Characteristics of parent- and child-reported anxiety in psychostimulant medication naïve, clinically referred children with attention deficit hyperactivity disorder, combined type (ADHD-CT)

OBJECTIVE: Anxiety is a frequent comorbid condition in referred primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT), yet there has been relatively little systematic research of the nature of this comorbid anxiety. We describe the characteristics of parent-reported child anxiety disorders and child-reported anxiety disorders in primary school-age children with ADHD-CT. METHOD: A cross-sectional study of 75 clinically-referred psychostimulant medication na?ve children with ADHD-CT examining separately parent and child reports of anxiety, defined categorically and dimensionally. A two-year follow up of 12 children with parent-reported child anxiety and 12 children with child-reported anxiety was also completed. RESULTS: There was no significant association between the child and parent reports of anxiety. Generalized anxiety disorder (GAD), separation anxiety disorder (SAD), specific phobia (SpPh) and social phobia (SoPh) were the most common anxiety disorder diagnoses reported by parents and children. Two-year follow-up data revealed no decrease in the parent report but a significant decrease in the child report of anxiety disorders. CONCLUSIONS: The dissonance between the parent report of child anxiety and the child report of anxiety, emphasizes the importance of careful and thorough clinical assessment of the child's perspective. The nature of parent-reported child anxiety and children's self-report of anxiety requires further systematic research.     

A 'crash' course on psychostimulant withdrawal as a model of depression

Most drugs of abuse generate diverse behavioral and neurochemical effects in mammals. However, one feature common to many such drugs is the phenomenon of the withdrawal syndrome that results from termination of drug administration. Early drug withdrawal, often referred to as the 'crash' phase in humans, is characterized by adverse psychological and/or somatic symptoms. Withdrawal from psychostimulant drugs precipitates a transient and primarily psychological condition that bears remarkable similarity to the symptoms of major depressive disorder in humans. Rodent paradigms of psychostimulant withdrawal faithfully model the human condition. Associated behavioral deficits in these animals can be reversed by treatments with antidepressant properties, suggesting that psychostimulant withdrawal might provide the basis for an animal model of depression. Current advances and limitations in the development of this model, together with recent evidence that psychostimulant withdrawal in rodents can be used to screen for novel, rapidly acting antidepressant treatments, are discussed.     

The King–Devick test is a valid and reliable tool for assessing sport-related concussion in Australian football: A prospective cohort study

Objectives

Sport-related concussion (SRC) research has focused on impaired oculomotor function. The King–Devick (K–D) test measures oculomotor performance and is reported to identify suboptimal brain function. The use of the K–D test in Australian football (AF), a sport involving body contact and tackling, has not been documented. Therefore, the objective of this study was to determine the test–retest reliability and diagnostic accuracy of the K–D test on a sub-elite AF team.

Withdrawal following repeated exposure to d-amphetamine decreases responding for a sucrose solution as measured by a progressive ratio schedule of reinforcement

Numerous studies have shown that withdrawal from sustained high doses of psychostimulant drugs such as cocaine or d-amphetamine produces depressive-like symptoms in both rats and humans. The majority of experiments with rodents have assessed the effects of amphetamine withdrawal on reinforcing electrical self-stimulation in different brain regions, but relatively few have examined effects on responding for natural reinforcers. In the present study, two groups of mildly food and water deprived male rats were trained to respond on a lever for a 4% sucrose solution under a progressive ratio schedule of reinforcement. One group was subsequently administered a 4-day regimen of injections of increasing doses of d-amphetamine based on a schedule shown previously to reduce self-stimulation behaviour. Break points were significantly reduced for up to 4 days after the termination of drug administration, suggesting a decreased motivation to obtain the natural reward. A further experiment demonstrated that the identical drug regimen produced no effect upon consumption of the 4% sucrose solution when it was freely available. These results demonstrate that the progressive ratio procedure may be a useful technique for evaluating changes in motivation for natural reinforcing stimuli following withdrawal from psychostimulant drugs. Received: 2 April 1998/Final version: 2 June 1998     

Standardized health check data from community-dwelling elderly people: the potential for comparing populations and estimating need

The main aim of this study was to compare EASY-Care data obtained during nurse-administered annual health checks in two populations of older people. A secondary aim was to determine whether a standardized assessment system administered as part of routine practice by a trained nurse during the over-75 health check could generate useful information for comparing population health and functional status of community-dwelling-older people. One hundred and seventy-nine elderly people (aged 75 years and over) from the Woodstock ward, Belfast, having relatively high deprivation; and 238 elderly people from south Hampshire, ranging from affluent wards in New Forest to inner city wards, were assessed using the EASY-Care assessment system as part of their annual health check. There was a high response rate to the standardized assessment in both populations (75% and 79%). Compared to people in south Hampshire, the people in Belfast had higher relative risk of having fair/poor self-rated health, and lower relative risk of having good/sufficient accommodation and of having difficulty chewing. People in Belfast had a higher relative risk of being dependent for six of the seven IADL items and for continence of urine, bathing, grooming, use of the stairs and dressing among the ADL items. The results demonstrate the ability of data generated by assessment system to discriminate between populations of older people when used as part of routine practice. Differences in health and functional status may be associated with deprivation. Data collected during the annual health check about the health and functional status of older people could provide a useful adjunct to census and survey data to measure population needs and to support locality planning.     

Comparison of unsafe drinking between a rural and metropolitan area

Factors associated with unsafe drinking in a rural area were identified and the prevalence of unsafe drinking and alcohol related mortality compared with a metropolitan area. Alcohol consumption data were collected from a random sample of adults in Greater Ballarat. Odds ratios of demographic factors associated with unsafe drinking were estimated by logistic regression. Compared with males and 20-29-year-olds, females and 30-59-year-olds had a significantly lower prevalence of 'intermediate' or higher risk drinking and binge-only drinking. Rural-metropolitan ratios for the prevalence of unsafe drinking and alcohol related mortality were also greatest in young adults. Young adults must adopt safer drinking habits if the rural excess in mortality is to be reduced.     

Comparison of Fc epsilon RI- and Fc gamma RI-mediated degranulation and TNF-alpha synthesis in human mast cells: selective utilization of phosphatidylinositol-3-kinase for Fc gamma RI-induced degranulation

We have demonstrated that CD34(+) IFN-gamma-treated human mast cells (HuMC) express functional Fc gamma RI and that aggregation of these receptors leads to mediator release. As the signaling pathways linking Fc gamma RI aggregation to mediator release are unknown, we examined Fc gamma RI-dependent activation of specific signal transduction molecules and determined the relative involvement of these events in HuMC degranulation and TNF-alpha production following both Fc gamma RI and Fc epsilon RI aggregation. Fc gamma RI aggregation resulted in the phosphorylation/activation of src kinases and p72(syk) and subsequent tyrosine phosphorylation of multiple substrates. Inhibitor studies revealed that these responses were required for degranulation and TNF-alpha synthesis. Both Fc gamma RI and Fc epsilon RI aggregation also activated the MAP kinases ERK 1/2, JNK and p38 and this was necessary for TNF-alpha synthesis, but not degranulation for both receptors. Thus, signaling events in HuMC following aggregation of Fc gamma RI were generally similar to those observed following Fc epsilon RI aggregation. The one exception was that, although phosphatidylinositol-3-kinase was activated after both Fc epsilon RI and Fc gamma RI aggregation, only the Fc gamma RI appeared to require this molecule for degranulation.