Tag Archives: Attention-deficit hyperactivity disorder

Study Finds Many Children in U.S. Potentially Misdiagnosed With ADHD

About  1 million children in the United States have potentially been misdiagnosed with attention deficit hyperactivity disorder (ADHD) — simply because they are the youngest, and therefore the most immature, in their kindergarten class.

These children are significantly more likely to be prescribed behavior-modifying drugs such as Ritalin.  Such inappropriate treatment is particularly troubling because of the unknown impacts of long-term stimulant use on children’s health.

According to Science Daily:

“It also wastes an estimated $320 million-$500 million a year on unnecessary medication — some $80 million-$90 million of it paid by Medicaid”.

Resources:
Science Daily August 18, 2010
Journal of Health Economics June 17, 2010 [Epub ahead of print]

Antidepressants and Other Psychotropic Medications Linked to Birth Defects

 

Between 1998 and 2007, psychotropic medications were associated with 429 adverse drug reactions in Danish children under the age of 17. More than half of the 429 cases were serious and several involved birth defects, such as birth deformities and severe withdrawal syndromes.
CLICK & SEE
Professors Lise Aagaard and Ebbe Holme Hansen studied all 4,500 pediatric adverse drug reaction reports submitted during the study period to find those which were linked to psychotropic medications. The two researchers found that 42 percent of adverse reactions were reported for psychostimulants, such as Ritalin, which treats attention deficit disorder (ADD), followed by 31 percent for antidepressants, such as Prozac, and 24 percent for antipsychotics, such as Haldol.

“A range of serious side effects such as birth deformities, low birth weight, premature birth, and development of neonatal withdrawal syndrome were reported in children under two years of age, most likely because of the mother’s intake of psychotropic medication during pregnancy,” says Associate Professor Lisa Aagaard.

The researchers believe that these tendencies should serve as a warning to doctors and health care personnel.

“Psychotropic medication should not be prescribed in ordinary circumstances, because this type of medication has a long half-life. If people take their medicine as prescribed it will be a constantly high dosage, and it could take weeks for one single tablet to exit the body’s system. Three out of four pregnancies are planned, and therefore society must take responsibility for informing women about the serious risks of transferring side effects to their unborn child,” says Aagaard.

There is a clear indication that use of antidepressants is increasing in Denmark, as well as in many other countries, and the tendency is the same when it comes to pregnant women.

“We are constantly reminded about the dangers of alcohol use and smoking during pregnancy, but there is no information offered to women with regards to use of psychotropic medication. There is simply not enough knowledge available in this area,” concludes Aagaard, suggesting that greater control should be required when prescribing psychotropic medications to pregnant women.


Source:
Elements4Health:25 June 2010

Enhanced by Zemanta

Tics

Definition:
Tics are purposeless, rapid and repeated contractions of a group of muscles that result in movement (a motor tic) or the production of a sound (a vocal tic). Sometimes, a tic involves more complex behaviour.

click to see ….>…..(01)..…(1).……...(2).……..

Motor tics often involve the muscles of the face, head and neck, with movements such as blinking, lip smacking, facial twitching, grimacing and shrugging of the shoulders. Common vocal tics include coughing, grunting or clearing the throat.

The intensity of a tic can vary. Occasionally, tics are forceful, which can be frightening and uncomfortable.

Tics aren’t voluntary movements – in other words, they can’t be consciously controlled – although some people say they feel a strong urge to move, linked to stress. Some people are able to suppress their tics briefly, but this is said to be like holding back a sneeze and tension rises until the tic finally escapes.

Tics are usually divided into several categories, as described below.:-

Transient tic disorders:-
As many as one in ten children will develop a transient or simple tic at some point during their school years. Such tics usually occur in just one muscle group and don’t last more than a few months, although a child may have a series of different transient tics over a period of years.

Transient motor tics may include blinking, squinting, snapping the fingers, jerking the head or wrinkling the nose. Occasionally, transient vocal tics such as gurgling or humming occur. The tic may even involve more bizarre behaviour, such as touching objects or licking.

