Article

Beyond polemics: Science and ethics of ADHD

London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
Nature Reviews Neuroscience (Impact Factor: 31.38). 01/2009; 9(12):957-64. DOI: 10.1038/nrn2514
Source: PubMed

ABSTRACT What is attention-deficit hyperactivity disorder (ADHD)? Why are so many children being diagnosed with ADHD and prescribed medication? Are stimulant drugs an effective and safe treatment strategy? This article explores the current state of scientific research into ADHD and the key social and ethical concerns that are emerging from the sharp rise in the number of diagnoses and the use of stimulant drug treatments in children. Collaborations among scientists, social scientists and ethicists are likely to be the most promising route to understanding what ADHD is and what stimulant drugs do.

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    • "ADHD becomes typically evident in the first decade of life, and tends to persist through adolescence and adulthood (Swanson et al. 1998). Despite extensive research, there is continuous debate on both the validity and prevalence of ADHD (Singh, 2008). The use of medications to treat ADHD has been rapidly increasing worldwide, a phenomenon that has raised concern about the appropriateness and safety of this practice (Dalsgaard et al. 2013; Thomas et al. 2014). "
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    ABSTRACT: Background. The rate with which attention deficit/hyperactivity disorder (ADHD) is diagnosed varies widely across countries, suggesting that cultural factors influence the clinical interpretation of child behaviour. This study estimated the point prevalence of severe ADHD among elementary and middle-school Italian children. Method. An epidemiological sample of 2016 children attending 2nd-8th grade in the Italian regions of Tuscany and Latium was selected based on census distribution of the school-age population. Teachers completed the Italian version of the ADHD Rating Scale for Teachers (SDAI). For children with at least six inattention symptoms and/or at least six hyperactivity/impulsivity symptoms rated 'very often' by the teachers, the parents completed the Italian ADHD Rating Scale for Parents (SDAG). Children with documented ADHD symptoms at both school and home received a complete psychiatric interview with the Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime version (K-SADS-PL). Results. Of the 1887 assessed children, 4.45% (95% CI 3.58-5.51) met the ADHD cut-off on teacher ratings, 1.43% (0.96-2.12) had ADHD symptoms endorsed by both teacher and parent, and 1.32% (0.87-1.97) were further confirmed by the psychiatric evaluation. The male:female ratio was 7:1. The inattentive type accounted for about half of the ADHD cases. Conclusions. When applying stringent criteria for both severity and pervasiveness of symptoms, it is estimated that about 1.3% of the Italian elementary and middle-school children suffer from severe ADHD.
    Epidemiology and Psychiatric Sciences 09/2014; DOI:10.1017/S2045796014000523 · 3.36 Impact Factor
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    • "The US congress federal law requires all the additives to be tested before they are added to food, drugs or cosmetics; out of many additives about 200 substances were withdrawn and nowadays only around 35 additives (i.e. coloring agents, preservatives, flavoring agents and sweeteners) are approved by FDA [19] [20] [21] [22] [23] [24] [25]. Despite of all the studies done, a DOI: 10.5963/PHF0303002 controversy about the negative effects of additive substances found in processed foods still exist and people are faced with a choice whether they can consume those products safely or not. "
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    • "Furthermore, the effects of ADHD are not limited to the diagnosed individual, as the associated behavioural difficulties can lead to longterm family suffering (Harpin 2005). Boys are much more likely than girls to be diagnosed with ADHD (Singh 2008), and those from lower socio-economic backgrounds are more likely to be diagnosed than those from wealthier families (Cantwell 1996). Worldwide reviews report incidence of ADHD among school-age children from 1% to nearly 20%. "
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    ABSTRACT: Background: The use of physical activity as an alternative to the pharmaceutical management of Attention Deficit/Hyperactivity Disorder is receiving increased attention partly because of claims of the over-diagnosis or mis-diagnosis of pharmaceutical prescription that is inappropriate for the cluster of behaviors exhibited by sufferers. Methods: A scoping review process was adopted. Searches of seven academic databases were performed using comprehensive search strings, targeting articles published between January 2002 and December 2012. Findings were analyzed and reported in a narrative discussion. Results: 10 articles were identified that matched the inclusion criteria. Findings from the studies included were varied though, generally speaking, each of the studies indicated negative correlations between participation in physical activity and the symptoms of ADHD. Conclusion: The evidence suggests that physical activity might be effective in the management of ADHD. In education settings this can be especially effective as results suggest post-physical activity outcomes for children diagnosed with ADHD have been reported to include improved behavior, increased attentiveness, and improved cognitive functioning.
    Education 3-13 06/2014; DOI:10.1080/03004279.2014.918160
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