging from neighborhood safety (i.e., crime and vehicular traffic), to urban density (and subsequent reductions in green space), to the cannibalization of what was once active time with screen-based entertainment. When taken together, the vast majority of America's youth are not moving much at all. Perhaps all of this bottled up energy is being manifested as unnatural hyperactivity, when the most unnatural part of the situation is the sedentary behavior of kids.
One of the few places youth can get protected and regular physical activity is in school, yet school districts across the country are cutting back on recess, gym classes, and after school sports programs. The most common rationale for this is that dwindling resources need to be spent on core topics (e.g., math and science) to prepare America's youth for a competitive global economy. Using precious time and money to invest in meaningful physical activity programs is thus inefficient. This is particularly ironic given studies demonstrate that when youth are engaged in regular physical activity they show less anxiety, increased focus, and better performance in academic settings, many of the primary symptoms of ADHD (not to mention the clear benefits of physical activity in reducing obesity, which some consider the country's most significant economic threat -- far greater than a lack of mathematicians and scientists). It seems we may be missing the forest for the trees.
Physical activity may work just as well if not better than strong drugs in countering the symptoms of ADHD. Yet we live in a culture where people are conditioned to want a quick fix for everything, and with a medical system that has learned to provide it. Unfortunately, this is not always the best approach, and the case of ADHD may be the latest example. Before turning to expensive drugs rife with side-effects to treat ADHD, parents, physicians, teachers, and education policy makers should consider the role of physical activity, and promote making it a regular part of children's diets.
Source : Huffington Post
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Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial
- Julia J. Rucklidge,
- Chris M. Frampton,
- Brigette Gorman and
- Anna Boggis
The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time.
To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults.
This double-blind randomised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients (n = 42) or placebo (n = 38) for 8 weeks (trial registered with the Australian New Zealand Clinical Trials Registry: ACTRN12609000308291).
Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms. Post hoc analyses showed that for those with moderate/severe depression at baseline, there was a greater change in mood favouring active treatment over placebo. There were no group differences in adverse events.
This study provides preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults, with a reassuring safety profile.
Source : British Journal Psychiatry
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Common Insecticides May Be Linked to Kids' Behavior Problems
A new study by researchers in Quebec is one of the first to investigate potential human health effects of pyrethroids, which are used in more than 3,500 commercial products
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.
No link was found between behavior scores and levels of organophosphate breakdown products.
The researchers reported that there have been few other studies investigating neurobehavioral outcomes associated with pyrethroids.
Use of pyrethroids has increased dramatically in recent years because they have replaced organophosphate pesticides, which are being phased out due to concerns about children’s health. Prenatal exposure to organophosphates has been linked to neurodevelopment delays, lower IQ scores and attention problems.
Permethrin and other pyrethroids have been widely touted as safer than organophosphates because they are a synthetic adaptation of a compound found naturally in chrysanthemum flowers.
But there is very little data on the potential health effects of pyrethroids in children. One study of 348 mother-child pairs in New York City found lower development scores in toddlers who had been exposed to pyrethroids in the womb. In studies with young laboratory animals, low levels of some pyrethroids have affected nervous system development.
“Children are at greatest risk from pesticide toxicity because the developing brain is more susceptible to neurotoxicants and they interact with their environment in particular ways such as frequent hand-to-mouth behavior and outside play,” the study authors wrote.
One limitation of the study was the small number of children that scored high for behavioral problems – only 69, or 6.8 percent of all those sampled. Pesticides also may be metabolized quickly in the body, so a single urine sample may not accurately represent a child’s exposure.
The study does not prove that pyrethroids cause behavior problems, but the authors said their findings suggest that more research is needed to determine their potential effects on children.
Source : Scientific American
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Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective
Martijn Arns, Kristiaan B. van der Heijden, L Eugene Arnold, J. Leon Kenemans
Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood, with average worldwide prevalence of 5.3%, varying by region.
We assessed the relationship between the prevalence of ADHD and solar intensity (SI) (kilowatt hours/square meters/day) on the basis of multinational and cross-state studies. Prevalence data for the U.S. were based on self-report of professional diagnoses; prevalence data for the other countries were based on diagnostic assessment. The SI data were obtained from national institutes.
In three datasets (across 49 U.S. states for 2003 and 2007, and across 9 non-U.S. countries) a relationship between SI and the prevalence of ADHD was found, explaining 34%–57% of the variance in ADHD prevalence, with high SI having an apparent preventative effect. Controlling for low birth weight, infant mortality, average income (socioeconomic status), latitude, and other relevant factors did not change these findings. Furthermore, these findings were specific to ADHD, not found for the prevalence of autism spectrum disorders or major depressive disorder.
In this study we found a lower prevalence of ADHD in areas with high SI for both U.S. and non-U.S. data. This association has not been reported before in the literature. 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
Source : Biology Psychiatry
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Cognitive Behaviour Therapy Helps Adults with ADHD
Many adults with ADHD do not obtain their diagnosis until adulthood and have struggled with difficulties related to undiagnosed ADHD for their entire lives. As documented in recent studies, this includes elevated rates of depression, anxiety disorders, substance use, work difficulties and interpersonal problems.
As with children and adolescents, medication treatment for adults with ADHD can be quite helpful, especially for reducing core ADHD symptoms of inattention and hyperactivity/impulsivity. However, as is true for children and adolescents, many adults with ADHD continue to struggle despite benefits provided by medication. In addition, some derive little if any benefit and even when core ADHD symptoms diminish, difficulties in other important areas often remain. Thus, medication alone is frequently an insufficient treatment treatment guidelines developed in the US and overseas recommend multimodal treatment for ADHD in adults. This would include psychoeducation, pharmacotherapy, and cognitive behaviour therapy (CBT).