Transient tics may become more prominent when a child is tired or excited, but they don’t lead to harm and don’t need treatment. They decrease or disappear when the child sleeps.

Chronic tic disorders:-
Not only do chronic tics persist, sometimes for years, but they change little in their character. While they don’t usually need treatment, they can be disruptive, especially if a child realises others think them strange. Occasionally, a person has several tics and is said to have chronic multiple tics.

Tourette syndrome:
Chronic tics are also a feature of Tourette syndrome. This neurological disorder causes multiple motor and vocal tics, which can be quite dramatic and frequently change in nature. Tourette syndrome usually begins in early childhood, varies in intensity and lasts more than a year.

Tourette can be particularly debilitating because the vocal tics can include the uncontrollable use of obscene language (known as coprolalia) and repetition of phrases the person hears others use (called echolalia).

Those with Tourette syndrome often have a variety of psychological problems too, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and self-harm behaviour, although the link isn’t clear.

Like other tics, the exact cause of Tourette syndrome isn’t known, although genetics appear to play a part. It’s likely that a particular gene makes a person more vulnerable than others to environmental factors that also contribute to the condition.

Simple tics:-
Simple motor tics are typically sudden, brief, meaningless movements that usually involve only one group of muscles, such as eye blinking, head jerking or

shoulder shrugging.   Motor tics can be of an endless variety and may include such movements as hand clapping, neck stretching, mouth movements, head, arm or leg jerks, and facial grimacing.

A simple phonic tic can be almost any sound or noise, with common vocal tics being throat clearing, sniffing, or grunting.

Complex tics:-
Complex motor tics are typically more purposeful-appearing and of a longer nature. They may involve a cluster of movements and appear coordinated.Examples of complex motor tics are pulling at clothes, touching people, touching objects, echopraxia and copropraxia.

Complex phonic tics may fall into various series (categories), including echolalia (repeating words just spoken by someone else), palilalia (repeating one’s own previously spoken words), lexilalia (repeating words after reading them) and coprolalia (the spontaneous utterance of socially objectionable or taboo words or phrases). Coprolalia is a highly publicized symptom of Tourette syndrome; however, only about 10% of TS patients exhibit coprolalia.Complex tics are rarely seen in the absence of simple tics. Tics “may be challenging to differentiate from compulsions”, as in the case of klazomania (compulsive shouting).

•Simple motor tics involve a single muscle group.
•Complex motor tics usually involve more than one muscle group.
•Complex vocal tics involve more meaningful speech (such as words) than simple vocal tics.
•Complex motor tics aren’t as rapid as simple motor tics and can even look like the person is performing the tic on purpose.

Shoulder shrugging is one of the most common simple motor tics; others include:
•nose wrinkling
•head twitching
•eye blinking
•lip biting
•facial grimacing
•repetitive or obsessive touching
•kicking
•jumping

Common vocal tics include:
•coughing
•throat clearing
•grunting
•sniffing
•barkingTransient vs. Chronic Tics

Transient vs. Chronic Tics:-
It’s perfectly normal to worry that a tic may never go away. Fortunately, that’s not usually the case. Most tics are temporary and are known as transient tics. They tend to not last more than 3 months at a time.In rarer instances people have tics that persist for an extended period of time. This is known as chronic tic disorder. These tics last for more than a year. Chronic tics can be either motor or vocal, but not both together.

Dignosis:
Tics can sometimes be diagnosed at a regular checkup after the doctor asks a bunch of questions. No specific test can diagnose tics, but sometimes doctors will run tests to rule out other conditions that might have symptoms similar to tics.

Tic disorders occur along a spectrum, ranging from mild to more severe, and are classified according to duration and severity (transient tics, chronic tics, or Tourette syndrome). Tourette syndrome is the more severe expression of a spectrum of tic disorders, which are thought to be due to the same genetic vulnerability. Nevertheless, most cases of Tourette syndrome are not severe.    The treatment for the spectrum of tic disorders is similar to the treatment of Tourette syndrome.

