University Research on ADHD Issues
A researcher has contacted ADDept as she is looking for families with children between the ages of 6 to17 years with a diagnosis of Attention Deficit Hyperactivity Disorder who would be interested in taking part. She is offering to pay families £30:00
In the first instance please contact:
Yorkshire Coordinator
ADDept Yorkshire ADHD & Learning Ability Support Group
Registered Charity 1072 007
CONTACT:
Home: 01765 658 878
Mobile: 07719 439 522
E-mail: kate.mowbray@btinternet.com
Website: http://www.adhd-yorkshire.com
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Clinical Studies
Journal of psychopharmacology (Oxford, England) 2008 Sep 18; In press
Chan H H, Chang C C, Chiang S S, Chen J J, Chen C C, Sun H H, Hwu H H, Lai M M
Department of General Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan; Graduate Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Abstract
The objective of this study was to compare the effects of risperidone and olanzapine in schizophrenic patients with intolerant extrapyramidal side effects (EPS) on first generation antipsychotics. We conducted an 8-week, rater-blinded, flexible dose study. Seventy patients with schizophrenia, who met the DSM-IV research criteria of having neuroleptic-induced acute dystonia or parkinsonism, were randomly assigned to risperidone or olanzapine group. The primary outcome was a comparison of the incidence of concomitant anticholinergic drugs usage between the groups to manage their acute dystonia and parkinsonism. The average doses of risperidone and olanzapine from baseline to study end point were 1.8-3.5 mg/day and 7.7-11.7 mg/day, respectively. There were no significant differences in demographic data, severity of EPS or psychotic symptoms between the groups at baseline assessment. Patients taking risperidone had significantly higher incidence of using anticholinergic drugs to manage acute dystonia or parkinsonism overall during the study (OR = 5.17, 95%CI = 1.49-17.88, P = 0.013). There was no significant between-group difference in the changing of rating scales of EPS and psychotic symptoms. The results of our study favour olanzapine as a better choice in schizophrenic patients with intolerant EPS. Double-blinded, fixed dose and different ethnical study for EPS-intolerant schizophrenic patients is needed to confirm the results of our study.
Adult ADHD Often Undiagnosed by
New York
University School of Medicine Survey Reveals
Inexperience and Lack of Training, Resources Cited as Barriers to
Diagnosis
NEW YORK –Inadequate clinical training, inexperience
and the lack of a well-validated screening tool are major barriers
prohibiting primary care physicians from diagnosing ADHD in adults,
according to a national survey released today by New York University
School of Medicine. The survey also revealed that primary care
physicians would take a more active role in treating adult ADHD if these
issues were addressed.
ADHD affects nearly 8 million American adults and can lead to increased healthcare costs, higher divorce rates, unemployment and motor vehicle accidents. Yet, the vast majority of these patients remain undiagnosed, with only one quarter seeking medical help for impairment associated with ADHD. Even those patients who seek help often aren’t identified as having ADHD.
"The results tell us that we need to do a better job of supporting primary care physicians who are on the front lines of diagnosing adult ADHD," said Lenard Adler, M.D., Associate Professor of Clinical Psychiatry and Neurology at New York University School of Medicine. "This disorder causes significant problems for millions of adults and yet their doctors, including internists and general practitioners, often miss it."
A new symptom assessment tool, the Adult ADHD Self-Report Scale (ASRS), may assist physicians in evaluating symptoms of ADHD. Dr. Adler and other ADHD experts, in conjunction with the World Health Organization, developed the ASRS.
Key Survey Findings
Nearly half (48 percent) of 400 primary care physicians surveyed said they do not feel confident in diagnosing ADHD in adults.
Only 34 percent of primary care physicians report being "very knowledgeable" or "extremely knowledgeable" about adult ADHD compared with 92 percent who said the same for depression and 83 percent for generalized anxiety disorder (GAD).