Cognitive behavior therapy was originally developed for the treatment of depression and anxiety disorders and is focused on identifying problematic ways of thinking, i.e., cognitions, that contribute to problematic behaviors. Once problematic ways of thinking are identified, the client is encouraged to evaluate whether their cognitions are accurate and to consider alternative ways for thinking about their situation. As faulty thinking patterns are altered, more adaptive ways of behaving can begin to take shape.
For example, an adult who struggled throughout their schooling because of undiagnosed ADHD might think of themselves as stupid and unable to learn. One can imagine how these thoughts could lead to poor self-esteem, depressive symptoms, and avoidance of situations that are linked to schooling and education. In CBT, the clinician would work with the client to develop a more realistic explanation for their academic struggles, e.g., you are actually quite capable intellectually but performed poorly because your ADHD was never diagnosed and treated. In conjunction with helping the client embrace this more reasonable way to think about their academic history, the clinician would help the client develop new and more adaptive behavior patterns. For a very nice discussion of CBT for adult ADHD see http://add.about.com/od/treatmentoptions/a/Cognitive-Behavioral-Therapy-And-The-Treatment-Of-Adult-Adhd.htm
There have been a handful of CBT trials for adults with ADHD. In general, these studies indicate that CBT can help with core ADHD symptoms in addition to benefits provided by medication. However, the benefits of CBT on co-occurring difficulties that adults with ADHD often have, e.g., depression, anxiety, relationship problems, etc., have not been clearly demonstrated. This is discouraging and somewhat surprising given that CBT is an effective treatment for depression and anxiety in adults who do not have ADHD.
A study published recently in BioMed Central Psychiatry [Cognitive behaviour therapy in medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. Emillson et al., (2011). BioMed Central Psychiatry, 11:116] presents new findings on CBT delivered in a group format to adults with ADHD. (Note - This is a peer reviewed open access journal and you can review the entire study online at http://www.biomedcentral.com/content/pdf/1471-244X-11-116.pdf ). The goal of this study was to test whether a cognitive behavioural group treatment program called Reasoning and Rehabilitation for ADHD Youths and Adults, i.e., R&R2, alleviated core ADHD symptoms and comorbid problems in adults with ADHD who were receiving medication.
The study was conducted in Iceland and involved 54 adults with ADHD (34 women, mean age 34.1), all of whom were receiving ADHD medication. In addition to their ADHD diagnosis, 35 reported depression, 20 reported some form of anxiety disorder, 12 reported a history of drug/alcohol abuse, and 9 reported some other psychiatric problem; only 8 reported no comorbid difficulties.
Participants were randomly assigned to cognitive therapy or to the treatment as usual condition; the latter involved medication only, although participants were free to pursue whatever additional treatments they wished. Adults assigned to CBT remained on medication. Thus, the researchers could learn whether CBT added to any benefits already being provided by medication treatment.
R&R2 ADHD Group Cognitive Behavioural Therapy
The treatment is a 15 session structured CBT intervention that aims to decrease core ADHD symptoms and improve social functioning, problem solving, and organizational skills. It targets the following 5 areas:
1. Neurocognitive functioning - Learning strategies to improve attentional control, memory, impulse control and planning.
2. Problem solving - Developing adaptive problem solving strategies, anticipating consequences, and managing conflict.
3. Emotional Control - Learning to manage feelings of anger and anxiety.
4. Pro-social skills - Learning to recognize the thoughts and feelings of others, negotiation skills, and conflict resolutions skills.
5. Critical reasoning - Learning to evaluate options and develop behavioral skills to pursue goals appropriately.
These areas were covered in twice weekly small group sessions that lasted for 90 minutes. In addition to the group meetings, coaches met individually with participants each week for 30 minutes to review session material and assist with assigned homework. Thus, during the 15-week treatment, participants devoted 3.5 hours weekly to the program, not counting travel time; it was thus a fairly time-intensive treatment.
The researchers employed a wide range of measures to evaluate core ADHD symptoms and comorbid difficulties. Adults reported on their ADHD symptoms using the Barkley ADHD Current Symptoms Scale. They also reported on depressive and anxiety symptoms using the Beck Depression Inventory and the Beck Anxiety Inventory; both are widely used measures that have been shown to provide reliable and valid information. Finally, participants completed a measure developed specifically for the study that assessed emotional control, antisocial behavior, and social functioning.
An important strength of the study was that in addition to the self-report measures noted above, participants were evaluated by clinicians who did not know whether they had received CBT treatment or were in the control condition. These clinicians provided an independent assessment of adults' ADHD symptoms and overall level of functioning.
These measures were collected on both groups of participants before treatment began, immediately following the CBT program, and again 3 months later. Although baseline assessments were obtained on nearly all participants, the post-treatment assessment was collected on only 17 adults in each group. At the 3-month follow-up, self-report measures were collected on a similar number but the independent evaluation was only conducted with 8 adults from the CBT group and 13 from the treatment as usual group. This reflected difficulty getting participants back to the study site for the interviews to be collected, a common difficulty in such studies. (Presumably, the self-report measures could be returned via mail.)
Twenty of 27 participants (74%) who began CBT treatment completed it. This was comparable to the treatment as usual condition.
Independent raters - After controlling for baseline ratings of ADHD symptoms, CBT participants received significantly lower symptom ratings from independent evaluators immediately after treatment. The magnitude of the treatment vs. control differences would be considered large. Independent clinicians raters also tended to rate CBT participants as functioning better overall.
Self-reports - Controlling for baseline ratings, CBT participants reported significantly fewer problems with attention and with hyperactivity-impulsivity. The magnitude of the differences were large for attention problems and smaller for hyperactivity-impulsivity.