Differential diagnosis:
Tourettism refers to the presence of Tourette-like symptoms in the absence of Tourette syndrome as the result of other diseases or conditions—also known as secondary causes. Although tic disorders are commonly considered to be childhood syndromes, tics occasionally develop during adulthood; adult-onset tics often have a secondary cause. Tics that begin after the age of 18 are generally not considered symptoms of Tourette’s syndrome.

Tics must be distinguished from fasciculations. Small twitches of the upper or lower eyelid, for example, are not tics, because they do not involve a whole muscle. They are twitches of a few muscle fibre bundles, which one can feel but barely see

The Embarrassment Factor
Many times, people don’t see themselves having a tic — they’re not walking around with a huge mirror at all times! So it’s only natural that they may think that their tic is the worst tic ever. Of course it isn’t, but it’s still a concern for many people with tics. And these exaggerated thoughts can cause unnecessary feelings of embarrassment or angst, and actually make the tic worse.

The tic might seem to begin either for no appreciable reason, or perhaps be incited by something like an eye irritation which begins a cycle of blinking that doesn’t stop when the irritation is gone. The simple tic usually goes away in six months or so, seemingly sooner if the child is not being reminded of it all the time by his family.

Sometimes the symptoms become more chronic. If the symptoms are limited to muscular movements, the condition is called multiple chronic motor tic disorder. If the child has both vocal and motor symptoms which last more than a year, the term Gilles de la Tourette syndrome or more commonly Tourette syndrome.

Symptoms (motor and vocal tics) in Tourette syndrome can be pretty bizarre.
Most extreme and distressing are involuntary cursing (coprolalia) and obscene gestures (copropraxia). Suffice it to say that any involuntary repetitive activities or vocalizations in children between 2 and 14 or so deserve consideration for Tourette syndrome.

A significant percentage of children with Tourette syndrome show signs of attention deficit disorder as well. Because treatment of ADD with stimulants such as methylphenidate (Ritalin¨) may possibly initiate or worsen tics, and perhaps may bring on full-blown Tourette syndrome, any new or worsening tics in a child on ADD medication must be immediately reported to the childs physician.

Long term studies of the natural history of Tourette syndrome show the average age of onset as about five to six years old. Tic severity peaks around 10 years of age, with a range between 8 and 12 years. About one fifth of patients with Tourette syndrome will have such severe problems that school is interfered with or impossible. Almost all patients get better with time, and by age 18, half of affected children are tic-free, and nine of ten have only mild or no tics.

Nobody wants to make tics worse, but is there any way to make them better? While you can’t cure tics, you can take some easy steps to lessen their impact:

•Don’t focus on it. If you know you have a tic, forget about it. Concentrating on it just makes it worse.
•Avoid stress-filled situations as much as you can — stress only makes tics worse. So get your work done early and avoid the stress that comes with procrastination and last-minute studying.
•A tic? What tic? If a friend of yours has a tic, don’t call attention to it. Chances are your friend knows the tic is there. Pointing it out only makes the person think about it more.
•Get enough sleep. Being tired can makes tics worse. So make sure to get a full night’s rest!
•Let it out! Holding back a tic can just turn it into a ticking bomb, waiting to explode. Have you ever felt a cough coming on and tried to avoid it? Didn’t work out so well, did it? Chances are it was much worse. Tics are very similar.
In certain cases, tics are bad enough to interfere with someone’s daily life and medication may be prescribed.

Don’t let a little tic dictate who you are or how you act. Learning to live with and not pay attention to the tic will make you stronger down the road.

Treatment and recovery :-
Psychological support and counselling can be helpful for those with disruptive tics and cognitive behavioural therapy may help some people control their condition.

Medication is the most effective treatment in reducing the tic itself. However, the powerful drugs used (such as haloperidol, pimozide, fluphenazine and clonidine) tend to have unpleasant side-effects. So, while 70 per cent of those with Tourette have tried drugs, for example, many people prefer to manage without medication if possible.

