by Physicians Weekly | Dec 20, 2012
Adults diagnosed with ADHD during childhood appear to suffer worse outcomes when they reach adulthood, according to a national study. Those diagnosed with ADHD during childhood had significantly worse educational, occupational, economic, and social outcomes. Abstract: Archives of General Psychiatry, December...
by Physicians Weekly | Apr 17, 2012
Contributing author: Mark L. Wolraich, MD. In 2000, the American Academy of Pediatrics (AAP) released its first clinical recommendations for the diagnosis and evaluation of ADHD in children and followed that a year later with treatment recommendations. In 2011, the AAP updated these guidelines due to new evidence that has emerged in the management of children with ADHD. Important Changes to the Guidelines The AAP’s 2011 guideline update recommends that primary care physicians (PCPs) evaluate children for ADHD from age 4 through 18. The earlier version of the guidelines covered children ages 6 to 12. This change was made because of an accumulation of evidence in recent years in a broader pediatric population. Enough evidence has emerged that we now feel comfortable about the criteria being appropriate for preschoolers and adolescents. Previously, the AAP had one guideline for diagnosis and evaluation and another for treatment. Now, the academy has included diagnosis, evaluation, and treatment in a single document. The revised guideline also includes recommendations for managing pediatric patients who exhibit some signs and symptoms of ADHD but don’t meet current diagnostic criteria for the condition. This information is particularly applicable to PCPs. Furthermore, a new process-of-care algorithm has been developed to provide physicians with step-by-step guidance on implementing the recommendations, and the AAP’s ADHD toolkit has been revised based on this algorithm. Key Action Statements for Pediatric ADHD The 2011 AAP guideline includes a summary of several key action statements: PCPs should initiate an ADHD evaluation for any child aged 4 to 18 who has school or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity. Symptoms and behavior must...
by Physicians Weekly | Dec 8, 2011
Researchers found four gene variants that may be involved in vital brain signaling pathways in a subset of kids with ADHD. This discovery may aid in the development of drugs that target those pathways. It’s estimated that a half million children in this country have ADHD and these gene variants, which belong to the glutamate receptor (GMR) gene family. While the disorder tends to occur in families, scientists are still uncertain of the exact cause. Drugs prescribed for the condition may not always work, especially when symptoms are severe. In a recent study published in Nature, 1,000 children with ADHD from a database at the Children’s Hospital of Philadelphia were found to have a considerably greater number of copy number variations (CNVs) on four GMR genes, compared with 4,100 kids in the control group who did not have ADHD. The one with the strongest result was gene GMR5. Carefully selected GRM agonists could be used in human studies to determine whether they might have potential as therapies for ADHD patients with particular...
