Talk:Attention deficit hyperactivity disorder/Archive 23

Outside comment on neutrality
Having quickly scoped the article after seeing it listed as a 'Good Article' nominee: it seems heavily biased towards the Pharma Industry's point of view. There's no inherent problem with moving "Controversy" to a side article. But most of the claims retained at this page are still controversial! They reflect the view of one particular side of the "controversy". Take this list of "Causes" for example. Am I the only one flabbergasted that classrooms and workplaces are not listed among possible causes of "attention deficit" problems? Another section mentions sociologists who describe "ADHD" as medicalization of deviant behavior; the following sentence counters that: "Most healthcare providers in U.S. accept that ADHD is a genuine disorder..." What does "genuine disorder" even mean? (Isn't deviance explicitly part of the DSM definition of a disorder?) The term also appears in the lead. The first source cited says that ADHD is generally recognized to "exist". Helpful? This article reads like sophisticated advertising for legal stimulants. groupuscule (talk) 06:19, 26 June 2013 (UTC)

Legal status of medications
I do not see the point of having this section in the article. The article is on ADHD. Facts of medications should be mentioned if they are important to understand the disease. However, the legal status of the medication, while very relevant for the articles on the medications does not really fit in an article on the disease, as it does not help to understand ADHD to know if it is easy or not to get the medication. In this sense I do not know of any article on a disease in wikipedia where there is a specific section dedicated to know the legal status of the meds used for such disease. I would eliminate the full section. --Garrondo (talk) 20:10, 30 June 2013 (UTC)
 * Well spotted - I agree and I have removed this section or rather moved it to the ADHD management article.-- MrADHD  |  T@1k?  15:07, 7 July 2013 (UTC)

Sources in special populations
I was doing some checking on sources in relation to GAN, and then I noticed that Zad had stopped reviewing sourcing. Instead of pointing out problems I am going to be bold and fix things myself, although I will try to comment here at least until the GAN finishes.


 * study

While pubmed considers it a study, when reading it it seems closer to a review; However, it is a review on high functioning children, and not specifically ADHD. Moreover it only has a 3 paragraphs in the whole article in connection with learning disabilities, and only one from those (the one cited) on ADHD, consisting in a citation from a primary source. I copy here all the text related to ADHD from the source:

In a recent study, Loureiro et al. have shown that highly gifted children with ADHD have a particular neuropsychological profile with an important difference (at least 20 points) between verbal IQ and performance IQ at Wechsler Intelligence Scale for Children (WISC III) when compared to highly gifted children without ADHD.

Comment on ADHD in the article is so tangential that the source cannot be considered a reliable secondary source.

I am going to simply eliminate content based on it and also the ref, since it is probably not critical for the article.

--Garrondo (talk) 06:54, 27 June 2013 (UTC)


 * The fact that the reference focuses on a narrow subject (cognitive and developmental issues in high intelligent children) makes it a higher quality source. We want focused sources rather than sources that skim over lots of bits of information. It would of course be better if more time was given to ADHD in this article but there is not a huge amount of research in high intelligence ADHD children. This large gap occurs in autism spectrum disorder and could contribute to a misdiagnosis of autism spectrum disorder in a high IQ ADHD child - how does it benefit our readers to remove this content from this article? I think that it is a disservice to our readers to remove this content from the article as it is an important finding in high IQ ADHD youth. Thoughts?
 * I have no problem with the ref itself, but with its use in the ADHD article since the only mention of ADHD is the one single sentence included above, which only says "in a single study X found X". In this sense it can hardly be considered a secondary source for such statement or ADHD and high IQ; while I believe it is a great source for other articles, for this specific article is quite crappy and probably not really reliable. Moreover, we have another high quality ref much more specific (since it is all about ADHD and high IQ) that does not mention the issue of differences between verbal and nonverbal IQ so I tend to think that it is not as clear. Finally: if you decide to keep the content I would say that it would have to be reworded to consider it a primary finding since the secondary source only mentions it without any kind of evaluation or modification. In this sense to generalise from it is to give undue weigth and commit (a mild) original research. If we are going to use we should specify that it was a single study by Loureiro, and if so I do not really see the point of using the secondary source... Best practice IMO would be to find another better source for that content. If there is none I would say it is not really that relevant. --Garrondo (talk) 06:53, 28 June 2013 (UTC)
 * More on the issue: I have now understood why the Loueiro study is mentioned in the review, when it does not really fit with the theme: it is an autocitation, since the last author of the Loueiro article is the author of the review. In this case I feel that the only intention of including it in the review was to increase the impact factor and citations of their own works. Moreover, the Loueiro article is published in frech in a not very important journal and in its title says "exploratory article", being further indication that it is not that relevant.
 * In summary: we have a review not on ADHD where the only mention of ADHD is 3 lines cited to the author of the article owns work, being the source an exploratory analysis in a low diffusion journal. The more I get into it the less appropiate the source seems to me. We shoule either find another source or eliminate the content.
 * --Garrondo (talk) 07:02, 28 June 2013 (UTC)


