Olaf Reis

Intelligence moderates impulsivity and attention in ADHD children: an ERP study using a go/nogo paradigm.

Abstract Objectives. If the cardinal symptoms of ADHD – hyperactivity, impulsivity and inattention – are combined with a learning disability (70 ≥ IQ < 85), the question arises whether a child shows hyperkinetic behaviour because of intellectual overload in a challenging situation, for example at school. Perhaps, this behaviour is not a primary attention deficit disorder but an impulse control disorder, determined by the primarily intelligence level. It raised the question whether attention deficit and impulse control regarded as behavioural inhibition deficit may depend on intelligence and therefore should be separated into distinct clinical entities. Methods. A total of 45 children (15 with ADHD, 15 with learning disabilities (LD), 15 with ADHD and learning disabilities) were compared in a matched-pair design with 42 control children using a go/no go paradigm (visual continuous performance test, CPT). The dependent variable was the target P3 amplitude, averaged from a 10–20 EEG measurements under distinct trigger conditions. For statistical analysis, a three-factor analysis of variance (MANOVA) with repeated measurements was used. In a subsequent regression analysis with residuals, the influence of intelligence (IQ) was calculated and a “parallel analysis of variance” was conducted. Results. No differences in the P3 amplitudes in the comparison ADHD-control group were found. Reduced P3 amplitudes as main effects in the LD group compared with controls were found and a significant group-dependent interaction on reduced P3 amplitudes comparing ADHD + LD versus control group. Using residuals (IQ), this interaction was not longer verifiable. Conclusion. Impulsivity and attention deficit as the cardinal symptoms of ADHD, regarded as behavioural inhibition deficit, are essentially moderated by the primary intelligence, rather than by an attention deficit. The lower the IQ, the more ADHD surfaces as a disturbed impulsivity and lesser as an attention deficit.

Prevalence, Course, and Risk Factors for Mental Disorders in Young Adults and Their Parents in East and West Germany

In this article, the authors present data from two longitudinal studies starting long before German reunification in East and West Germany. After unification, 533 twenty-five-year-olds and their parents were interviewed about mental health status, experience of life events and difficulties, and social support. The findings show that (a) externalizing disorders were more common in West Germany, whereas internalizing disorders were more common in East Germany; (b) there was a generation-specific differential course of disorders in East Germany after unification; and (c) the detrimental effect of life events and chronic difficulties on mental health could be weakened by kin and nonkin social support.

Polypharmacy in the treatment of subjects with intellectual disability

Abstract People with intellectual disabilities often suffer from mental disorders or display challenging behavior. For both impairments, treatment with more than one psychopharmacological drug is common, although little is known about efficacy and side effects of polypharmacological treatment. The paper reviews studies on treatment of people with intellectual disability (ID) with more than one psychoactive drug. Many studies rely on poor evidence and are supplemented with data from our own research. Risks and benefits of different combinations containing neuroleptics are listed. Ethical considerations for the use of different drugs combined are discussed. The use of combinations of neuroleptics on people with ID should be carried out with great care, since side effects may be amplified in people with ID, depending on the combination.

Modified magnesium and lipoproteins in children with attention deficite hyperactivity disorder (ADHD)

Abstract Objective. Polyunsaturated fatty acids (PUFAs) have shown to be helpful in the therapy of ADHD. Various stabilizing co-factors may contribute to this effect, as like magnesium (Mg). Mg supports fatty acid enzyme activity and is essential for the neuronal activity. However, the way of Mg to influence psychic processes, particularly in ADHS, is not yet known precisely. Therefore, in this study the concentrations of further lipid parameters were assessed. We intended to prove, if there is a lack of Mg and someone different lipoprotein concentration in ADHD patients compared to controls. Methods. In nine boys with ADHD (8.2 ± 0.6 years) and 11 controls (7.9 ± 0.87 years), blood serum Mg, total cholesterol, triglycerides, Lipoprotein Lipase, total Phospholipids, Apolipoproteins a and b, HDL- and LDL-cholesterol were measured, under two different stressful conditions. Results. In ADHD, Mg and HDL concentrations were significantly higher and Apob lower than in controls. Conclusions. Contrary to our supposition, in ADHD was no lack, but an excess of Mg. HDL was hightened and Apob lowered. Lipoprotein metabolism seems to be modified in ADHD.

