Attention deficit disorder: evaluation and treatment

The use of qualitative methods in the study of wellness in children with attention deficit hyperactivity disorder

TOPIC

Attention deficit hyperactivity disorder (ADHD) effects on children and families.

PURPOSE

To describe the gaps in current ADHD literature, exploring the role of qualitative research methods to study the health and well-being of children and families with ADHD.

CONCLUSIONS

In light of the difficult problems ADHD children experience and the low efficacy of many medical and psychological treatment, a need exists for understanding the contexts and everyday circumstances under which ADHD children and their families achieve well-being.

The use of methylphenidate in the treatment of refractory neurocardiogenic syncope

Recurrent neurocardiogenically mediated episodes of hypotension and bradycardia are a common cause of recurrent syncope that can be identified by head upright tilt table testing. While the use of beta-blockers, theophylline, fludrocortisone, disopyramide, and serotonin re-uptake inhibitors can be helpful in preventing further episodes, some patients are unresponsive to or poorly tolerant of these agents. We investigated the use of the central nervous system stimulant and peripheral vasoconstrictor methylphenidate in preventing both tilt induced and spontaneous neurocardiogenic syncope. Seven patients (all women, mean age 31 +/- 15 years) with recurrent syncope and positive head upright tilt induced hypotension/bradycardia (refractory to normal therapy) were placed on methylphenidate 10 mg orally three times per day. Six of the seven patients became both tilt negative and clinically asymptomatic over a 7-month follow-up period. We conclude that methylphenidate may be an effective therapy in patients with recurrent neurocardiogenic syncope refractory to other forms of therapy.

Attention deficit hyperactivity disorder in children: diagnosis, treatment, and follow-up

Hyperactive, and fidgeting behavior in children, is not a new syndrome, but has been present in children for centuries. Only in recent years have health providers begun to observe these features and behaviors in children and recommend some therapies. Children labeled with Attention Deficit Hyperactivity Disorder (ADHD) display the symptoms of inattention, impulsivity, and hyperactivity; however, these behaviors are seen in a variety of conditions. This article describes some of the symptoms associated with ADHD, as well as the evaluation, therapeutic modalities (behavioral, psychodynamic and pharmacological), and the follow-up of children with ADHD.