Accidents & Violence, ADHD, Author Interviews, Columbia, JAMA / 04.10.2023

MedicalResearch.com Interview with: Guohua Li, MD, DrPH Finster Professor of Epidemiology and Anesthesiology Columbia University Irving Medical Center MedicalResearch.com: What is the background for this study? How was the ADHD diagnosis determined? Response: The reported prevalence of ADHD in children and young adults in the United States has more than doubled since the 1990s because of improved diagnosis.  Currently, ADHD affects about 13 percent of children under 18 years of age and eight percent of adults under 45 years of age.  Little is known about the prevalence of ADHD in older adults although it is estimated that ADHD symptoms may persist throughout the lifespan in about one-third of children diagnosed with the disorder.  Diagnostic criteria for adulthood ADHD include having five or more relevant symptoms, adverse impact on social, academic, and occupational activities,  and onset of symptoms before age 12. In this study, ADHD status is determined based on an affirmative response to the question of whether the participant had ever had ADHD or had ever been told by a doctor or other health professional that he or she had ADHD. (more…)
ADHD, Author Interviews, JAMA, Pediatrics, University of Michigan / 18.04.2023

MedicalResearch.com Interview with: Sean Esteban McCabe, PhD Director, Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences University of Michigan School of Nursing Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: Prescription stimulant therapy for ADHD helps millions of people, including in my own family, and students, friends and colleagues. It's critical to balance the need for access to these medications while reducing the risk for misuse. This is more important than ever now because there have been recent increases in the prescribing of stimulant therapy for ADHD. There is a need to understand the prevalence of stimulant therapy for ADHD and prescription stimulant misuse in U.S. middle and high schools. (more…)
ADHD, Author Interviews, Cost of Health Care, Eating Disorders, Pharmacology / 09.01.2022

MedicalResearch.com Interview with: Sneha Vaddadi, BS Department of Medical Education Geisinger Commonwealth School of Medicine Scranton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: The prescription stimulants methylphenidate, amphetamine, and lisdexamfetamine, classified as Schedule II substances, are sympathomimetic drugs with therapeutic use widely used in the US for Attention Deficit Hyperactivity Disorder. Changes in criteria for diagnosis of Attention Deficit Hyperactivity Disorder in 2013 and approval of lisdexamfetamine for binge eating disorder in 2015 may have impacted usage patterns. The goal of this study1 was to extend upon past research2 to compare the pharmacoepidemiology of these stimulants in the United States from 2010–2017, including consideration to variation within geographic regions, the Hispanic population, and the Medicaid population. (more…)
Author Interviews, Autism, Environmental Risks, JAMA, Pediatrics / 31.08.2020

MedicalResearch.com Interview with: Jessica Shoaff, MPH, PhD Postdoctoral Research Fellow and Susan A. Korrick, MD Pulmonary and Critical Care Assistant Professor in the Department of Environmental Health Harvard Medical School · Harvard T. H. Chan School of Public Health Brigham and Women's Hospital Channing Laboratory Boston, MA 02115   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study posed the question:  Do teenagers’ exposures to chemicals that are often found in consumer products increase behaviors that are common among individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD)? Our results suggest that teenagers exposed to chemicals often found in consumer products (particularly phthalates) may have increased behaviors that are common among individuals diagnosed with ADHD.  However, we did not study the diagnosis of ADHD (most of our study teens did not have ADHD).  This means our results cannot answer the question of whether these chemical exposures increase the likelihood of being diagnosed with ADHD. Also, in our study design, chemical exposures and ADHD-related behaviors were measured at the same time, so it is not possible to know with certainty whether the chemical exposures altered behavior or behavior altered chemical exposures.  (more…)
ADHD, Author Interviews, Depression, Education, JAMA, Mental Health Research, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Jeremy Brown BA MSc RESEARCH DEGREE STUDENT IN PHARMACOEPIDEMIOLOGY London School of Hygiene & Tropical Medicine MedicalResearch.com: What is the background for this study? Response: Given the way schools typically work, children in the same year as each other can be almost a whole year apart in terms of age. We’ve known for a while that children who are young in their year at school are also more likely to be diagnosed as having hyperactivity disorders and tend to do less well academically than the older children in the year. They also seem to be at increased risk of suicide. This is thankfully an extremely rare occurrence in children, but there is little evidence about whether younger children are more likely to be diagnosed with depression. We used electronic health records for just over a million children in the UK to see if there was any association between how old the children were in their year and whether they got diagnosed with ADHD, intellectual disability and depression. (more…)
ADHD, Author Interviews, JAMA, OBGYNE, Pediatrics, Pharmacology / 08.04.2019

