NEWS


ADHD and absenteeism

posted Oct 23, 2012, 8:39 PM by Neville Misquitta   [ updated Oct 24, 2012, 9:15 AM ]

ADHD, emotions and absenteeism

ADHD, emotions, and absenteeism

ADHD is associated with increased absenteeism in children. Absenteeism varies with the type and intensity of emotional problems experienced by children with ADHD. Many children with ADHD are scapegoats for any incident in the class or at home which compounds their emotional problems. A thorough evaluation often reveals these children have emotional disorders like depression and  anxiety. Depression occurs in 12-50% of children with ADHD, and anxiety disorder in upto 33% of these children. ADHD, depression and anxiety lead to poor academic performance. Poor academic performance is a common reason why children are referred to us by the school counselor or parents.

Poor academic performance in ADHD is now shown to be associated with increased primary care doctor visits and emergency room vists as compared to typical children. Children with ADHD are prone to injuries through their inattention and impulsivity. Associated emotional problems delay help seeking. Injuries and neglect result in increased doctor and emergency care visits. These visits contribute to increased school absenteeism. This combination of ADHD, emotional problems and absenteeism is associated with poor academic performance.

Treatment for ADHD in children can improve academic performance when it addresses the associated emotional problems, and not just the behaviours.

Source
Classi P, Milton D, Ward S, Sarsour K, Johnston J. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization. Child and Adolescent Psychiatry and Mental Health 2012, 6:33 (4 October 2012)

World Mental Health Day

posted Oct 9, 2012, 10:32 AM by Neville Misquitta   [ updated Oct 9, 2012, 10:35 AM ]

world mental health day

World Mental Health Day - Movie Survey

Mad about the Movies?

But what do the movies say about 'madness'? Give us your views on the depiction of mental illness in the movies. To create awareness on World Mental Health Day (10th October) we invite you to share your views on ANY Hindi, or regional Indian Language film in which one of the main characters has a mental illness or mental disorder.

Think beyond the cliche - think Intellectual Disability (Anjali), Alcoholism (Devdas), Dementia (U Me aur Hum), erotomania (Darr, Gupt). Don't just look for 'serious' movies - remember Munnabhai had visual hallucinations in Lage Raho Munnabhai.

Take the survey, tell us what you think

Alcoholism treatment financial benefits

posted Sep 29, 2012, 7:37 PM by Neville Misquitta   [ updated Sep 29, 2012, 11:24 PM ]

Alcoholism treatment financially benefits family

Alcoholism treatment lowers the financial burden on the family more than 400%. The time spent by family members in dealing with the addicted person is reduced by upto 4 times with alcoholism treatment. Alcholism treatment also improves quality of life for the family. Alcoholism treatment has a large financial effect not just on the alcoholic but also on his or her spouse, partner, children, and parents. The benefits of treatment reach well beyond the individual patient.

 

 
alcoholism untreated
Untreated
alcoholism treated
Treated
expenditure
Expenditure (€/mth)

 676.44

145.40

alcoholism time wasted
Time (hrs/mth)    

32.3 

8.2

quality of life
 Quality of Life

60.6

68.0 


Source
Hans Joachim Salize, Christian Jacke, Sven Kief, Michael Franz, Karl Mann.
Treating alcoholism reduces financial burden on care-givers and increases quality-adjusted life years. Article first published online: 25 SEP 2012. DOI: 10.1111/j.1360-0443.2012.04002.x

World Alzheimer's Day 2012

posted Sep 21, 2012, 3:30 AM by Neville Misquitta   [ updated Oct 9, 2012, 10:36 AM ]

Insomnia and melatonin

posted Sep 16, 2012, 6:56 AM by Neville Misquitta   [ updated Sep 18, 2012, 7:55 PM ]

Insomnia can result from melatonin suppression by iPad use. Insomnia treatment is a common need for which people seek psychiatric consultation. Insomnia is a symptom associated with emotional problems depression and anxiety. Insomnia also results from work-shift changes. Most frequently insomnia results from poor sleep hygeine - a gradual deterioration of sleep rituals until they are non existent. Sleep is a basic cyclical occurrence in most animals including humans. It is induced by natural cycles of light and dark to which the brain is entrained (circadian rhythms) by evolution. The socialised animal that is present day man has moved away from these natural cues and replaced them with artificial social cures.

