Subspecialty Collections : Attention Deficit Hyperactivity Disorder

American Journal of Psychiatry :

Attention Deficit Hyperactivity Disorder

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This is a handy link to recent publications... Robt.

Abstract: A 14-Month Randomized Clinical Trial of Treatment Strategies for ADHD

Arch Gen Psychiatry -- December 1999, The MTA Cooperative Group 56 (12): 1073:

For ADHD symptoms, our carefully crafted medication management was superior to behavioral treatment and to routine community care that included medication. Our combined treatment did not yield significantly greater benefits than medication management for core ADHD symptoms, but may have provided modest advantages for non-ADHD symptom and positive functioning outcomes.

This leads me to believe that the best treatment is to begin with an inpatient program much the same as the Vet.Admin. uses for PTSD, then follow up with local out-patient treatment taylored from the results of the in-patient program... Robt.

Changing Perspectives on ADHD -- Volkmar 160 (6): 1025

-- American Journal of Psychiatry:

...Inclusion of three subtypes in DSM-IV increases the prevalence of the condition (3). Issues of syndrome thresholds clearly have a major impact on case definition, and it is clear that important problems, e.g., the pervasiveness of symptoms over settings, the degree of distress or impairment exhibited, and the persistence of disability over development need to be addressed (6). These issues call for a careful reappraisal of the current 'epidemic' of ADHD in this country...

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...In conclusion, although DSM-IV opens the door to increased prevalence of ADHD, we must also be concerned about missing cases in schools and primary care settings. Moreover, even when ADHD is recognized, children may not get appropriate treatment because of problems of access to services or difficulites in dissemination of best practices....

Toward Understanding the Basis of ADHD -- Volkmar 162 (6): 1043

-- American Journal of Psychiatry:

Fred Volkmar, M.D.

Difficulties in attention associated with impulsive behavior and overactivity are common presenting problems in both preschool and school-age children and are the cardinal features of attention deficit hyperactivity disorder. Over time there have been significant changes in definition that have helped to clarify important aspects of the condition (1). In turn, research on potential mechanisms has also become increasingly sophisticated. Although the etiology of the condition is likely heterogeneous, a substantial body of research has implicated a range of neurobiological factors, including genetic ones (2). Follow-up studies have demonstrated the persistence of difficulties into adulthood in many cases, and a body of work on the manifestations of the disorder in adults has now appeared (3).