Sixty-four percent of survey respondents indicated they received "not at all thorough" or "not very thorough" instruction in diagnosing and treating adult ADHD, compared with 13 percent who said the same for their training in depression.
Sixty-five percent of primary care physicians defer to a specialist when diagnosing adult ADHD compared with two percent for depression and three percent for GAD.
Eighty-five percent of primary care physicians surveyed said they would
take a more active role in diagnosing and treating adult ADHD if they
had an easy-to-use screening tool.
"Making quality, easy-to-use screening and symptom assessment tools available to physicians and the public will help adults with ADHD receive an accurate evaluation," added Dr. Adler. "These tools could go a long way to help increase confidence among primary care physicians in diagnosing adult ADHD."
Development of the ASRS was supported in part by an unrestricted educational grant from Eli Lilly and Company.
Survey Methodology
Four hundred physicians completed the survey from May 14, 2003 through
May 28, 2003. New York University School of Medicine Institutional Board
of Research Associates approved the final survey instrument. The survey
was conducted by Harris Interactive® for New York University School of
Medicine, with support from Eli Lilly and Company. Target physicians
were in family practice, general practice or internal medicine and were
recruited randomly from the American Medical Association master file. In
order to qualify, physicians must have been practicing for at least two
years and treating at least 30 patients per week with any combination of
ADHD, bipolar disorder, depression, GAD or obsessive compulsive
disorder. Recruitment for the survey was completed by mail, and the
survey was conducted online.
Until the 1970s, ADHD was believed to be a childhood disorder that was
outgrown. However, scientists now know that while hyperactivity may
diminish, clinically significant inattentiveness and impulsivity can
persist into adulthood. In adults, ADHD manifests itself through
symptoms including inability to focus, disorganization and restlessness.
Adults with ADHD have lower rates of professional employment, frequent
job changes, lower self-esteem and poor social skills.
For more information about adult ADHD, visit
www.adultadd.com,
www.medscape.com,
www.webmd.com,
www.chadd.org and
www.add.org.
For complete survey results, please contact:
Leslie Forte, Chamberlain
Communications Group at 212-884-0684 or
lforte@chamberlainpr.com, or Nancy Wong, Harris Interactive at
nwong@harrisinteractive.com.
About New York University
One of the world’s premier academic medical institutions for more than
155 years, NYU Medical Center continues to be a leader in patient care,
physician education and scientific research. NYU Medical Center is
internationally renowned for excellence in areas such as cardiovascular
disease, pediatrics, skin care, neurosurgery, urology, cancer care,
rehabilitation, plastic surgery, minimally invasive surgery, transplant
surgery, infertility, women’s health and day surgery.
Dr. Adler has received research grants and educational grants, and has
participated in consulting, advisory boards and speakers’ bureaus for:
Eli Lilly and Company, Pfizer Inc., Novartis Pharmaceuticals Corp.,
Abbott Laboratories, McNeil Pharmaceutical, Johnson & Johnson,
GlaxoSmithKline, Bristol-Myers Squibb Company and Merck & Co., Inc.
About Harris Interactive
Harris Interactive (www.harrisinteractive.com ) is a worldwide market research and consulting firm best known for
The Harris Poll®, and for pioneering the Internet
method to conduct scientifically accurate market research. Headquartered
in Rochester, New York, U.S.A., Harris Interactive combines proprietary
methodologies and technology with expertise in predictive, custom and
strategic research. The Company conducts international research through
wholly owned subsidiaries—London-based HI Europe (www.hieurope.com)
and Tokyo-based Harris Interactive Japan—as well as through the Harris
Interactive Global Network of local market- and opinion-research firms,
and various U.S. offices. EOE M/F/D/V
Contact: Pamela McDonnell
Office of Public Affairs
NYU School of Medicine
Tel: 212-404-3555
Fax: 212-404-3570
E-mail:
Pamela.McDonnell@med.nyu.edu