However, no post-treatment differences were evident in participants' reports of anxiety or depression. There were also no differences found for emotional control or social functioning. CBT participants did report greater reductions in antisocial behavior.
Independent raters - Differences in ratings of ADHD symptoms made by independent raters remained significant and of large magnitude. In addition, ratings of overall adjustment also significantly favored CBT participants at follow-up.
Self-reports - Group differences in self-reported ADHD symptoms remained significant at follow-up. In addition, group differences were also evident in participants' reports of depression, anxiety, emotional control, antisocial behavior, and social functioning. In all cases, the differences were of a magnitude that would be considered large.
Summary and Implications
The key findings from this study are that group CBT improved core ADHD symptoms at the end of treatment according to blind, independent observers and participants themselves. And, three months after treatment ended, evidence emerged that CBT was associated with significant reductions in a range of comorbid difficulties that many adults with ADHD struggle with. Because all participants were receiving medication, these findings suggest that the CBT program yielded benefits beyond those provided by medication.
A key strength of the study was the use of 'blind' clinicians to assess outcomes for core ADHD symptoms. Because these clinicians did not know the treatment of the adults they were evaluating, their ratings would not be influenced by this knowledge. A limitation, however, is that these clinicians only rated core ADHD symptoms and overall functioning, rather than each of the domains covered in participants' self-reports. Had these clinicians evaluated participants on depression, anxiety, etc., and reached conclusision consistent with the self-report findings, the results from this study would be even stronger.
A second limitation is that fewer than half the participants were evaluated by the independent clinicians at the 3-month follow-up. The adults who completed the 3-month independent evaluation may have been a more motivated group than those who did not, perhaps because they had attained greater benefits. However, the same argument would apply to those in the control group who returned for the 3-month follow-up. It was also the case that the subset of adults who completed the follow-up evaluation did not differ from other participants at baseline on any of the study measures. These factors serve to mitigate concerns about the validity of the follow-up data. However, the fact remains that only a small number of participants fully completed the follow-up assessment which highlights the need for replicating these findings with a larger sample.
Two other caveats are worth noting. First, the study was conducted in Iceland and whether similar findings would be attained with adults from other countries is unknown. There is no reason to assume that special characteristics of Icelandic adults with ADHD would explain the findings, however. Second, those in the CBT group received substantial amounts of attention and time from clinicians relative to those in the treatment as usual group. Thus, it is possible that it was the extra attention alone and not the specific nature of the CBT program that accounts for the more positive outcomes in the CBT group. It would be difficult to conclusively rule out this possibility in future studies, however, as it would be ethically problematic to involve adults with ADHD in a time consuming intervention that was not intended to produce tangible benefits, but simply to function as a control for the amount of attention that CBT treated participants received.
In summary, results from this study highlight that although medication treatment provides important benefits to many adults with ADHD, the addition of a well-conceived and structured group CBT treatment can yield significant incremental improvements. These gains appear to extend beyond alleviating core ADHD symptoms to include many of the important comorbid problems that adults with ADHD often struggle with. Making such treatment more widely available to adults in the community, in addition to conducting additional research on treatments for adults with ADHD, should thus be an important priority.
(Note - If you are interested in learning more about cognitive behavioral treatment for adults with ADHD, an excellent book you can consult is titled "Cognitive-Behavioral Therapy for Adult ADHD: An Integrative Psychosocial and Medical Approach" by Drs. Russell Ramsay and Anthony Rostain. It is available on Amazon and elsewhere.)
Source : Attention Research Update
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Complementary and Alternative Medical Therapies for Children with Attention-Deficit/Hyperactivity Disorder (ADHD)
Janice Pellow, M.Tech (Hom); Elizabeth M. Solomon, HD, ND, DO, BA; Candice N. Barnard, M.Tech (Hom), B.Phys.Ed
Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterized by impulsivity,
inattention, and hyperactivity. ADHD affects up to 1 in 20 children in the United States. The underlying etiologies of
ADHD may be heterogeneous and diverse, and many possible risk factors in the development of ADHD have been identified.
Conventional treatment usually consists of behavioral accommodations and medication, with stimulant medication
most commonly being prescribed. Parents concerned about the side effects and long-term use of conventional medications
are increasingly seeking alternatives to pharmacologic treatment. Complementary and alternative medicine (CAM)
offers parents various treatment options for this condition, including dietary modifications, nutritional supplementation,
herbal medicine, and homeopathy. CAM appears to be most effective when prescribed holistically and according to each
individual’s characteristic symptoms. Possible etiologies and risk factors for the condition also need to be considered when
developing a treatment plan. This article serves to highlight the latest research regarding the most commonly used CAM
for children with ADHD.
Source : Altern Med Rev 2011;16(4):323-337)
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Attention Deficit Disorder (ADHD/ADD) In Herbal Medicine Perspective
Attention Deficit Disorder (ADHD/ADD) also known as attention deficit hyperactivity disorder is a chronic disease occurs in certain age and years of a children, defined as a condition with characteristics of co-existence of attentional problems and hyperactivity. It effects about 5% of the all children in the world with boys have 3-4 times higher risk than girl. Over one third of children with ADHD will have continued symptoms existed into their adult life.
In Herbal medicine perspective
Herbal medicine believe ADHD is a result of coordination failure in the reticular activating system of the brain. Therefore, herbs used to treat ADHD are those improves concentration, attention, motivation and performance, promote the stay on task and normal energy levels and particular enhance the flow of oxygen and nutrients to the brain and supports brain functions in information processing and memory, etc.