MedicalResearch.com Interview with: Dr. Angela Lupattelli, PhD School of Pharmacy University of Oslo MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women. However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. (more…)
Author Interviews, Methamphetamine / 06.01.2019

MedicalResearch.com Interview with: Brian J. Piper, PhD, MS Assistant Professor of Neuroscience Department of Basic Sciences, Geisinger Commonwealth School of Medicine, Scranton PA 18509  MedicalResearch.com: What is the background for this study? Response: The U.S. accounts for five percent of the world population but more than 92 percent of the world’s spending on pharmacotherapies for Attention Deficit Hyperactivity Disorder (ADHD). According to the 2011 National Survey of Children’s Health, ADHD increased to 11.0 percent of U.S. children, seven percent of girls and 15 percent of boys. Interestingly, ADHD rates were much lower among Hispanic children. The 2013 revision to the Diagnostic and Statistical Manual of Mental Disorders broadened the criteria such that it became easier to diagnose adult ADHD. Together, we hypothesized that use of amphetamine (Adderall), methylphenidate (Ritalin), and lisdexamfetamine (Vyvanse) would be increasing. We also predicted that there would be some regional differences in stimulant use. (more…)
ADHD, Author Interviews, Autism, JAMA, Pediatrics, UC Davis / 10.12.2018

MedicalResearch.com Interview with: Meghan Miller, Ph.D. Assistant Professor Department of Psychiatry & Behavioral Sciences UC Davis MIND Institute Sacramento, CA 95817 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study evaluated within-diagnosis sibling recurrence and sibling cross-aggregation of ADHD and autism spectrum disorder among later-born siblings of diagnosed children. We specifically chose to include only families who had at least one subsequent child after the diagnosis of an older child because failing to do so could bias recurrence risk estimates. We found that, compared to later-born siblings of non-diagnosed children, later-born siblings of children with autism were more likely to be diagnosed with autism or with ADHD. Likewise, compared to later-born siblings of non-diagnosed children, later-born siblings of children with ADHD were more likely to be diagnosed with ADHD or with autism. (more…)
ADHD, Author Interviews, Pediatrics, Race/Ethnic Diversity / 05.12.2018

MedicalResearch.com Interview with: George J. DuPaul, PhD Department of Education and Human Services Lehigh University   Charles Barrett. Ph.D. School Psychologist Loudon County Virginia Public Schools   MedicalResearch.com: What is the background for this study? What are the main findings? Response: Numerous studies have shown that Black children are more likely to receive ratings that are more indicative of displaying externalizing behavior difficulties, including Attention Deficit Hyperactivity Disorder (ADHD).  However, many of these studies included teachers as the informants. Consistent with most teachers in the United States, raters have typically been White females.  For this reason, it is unclear if these outcomes would exist if the rater and child shared the same racial/ethnic background. Additionally, most research in the United States that involved cross-cultural comparisons has used White and Hispanic boys.  Few empirical studies have examined differences between Black and White boys. The present study sought to address several limitations in the field.  Most notably, cross-cultural comparisons between Black and White boys were included instead of Hispanic and White children.  Next, maternal figures, rather than teachers, were included as the informants. The present study was developed using a similar methodology that examined Hispanic and White boys’ behavior from the perspective of Hispanic and White teachers (Dominguez de Ramirez & Shapiro, 2005). In sum, we sought to determine if there were differences in how Black and White maternal figures rated Black and White boys who were demonstrating the same level/type of behavior (i.e., sub-clinical levels of ADHD).  Notably, although the boys’ behaviors were the same, maternal ratings were not identical. Specifically, using the ADHD Rating Scale, Fourth Edition (ARS-4), Black mothers assigned higher ratings to both Black and White boys. (more…)
ADHD, Author Interviews, Psychological Science, University of Michigan / 11.10.2018