 * Review. Redundant ref that can be eliminated: used only twice, in lead and adult section, to source the same statement on prevalence (2-5%) and both times accompanied by another ref (Kooij) that gives the same number, is open and of similar quality.

I am going to eliminate the redundant ref.

--Garrondo (talk) 06:57, 27 June 2013 (UTC)
 * The 2009 review probably didn't mention the Loureiro study because it was too new being published in the same year. I don't think the motivation was to 'increase the impact factor' but rather because it is an important research finding which many psychologists and diagnosticians will find of interest and importance. It is the finding that is relevant rather than the journal although I do accept and appreciate that some journals are of higher quality than others. I have added some wording to make clear that the results are based on the findings of a single study. I am going to ask a psychologist who has knowledge of ADHD professionally for her thoughts on this. I may be wrong in my thoughts on this issue. I do appreciate your points that you raise Garrondo which are valid.-- MrADHD  |  T@1k?  14:48, 7 July 2013 (UTC)

Here I am and I fully agree with Garrondo!
 * To start with: the title of the original study says: "étude exploratoire", that is "exploratory study".
 * Even though this study is mentioned in the source - and thus it could be argued that it is a secondary source - the authors of this article just have "copied" the results of the exploratory study and have not added anything to it. They don't compare it to other study results, they don't discuss these results, so actually, as a secondary source it is as meager as it can get.
 * The "exploratory study" was published in 2009 and now it's 2013. Where are the follow-ups? What do they say? And if there are no follow-ups, it could mean that the results of this study are not considered important enough...
 * The study was done in France. But French kids don't have ADHD!. No, actually I don't believe that they don't have ADHD but apparently "In France, the percentage of kids diagnosed and medicated for ADHD is less than .5%". This rises the suspicion that diagnosing practices in France are not the same as those in the rest of the world. The results of the study could very well be specific for this tiny subgroup of children in France who get this diagnosis - but not for the much larger subgroup of children who don't live in France.

With a warm hug to both of you MrADHD and Garrondo. Lova Falk    talk   08:55, 8 July 2013 (UTC)
 * Oops! Look at the fourth name of the authors of the original study: L. Vaivre-Douret. Guess who wrote the review article? Yes! Laurence Vaivre-Douret. Need I say more?
 * As a side note: self- overciting is a well known sub-ethical researchers strategy to increase both the impact factor of the journals you have published and the number of citations of your work. When a source cites a losely connected article by the same authors it should be taken as an important red flag. I am quite sure this is the case here.--Garrondo (talk) 15:12, 9 July 2013 (UTC)
 * Re-eliminated per comment by Lova. --Garrondo (talk) 07:10, 11 July 2013 (UTC)
 * Hi guys, sorry I have been on holiday where I did not have internet access. Thanks for your helpful analysis Lova Falk and commentary; I see that consensus is that it should be removed - I agree with the removal of this content by Garrondo per the valid arguments above against it's inclusion. :-)-- MrADHD  |  T@1k?  19:49, 13 July 2013 (UTC)

Adults
Some comments:


 * Other problems include relationship and job difficulties, and an increased propensity to become involved in criminal activities.[8] They often have such associated psychiatric comorbidities as depression, anxiety disorder, substance abuse, or a learning disability: Right now it is not clear if this is true for all ADHD adults or only for ADHD untreated adults