1. Ginkgo Biloba
a. Brain-cognition effects
Ginkgo Biloba extract (GBE) have exhibited the function of alleviating symptoms of cognitive impairment in aging populationby increasing the SSVEP(state visually evoked potentia) amplitude at occipital and frontal sites and SSVEP latency at left temporal and left frontal sites, according to the study of "Examining brain-cognition effects of ginkgo biloba extract: brain activation in the left temporal and left prefrontal cortex in an object working memory task" by Silberstein RB, Pipingas A, Song J, Camfield DA, Nathan PJ, Stough C., posted in PubMed(67)
b. Acute cognitive effects
Administration of GBE complexed with phosphatidylserine have exerted the results of improingsecondary memory performance and speed of memory task performance, according to the study of "Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserine" by Kennedy DO, Haskell CF, Mauri PL, Scholey AB., posted in PubMed(68)
c. Tardive dyskinesia
Extract of Ginkgo biloba (EGb) has exerted the activity as an antioxidant in scavenging free radicals for tardive dyskinesia (TD) in in schizophrenia patients by significantly decreased the AIMS(Abnormal Involuntary Movement Scale) total score in patients with TD, according to the study of "Extract of Ginkgo biloba treatment for tardive dyskinesia in schizophrenia: a randomized, double-blind, placebo-controlled trial" by Zhang WF, Tan YL, Zhang XY, Chan RC, Wu HR, Zhou DF., posted in PubMed(69)
2. Panax ginseng
a. Antioxidant activity
In the evaluation of the extraction conditions of polysaccharides from the rhizomes of Panax japonicus C.A. Meyer and its antioxidant effect found that antioxidant activity exhibited Panax japonicus polysaccharides (PJP) had a good potential for antioxidant, according to "Optimization of polysaccharides from Panax japonicus C.A. Meyer by RSM and its anti-oxidant activity" by Wang R, Chen P, Jia F, Tang J, Ma F.(70)
b. Antipsychotic effect
In the investigation of Panax quinquefolium (PQ) and its significant neuroactive properties for its antipsychotic potential found that PQ blocked ketamine induced memory impairment in the passive avoidance paradigm. In the chronic studies, PQ reduced the ketamine induced enhanced immobility in the forced swim test and did not show extra-pyramidal side effects in bar test and wood block test of catalepsy. These behavioural effects were compared with standard drugs haloperidol and clozapine. Further PQ reduced DA and 5-HT content after chronic treatment, but not after acute administration, according to "Evaluation of the Antipsychotic Potential of Panax quinquefolium in Ketamine Induced Experimental Psychosis Model in Mice" by Chatterjee M, Singh S, Kumari R, Verma AK, Palit G.(71)
c. Neuroprotective effect
In the analyzing Panax ginseng C.A. Meyer and its beneficial effects in cerebral ischemia and inhibition of the inflammatory cascade in sepsis found that Ginsenoside Rb1 (GRb1) partially inhibited the activation of nuclear factor-κB (NF-κB) pathway from 6 h to 72 h after ischemia and reperfusion onset, as determined by the expression of total and phosphorylated NF-κB/p65, inhibitor protein of κB (IκB)-α, and IκB-kinase complex (IKK)-α. All these results indicate that suppression of local inflammation after cerebral ischemia might be one mechanism that contributes to the neuroprotection of GRb1, according to "Suppression of local inflammation contributes to the neuroprotective effect of ginsenoside Rb1 in rats with cerebral ischemia" by Zhu J, Jiang Y, Wu L, Lu T, Xu G, Liu X.(72)
d. Immunological activities
In the study of Water-soluble ginseng oligosaccharides (designated as WGOS) with a degree of polymerization ranging from 2 to 10 were obtained from warm-water extract of Panax ginseng roots, found that WGOS were potent B and T-cell stimulators and WGOS-1 has the highest immunostimulating effect on lymphocyte proliferation among those purified fractions. It is hoped that the WGOS will be developed into functional food or medicine, according to "Structural characterization and immunological activities of the water-soluble oligosaccharides isolated from the Panax ginseng roots" by Wan D, Jiao L, Yang H, Liu S.(73)
a. Liver diseases
In the evaluation of the anti-proliferative effects on human hepatoma HepG2 and Hep3B cells of each fraction of Pheophorbide a, a major antitumor component purified from Scutellaria barbata, found that pheophorbide a induced apoptosis in Hep3B cells, a viral-induced hepatoma cell line. However, it was found to be non-toxic in normal human liver cells WRL-68. DNA fragmentation, sub-G1 cell cycle arrest, as well as suppression of the anti-apoptotic protein Bcl-2, release of cytochrome c to the cytosol, and activation of pro-caspase 3 and pro-caspase 9 were observed when Hep3B cells were treated with 40 microg/mL (i. e., 67.5 microM) pheophorbide a for 48 hours, according to "Pheophorbide a, a major antitumor component purified from Scutellaria barbata, induces apoptosis in human hepatocellular carcinoma cells" by Chan JY, Tang PM, Hon PM, Au SW, Tsui SK, Waye MM, Kong SK, Mak TC, Fung KP.(74)
In the Comparisons of Scutellaria baicalensis, Scutellaria lateriflora and Scutellaria racemosa: genome size, antioxidant potential, found that Antioxidant potential studies showed that there were no significant differences in the 3 Scutellaria species. Phytochemical analyses detected and quantified the flavonoids baicalin, baicalein, scutellarin, and wogonin as well as the human neurohormones melatonin and serotonin in leaf and stem tissues from S. baicalensis, S. lateriflora, and S. racemosa, according to "Comparisons of Scutellaria baicalensis, Scutellaria lateriflora and Scutellaria racemosa: genome size, antioxidant potential and phytochemistry" by Cole IB, Cao J, Alan AR, Saxena PK, Murch SJ.(75)
c. Neurodegeneration diseases