MedicalResearch.com Interview with: Holly White, PhD Research Scientist Basic and Applied Cognition Laboratory Department of Psychology University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study was inspired by my previous findings of higher originality and creative achievement among adults with ADHD, as well as my personal observations of individuals with ADHD choosing non-traditional approaches to problem solving. College students with ADHD sometimes ignore task instructions and examples, and while this may lead to errors, it may also lead to extraordinarily unique answers and solutions. I was curious as to whether this tendency of ADHD individuals to think in an unconventional and expansive manner might lead to resistance to conformity during creative tasks. In the present study, college students with ADHD were less likely to copy experimenter-provided task examples, compared to non-ADHD peers, on a product label invention task. ADHD participants were also less likely to create imaginary fruits that resembled typical Earth fruit, compared to non-ADHD participants. Students with ADHD were less likely to conform to pre-existing prototypes of fruit and therefore invented more original creations. Individuals with ADHD may be more flexible in tasks which require creating something new, and less likely to rely on examples and previous knowledge. As a result, the creative products of individuals with ADHD may be more innovative, relative to creations of non-ADHD peers.  (more…)
Author Interviews, Autism, Education, Exercise - Fitness, Pediatrics / 26.09.2018

MedicalResearch.com Interview with: Dr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming ProjectDr. Marcus Smith PhD Reader in Sport and Exercise Physiology University of Chichester Co-founder, Clem Burke Drumming Project MedicalResearch.com: What is the background for this study? Response: The research group first started to examine rock drumming from a scientific perspective in 1999 through collaboration with Clem Burke, drummer with the iconic band ‘Blondie’. In 2008 the Clem Burke Drumming Project (CBDP) was formed (visit clemburkedrummingproject.org for further information) where academics from different disciplines came together to not only explore the physiological demands of rock drumming but also the potential use of rock drumming as an intervention in research studies. Rock drumming is attractive to the scientist in that it is a unique activity that requires the coordination of multiple limbs to produce the required drumming pattern. Inherent demands relating to timing, tempo and volume must also be met. Therefore, the ability to manipulate these facets of drumming performance in a research setting is very appealing. In relation to potential research populations drumming has a universal fascination regardless of age, gender, culture, language competency and ethnicity. Anecdotal evidence suggests that drumming is a ‘cool’ activity that has a unique ‘language currency’ in terms of stimulating communication within and between those who can and cannot play the drums. The impetus for our research study came from parents of autistic children contacting us to express their belief that drumming was having a positive effect on their child’s physical and psychological behaviour. A review of the literature showed a range of anecdotal evidence in support of such statements (Freidman 2000) and an increase in empirical drumming based research being undertaken (Bungay 2010). More recent studies have reported psychosocial benefits such as enhanced communication (Maschi et al. 2010; 2012), emotional processing and tension reduction (Flores et al. 2016; Maschi et al. 2010; 2012), group cohesion and connectedness (Blackett et al. 2005), concentration, psychomotor coordination and posture (Chen et al. 2017). The majority of this work was undertaken with adolescents with very little work focused on younger age groups. (more…)
Author Interviews, Autism, Blood Pressure - Hypertension, JAMA, OBGYNE, Pediatrics / 08.06.2018

MedicalResearch.com Interview with: “Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Ali Khashan, PhD Senior Lecturer in Epidemiology School of Public Health & INFANT Centre University College Cork Cork, Ireland MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is some evidence to suggest an increased likelihood of neurodevelopmental disorders in relation to hypertensive disorders in pregnancy, however consensus is lacking. Considering hypertensive disorders in pregnancy are among the most common prenatal complication, we decided to synthesise the published literature on this topic by conducting a comprehensive systematic review and meta-analysis. Our main findings suggest that hypertensive disorders in pregnancy are associated with about 30% increase in the likelihood of autism spectrum disorders (ASD) and ADHD in the offspring, compared to offspring not exposed to hypertensive disorders in pregnancy. (more…)
Author Interviews, Columbia, OBGYNE, Toxin Research / 29.05.2018

