Talk:Attention deficit hyperactivity disorder

Edit request on 28 May 2012

It is written: "The pathophysiology of ADHD is unclear and there are a number of competing theories.[92] Research on children with ADHD has shown a general reduction of brain volume, but with a proportionally greater reduction in the volume of the left-sided prefrontal cortex."

A lot of data suggests that the decrease of RIGHT PFC can be observed due to impairment of mesocortical dopamine pathway. For confirmation please read: Ron M. Sullivan and Wayne G. Brake, 2003, Behavioural Brain Research 146: 43-55.

Epidemiology

We lost "ADHD's is estimated to affect about 3 to 5 percent of people under the age of 19. There is, however, both geographical and local variability among studies. Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East." This was specifically a global look and I am not sure the new stats are. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:33, 19 May 2013 (UTC)

Actually it appears it is global stats so all good. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:37, 19 May 2013 (UTC)

Mood disorder

ADHD symptoms which are related to other disorders
Depression	Anxiety disorder	Bipolar disorder
feelings of guilt, hopelessness, low self-esteem, pessimism, unhappiness, or worthlessness Anhedonia or loss of interest in hobbies, regular activities, sex, or work fatigue Sleep problems including insomnia, dyssomnia, or hypersomnia difficulty maintaining attentional control change in appetite Irritability or hostility low tolerance for stress thoughts of death or suicidal ideation unexplained pain or symptoms unresponsive to treatment, such as headache or dyspepsia	worry or any persistent feeling of anxiety experienced daily for 3-6 months Irritability occasional feelings of panic, fear, or angst inability to relax being hyperalert inability to pay attention tire easily low tolerance for stress difficulty maintaining attentional control	in manic state excessive happiness, euphoria, or exhuberance Hyperactivity Racing thoughts Aggression excessive talking Grandiose delusions decreased need for sleep inappropriate social behavior difficulty maintaining attentional control in depressive state same symptoms as in the depression section of this table

Cut from body of article:

• Where a mood disorder complicates ADHD, it is usually best to treat the mood disorder first, but parents of children with ADHD often wish to have the ADHD treated first, because the response to treatment is quicker.

Who says it's best? The journal article authors themselves? Psychiatrists generally?

I tried reading the article online, but I couldn't find the part which says that it is usually best to treat the mood disorder first. Perhaps the contributor who added this bit could insert a quotation from the article. --Uncle Ed (talk) 16:16, 19 May 2013 (UTC)

Best leaving it deleted in my view to be honest - doesn't seem essential information for a general overview, the source is not the best and importantly as you have stated the source does not support the text. Well spotted - thanks Ed!--MrADHD | T@1k? 17:29, 19 May 2013 (UTC)

IMO this table would be best as prose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:49, 22 May 2013 (UTC)

Not sure: I am not a big fan of tables, but in this case it might be a good way of presenting lots of information in a short space. If developed into text it might end as something similar to a bullet list, or it might take lots of space. Maybe it can be left as table, and if some extra content wants to be added for any of the symtoms it can be developed into text.--Garrondo (talk) 06:44, 23 May 2013 (UTC)

Yes not a really big fan of tables either. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 23 May 2013 (UTC)

Nonpharmalogical treatments

Please have a look at PMID 23360949 and editorial comment at PMID 23450282. It would appear to be a useful source. LeadSongDog come howl! 14:39, 10 June 2013 (UTC)

Image in Signs and symptoms

I don't believe that File:Adhd-facts1.jpg, which heads up the "Signs and symptoms" section of the article, is doing any good. It doesn't do anything to illustrate the article as is. What it does do is portray a stereotype of ADHD-influenced behavior. While this image might be good in a section about common misperceptions of ADHD, it's inappropriate to have it where it is. Cymru.lass in America (talk) 23:35, 10 June 2013 (UTC)

Have you let the CDC know about your concerns? That fact that kids with ADHD are often disruptive in class is not a stereotype but part of the diagnostic criteria. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:46, 11 June 2013 (UTC)

Yes, but "disrupting class" and "sticking out one's tongue" are two completely different things. Disrupting class generally entails things like getting out of one's seat, "zooming around", talking out of turn, talking back to the teacher, having side conversations. — Preceding signed comment added by Cymru.lass (talk • contribs) 01:21, 11 June 2013 (UTC)