In the study of flavones isolated from Scutellaria baicalensis root exhibit strong neuroprotective effects on the brain, found that Baicalein, the main flavone present in Scutellaria baicalensis root, strongly inhibited aggregation of neuronal amyloidogenic proteins in vitro and induces dissolution of amyloid deposits. It exerts strong antioxidative and anti-inflammatory activities and also exhibits anti-convulsive, anxiolytic, and mild sedative actions. Importantly, baicalein, and also another flavone: oroxylin A, markedly enhanced cognitive and mnestic functions in animal models of aging brains and neurodegeneration, according to "Flavones from root of Scutellaria baicalensis Georgi: drugs of the future in neurodegeneration?" by Gasiorowski K, Lamer-Zarawska E, Leszek J, Parvathaneni K, Yendluri BB, Błach-Olszewska Z, Aliev G.(76)
d. Anxiolytic activity
In the investigation of the phytochemistry and biological activity of Scutellaria lateriflora L. (American skullcap) which has been traditionally used as a sedative and to treat various nervous disorders, found that these compounds may play a role in anxiolytic activity since baicalin and baicalein are known to bind to the benzodiazepine site of the GABAA receptor and since GABA is the main inhibitory neurotransmitter, according to "Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties" byAwad R, Arnason JT, Trudeau V, Bergeron C, Budzinski JW, Foster BC, Merali Z.(77)
4. Gotu Kola
a. Locomotor activity
In the investigation of the asiatic acid, a triterpenoids isolated from Centella asiatica and its inhibitory effect on acetylcholinesterase (AChE) properties, excitatory post synaptic potential (EPSP) and locomotor activity. found that asiatic acid having an effect on AChE, a selective GABA(B) receptor agonist and no sedative effect on locomotor, according to "Inhibitory effect of asiatic acid on acetylcholinesterase, excitatory post synapticpotential and locomotor activity" by Nasir MN, Abdullah J, Habsah M, Ghani RI, Rammes G.(78)
b. Cognitive effects
In the assessment of the role of "Brahmi" (Bocopa monnieri and Centella asiatica) and its effect on the loss of memory, cognitive deficits, impaired mental function found that both plants possess neuroprotective properties, have nootropic activity with therapeutic implications for patients with memory loss. The field has witnessed exciting patent activity with most inventions aiming at either (i) improving the methods of herbal extraction or (ii) enrichment and purification of novel compounds from brahmi or (iii) providing novel synergistic formulations for therapeutics in various human ailments, according to "Exploring the role of "Brahmi" (Bocopa monnieri and Centella asiatica) in brain function and therapy" by Shinomol GK, Muralidhara, Bharath MM.(79)
c. Antioxidant capacity
In the identification of antioxidant effects of C. asiatica was exposed to various fermentations: no fermentation (0 min), partial fermentation (120 min) and full fermentation (24 h). Total phenolic content (TPC) and ferric-reducing antioxidant power (FRAP) of C. asiatica, found that C. asiatica herbal teas should be prepared at 100 °C for 10 min to obtain the optimum antioxidant capacity. Multiple brewing steps in C. asiatica herbal tea are encouraged due to the certain amount of antioxidant obtained, according to "Antioxidant capacity and phenolic composition of fermented Centella asiatica herbal teas" by Ariffin F, Heong Chew S, Bhupinder K, Karim AA, Huda N.(80)
a. Anti-allergic activity
The methanol extract of Matricaria recutita L. has shown anti-allergic activity by inhibition of histamine release from mast cells, according to the study of "Anti-allergic activity of German chamomile (Matricaria recutita L.) in mast cell mediated allergy model" by Chandrashekhar VM, Halagali KS, Nidavani RB, Shalavadi MH, Biradar BS, Biswas D, Muchchandi IS.(81)
b. Neuroprotective activity
German chamomile methanol extract (GCME) has shown shown the ability to treat neuroprotective activity by significant decrease in lipid peroxidation (LPO) and increase in the superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), and total thiol levels, against AlF₄⁻- and may be used to treat oxidative brain damage, according to the study of "Neuroprotective activity of Matricaria recutita against fluoride-induced stress in rats" by Ranpariya VL, Parmar SK, Sheth NR, Chandrashekhar VM.(82)
Matricaria recutita (chamomile) extract therapy has exerted the modest anxiolytic activity in patients with mild to moderate generalized anxiety disorder, according to the study of "A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder" by Amsterdam JD, Li Y, Soeller I, Rockwell K, Mao JJ, Shults J.(83)
a. Neuroprotective effects
In the investigation of the neuroprotective effects on PC12 cells from the methanol extracts of Spatholobus suberectus, Uncaria rhynchophylla, Alpinia officinarum, Drynaria fortunei, and Crataegus pinnatifida found that The CPE, SSE, and URE presented neurogrowth effects and neuroprotective activities on H(2)O(2)-induced PC12 cell death at 0.5-5.0 μg/mL. The CPE represents a promising medicinal plant source for the treatment of H(2)O(2)-induced neurodegenerative disease, because of its useful phytochemical characteristic, according to "Phytochemical characteristics, free radical scavenging activities, and neuroprotection of five medicinal plant extracts" byChang CL, Lin CS, Lai GH.(84)
b. Immunomodulatory effect
In the determination of sheds more light on the extract's mechanism of neuroprotection, especially its immunomodulatory effect found that Hawthorn extract helped alleviate pro-inflammatory immune responses associated with I/R-induced injury, boosted IL-10 levels, and increased Foxp3-positive T(regs) in the brain, which may have aided in suppression of activated inflammatory cells. Such treatment also minimizes apoptotic cell death by influencing STAT-3 phosphorylation and Bcl-xL expression in the brain. Taken together, the immunomodulatory effect of Hawthorn extract may play a critical role in the neuroprotection observed in this MCAO-induced stroke model, according to "Immunomodulatory effect of Hawthorn extract in an experimental stroke model" by Elango C, Devaraj SN.(85)