MedicalResearch.com Interview with: Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high. Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations. For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment. (more…)
ADHD, Author Interviews, Columbia, JAMA, Toxin Research / 21.05.2018

MedicalResearch.com Interview with: Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  Marianthi-Anna Kioumourtzoglou ScD Assistant Professor Environmental Health Sciences Mailman School of Public Health Columbia University  MedicalResearch.com: What is the background for this study? Response: The prevalence of neurodevelopmental disorders, like attention deficit/hyperactivity disorder (ADHD) has been increasing. One of the hypothesized risk factors for increased risk for neurodevelopmental disorders is a class of chemicals known as endocrine disrupting chemicals (EDCs). These chemicals are known to interfere with the endocrine system, i.e. the system that uses hormones to control and coordinate metabolism, reproduction and development. Several high production volume chemicals, ubiquitously present in commercial products, are known or suspected endocrine disruptors. Because of their widespread use in consumer products, the population-wide exposure to known and suspected EDCs is very high. Recently, there has been increased attention in the potential effects of EDCs on neurodevelopment that span multiple generations. Animal studies have provided evidence that exposure to EDCs, such as phthalates and bisphenol A (BPA), alter the behavior and social interactions in mice in three to five generations after exposure. However, evidence of such multi-generational impacts of EDC exposure on neurodevelopment in humans is unavailable, likely because of the lack of detailed information on exposures and outcomes across generations. For this study we leveraged information from a nationwide cohort, the Nurses’ Health Study II (NHSII), to investigate the potential link between exposure to diethylstilbestrol (DES) and third generation ADHD, i.e. ADHD among the grandchildren of the women who used DES while pregnant. DES is a very potent endocrine disruptor that was prescribed between 1938 and 1971 to pregnant women thought to prevent pregnancy complications. In the United States, between 5 and 10 million women are estimated to have used DES, although the exact number is not known. DES was banned in 1971, when was linked to vaginal adenocarcinomas (a rare cancer of the reproductive system) in the daughters of the women who had used it during pregnancy. Since then, DES has been also linked to multiple other reproductive outcomes in DES daughters, as well as with some reproductive outcomes in the grandchildren of the women who used it, such as hypospadias and delated menstrual regularization. However, to our knowledge, no study to date has evaluated the association between DES, or any other EDC, and multigenerational neurodevelopment. (more…)
ADHD, Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, OBGYNE / 14.12.2017

MedicalResearch.com Interview with: Krista F. Huybrechts, MS PhD Assistant Professor of Medicine Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital Harvard Medical School Boston, MA 02120   MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, use of stimulant medications in adults, including women of reproductive age, has increased substantially. However, data regarding the safety of stimulant medications in early pregnancy are sparse and conflicting.  For example, two recent cohort studies failed to detect an association between use of methylphenidate in early pregnancy and overall or cardiac malformations, while another found an 81% increased risk of cardiac malformations, although the estimate was imprecise. Given the rapidly increasing use of stimulant medications during pregnancy and among women of reproductive age who may become pregnant inadvertently, there is an urgent need to better understand their safety. (more…)
ADHD, Author Interviews, Autism, JAMA, NYU / 12.09.2017

MedicalResearch.com Interview with: Dr. Adriana Di Martino, MD Associate Professor, Department of Child and Adolescent Psychiatry NYU Langone Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: While there has been an increased awareness of the co-occurrence of symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in children with a primary diagnosis of ASD, only recently has there been an appreciation that a substantial proportion of children with ADHD may also have ASD traits. These symptom domains overlap pose a challenge for accurate recognition and targeted treatments, yet their underlying mechanisms have been unknown. With more traditional diagnostic group comparisons we detected a significant influence of ASD on white matter organization, but our analyses of the severity of symptoms across individuals revealed an association between autistic traits and white matter organization, regardless of the individual's diagnosis. These findings were mostly centered around the corpus callosum, a structure that enables communication between the left and right cerebral hemispheres. (more…)
ADHD, Author Interviews, JAMA, Pharmacology / 26.07.2017