Light can be harnessed for insomnia treatment. Light is the prime natural cue for the sleep-wake cycle. The most powerful of light cues are those that are driven by dawn (wakefulness) and dusk (sleep). Dawn light phase is a major suppressor of melatonin, the natural sleep inducing hormone secreted by the pineal gland in the brain. Dusk is the strongest booster of melatonin and primes the brain for sleep. This natural cycle of day and night has governed human activity and sleep until the advent of interior lighting. The relationship of mood and circadian rhythms is manipulated in light therapy and sleep deprivation for the insomnia treatment. Research now shows that 2 or more hours of iPad use before bed can suppress melatonin and cause insomnia.

Natural melatonin for insomnia treatment

  • Go for a walk at dusk
  • Use only essential artificial light at the dimmest possible level after dark
  • Switch of all screens including your iPad at least half an hour before planned sleep

Source

Brittany Wood, Mark S. Rea, Barbara Plitnick, Mariana G. Figueiro. Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression. Applied Ergonomics, Available online 31 July 2012http://dx.doi.org/10.1016/j.apergo.2012.07.008

Depression symptoms and vitamin D deficiency

posted Aug 24, 2012, 8:50 PM by Neville Misquitta   [ updated Aug 24, 2012, 8:52 PM ]

Depression symptoms and vitamin D deficiency

Vitamin D deficiency causes depression symptoms?

Depression symptoms are not caused by vitamin D deficiency. People with depression symptoms and Vitamin D deficiency do not recover when treated with high dose Vitamin D replacement therapy. Vitamin D is not an effective depression treatment even when blood levels of vitamin D are low. Vitamin D deficiency is a result of depressed mood and not a cause. This relationship of depression symptoms as a cause - not an effect - of Vitamin D deficiency was highlighted in a recent study. Treatment of depressed mood with Vitamin D replacement is ineffective.  

Estimating blood levels of Vitamin D in people with depression symptoms has recently become routine.  Laboratory chains too, have  got onto this lucrative bandwagon. High dose Vitamin D replacement is now being prescribed as the new treatment for depression.This is ineffective, and Vitamin D replacement can be toxic. Vitamin D toxicity manifests with nonspecific symptoms of nausea, vomiting, poor appetite, constipation, and weakness and calcium abnormalities. Therefore, treatment of Vitamin D deficiency and vitamin D supplements need to be coupled with appropriate medical supervision and monitoring while managing depressed mood.

Blood Vitamin D Levels
Interpretation ng/mL
Normal 30-60
Low <20
Insufficiency <30
Toxic >150

Exercise is routinely advised with prescription antidpressants for treatment of depression symptoms. Sunshine maintains healthy vitamin D levels. Ensure 5-10 minutes of sun exposure to the arms and legs two or three times a week. Get this sunshine by  walking outdoors.  Depressed mood is known  to improve with outdoor exercise in sunlight. If depressed mood still persists seek formal psychiatric consultation for what may be a moderate to severe depression. Vitamin D supplements can be toxic and are not an effective treatment for depression with or without a Vitamin D deficiency. Consult a psychiatrist for treatment of your depression symptoms.