c. Prevention and treatment of cataracts
In the evaluation of the anticataract potential of Crataegus pinnatifida (hawthorn tree) leaves and its extract in selenite-induced cataract in vivo and antioxidant effects in vitro, found that administration of C. pinnatifida leaves extract eye drops alternately three times a day in rat pups with selenite-induced oxidative stress significantly increased serum SOD and CAT activities, and tended to reduce MDA level compared with control group. The antioxidant enzyme SOD, CAT, and GSH activities in lens showed a significant increase. These results may be applied in the future for the prevention and treatment of cataracts, according to "Prevention effect in selenite-induced cataract in vivo and antioxidative effects in vitro of Crataegus pinnatifida leaves" by Wang T, Zhang P, Zhao C, Zhang Y, Liu H, Hu L, Gao X, Zhang D.(86)
7. Green oat (Avena sativa)
Magnesium not only important for bone health, according to the study of "Magnesium, zinc, copper, manganese, and selenium levels in postmenopausal women with osteoporosis. Can magnesium play a key role in osteoporosis?" by Odabasi E, Turan M, Aydin A, Akay C, Kutlu M(87) but also play and important role in protecting against Alzheimer's disease, according to the study of "Altered ionized magnesium levels in mild-to-moderate Alzheimer's disease" by Barbagallo M, Belvedere M, Di Bella G, Dominguez LJ.(88)
The ingredients of avenanthramides and phenolic acids in oat protect the LDL cholesterol against the forming of free radicals by inducing the functions of copper and selenium against oxidation, according to the study of "Avenanthramides and phenolic acids from oats are bioavailable and act synergistically with vitamin C to enhance hamster and human LDL resistance to oxidation" by Chen CY, Milbury PE, Kwak HK, Collins FW, Samuel P, Blumberg JB., posted in PubMed(89)
c. Immune system
Selenium in Oat improves the immune system in fighting the foreign invasion of virus and bacteria causes of infection and inflammation, according to the study of "Selenium in the immune system" by Arthur JR, McKenzie RC, Beckett GJ., posted in PubMed(90)
Source : Medical Advisor Journals - Home of Kyle J. Norton for The Better of Living & Living Health
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Cell Phone Use in Pregnancy May Cause Behavioral Disorders in Offspring, Mouse Study Suggests
Exposure to radiation from cell phones during pregnancy affects the brain development of offspring, potentially leading to hyperactivity, Yale School of Medicine researchers have determined.
The results, based on studies in mice, are published in the March 15 issue of Scientific Reports, a Nature publication.
"This is the first experimental evidence that fetal exposure to radiofrequency radiation from cellular telephones does in fact affect adult behavior," said senior author Dr. Hugh S. Taylor, professor and chief of the Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics, Gynecology & Reproductive Sciences.
Taylor and co-authors exposed pregnant mice to radiation from a muted and silenced cell phone positioned above the cage and placed on an active phone call for the duration of the trial. A control group of mice was kept under the same conditions but with the phone deactivated.
The team measured the brain electrical activity of adult mice that were exposed to radiation as fetuses, and conducted a battery of psychological and behavioral tests. They found that the mice that were exposed to radiation tended to be more hyperactive and had reduced memory capacity. Taylor attributed the behavioral changes to an effect during pregnancy on the development of neurons in the prefrontal cortex region of the brain.
Attention deficit hyperactivity disorder (ADHD), is a developmental disorder associated with neuropathology localized primarily to the same brain region, and is characterized by inattention and hyperactivity.
"We have shown that behavioral problems in mice that resemble ADHD are caused by cell phone exposure in the womb," said Taylor. "The rise in behavioral disorders in human children may be in part due to fetal cellular telephone irradiation exposure."
Taylor said that further research is needed in humans to better understand the mechanisms behind these findings and to establish safe exposure limits during pregnancy. Nevertheless, he said, limiting exposure of the fetus seems warranted.
First author Tamir Aldad added that rodent pregnancies last only 19 days and offspring are born with a less-developed brain than human babies, so further research is needed to determine if the potential risks of exposure to radiation during human pregnancy are similar.
"Cell phones were used in this study to mimic potential human exposure but future research will instead use standard electromagnetic field generators to more precisely define the level of exposure," said Aldad.
Other Yale authors on the study include Geliang Gan and Xiao-Bing Gao.
The study was funded by grants from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, and Environment and Human Health, Inc.
Source : Science Daily
via Tamir S. Aldad, Geliang Gan, Xiao-Bing Gao, Hugh S. Taylor. Fetal Radiofrequency Radiation Exposure From 800-1900 Mhz-Rated Cellular Telephones Affects Neurodevelopment and Behavior in Mice. Scientific Reports, 2012; 2 DOI: 10.1038/srep00312
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Study: Diet May Help ADHD Kids More Than Drugs
Hyperactivity. Fidgeting. Inattention. Impulsivity. If your child has one or more of these qualities on a regular basis, you may be told that he or she has attention deficit hyperactivity disorder. If so, they'd be among about 10 percent of children in the United States.
Kids with ADHD can be restless and difficult to handle. Many of them are treated with drugs, but a new study says food may be the key. Published in The Lancet journal, the study suggests that with a very restrictive diet, kids with ADHD could experience a significant reduction in symptoms.