I don't particularly like that image either. It's a subtle, subjective thing but the image has the tone of mocking the boy with ADHD as opposed to non-judgmentally presenting the symptom. I do understand that the symptom presented is very common and defining. If there were another, better image that had the same benefit of visually presenting a defining symptom without the mocking quality, I would very much support switching it. But until a better image is located I think the article is stuck with it. Zad68 02:31, 11 June 2013 (UTC)

If the image in question has an improper, mocking quality, then the article should by no means be "stuck" with it. If this were a piece of text that had a mocking tone, even a subtle one, it would be removed if it could not be readily re-written. — Preceding signed comment added by Cymru.lass (talk • contribs) 04:15, 11 June 2013 (UTC)

Oh, I just realized that I should clarify that I (cymru.lass) am the same as the original poster in this section User:Cymru.lass in America is my alt account for editing on public computers. — Preceding signed comment added by Cymru.lass (talk • contribs) 00:28, 12 June 2013 (UTC)

Reader feedback: In February 28, 2013 The Lan...

Xrcal posted this comment on 1 March 2013 (view all feedback).

In February 28, 2013 The Lancet published an article about the possible genetic correlation between autism spectrum disorder, attention deficit-hyperactivity disorder, bipolar disorder, major depressive disorder, and schizophrenia. They analyzed genome-wide single-nucleotide polymorphism (SNP) data for the five disorders in 33 332 cases and 27 888 controls of European ancestory. The lead researcher was Dr. Jordan Smoller, a professor of psychiatry at Harvard Medical School in Boston. Smoller's group found four gene areas that all overlapped with the five disorders, two of which regulate calcium balance in the brain. <ref>http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2962129-1/fulltext</ref>

Thought I'd move it on over to the talkpage and see what people more knowledgeable than I have to say. Any thoughts? — Preceding signed comment added by Cymru.lass (talk • contribs) 01:17, 11 June 2013 (UTC)

Outside comment on neutrality

Having quickly scoped the article after seeing it listed as a 'Good Article' nominee: it seems heavily biased towards the Pharma Industry's point of view. There's no inherent problem with moving "Controversy" to a side article. But most of the claims retained at this page are still controversial! They reflect the view of one particular side of the "controversy". Take this list of "Causes" for example. Am I the only one flabbergasted that classrooms and workplaces are not listed among possible causes of "attention deficit" problems? Another section mentions sociologists who describe "ADHD" as medicalization of deviant behavior; the following sentence counters that: "Most healthcare providers in U.S. accept that ADHD is a genuine disorder..." What does "genuine disorder" even mean? (Isn't deviance explicitly part of the DSM definition of a disorder?) The term also appears in the lead. The first source cited says that ADHD is generally recognized to "exist". Helpful? This article reads like sophisticated advertising for legal stimulants. groupuscule (talk) 06:19, 26 June 2013 (UTC)

Sources in special populations

I was doing some checking on sources in relation to GAN, and then I noticed that Zad had stopped reviewing sourcing. Instead of pointing out problems I am going to be bold and fix things myself, although I will try to comment here at least until the GAN finishes.

PMID 21977044: study

While pubmed considers it a study, when reading it it seems closer to a review; However, it is a review on high functioning children, and not specifically ADHD. Moreover it only has a 3 paragraphs in the whole article in connection with learning disabilities, and only one from those (the one cited) on ADHD, consisting in a citation from a primary source. I copy here all the text related to ADHD from the source:

In a recent study, Loureiro et al. have shown that highly gifted children with ADHD have a particular neuropsychological profile with an important difference (at least 20 points) between verbal IQ and performance IQ at Wechsler Intelligence Scale for Children (WISC III) when compared to highly gifted children without ADHD.

Comment on ADHD in the article is so tangential that the source cannot be considered a reliable secondary source.

I am going to simply eliminate content based on it and also the ref, since it is probably not critical for the article.

--Garrondo (talk) 06:54, 27 June 2013 (UTC)

The fact that the reference focuses on a narrow subject (cognitive and developmental issues in high intelligent children) makes it a higher quality source. We want focused sources rather than sources that skim over lots of bits of information. It would of course be better if more time was given to ADHD in this article but there is not a huge amount of research in high intelligence ADHD children. This large gap occurs in autism spectrum disorder and could contribute to a misdiagnosis of autism spectrum disorder in a high IQ ADHD child - how does it benefit our readers to remove this content from this article? I think that it is a disservice to our readers to remove this content from the article as it is an important finding in high IQ ADHD youth. Thoughts?