Sources:

  1. Marie Kjærgaard, Knut Waterloo, Catharina E. A. Wang, Bjørg Almås, Yngve Figenschau, Moira S. Hutchinson, Johan Svartberg and Rolf Jorde. Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case–control study and randomised clinical trial . Published online ahead of print July 12, 2012, doi: 10.1192/bjp.bp.111.104349
  2. Sue Penckofer, PhD, RN, Joanne Kouba, PhD, RD, Mary Byrn, BSN, RN, and Carol Estwing Ferrans. Vitamin D and Depression: Where is all the Sunshine? Issues Ment Health Nurs. 2010 June; 31(6): 385–393. doi: 10.3109/01612840903437657

Inattentive ADHD children prone to smoking

posted Aug 12, 2012, 10:31 AM by Neville Misquitta   [ updated Aug 12, 2012, 10:33 AM ]

ADHD treatment can help smoking ADHD children by controlling inattention.

Source: J-B Pingault, S M Côté, C Galéra, C Genolini, B Falissard, F Vitaro and R E Tremblay. Childhood trajectories of inattention, hyperactivity and oppositional behaviors and prediction of substance abuse/dependence: a 15-year longitudinal population-based study. Molecular Psychiatry advance online publication 26 June 2012; doi: 10.1038/mp.2012.87

Inattention and smoking in ADHD children

Inattentive ADHD children are twice as likely to be smokers by 21 years of age. Inattention and hyperactivity are primary ADHD symptoms. Unfortunately it is only the ADHD children with hyperactivity that are identified early. Many parents feels they can tolerate the the 'hyperactive child syndrome' and avoid ADHD treatment with medication. They believe that parent training and  natural ADHD treatment will control their hyperactive children. However, in doing so they lay their ADHD children open to the adverse effects of inattention, a core symptom of attention deficit hyperactivity disorder.

ADHD children may manifest only inattention without the 'hyperactive child syndrome'.  Inattention does not respond to parent training alone. Inattention is caused by neurochemical deficitis, especially dopamine and noradrenaline. ADHD tretment is essential to correct this imbalance. At this critical inattention phaseimpacts learning and leads to subsequent difficulties through the 80+ life span of the ADHD children. ADHD treatment addresses both ADHD symptoms of inattention and hyperactivity. ADHD treatment is proven to improve academic performance when started early enough.

Attention deficity hyperactivity disorder (ADHD) is known to be associated with substance abuse including nicotine dependence. Research now shows that smoking and nicotine dependence are especially assoicated with inattention in ADHD children. ADHD treatment specifically addresses inattention and improves learning. Reducing the number of smoking children is another reason to initiate ADHD treatment, at least when the ADHD children are in primary school.

Mothers, Suicide and Cats

posted Jul 8, 2012, 9:01 AM by Neville Misquitta   [ updated Jul 8, 2012, 9:02 AM ]



Suicide attempts are more likely in mothers infected with the cat parasite, Toxoplasmosis gondii. The risk increases with increasing titres of the infection at the time of delivery.

Sources:
  1. Marianne G. Pedersen, MSc; Preben Bo Mortensen, DrMedSc; Bent Norgaard-Pedersen, DrMedSc; Teodor T. Postolache. Toxoplasma gondii Infection and Self-directed Violence in Mothers. Arch Gen Psychiatry. 2012;():1-8. doi:10.1001/archgenpsychiatry.2012.668 Published online July 2012
  2. Adriana Lopez, Vance J. Dietz, Marianna Wilson, Thomas R. Navin, Jeffrey L. Jones. Preventing Congenital Toxoplasmosis. MMWR. Reccommendations and Reports. March 31, 2000 / 49(RR02);57-75

Suicide Attempts in Mothers with Cat Parasite Infection

Mothers with the cat parasite Toxoplasmosis gondi infection are at risk for suicide attempts post partum.

Toxoplasma gondii is a protozoan parasite that infects the brain affecting approximately one-third of people worldwide. Cats have been identified as the primary source of T gondii. Humans are infected by ingestion of T gondii from feces of infected cats (eg, contaminated sandbox, eating unwashed vegetables). The ingested parasite spreads from the intestine to the brain. There the parasite hides within neurons and glial cells of multiple brain structures, including the amygdala and the prefrontal cortex. These areas play a leading role in emotional and behavioral regulation. T gondii infection disrupts modulation of mood and behavior and thus elevates risk of suicide.