The study's lead author, Dr. Lidy Pelsser of the ADHD Research Centre in the Netherlands, writes in The Lancet that the disorder is triggered in many cases by external factors — and those can be treated through changes to one's environment.
"ADHD, it's just a couple of symptoms — it's not a disease," the Dutch researcher tells All Things Considered weekend host Guy Raz.
The way we think about — and treat — these behaviors is wrong, Pelsser says. "There is a paradigm shift needed. If a child is diagnosed ADHD, we should say, 'OK, we have got those symptoms, now let's start looking for a cause.' "
Pelsser compares ADHD to eczema. "The skin is affected, but a lot of people get eczema because of a latex allergy or because they are eating a pineapple or strawberries."
According to Pelsser, 64 percent of children diagnosed with ADHD are actually experiencing a hypersensitivity to food. Researchers determined that by starting kids on a very elaborate diet, then restricting it over a few weeks' time.
"It's only five weeks," Pelsser says. "If it is the diet, then we start to find out which foods are causing the problems."
Teachers and doctors who worked with children in the study reported marked changes in behavior. "In fact, they were flabbergasted," Pelsser says.
"After the diet, they were just normal children with normal behavior," she says. No longer were they easily distracted or forgetful, and the temper tantrums subsided.
Some teachers said they never thought it would work, Pelsser says. "It was so strange," she says, "that a diet would change the behavior of a child as thoroughly as they saw it. It was a miracle, a teacher said."
But diet is not the solution for all children with ADHD, Pelsser cautions.
"In all children, we should start with diet research," she says. If a child's behavior doesn't change, then drugs may still be necessary. "But now we are giving them all drugs, and I think that's a huge mistake," she says.
Also, Pelsser warns, altering your child's diet without a doctor's supervision is inadvisable.
"We have got good news — that food is the main cause of ADHD," she says. "We've got bad news — that we have to train physicians to monitor this procedure because it cannot be done by a physician who is not trained."
Source : npr
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Nutritional Status of Children with Attention Deficit Hyperactivity Disorder: A Pilot Study
Joy Y. Kiddie,1 Margaret D. Weiss,2,3 David D. Kitts,1 Ryna Levy-Milne,4 and Michael B. Wasdell5
1Food Nutrition and Health, University of British Columbia, Vancouver, BC, Canada V6T 1Z4
2Division of Child Psychiatry, University of British Columbia, Vancouver, BC, Canada V6T 2A1
3Children's and Women's Health Centre of British Columbia, P.O. Box 178, P2-229, Vancouver, BC, Canada V6H 3N1
4Oncology Nutrition, BC Cancer Agency, Vancouver, BC, Canada
5Fraser Health Authority, British Columbia, BC, Canada
Objectives. This is a pilot study of the dietary intake and nutrient status of children with Attention Deficit Hyperactivity Disorder (ADHD).
Method. Nutritional assessment of 43 children aged 6–12 with ADHD was performed using a 3-day food record, 24-hour recall, and serum assessors.
Results. Macronutrient intake and consumption of Low-Nutrient Foods were comparable to population norms; however, 66% were found to be deficient in zinc and 23% in copper.
Conclusions. This pilot study reports the food intake and nutrient status of children with ADHD and shows a predisposition for low zinc and copper status in ADHD.
Source : International Journal of Pediatrics Volume 2010 (2010), Article ID 767318,
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Regular 'Green Time' Linked To Milder Symptoms In ADHD,
A study of more than 400 children diagnosed with Attention Deficit Hyperactivity Disorder has found a link between the children's routine play settings and the severity of their symptoms, researchers report. Those who regularly play in outdoor settings with lots of green (grass and trees, for example) have milder ADHD symptoms than those who play indoors or in built outdoor environments, the researchers found. The association holds even when the researchers controlled for income and other variables.
The study appears in the journal Applied Psychology: Health and Well-Being.
According to the Centers for Disease Control and Prevention, about 9.5 percent of children aged 4-17 had been diagnosed with ADHD as of 2007. Symptoms include severe difficulty concentrating, hyperactivity and poor impulse control.
Although many children with ADHD are medicated, most "would benefit from a low-cost, side-effect-free way of managing their symptoms," wrote University of Illinois crop sciences visiting teaching associate Andrea Faber Taylor and natural resources and environmental sciences professor Frances (Ming) Kuo, the authors of the study.
Previous research has shown that brief exposure to green outdoor spaces - and in one study, to photos of green settings - can improve concentration and impulse control in children and adults in the general population - individuals without ADHD.
These findings led Taylor and Kuo to examine whether children diagnosed with ADHD, which is characterized by deficits in concentration and impulse control, might also benefit from "green time." In a study published in 2004, they analyzed data from a national Internet-based survey of parents of children formally diagnosed with ADHD and found that activities conducted in greener outdoor settings did correlate with milder symptoms immediately afterward, compared to activities in other settings.
The new study explores other data from the same survey to determine whether the effect also is true for green play settings that are routinely experienced - the park, playground or backyard that a child visits daily or several times a week.
"Before the current study, we were confident that acute exposures to nature - sort of one-time doses - have short-term impacts on ADHD symptoms," Kuo said. "The question is, if you're getting chronic exposure, but it's the same old stuff because it's in your backyard or it's the playground at your school, then does that help?"
To address this question, the researchers examined parents' descriptions of their child's daily play setting and overall symptom severity. They also looked at the children's age, sex, formal diagnosis (ADD or ADHD) and total household income.
The analyses revealed an association between routine play in green, outdoor settings and milder ADHD symptoms.
"On the whole, the green settings were related to milder overall symptoms than either the 'built outdoors' or 'indoors' settings," Taylor said.