I have no problem with the ref itself, but with its use in the ADHD article since the only mention of ADHD is the one single sentence included above, which only says "in a single study X found X". In this sense it can hardly be considered a secondary source for such statement or ADHD and high IQ; while I believe it is a great source for other articles, for this specific article is quite crappy and probably not really reliable. Moreover, we have another high quality ref much more specific (since it is all about ADHD and high IQ) that does not mention the issue of differences between verbal and nonverbal IQ so I tend to think that it is not as clear. Finally: if you decide to keep the content I would say that it would have to be reworded to consider it a primary finding since the secondary source only mentions it without any kind of evaluation or modification. In this sense to generalise from it is to give undue weigth and commit (a mild) original research. If we are going to use we should specify that it was a single study by Loureiro, and if so I do not really see the point of using the secondary source... Best practice IMO would be to find another better source for that content. If there is none I would say it is not really that relevant. --Garrondo (talk) 06:53, 28 June 2013 (UTC)

More on the issue: I have now understood why the Loueiro study is mentioned in the review, when it does not really fit with the theme: it is an autocitation, since the last author of the Loueiro article is the author of the review. In this case I feel that the only intention of including it in the review was to increase the impact factor and citations of their own works. Moreover, the Loueiro article is published in frech in a not very important journal and in its title says "exploratory article", being further indication that it is not that relevant.

In summary: we have a review not on ADHD where the only mention of ADHD is 3 lines cited to the author of the article owns work, being the source an exploratory analysis in a low diffusion journal. The more I get into it the less appropiate the source seems to me. We shoule either find another source or eliminate the content.

--Garrondo (talk) 07:02, 28 June 2013 (UTC)

PMID 22104513: Review. Redundant ref that can be eliminated: used only twice, in lead and adult section, to source the same statement on prevalence (2-5%) and both times accompanied by another ref (Kooij) that gives the same number, is open and of similar quality.

I am going to eliminate the redundant ref.

--Garrondo (talk) 06:57, 27 June 2013 (UTC)

The 2009 review probably didn't mention the Loureiro study because it was too new being published in the same year. I don't think the motivation was to 'increase the impact factor' but rather because it is an important research finding which many psychologists and diagnosticians will find of interest and importance. It is the finding that is relevant rather than the journal although I do accept and appreciate that some journals are of higher quality than others. I have added some wording to make clear that the results are based on the findings of a single study. I am going to ask a psychologist who has knowledge of ADHD professionally for her thoughts on this. I may be wrong in my thoughts on this issue. I do appreciate your points that you raise Garrondo which are valid.--MrADHD | T@1k? 14:48, 7 July 2013 (UTC)

Here I am and I fully agree with Garrondo!

• To start with: the title of the original study says: "étude exploratoire", that is "exploratory study".
• Even though this study is mentioned in the source - and thus it could be argued that it is a secondary source - the authors of this article just have "copied" the results of the exploratory study and have not added anything to it. They don't compare it to other study results, they don't discuss these results, so actually, as a secondary source it is as meager as it can get.
• The "exploratory study" was published in 2009 and now it's 2013. Where are the follow-ups? What do they say? And if there are no follow-ups, it could mean that the results of this study are not considered important enough...
• The study was done in France. But French kids don't have ADHD!. No, actually I don't believe that they don't have ADHD but apparently "In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%". This rises the suspicion that diagnosing practices in France are not the same as those in the rest of the world. The results of the study could very well be specific for this tiny subgroup of children in France who get this diagnosis - but not for the much larger subgroup of children who don't live in France.
  
• Oops! Look at the fourth name of the authors of the original study: L. Vaivre-Douret. Guess who wrote the review article? Yes! Laurence Vaivre-Douret. Need I say more?

With a warm hug to both of you MrADHD and Garrondo. Lova Falk talk 08:55, 8 July 2013 (UTC)

As a side note: self- overciting is a well known sub-ethical researchers strategy to increase both the impact factor of the journals you have published and the number of citations of your work. When a source cites a losely connected article by the same authors it should be taken as an important red flag. I am quite sure this is the case here.--Garrondo (talk) 15:12, 9 July 2013 (UTC)

Re-eliminated per comment by Lova. --Garrondo (talk) 07:10, 11 July 2013 (UTC)

Hi guys, sorry I have been on holiday where I did not have internet access. Thanks for your helpful analysis Lova Falk and commentary; I see that consensus is that it should be removed - I agree with the removal of this content by Garrondo per the valid arguments above against it's inclusion. :-)--MrADHD | T@1k? 19:49, 13 July 2013 (UTC)