Von der Geburt bis 25

Zusammenfassung. Die Rostocker Langsschnittstudie entstammt der Kinderpsychiatrie und trat 1970/71 mit dem Ziel an, die Interaktion zwischen perinatologischen Risikofaktoren und Umweltverhaltnissen fur die Personlichkeitsentwicklung durchschaubarer zu machen. Sie verfolgt prospektiv seit der Geburt 294 Kinder mit weiteren Querschnittserhebungen im Alter von zwei, sechs, zehn, 14, 20 und 25 Jahren und konnte zum letzten MZP noch 72 % der Ausgangsstichprobe erfassen. Der vorliegende Beitrag berichtet zusammenfassend uber Verlaufsbefunde zu den Leitlinien: Wirkungen biologischer und psychosozialer Risikofaktoren, Stabilitat und Veranderung von Intelligenzmeswerten, Schulerfolg und seelische Gesundheit, Problemverhalten und psychische Storungen, Familienklima und Personlichkeitsentwicklung und als Beispiel fur Reanalysen uber Scheidungskinder. Abschliesend wird die Entwicklungsdynamik als Storfaktor prognostischer Aussagen, der schwierige Umgang mit vernetzten Daten und die masgebliche Entwicklungsrelevanz vo...

Patterns of Social Support and Mental Health Among Ethnically-Diverse Adolescents During School Transitions

This study investigated age and ethnicity variations in the association between patterns of perceived emotional support from family, friends, and teachers and depression in early and late adolescents during their transition to junior high school and college. Eighty-seven early and 106 late adolescents participated. Cluster analyses revealed four patterns: Youth who received emotional support only from friends and teachers were distinguishable from youth who received support from all three domains, only from their family, or only from teachers. Perceiving support from all three domains was associated with the lowest depressive symptoms. However, ethnic majority adolescents benefited more from this pattern than ethnic minority adolescents. To some degree, high emotional support in one domain cross-buffered low emotional support in another. Contrary to predictions, high family support protected ethnic minority adolescents only when other sources of support were not available.

HKS/ADHS und rechtliche Aspekte

With a prevalence of 2-6%, hyperkinetic disorders (F 90, ICD-10) and disturbances of activity and attention (F 90.0, ADHD, ICD-10) are among the psychiatric disorders most commonly diagnosed in children, adolescents, and adults. Children and adolescents diagnosed with ADHD suffer from hyperactivity and deficits in attention and impulse control. Adults usually have problems focusing on one goal, maintaining their attention, modulating emotions effectively, structuring their tasks, and controlling impulses and in executive functions. Legal implications derive from core symptoms and from treatment with stimulants governed by legislation on narcotics. This paper discusses juridical aspects of ADHD in connection with the administration of medication at school, trips abroad within and outside the Schengen area, driving, competitive sports, military service, the increased risk of delinquency, the individual capacity to incur criminal responsibility, developmental criteria for the ability to act responsibly, and modalities for withdrawal treatment or treatment during detention.

A Case of Catatonia in a 14-Year-Old Girl with Schizophrenia Treated with Electroconvulsive Therapy

This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

Individuation during adolescence and emerging adulthood – five German studies

Among theories describing human relationships and interactions, individuation theory has increasingly gained attention over the last three decades. After ideas of individuation were introduced to the USA by German emigrants, such as Erik Erikson and Peter Blos, a second generation of American researchers brought the issue to the fore during the 1980s. Since then, German research has taken up the topic. Current lines of German research resonate with contemporary American research (e.g., Allen, Smetana), but also explore possible extensions of the theory. Here we introduce five German studies that explore relations between individuation and attachment, interactions between transmissions and relationships, or try to extend individuation theory beyond adolescence and the family system.

Objective measurement of tissue tension in myofascial trigger point areas before and during the administration of anesthesia with complete blocking of neuromuscular transmission.

Objectives:Myofascial trigger points (MTPs) are extremely frequent in the human musculoskeletal system. Despite this, little is known about their etiology. Increased muscular tension in the trigger point area could be a major factor for the development of MTPs. To investigate the impact of muscular tension in the taut band with an MTP and thereby, the spinal excitability of associated segmental neurons, we objectively measured the tissue tension in MTPs before and during the administration of anesthesia using a transducer. Methods:Three target muscles (m. temporalis, upper part of m. trapezius, and m. extensor carpi radialis longus) with an MTP and 1 control muscle without an MTP were examined in 62 patients scheduled for an operation. Results:We found significant 2-way interactions (ANOVA, P<0.05) between the analyzed regions of the target muscles dependent on the time of measurement, that is, before and during a complete blocking of neuromuscular transmission. These effects could be demonstrated for each target muscle separately. Discussion:An increased muscle tension in MTPs, and not a primary local inflammation with enhanced viscoelasticity, was the main result of our investigation. We interpret this increased muscular tension in the taut band with an MTP as increased spinal segmental excitability. In line with this, we assume a predominant, but not unique, impact of increased spinal excitability resulting in an augmented tension of segmental-associated muscle fibers for the etiology of MTP. Consequently, postisometric relaxation might be a promising therapeutic option for MTPs.