Impaired working memory in children with attention deficit hyperactivity disorder and their siblings

Introduction: Impairment of working memory in children with attention deficit hyperactivity disorder (ADHD) has been well described. If similar impairment in working memory can be demonstrated among their siblings, this could suggest impaired working memory is a genetic component of ADHD. Methods: Fifty‐seven subjects were recruited: (1) ADHD group (n=21); (2) siblings of ADHD children group (n=15); and (3) non‐ADHD children with chronic medical condition as the control group (n=21). All subjects were aged between 6 and 15 years, and ADHD was diagnosed according to DSM‐IV‐TR. Those with other comorbidity or IQ<70 were excluded. Digit Recall was used for assessment of the phonological loop component, Maze Memory test for the visuospatial sketch pad component and Backward Digit Recall for the central executive component of working memory. Results: ADHD children and their siblings showed similar impairment and both differed from the control group on the Maze Memory test. ADHD children also showed impairment in the Digit Recall test; however, the sibling group did not differ from the control group on this test. The Backward Digit Recall score did not show any significant difference between the three groups. Discussion: Impairment of the visuospatial sketch pad component of working memory seems to cluster in ADHD children and their siblings. Thus, impairment of the visuospatial sketch pad component of working memory may point towards a genetic predisposition of ADHD.     

Women's mental health: an overview

Women often have different outcomes and experiences with mental illness compared to men. However, there is still a ‘gender-blind’ approach to the understanding and development of new treatments for mental illness. The emphasis is on: women and schizophrenia, depression in women and existing sex differences in anxiety disorders (including phobias, agoraphobia, panic disorder, generalised anxiety disorder and post-traumatic stress disorder). Utilizing gender differences in the onset, course and outcomes of mental illness may enable a better development of best outcomes for women with mental illness.     

The paediatrician and the sexually abused child

Sexual abuse is an aspect of cruelty to children which merits greater scientific attention. It has potential for damaging the mental health of the victim and intergenerational cycles of this behaviour pattern may develop. The paediatrician is in a position to detect children at risk and may be able to intervene. Three types of sexual abuse are described (i) single sexual attacks which may be accompanied by physical violence: (ii) sexual exploitation of children for financial gain, and (iii) longstanding sexual relationships, generally between girls and father figures; these are far the most common. Although it is hard to separate the effects of premature sexual experience from other adverse environmental influences. the child victim of longstanding sexual abuse emerges immature, with considerable confusion as to her role in the family, and with constricted personality development. Her primary motivation is attention seeking, and she adopts sexual activity with an adult as a means of survival in often deplorable conditions. The sensitivity of management following the assault being made public is an important factor in determining eventual adjustment.     

A Study of Depression in Two Cultures: A Transcultural Study with Japanese and Australian Clinically Depressed Patients

Abstract: Recently there has emerged a growing interest in transcultural aspects of depressive disorders. Unlike earlier studies, recent research has concentrated on using standardized assessment and evaluation procedures in an effort to reduce "differences" associated with research techniques. The following paper reports a study which, using the WHO developed Standardized Assessment of Depressive Disorders (WHO/SADD) schedule, examines the nature of depressive symptomatology in Australian and Japanese clinically depressed patients. While results supported the presence of a "symptom core" common to both cultures, some unexpected findings in relation to "feelings of guilt" and "severity of depression" were noted.     

Do Internet interventions for consumers cause more harm than good? A systematic review

Objective  To systematically review the effect of consumer use of online health information on decision-making, attitudes, knowledge, satisfaction and health outcomes and utilization.
Search strategy  Electronic databases searched included the Cochrane Controlled Trials Register, MEDLINE, PREMEDLINE (to 14 March 2001), CINAHL, Australian Medical Index, Health and Society, National Institutes of Health Clinical Trials Database and CenterWatch.
Inclusion criteria  All post-1995 comparative studies (including controlled studies, before and after studies, and interrupted time series analyses) of Internet users vs. non-Internet users and other communications mediums, and Internet characteristics such as e-mail vs. other communication mediums, were included. Outcomes included consumer decision-making, attitudes, knowledge, satisfaction and measurable changes in health status or health utilization.
Data extraction and synthesis  One reviewer screened all papers then two reviewers independently assessed studies against the selection criteria and any discrepancies were resolved by discussion with a third reviewer. No attempt was made to combine the data for further statistical analysis.
Main results  We identified 10 comparative studies. Studies evaluated the effectiveness of using the Internet to deliver a smoking cessation programme, cardiac and nutrition educational programmes, behavioural interventions for headache and weight loss, and pharmacy and augmentative services. All studies showed some positive effects on health outcomes, although the methodological quality of many studies was poor.
Conclusions  Despite widespread consumer Internet use to obtain health-care information, there is almost a complete lack of evidence of any effects this may have on health outcomes.