Legal status of medications

I do not see the point of having this section in the article. The article is on ADHD. Facts of medications should be mentioned if they are important to understand the disease. However, the legal status of the medication, while very relevant for the articles on the medications does not really fit in an article on the disease, as it does not help to understand ADHD to know if it is easy or not to get the medication. In this sense I do not know of any article on a disease in wikipedia where there is a specific section dedicated to know the legal status of the meds used for such disease. I would eliminate the full section. --Garrondo (talk) 20:10, 30 June 2013 (UTC)

Well spotted - I agree and I have removed this section or rather moved it to the ADHD management article.--MrADHD | T@1k? 15:07, 7 July 2013 (UTC)

Further reading

There are thousands of books on ADHD each year. Any reason to have these specific ones and not other? How can be sure they a good enough or notable? I do not really think they add much to the article. I would eliminate most/all of them. --Garrondo (talk) 20:22, 30 June 2013 (UTC)

Yes, you are correct and I have deleted the entire section. It doesn't add anything for our readers and is potentially promotional in nature.--MrADHD | T@1k? 15:13, 7 July 2013 (UTC)

Agree. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:58, 7 July 2013 (UTC)

Adults

Some comments:

• Other problems include relationship and job difficulties, and an increased propensity to become involved in criminal activities.[8] They often have such associated psychiatric comorbidities as depression, anxiety disorder, substance abuse, or a learning disability: Right now it is not clear if this is true for all ADHD adults or only for ADHD untreated adults

• Some ADHD symptoms of in adults differ from those seen in children — for example whereas children with ADHD may climb and run about excessively, adults may experience an inability to relax and talk excessively in social situations. Adults with ADHD may start relationships impulsively and may display sensation seeking behaviour and be short-tempered. Addictive behaviour such as substance abuse and gambling are also very common.: while not really sure on how to improve it I do think it could be better written and summarized. It is also unreferenced (or at least it is not really clear if the later ref applies to the text). Finally some wikilinks would also improve it.--Garrondo (talk) 07:08, 11 July 2013 (UTC)

news

With the overhaul of state run health systems the cost aspect receives new attention. A new Russian study (Yu. Vashmashinewskii, Ya. Ostrogatzkii. (2013). "Elektriskaya renoviska idiotskaya" Novshmozkapopnaya Chorkbotolovodkaya, 2013(5): 31–47 ) proved, that ECT (electroconvulsive therapy) is at least as effective as medications in hyperactive and attention deficient (Russ. dawaii parshol uri-uri, waser aus wand) children and adults. In addition it is much more cost effective, as 1 KWh (Kilowatthour) replaces 36,000 single doses of pharmaceuticals and costs only 0.20 Rubles (Da! 20 Kopeki!) 70.137.135.207 (talk) 07:08, 13 July 2013 (UTC)

Of course the first experiments were done without expensive electronic apparatus. 70.137.142.55 (talk) 05:25, 26 July 2013 (UTC)

We need to use secondary sources to put things into proper context. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:46, 31 July 2013 (UTC)

Prevalence

We discuss how rates have changed but we do not discuss why they have changed. There is a fair bit of literature on this. Most seem to agree that it is due to loosening of the diagnostic criteria among other factors rather than an increase in hyperactivity among children. Either way it should be discussed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:34, 2 August 2013 (UTC)

I am unsure what references support what text in this part of the article. Could use some clarification. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:33, 2 August 2013 (UTC)

Okay have made the section more globally and less UK / US in scope. Country specific data can go on the subpage. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:35, 2 August 2013 (UTC)

Sourcing

An online CME course IMO would not count as a reliable source [1]. Is there a better ref to support this? Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:16, 2 August 2013 (UTC)

Edit request on 2 August 2013

Over-Thinking syndrome is a relevant disorder that should be added to the related disorders section with the following description "Due to the hyperactivity associated with ADHD Over-Thinking of situations could lead to Over-Thinking syndrome, which could aggravate any related insomnia and substance abuse caused by ADHD" 217.42.37.245 (talk) 19:58, 2 August 2013 (UTC)

 Not done: please provide reliable sources that support the change you want to be made.. Please note that a WP:RSMED-compliant source may be required. Rivertorch (talk) 06:47, 5 August 2013 (UTC)

Spelling Error

Under the section "Signs and Symptoms", the word "inappropriate" is misspelled "innapropriate".