*Don’t panic if your child develops a tic – most are mild and transient
*Most tics don’t interfere with life or school and don’t require treatment
*People taking stimulant drugs (for ADHD, for example) may develop tics but these should cease when the drug is stopped
*Stress can aggravate symptoms or simply make life harder – relaxation and biofeedback techniques may help.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/conditions/tics1.shtml
http://kidshealth.org/teen/diseases_conditions/brain_nervous/tics.html
http://www.drhull.com/EncyMaster/T/tics.html
Tics

http://en.wikipedia.org/wiki/Tic

 

Enhanced by Zemanta

Attention Deficit Hyperactivity Disorder (ADHD)

Definition:
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood.. Children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. If untreated, the disorder can have long-term adverse effects into adolescence and adulthood.

Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).

……….

ADHD has three subtypes:
1.Predominantly hyperactive-impulsive ……
*Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
*Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.

2.Predominantly inattentive
…………………
*The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.

*Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.

3.Combined hyperactive-impulsive and inattentive. .
*Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
*Most children have the combined type of ADHD

Treatments can relieve many of the disorder’s symptoms, but there is no cure. With treatment, most people with ADHD can be successful in school and lead productive lives. Researchers are developing more effective treatments and interventions, and using new tools such as brain imaging, to better understand ADHD and to find more effective ways to treat and prevent it.

Signs & Symptoms
Symptoms of ADHD will appear over the course of many months, and include:

Impulsiveness: a child who acts quickly without thinking first.
Hyperactivity: a child who can’t sit still, walks, runs, or climbs around when others are seated, talks when others are talking.

Inattention: a child who daydreams or seems to be in another world, is sidetracked by what is going on around him or her.

Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.

Children who have symptoms of inattention may:
*Be easily distracted, miss details, forget things, and frequently switch from one activity to another
*Have difficulty focusing on one thing
*Become bored with a task after only a few minutes, unless they are doing something enjoyable
*Have difficulty focusing attention on organizing and completing a task or learning something new
*Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
*Not seem to listen when spoken to
*Daydream, become easily confused, and move slowly
*Have difficulty processing information as quickly and accurately as others
*Struggle to follow instructions.

Children who have symptoms of hyperactivity may:
*Fidget and squirm in their seats
*Talk nonstop
*Dash around, touching or playing with anything and everything in sight
*Have trouble sitting still during dinner, school, and story time
*Be constantly in motion
*Have difficulty doing quiet tasks or activities.

Children who have symptoms of impulsivity may:
*Be very impatient
*Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
*Have difficulty waiting for things they want or waiting their turns in games
*Often interrupt conversations or others’ activities.

ADHD Can Be Mistaken for Other Problems too.
Parents and teachers can miss the fact that children with symptoms of inattention have the disorder because they are often quiet and less likely to act out. They may sit quietly, seeming to work, but they are often not paying attention to what they are doing. They may get along well with other children, compared with those with the other subtypes, who tend to have social problems. But children with the inattentive kind of ADHD are not the only ones whose disorders can be missed. For example, adults may think that children with the hyperactive and impulsive subtypes just have emotional or disciplinary problems.

Diagnosis:
If ADHD is suspected, the diagnosis should be made by a professional with training in ADHD. This includes child psychiatrists, psychologists, developmental/behavioral pediatricians, behavioral neurologists, and clinical social workers. After ruling out other possible reasons for the child’s behavior, the specialist checks the child’s school and medical records and talks to teachers and parents who have filled out a behavior rating scale for the child. A diagnosis is made only after all this information has been considered.

Children mature at different rates and have different personalities, temperaments, and energy levels. Most children get distracted, act impulsively, and struggle to concentrate at one time or another. Sometimes, these normal factors may be mistaken for ADHD. ADHD symptoms usually appear early in life, often between the ages of 3 and 6, and because symptoms vary from person to person, the disorder can be hard to diagnose. Parents may first notice that their child loses interest in things sooner than other children, or seems constantly “out of control.” Often, teachers notice the symptoms first, when a child has trouble following rules, or frequently “spaces out” in the classroom or on the playground.

