Wednesday, March 9, 2011

UGH ADHD meds

What does this mean?
"Lifetime and 1-year risks for all composite categories of psychopathology were significantly greater in girls with ADHD grown up relative to comparison girls; lifetime hazard ratios were 7.2 (95% CI=4.0-12.7) for antisocial disorders, 6.8 (95% CI=3.7-12.6) for mood disorders, 2.1 (95% CI=1.6-2.9) for anxiety disorders, 3.2 (95% CI=2.0-5.3) for developmental disorders, 2.7 (95% CI=1.6-4.3) for addictive disorders, and 3.5 (95% CI=1.6-7.3) for eating disorders. For lifetime psychopathology, all six composite categories remained statistically significant after controlling for other baseline psychopathology. Except for addictive disorders, significant 1-year findings remained significant after controlling for baseline psychopathology. The 1-year prevalences of composite disorders were not associated with lifetime or 1-year use of ADHD medication."
 
Does this mean medication use did not have any affect?
 
Because if so, then why are assholes obsessing over how to force kids that don't want to take meds to take them?
 
 
"Attention-deficit/hyperactivity disorder (ADHD) is one such chronic health condition requiring long-term adherence to treatment. (Who says?) The aims of this review are to 1) review the extant literature regarding rates of adherence to medication for youth with ADHD; 2) summarize what is known regarding factors that impede and support greater adherence to medication; 3) introduce the Unified Theory of Behavior Change as a conceptual model that may assist in developing adherence treatment packages to support medication adherence; and 4) describe several potential interventions based on the Unified Theory of Behavior Change that may improve adherence to medication for youth with ADHD."

Friday, March 4, 2011

Inflammation, ADHD, and Chronic Disorginization

Chronic disorganization was previously considered to be a symptom of OCD, however, while it is commonly found in OCD patients new research finds that it has higher correlation with ADD (non-hyperactive) symptomology. Such is implied in such research:

"Multiple linear regressions demonstrated that after controlling for global negative affect, OCD symptoms did not significantly predict any of the core features of HD. Conversely, the inattentive (but not hyperactive/impulsive) symptoms of ADHD significantly predicted severity of clutter, difficulty discarding, and acquiring. These results challenge current conceptualizations of hoarding as a subtype of OCD, and suggest an association with neurocognitive impairment."

(Study available full text)

and also here:

In conclusion, salient hoarding behaviors were found to be relatively common in a sample of children with learning disabilities and not necessarily associated with obsessive-compulsive disorder, supporting its nosological independence. It is unclear whether underlying cognitive features may play a major role in the development of hoarding behaviors in children with learning disabilities."

Also available full text.

ADHD has been correlated with high levels of proinflammatory cytokines and biomarkers.
As demonstrated here:
"(1) Total symptom ratings were associated with increases of the interleukins IL-16 and IL-13, where relations of IL-16 (along with decreased S100B) with hyperactivity, and IL-13 with inattention were notable. Opposition ratings were predicted by increased IL-2 in ADHD and IL-6 in control children. (2) In the CPT, IL-16 related to motor measures and errors of commission, while IL-13 was associated with errors of omission. Increased RT variability related to lower TNF-alpha, but to higher IFN-gamma levels. (3) Tryptophan metabolites were not significantly related to symptoms. But increased tryptophan predicted errors of omission, its breakdown predicted errors of commission and kynurenine levels related to faster RTs."

Available full text.

I'll go into greater detail about what the pro-inflammatory markers mean a little later. For now I will say that exercise, dietary phytochemicals from plants, amino acids, and also interestingly, social support, seem to show promise in reducing levels of interleukin 6 (IL6) which seems to be most prominantly related to inflammation in the brain. I'll link up a huge list of studies demonstrating that relationship shortly.

Changing the face of Mental Health treatment

I'm writing a gargantuan paper on inflammation, mental health, exercise and physical activity interventions, amino acids, HPA, trauma, and dietary interventions. This will only be based on abstracts of peer reviewed studies because I'm not qualified to judge the worth of the research itself, so my paper will do nothing but I hope inspire motivation for further research into more appropriate treatment models for mental health conditions.
 
If there is significant evidence that research based lifestyle interventions have clinical application to mental health recovery (there is)--- then I propose that we consider addressing the obstacles that mental health patients face with implementing lifestyle changes and do research on usability of programs--- if a program is clinically successful but only if patients are living in--- then it's not applicable to living out patients. We need to research ways to address the daily life dysfunction mentally ill have in participating in behaviors that will provide stability, nutrition, and recovery of brain functioning when ability to do self care has been compromised due to fatigue, low motivation, disorientation, spaciness, confusion, lack of focus, inattentiveness, and basic impairment of cognitive function.
 
My goal is to advocate for in home support, assistance with managing the difficulties of cooking, cleaning, organizing and creating routine--- or a pick up service for patients who have problems with timeliness and waking up in the morning, and continuing to show up, which is common in many forms of mental illness and impairs work performance and ability to hold jobs (and ability to successfully continue with a desired program or lifestyle change). Possibly we could provide semi-prepared meals with high fresh vegetable content, phytochemicals, fiber, protein and unsaturated fats that can be cooked in one pot or pan and easily cleaned up after--- either fully prepared for daily pick up--- or vegetables chopped and seasoned for weekly pick up.
  
I recognize the main reason such programs are unpopular is due to the economic cost of implementing them when we could just continue to pump meds into people and pharm companies and psychiatrists get paid and it's easy--- but it doesn't work. We aren't making these people better and we are ignoring the underlying medical conditions that are causing these symptoms.
 
(So far as pateints being disinterested in lifestyle changes--- this is another area worthy of research-- why the resistance and is there any way we can genuinely hear the obstacles people are facing with seeing lifestyle change as desirable and address those concerns with respect for individual choice and the desired results of the client/patient)
 
I'm not doing the research for this paper but my next thing will be to study the clinical significance of identifying struggling areas of the brain and doing physical and mental exercises that use that area of the brain in order to enhance functioning. Also research on the benefits of social relationships on health might call for some intervention in assisting people with creating meaningful relationships and encouraging social policies that increase peer relationships, empathy, and connectedness in school and family settings.
 
What will ultimately happen is that this research will probably generate some fairly successful (RIDICULOUSLY EXPENSIVE) dietary and therapeutic programs that wealthy people can try out. If success is continually seen, my hope is that the use of such services will trickle down to lower income people. I wish I wasn't in the midst of right brained inflammation whatever brain disorder or this paper would paper would be so awesome and could probably convince the state mental hospital here to let me rework their dietary program. Of course if I didn't have these issues I would have an awesome degree by now anyways. Grrrrr.

Tuesday, March 1, 2011

What are REALLY trying to cure?

Reading a study on depression and IBS relationship with pupil dilation at presentation of negative information--- I came accross this quote:

"Depressed youths potentially demonstrate affective blunting, emotional avoidance, or a failure to regulate emotion after exposure to negative emotional information."

(Sorry can't link it's study as it's available through school)

Perhaps if you were to pull up the demographic of levels of shittiness in the lives of "depressed youth" you might find this response to be appropriate. You're trying to fix the wrong problem- YO. It's possible that the problem is not "the kids respond too much to negative"--- perhaps the problem is that the kids have adapted to too much negative existing in their reality.

Perhaps that's a factor in the development of IBS to begin with. Seeing as like everything in world cures IBS--- i.e. placebos seems to cure the shit out of IBS, perhaps that's actually what we should be researching and seeking "cures" for--- unhealthy environments--

What are they and how to assist families in achieving healthy relationships?