MedicalResearch.com Interview with: Professor Ian Chi Kei Wong and Kenneth KC Man, Senior Research Assistant Department of Social Work and Social Administration, Faculty of Social Science Department of Pharmacology and Pharmacy, LKS Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients with attention-deficit/hyperactivity disorder (ADHD) are at higher risk of various mental health problems. Previous studies suggested that individuals with ADHD are having a higher chance of both attempted and completed suicide. Methylphenidate is a psychostimulant that is recommended for the treatment of ADHD. With the increasing usage of methylphenidate over the past decade, there are concerns about the safety of the medication, in particular, psychiatric adverse effects such as suicide attempt. The current study looked into over 25,000 patients aged 6 to 25 years in Hong Kong who were receiving methylphenidate in 2001 to 2015. Using the self-controlled case series design, in which the patients act as their own control, we found that the risk of suicide attempt was 6.5 fold higher during a 90-day period before methylphenidate was initiated, remained elevated 4-fold during the first 90 days of treatment, and returned to the normal level during ongoing treatment. (more…)
ADHD, Author Interviews, JAMA, Karolinski Institute / 11.05.2017

MedicalResearch.com Interview with: Zheng Chang PhD MSc Department of Medical Epidemiology and Biostatistics (MEB) Karolinska Institutet Stockholm Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: About 1.25 million people worldwide die annually because of motor vehicle crashes (MVCs). ADHD is a prevalent neurodevelopmental disorder with symptoms that include poor sustained attention, impaired impulse control and hyperactivity. ADHD affects 5 percent to 7 percent of children and adolescent and for many people it persists into adulthood. Prior studies have suggested people with ADHD are more likely to experience MVCs. Pharmacotherapy is a first-line treatment for the condition and rates of ADHD medication prescribing have increased over the last decade in the United States and in other countries. Among the more than 2.3 million patients with ADHD (average age 32.5), we found patients with ADHD had a higher risk of an MVC than a control group of people without ADHD. The use of medication in patients with ADHD was associated with reduced risk for motor vehicle crashes in both male and female patients. (more…)
ADHD, Author Interviews, Education, Gender Differences, JAMA, Pediatrics / 01.05.2017

MedicalResearch.com Interview with: Professor Jill Pell MD Director of Institute (Institute of Health and Wellbeing) Associate (School of Medicine, Dentistry and Nursing) University of Glasgow MedicalResearch.com: What is the background for this study? Response: The novelty of our study lies in its scale and scope. In terms of scope, it reported on six educational outcomes and three health outcomes in the same group of children. In terms of scale, it is the first study of a whole country to compare educational outcomes of children with treated ADHD with their unaffected peers and is more than 20 times larger than previous studies on similar educational outcomes. The only previous countrywide study on health outcomes, included only children with very severe ADHD who were in psychiatric hospitals. (more…)
Author Interviews, Autism, Depression, JAMA, OBGYNE, Pediatrics / 19.04.2017

MedicalResearch.com Interview with: Simone Vigod, MD, MSc, FRCPC Psychiatrist and Lead, Reproductive Life Stages Program Women’s Mental Health Program Women’s College Hospital Toronto, ON MedicalResearch.com: What is the background for this study? What are the main findings? Response: Depression is one of the most common problems that can complicate a pregnancy. Untreated, or incompletely treated, it can be associated with significant harm to mother and child. While psychotherapies alone may be effective for women with mild (or even moderate) severity symptoms, sometimes antidepressant medication is required. In these cases, the benefits of treatment must be weighed against potential risks. Previous research suggested that there may be an increased risk for autism in children exposed to antidepressant medication during pregnancy. However, previous studies were limited in their ability to account for other potential causes of autism in their analyses. In our study, we used several different strategies to try to compare children whose pregnancy exposures were very similar, except for exposure to an antidepressant. The main finding was that after using these strategies, there was no longer a statistically significant association between in-utero antidepressant exposure and autism. (more…)
ADHD, Author Interviews, Lancet, MRI, Neurological Disorders / 01.03.2017