No single test can diagnose a child as having ADHD. Instead, a licensed health professional needs to gather information about the child, and his or her behavior and environment. A family may want to first talk with the child’s pediatrician. Some pediatricians can assess the child themselves, but many will refer the family to a mental health specialist with experience in childhood mental disorders such as ADHD. The pediatrician or mental health specialist will first try to rule out other possibilities for the symptoms. For example, certain situations, events, or health conditions may cause temporary behaviors in a child that seem like ADHD.

Between them, the referring pediatrician and specialist will determine if a child:

*Is experiencing undetected seizures that could be associated with other medical conditions
*Has a middle ear infection that is causing hearing problems
*Has any undetected hearing or vision problems
*Has any medical problems that affect thinking and behavior
*Has any learning disabilities
*Has anxiety or depression, or other psychiatric problems that might cause ADHD-like symptoms
*Has been affected by a significant and sudden change, such as the death of a family member, a divorce, or parent’s job loss.
A specialist will also check school and medical records for clues, to see if the child’s home or school settings appear unusually stressful or disrupted, and gather information from the child’s parents and teachers. Coaches, babysitters, and other adults who know the child well also may be consulted.

The specialist also will ask:
*Are the behaviors excessive and long-term, and do they affect all aspects of the child’s life?
*Do they happen more often in this child compared with the child’s peers?
*Are the behaviors a continuous problem or a response to a temporary situation?
*Do the behaviors occur in several settings or only in one place, such as the playground, classroom, or home?
The specialist pays close attention to the child’s behavior during different situations. Some situations are highly structured, some have less structure. Others would require the child to keep paying attention. Most children with ADHD are better able to control their behaviors in situations where they are getting individual attention and when they are free to focus on enjoyable activities. These types of situations are less important in the assessment. A child also may be evaluated to see how he or she acts in social situations, and may be given tests of intellectual ability and academic achievement to see if he or she has a learning disability.

Finally, if after gathering all this information the child meets the criteria for ADHD, he or she will be diagnosed with the disorder.

Treatment
Effective treatments for ADHD are available, and include behavioral therapy and medications.

Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education or training, or a combination of treatments.

Getting Help: Locate Services
Locate mental health services in your area, affordable healthcare, NIMH clinical trials, and listings of professionals and organizations.

Click to see for more locational services
You may also clic to see:->
*Child and Adolescent Mental Health:
*Treatment of Children with Mental Disorders
*Information about medications
*Attention Deficit Hyperactivity Disorder Information and Organizations from NLM’s MedlinePlus (en Español) :
*Listen to a NIH podcast about a study on ADHD medications by the National Institute on Environmental and Health Sciences:

*Chiropractic Care for ADD/ADHD

*ADD & Toxins

Resources:
http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtm

Reblog this post [with Zemanta]

Irritability ‘Key to Bipolar Disorder’

Parents, please note — want to know where your child is suffering from bipolar disorder? It’s simple for a study says that irritability should be considered when diagnosing for the condition.
………………irritable children
Researchers at Bradley Hospital in Providence have found that some kids with bipolar disorder experience manic episodes without extreme elation — one of the hallmarks of the disorder — and are diagnosed based on irritable mood.

“Diagnosing kids with bipolar disorder is challenging. One of the chief controversies is whether irritability should be included among the criteria for this diagnosis because it can also overlap with a number of other psychiatric disorders, such as attention deficit hyperactivity disorder.

“Our findings confirm that while irritable-only mania is uncommon, it does exist — particularly in younger children — and should be considered in a bipolar diagnosis,” Jeffrey Hunt, who led the study, said in a statement.

For their study, the researchers quantified frequency and severity of manic symptoms — including irritability and elation — in 361 children, all between the ages of 7 and 17, already diagnosed with bipolar disorder.

The researchers found 10% of children were irritable-only and about 15% were elated-only. Nearly three-quarters experienced both elation and irritability, the findings revealed.

The study has been published in the latest edition of the ‘Journal of the American Academy of Child and Adolescent Psychiatry‘.

Source:
BBC NEWS:28Th. June. ’09

Reblog this post [with Zemanta]