The researchers also found that children who were high in hyperactivity (diagnosed with ADHD rather than ADD) tended to have milder symptoms if they regularly played in a green and open environment (such as a soccer field or expansive lawn) rather than in a green space with lots of trees or an indoor or built outdoor setting.
The researchers found no significant differences between boys and girls or income groups in terms of the relationship between the greenness of play settings and overall symptom severity.
Kuo noted that the findings don't by themselves prove that routine playtime in green space reduces symptom severity in children with ADHD. But in light of all the previous studies showing a cause-and-effect relationship between exposure to nature and improved concentration and impulse control, she said, "it is reasonably safe to guess that that's true here as well."
The study was performed with Hatch Act funds, and with support from the USDA CSREES National Research Initiative with a recommendation from the National Urban and Community Forestry Advisory Council.
Source : Medical News Today
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The Effects of L-Theanine (Suntheanine®) on Objective Sleep Quality in Boys with Attention Deficit Hyperactivity Disorder (ADHD): a Randomized, Double-blind, Placebo-controlled Clinical Trial.
Lyon MR, Kapoor MP, Juneja LR.
University of British Columbia, Food, Nutrition and Health; Canadian Centre for Functional Medicine, Coquitlam, BC, Canada.
INTRODUCTION: The purpose of this study was to investigate the efficacy and safety of L-theanine as an aid to the improvement of objectively measured sleep quality in a population of 98 male children formally diagnosed with attention-deficit/hyperactivity disorder (ADHD).
METHODS: A randomized, double-blind, placebo-controlled trial was conducted involving boys, ages 8-12 years, who had been previously diagnosed with ADHD. An experienced physician confirmed the diagnosis of ADHD in each subject. Randomization was stratified based upon current use of stimulant medication to ensure an equal distribution of stimulant/non-stimulant treated subjects into active and placebo treated groups. Participants consumed two chewable tablets twice daily (at breakfast and after school), with each tablet containing 100 mg of L-theanine (total 400 mg daily Suntheanine®, Taiyo Kagaku, Yokkaichi, Japan) or identical tasting chewable placebo for six weeks. Subjects were evaluated for five consecutive nights using wrist actigraphy at baseline, and again at the end of the six-week treatment period. The Pediatric Sleep Questionnaire (PSQ) was completed by parents at baseline and at the end of the treatment period.
RESULTS: Actigraph watch data findings indicated that boys who consumed L-theanine obtained significantly higher sleep percentage and sleep efficiency scores, along with a non-significant trend for less activity during sleep (defined as less time awake after sleep onset) compared to those in the placebo group. Sleep latency and other sleep parameters were unchanged. The PSQ data did not correlate significantly to the objective data gathered from actigraphy, suggesting that parents were not particularly aware of their children's sleep quality. L-theanine at relatively high doses was well tolerated with no significant adverse events.
CONCLUSIONS: This study demonstrates that 400 mg daily of L-theanine is safe and effective in improving some aspects of sleep quality in boys diagnosed with ADHD. Since sleep problems are a common co-morbidity associated with ADHD, and because disturbed sleep may be linked etiologically to this disorder, L-theanine may represent a safe and important adjunctive therapy in childhood ADHD. Larger, long-term studies looking at the wider therapeutic role of this agent in this population are warranted.
Source : Altern Med Rev. 2011 Dec;16(4):348-54.
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Complementary and Alternative Medical Therapies for Children with Attention-Deficit/ Hyperactivity Disorder (ADHD)
Janice Pellow, M.Tech (Hom); Elizabeth M. Solomon, HD, ND, DO, BA;
Candice N. Barnard, M.Tech (Hom), B.Phys.Ed
Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterized by impulsivity, inattention, and hyperactivity. ADHD affects up to 1 in 20 children in the United States. The underlying etiologies of ADHD may be heterogeneous and diverse, and many possible risk factors in the development of ADHD have been identified. Conventional treatment usually consists of behavioral
accommodations and medication, with stimulant medication most commonly being prescribed. Parents concerned about the side effects and long-term use of conventional medications are increasingly seeking alternatives to pharmacologic treatment. Complementary and alternative medicine (CAM) offers parents various treatment options for this condition, including dietary modifications, nutritional supplementation,
herbal medicine, and homeopathy. CAM appears to be most effective when prescribed holistically and according to each individual’s characteristic symptoms. Possible etiologies and risk factors for the condition also need to be considered when developing a treatment plan. This article serves to highlight
the latest research regarding the most commonly used CAM for children with ADHD.
ADHD is a complex, chronic, and heterogeneous condition that affects up to 1 in 20 children in the United States. ADHD appears to have multiple possible etiologies and risk factors associated with its development, requiring long-term case management using various treatment modalities. CAM offers many alternatives to conventional medications. Treatment should be tailored to each individual. Dietary corrections, exercise therapy, and nutritional supplements all offer potential benefits to the ADHD child. Herbal remedies that are indicated for restlessness, anxiety, and depression may offer viable alternatives to pharmacotherapy, although further research related to children with ADHD is required. Homeopathy may provide a safe and gentle approach through both similimum and mixed homeopathic remedy treatment, with various research studies purporting its efficacy.
Source : Altern Med Rev. 2011 Dec;16(4):323-37
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Pesticides + ADHD
The Pesticide Action Network (PAN) report on a new study out of Harvard shows that even tiny, allowable amounts of a common pesticide class can have dramatic effects on brain chemistry. Organophosphate insecticides (OP’s) are among the most widely used pesticides in the U.S. & have long been known to be particularly toxic for children. This is the first study to examine their effects across a representative population with average levels of exposure. Conclusion :: Kids with above-average pesticide exposures are 2x as likely to have ADHD.
To see the full report in the American Academy of Pediatrics......read more