MedicalResearch.com Interview with: M. (Martine) Hoogman PhD. Postdoc and PI of ENIGMA-ADHD Radboud universitair medisch centrum Department of Human Genetics Nijmegen, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many neuro-imaging studies aimed at investigating structural brain changes related to ADHD, but the results are often inconclusive. There are two main reasons for this: 1) the small sample size of the studies and 2) the heterogeneous methods used. We tried to address these issues by forming an international collaboration to provide a sample size sufficient to detect even small effects in volume differences. And in addition, we analyzed all the raw scans again using homogenized methods. There are data of more than 1700 patients (aged 4-63 years of age) and more than 1500 healthy controls in our dataset, coming from 23 sites around the world. We studied the possible volume differences between cases and controls of 7 subcortical regions and intracranial volume by performing mega- and meta-analysis. (more…)
ADHD, Author Interviews, Education, JAMA, UCSF / 08.12.2016

MedicalResearch.com Interview with:  

Lisa Meeks , PhD Director, Medical Student Disability UCSF Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was the first study to include students with AD/HD, learning, psychological, and chronic health conditions. This study found that the prevalence of students with disabilities is up to four times higher than previous studies indicated.

AD/HD, learning, and psychological disabilities were the most prevalent, suggesting that most students with disabilities in medicine have non-apparent disabilities. Within MD granting programs, the number of students self-reporting disability varied between 0% and 12%. Explanations for the high variability between programs are unknown, however, anecdotal reports suggest the degree to which programs have dedicated resources and inclusive practices for students with disabilities influence student disclosure. (more…)
ADHD, Author Interviews, Genetic Research, Pediatrics / 01.11.2016

MedicalResearch.com Interview with: Dr. Josephine Elia, M.D. Neuroscience Center Department of Child and Adolescent Psychiatry Nemours/Alfred I. DuPont Hospital for Children MedicalResearch.com: What is the background for this study? What are the main findings? Response: Glutamate neurotransmission may play an important role in ADHD and other neuropsychiatric disorders. The purpose of this study is to determine the frequency of genetic mutations involving specific genes (GRM network genes) which influence glutamatergic neurotransmission. A total of 23 study sites across the USA enrolled 1,013 children, aged 6-17 years who had been previously diagnosed with ADHD. Saliva samples were submitted to The Center for Applied Genomics (CAG) at CHOP for analysis of mutations of interest. Information on medical history, including other neuropsychiatric diagnoses and family history as well as areas of academic and social concern were also collected. Overall, the mutation frequency was 22%, with a higher prevalence of 25% observed in patients aged 6-12. When compared to mutation negative ADHD patients, the patients with the mutations of interest were more likely to have concerns about anger control and disruptive behaviors. (more…)
Accidents & Violence, Addiction, ADHD, Author Interviews / 29.07.2016

MedicalResearch.com Interview with: Anna Chorniy PhD Postdoctoral Research Associate Center for Health and Wellbeing Princeton University Princeton NJ 08544 MedicalResearch.com: What is the background for this study? Response: Attention-deficit/hyperactivity disorder (ADHD) is one of the common chronic mental conditions affecting children. In the U.S., 11% of children ages 4–17 (6.4 million) are estimated to have an ADHD diagnosis and almost 70% of them report taking medication for the condition (e.g. Visser et al., 2014). However, little evidence exists on the effects of ADHD treatment on children’s outcomes. We use a panel data set of South Carolina Medicaid claims paid out in 2003–2013 to investigate the effects of ADHD medication treatment on a seldom studied set of outcomes associated with this condition: adolescent risky behaviors and the incidence of injuries. The occurrence of injuries allows us to evaluate short-term effects of ADHD treatment, while substance abuse and risky sexual behavior outcomes speak for the long-term effects of medication. Second, we use Medicaid spending on treatment of these negative events to evaluate the impact of ADHD drugs on the severity of ADHD, and compare the cost of ADHD treatment with the costs of negative health events. (more…)
ADHD, Author Interviews, JAMA, Pediatrics / 23.05.2016

