ADHD 1 Flashcards
How is ADHD diagnosed?
You need at least 6 or more DSM-5 criteria
How does ADHD symptoms- diagnosis- treatment go in clinical practice?
- Reason referral
- Objectivy and quantify symptoms
- Identification of possible causes
- Diagnosis (DSM-5)
- Treatment indication
- Treatment
Etiology: what happens regarding genes, brain and environment?
- Genes: shows substantial heritability (~76%), but complex genetic architecture
- Brain
- alterations/impaired functions in brain networks (e.g. volume) implicated in ADHD
- innervated by neurotransmitters that play an important role in ADHD.
- Environment
- Prenatal: maternal stress, smoking & alcohol use
- Perinatal: stress, low birth weight, premature birth, breastfeeding
- Contribute directly or indirectly
What are the treatment guidelines of adhd?
- Psychoeducation
- Parent and/or teacher training aimed at behavioral problems
- medication
Why is it needed to develop new treatments?
There is no long-term efficacy
Why is ADHD research focusing on food?
- Growing group of parents that do not prefer medication [2]
- Concerns about the safety
- ±50% of children and adolescents discontinue their medication within 1 – 2 years
Therefore, research is focusing on food
Artificial food colors and preservatives: what is the 2 effect, 3 advice and 1 evidence for ADHD?
- Meta-analysis
- 8% symptoms related to food colors
- not quantified as stand-alone treatment (small effect size)
Sugar: what is the proposed mechanism for ADHD?
Long term: sugar consumption -> desentisization of dopaminergic receptors -> inhibition control mechanisms related to ADHD
Sugar: what is the 2 effect, 3 advice and 1 evidence for ADHD?
- Birth cohort, review, meta-analysis
- Some associations between sugar and ADHD, but sugars alone do not increase risk
- Small effect size: not qualified as stand-alone treatment
- 25-30% of all fatty acids in the brain are rich in poly-unsaturated fatty acids (PUFAs)
- Serotonin: modulated by omega-3 fatty acids serotonin regulates a wide variety of brain functions (executive functions, social behavior)
What is seen in children and adults with ADHD?
Lower concentrations of omega-3 fatty acids in children and adults with ADHD
Omega-3-FA: what is the 2 effect, 3 advice and 1 evidence for ADHD?
- Meta, review, RCT
- Some effects seen
- Omega-3 on average reduced in ADHD, sufficient evidence to consider supplementation, however uncertainty for whom the intervention is effective
Supplementation of micronutrients: proposed mechanism?
Impaired brain metabolic activity may be corretable through nutrient supplementation
Supplementation of micronutrients: what is the 2 effect, 3 advice and 1 evidence for ADHD?
- RCT
- Multi-ingredient: benefit for nearly all studies, compared to single ingredient: almost no effect
- No specific recommendation, but no safety concerns, dose and breath of infredients important
What is the rationale behind using probiotics for ADHD?
Children with ASD (autism) They may have gut microbiota imbalance or increased intestinal permeability bc of their increased GI symptoms.
ASD+ ADHD often occur together
Ongoing studies!
Elimination diet: rationale for using this with ADHD patients?
Adverse physical reactions to food -> might have impact on brain -> ADHD: increased risk of developing such reactions