What to do if you are pregnant and have a cat

  1. Wear gloves when gardening and during any contact with soil or sand because cat waste might be in soil or sand. After gardening or contact with soil or sand, wash hands thoroughly.
  2. Avoid changing cat litter if possible. If no one else is available to change the cat litter, use gloves, then wash hands thoroughly.
  3. Change the litter box daily because Toxoplasma requires several days to become infectious.
  4. Keep your cat inside and do not adopt or handle stray cats.
  5. Cats should be fed only canned or dried commercial food or well-cooked table food, not raw or undercooked meats.

Fruit vegetables help quit smoking

posted Jun 27, 2012, 7:51 PM by Neville Misquitta   [ updated Jun 27, 2012, 7:52 PM ]


Quit smoking with fruit and vegetables? Higher fruit and vegetable consumption means fewer cigarettes smoked per day and a longer time for relapse to smoking.

Fruits and vegetables help quit smoking

Smokers who eat fruits and vegetables an average of 4 or more times a day are 3 times more likely to be abstinent from cigarettes and other tobacco products. The heavier the alcohol use the stronger the dissatisfaction with life.

Smokers lack essential vitamins and minerals in their diets. This lower nutrient intake contributes further to the higher rates of cancer and heart disease seen among smokers. This pattern of eating behaviour may reflect different personality types or the effect of smoking on taste.Those who continue to smoke have less regard for their health, including their diet.

Eating more fruits and vegetables may be a sign of health consciousness, and make a person more amenable to smoking cessation. People who are experiencing cigarette craving can eat a piece of fruit, a vegetable, or drink a glass of water to help them avoid giving in to the urge to smoke.
Sources:
  1. Jeffrey P. Haibach Gregory G. Homish,. and Gary A. Giovino. A Longitudinal Evaluation of Fruit and Vegetable Consumption and Cigarette Smoking. Nicotine Tob Res (2012) doi: 10.1093/ntr/nts130 First published online: May 21, 2012
  2. J E Cade and B M Margetts. Relationship between diet and smoking--is the diet of smokers different? J Epidemiol Community Health. 1991 December; 45(4): 270–272.

Recognising cannabis addiction

posted Jun 4, 2012, 9:55 AM by Neville Misquitta   [ updated Jun 4, 2012, 9:57 AM ]


cannabis stash

Teenagers using cannabis are especially prone to schizophrenia. Recognising when 'experimental use' has become 'problem use' will help prevent this adverse outcome.

Sources
  1. WHO. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines. F10 - F19 Mental and behavioural disorders due to psychoactive substance use. WHO. Geneva. 1992
  2. Marijuana Anonymous World Services. Accessed 03-Jun-2012

Recognising cannabis addiction

Cannabis use becomes an addiction when it takes on a much higher priority than other behaviours that once had greater value (studies, football). A central characteristic of cannabis dependence syndrome is craving - a strong and overpowering desire to take the drug.

12 signs of cannabis addiction

  • Has smoking pot stopped being fun?
  • Do you ever get high alone?
  • Is it hard for you to imagine a life without marijuana?
  • Do you find that your friends are determined by your marijuana use?
  • Do you smoke marijuana to avoid dealing with your problems?
  • Do you smoke pot to cope with your feelings?
  • Does your marijuana use let you live in a privately defined world?
  • Have you ever failed to keep promises you made about cutting down or controlling your dope smoking?
  • Has marijuana caused problems with memory, concentration, or motivation?
  • When your stash is nearly empty, do you feel anxious or worried about how to get more?
  • Do you plan your life around your marijuana use?
  • Have friends or relatives ever complained that your pot smoking is damaging your relationship with them?

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