MedicalResearch.com Interview with: Luis Augusto Rohde MD, PhD Full Professor Department of Psychiatry Federal University of Rio Grande do Sul Director ADHD Program Hospital de Clínicas de Porto Alegre  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The idea that Attention-deficit/Hyperactivity Disorder always begins in childhood has been held for decades even without proper testing. The main manuals of psychiatric diagnoses require age at onset in childhood as a core feature of the disorder. In a large birth cohort followed until age 18, we identified many young adults presenting with a full impairing ADHD syndrome. They had consistently worse outcomes - criminality, substance abuse, traffic accidents, among others - than their counterparts without ADHD. However, most of these young adults (84.6%) presenting with a full impairing syndrome did not have a prior diagnosis in their childhood years. This surprising observation held after many secondary analyses exploring possible biases, like comorbidities in young adulthood, subthreshold ADHD in childhood and change of information source. (more…)
Addiction, ADHD, Author Interviews, Eating Disorders / 29.01.2016

MedicalResearch.com Interview with: Dr. Kenneth Koblan PhD Sunovion Pharmaceuticals Inc. Fort Lee, NJ and Marlborough, MA Medical Research: What is the background for this study? Dr. Koblan: Assessing abuse potential is important in the clinical development process for any therapy affecting the central nervous system, especially those that may act on dopamine and norepinephrine neurotransmitter systems. Human abuse liability studies are conducted to evaluate the abuse potential associated with drugs that affect the central nervous system. Drugs that increase dopamine levels may be associated with stimulant effects and abuse (e.g., cocaine and amphetamine), whereas drugs that increase serotonin and/or norepinephrine levels are not generally associated with recreational abuse (e.g., selective serotonin reuptake inhibitors). Among drugs with effects on dopamine neurotransmission, slowing the rate of absorption is thought to reduce abuse potential, and increasing the rate of elimination is thought to reduce rewarding effects and abuse liability due to sustained elevations in drug concentrations resulting in sustained inhibition of dopamine transporters (DAT). Dasotraline is an investigational dopamine and norepinephrine reuptake inhibitor from Sunovion in late-stage development to evaluate its use in treating the symptoms of attention deficit hyperactivity disorder (ADHD) and binge-eating disorder (BED). Dasotraline has slow absorption and elimination that supports the potential for plasma concentrations yielding a continuous therapeutic effect over the 24-hour dosing interval at steady state. (more…)
ADHD, Author Interviews, BMJ, Pharmacology / 26.11.2015

MedicalResearch.com Interview with: Dr. Ole Jakob Storebø Region Zealand, Child and Adolescent Psychiatric Department, Roskilde Region Zealand Psychiatry Psychiatric Research Unit, Slagelse University of Southern Denmark Department of Psychology Faculty of Health Science, Odense Denmark Medical Research: What is the background for this study? What are the main findings? Dr. Storebø: Despite widespread use of methylphenidate for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD), a comprehensive systematic review of its benefits and harms has not yet been conducted. Over the past 15 years, several reviews investigating the efficacy of methylphenidate for ADHD (with or without meta-analyses) have been published. Each of these reviews, however, has several shortcomings and these are described in detail in the review. The most important concerns are that none of these reviews are based on a pre-published protocol, and most assessed neither the risk of bias (systematic errors) of included trials nor adverse events. Moreover, none of these reviews considered the risk of random errors. Therefore, their interpretation of findings is unlikely to have taken into account the poor reporting of adverse events, the impact of combining data from small trial samples, or the impact of risk of bias on their analyses; information about adverse events is also missing from several RCTs. Because of this it is our opinion that these previous reviews might have overestimated the true treatment effect. We found that Methylphenidate may improve ADHD symptoms, general behaviour and quality of life in children and adolescents aged 18 years and younger with ADHD. We rated the evidence to be of very low quality and, as a result, we cannot be certain about the magnitude of the effects from the meta-analyses. The evidence is limited by serious risk of bias in the included trials, under-reporting of relevant outcome data, and a high level of statistical variation between the results. We found no evidence for serious adverse events, but a lot of non-serious adverse events. Most of these are well known but the number of adverse events might even be higher than the number we found due to underreporting of adverse events. We know very little about the long term effects or harms as most of the trials in our review did not measure outcomes beyond 6 months. The risk of rare, serious adverse events seem low over the short duration of follow-up of the trials that reported on harms, but in general there was inadequate reporting of adverse events in many trials. (more…)