Yes that bit not needed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:20, 5 August 2013 (UTC)

Ref needed

• For "Often people refer to ADHD-PI as "attention deficit disorder" (ADD), " Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:19, 5 August 2013 (UTC)
• This ref does not support the text in question? "Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed." Ref can be seen here [2] Doc James (talk · contribs · email) (if I write on your page reply on mine) 09:47, 5 August 2013 (UTC)

Okay found a better ref for this last bit. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:04, 5 August 2013 (UTC)

Secondary source needed

This needs a secondary source "Factors other than those within the DSM or ICD have been found to affect the diagnosis in clinical practice. For example, a study found that the youngest children in a class are much more likely to be diagnosed as having ADHD compared to their older counterparts in the same year. This because younger children typically have greater hyperactivity, not because they necessarily have ADHD. It is estimated that about 20 percent of children given a diagnosis of ADHD are misdiagnosed because of the month they were born." Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:32, 5 August 2013 (UTC)

Unfortunately not a secondary source but another study from Canada which reaches a similar conclusion Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children dolfrog (talk) 20:01, 8 August 2013 (UTC)

History of ADHD

This would be a good ref. Lange, KW (2010 Dec). "The history of attention deficit hyperactivity disorder". Attention deficit and hyperactivity disorders. 2 (4): 241–55. PMID 21258430. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:19, 5 August 2013 (UTC)

ADHD is total fraud - do not trust

WP:NOTAFORUM
The following discussion has been closed. Please do not modify it.
ADHD is a fabrication to produce a lucrative market for the big-pharma industry. The effects that children have is due to teenagers developing to adults, consequences caused from parental pressure due to poor/wrong parenting, media influence, other globalist psychological operations aimed, the effects of hollywood and music. Mostly, the education system is not created for children's well being, it is an indoctrination scheme for this system, children are bored because they're being forced to learn something they don't need, learn something that will be obsolete a few years later, learn something that isn't even accurate at the time of learning. If you want to fix ADHD, go outside for fresh air, do a lot of things during the day, don't watch TV for 5-6 hours straigh or more, start exercising, start eating healthy, avoid gluten, avoid diary, avoid fast food and all kinds of snacks, avoid all fuzzy drinks and sodas, do not take vaccines, do not eat GMO, filter your tap water to remove flourides. Certain contributors to this article may be agents and shills (liars) working for the pharmaceutical industry. They will definitely try to bring some excuse up to smear me and put some self-proclaimed moderators to bother me on my page about a "controversial post" or something to make it feel like I am some troll or something, I won't be even reading it save your time and effort. Xowets (talk) 17:07, 8 August 2013 (UTC)

jj

lots of people with ADHD can read nonverbal communication. — Preceding unsigned comment added by 2601:2:2380:BF:4916:9FCD:6A7F:602B (talk) 22:21, 12 August 2013 (UTC)

True. But our article clarifies that only some ADHD people are impaired.--MrADHD | T@1k? 21:22, 17 August 2013 (UTC)

jjk

people with adhd are able to read nonverbal communication and people with adhd can read between the lines. It's not rocket science. ADHD is not autism and not aspergers. Stop making believe it is. Adhd people do get married as much as non adhdh people.This article sucks big time. There is no proof that ADHD people have harder times in relationships. S — Preceding unsigned comment added by 2601:2:2380:BF:95D3:C6DF:52F5:76D8 (talk) 01:05, 13 August 2013 (UTC)

I don't have problems reading non-verbal communications nor do I have any problems reading between the lines and have sympathy for your viewpoint but it is what the source says. The impairments of ADHD in social situations and such like is of a different cause and is much less severe than autism spectrum disorder. Asperger's no longer exists now anyway and is diagnosed as autism spectrum disorder. What I am going to do is ask for the opinion of a psychologist who could provide better input into this - perhaps we need to clarify our article better regarding the nature of the impairments. --MrADHD | T@1k? 21:18, 17 August 2013 (UTC)

Many studies have shown that ADHD people tend to have problems with non-verbal communicattion, so unless there is a reliable source saying the opposite it should stay. This does not mean that all ADHD patients have these problems or that they are anything similar to autism either qualitatively or quantitatitevely. Regarding ADHD people having problems with relationships, there is even clearer consensus. --Garrondo (talk) 08:50, 20 August 2013 (UTC)

Image

I sort of like the previous image of the student studying, especially since school performance is such a key symptoms of ADHD. Wondering if we should look for another one? Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:59, 19 August 2013 (UTC)