PurposeTo systematically identify and review the currently available evidence on the long-term outcomes of recommended attention-deficit hyperactivity disorder (ADHD) interventions following randomized controlled trials with children and young people.MethodA systematic search was conducted to identify trials >1 year in length using the following databases: CINAHL (January 1982– July 2012), MEDLINE (Ovid and Cambridge Scientific Abstracts [CSA]), Psych info, Science Direct (Elsevier), and Cochrane Library. Hand searches of key journals in the subject, book chapters, and conference proceedings were also carried out. Relevant papers were critically appraised using the Cochrane risk of bias tool.ResultsEight controlled trials were identified as being relevant, of duration ranging from 1 year to 8 years (at follow up). The total number of participants in the studies was 1,057, of whom 579 (54.7%) were from one cohort and included 26 different outcome measures. Results suggest there is moderate-to-high-level evidence that combined pharmacological and behavioral interventions, and pharmacological interventions alone can be effective in managing the core ADHD symptoms and academic performance at 14 months. However, the effect size may decrease beyond this period.ConclusionThis review has highlighted the paucity and limitations of the evidence investigating the long-term outcomes of recommended interventions for managing ADHD symptoms. There is little evidence to suggest that the effects observed over the relatively short term are maintained throughout longer periods of impairment. Furthermore, much of the existing evidence examining effectiveness beyond 12 months does not include newer medications currently available or consider significant contextual and cultural differences, such as UK/European and Asian populations. Longitudinal studies are required to examine the long-term outcomes for children and young people with ADHD managed with currently recommended service interventions. They should also include the whole spectrum of ADHD, with its full range of coexisting conditions, and cultural and contextual diversity.
Background: Stimulants are used as a first line option in the treatment of ADHD and are amongst the safest drugs used in children and adolescents. The potential for psychotic side effects are well known, but reported as rare. Method: We are reporting four cases of stimulant induced psychosis which presented over a 2 year period in a small community CAMHS setting. Results: Our findings suggest that stimulant induced psychosis occurs. The symptoms in the early stages of the psychotic episode mimicked ADHD. Long acting preparations appeared to be a contributory factor to the development of psychotic side effects. Rechallenge with stimulant medication is described. Conclusion: Psychosis is an important, unpredictable side effect of stimulant medication. Symptoms resolve with discontinuation of treatment. Remergence of ADHD symptoms are rapid and rechallenge is often indicated. It would be advisable for all professionals involved in the care and treatment of patients with ADHD to receive mental health training to aid the early recognition and appropriate management of such side effects.
Stalking has overlaps with criminal justice system and mental health services. Research has, so far, identified stalking to be a predominantly adult male phenomenon. We present the case of a 15‐year‐old girl who was referred for stalking her learning mentor. The relevant literature is discussed and areas for further research are highlighted.
Bulimia nervosa is very rare in children below the age of 14 years, and no reliable reports of prepubertal bulimia nervosa have been published. We describe two cases of early‐onset bulimia nervosa who presented before the age of 14 years, and with premenarchal onset in one patient. Both girls demonstrated high levels of the risk factors known to play a part in the etiology of bulimia nervosa. Implications of these cases regarding the etiology and occurrence of bulimia nervosa in younger adolescents are discussed. © 1998 by John Wiley & Sons, Inc. Int J Eat Disord 24: 323–327, 1998.
Engaging adolescents is one of many challenges facing Child and Adolescent Mental Health Services today. However, taking advantage of the technology available can bring professionals a step closer to their patients by providing an alternative means of interaction. In this article we explore the use of e-mail as a method of engaging adolescents. The advantages and disadvantages of e-mailing patients are discussed along with recommendations for its safe use.
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