 * Some ADHD symptoms of in adults differ from those seen in children — for example whereas children with ADHD may climb and run about excessively, adults may experience an inability to relax and talk excessively in social situations. Adults with ADHD may start relationships impulsively and may display sensation seeking behaviour and be short-tempered. Addictive behaviour such as substance abuse and gambling are also very common.: while not really sure on how to improve it I do think it could be better written and summarized. It is also unreferenced (or at least it is not really clear if the later ref applies to the text). Finally some wikilinks would also improve it.--Garrondo (talk) 07:08, 11 July 2013 (UTC)

news
With the overhaul of state run health systems the cost aspect receives new attention. A new Russian study (Yu. Vashmashinewskii, Ya. Ostrogatzkii. (2013). "Elektriskaya renoviska idiotskaya" Novshmozkapopnaya Chorkbotolovodkaya, 2013(5): 31–47 ) proved, that ECT (electroconvulsive therapy) is at least as effective as medications in hyperactive and attention deficient (Russ. dawaii parshol uri-uri, waser aus wand) children and adults. In addition it is much more cost effective, as 1 KWh (Kilowatthour) replaces 36,000 single doses of pharmaceuticals and costs only 0.20 Rubles (Da! 20 Kopeki!) 70.137.135.207 (talk) 07:08, 13 July 2013 (UTC)

Of course the first experiments were done without expensive electronic apparatus. 70.137.142.55 (talk) 05:25, 26 July 2013 (UTC)
 * We need to use secondary sources to put things into proper context. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:46, 31 July 2013 (UTC)

Prevalence
We discuss how rates have changed but we do not discuss why they have changed. There is a fair bit of literature on this. Most seem to agree that it is due to loosening of the diagnostic criteria among other factors rather than an increase in hyperactivity among children. Either way it should be discussed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:34, 2 August 2013 (UTC)
 * I am unsure what references support what text in this part of the article. Could use some clarification. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:33, 2 August 2013 (UTC)
 * Okay have made the section more globally and less UK / US in scope. Country specific data can go on the subpage. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 11:35, 2 August 2013 (UTC)

Sourcing
An online CME course IMO would not count as a reliable source. Is there a better ref to support this? Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:16, 2 August 2013 (UTC)

Edit request on 2 August 2013
Over-Thinking syndrome is a relevant disorder that should be added to the related disorders section with the following description "Due to the hyperactivity associated with ADHD Over-Thinking of situations could lead to Over-Thinking syndrome, which could aggravate any related insomnia and substance abuse caused by ADHD"

217.42.37.245 (talk) 19:58, 2 August 2013 (UTC)


 * Red information icon with gradient background.svg Not done: please provide reliable sources that support the change you want to be made.. Please note that a WP:RSMED-compliant source may be required. Rivertorch (talk) 06:47, 5 August 2013 (UTC)

Spelling Error
Under the section "Signs and Symptoms", the word "inappropriate" is misspelled "innapropriate".
 * Yes that bit not needed. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:20, 5 August 2013 (UTC)

Ref needed

 * For "Often people refer to ADHD-PI as "attention deficit disorder" (ADD), " Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:19, 5 August 2013 (UTC)
 * This ref does not support the text in question? "Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed. " Ref can be seen here  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:47, 5 August 2013 (UTC)
 * Okay found a better ref for this last bit. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 10:04, 5 August 2013 (UTC)

History of ADHD
This would be a good ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:19, 5 August 2013 (UTC)

Secondary source needed
This needs a secondary source "Factors other than those within the DSM or ICD have been found to affect the diagnosis in clinical practice. For example, a study found that the youngest children in a class are much more likely to be diagnosed as having ADHD compared to their older counterparts in the same year. This because younger children typically have greater hyperactivity, not because they necessarily have ADHD. It is estimated that about 20 percent of children given a diagnosis of ADHD are misdiagnosed because of the month they were born." Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:32, 5 August 2013 (UTC)
 * Unfortunately not a secondary source but another study from Canada which reaches a similar conclusion Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children dolfrog (talk) 20:01, 8 August 2013 (UTC)

ADHD is total fraud - do not trust
ADHD is a fabrication to produce a lucrative market for the big-pharma industry.

The effects that children have is due to teenagers developing to adults, consequences caused from parental pressure due to poor/wrong parenting, media influence, other globalist psychological operations aimed, the effects of hollywood and music. Mostly, the education system is not created for children's well being, it is an indoctrination scheme for this system, children are bored because they're being forced to learn something they don't need, learn something that will be obsolete a few years later, learn something that isn't even accurate at the time of learning.

If you want to fix ADHD, go outside for fresh air, do a lot of things during the day, don't watch TV for 5-6 hours straigh or more, start exercising, start eating healthy, avoid gluten, avoid diary, avoid fast food and all kinds of snacks, avoid all fuzzy drinks and sodas, do not take vaccines, do not eat GMO, filter your tap water to remove flourides.

Certain contributors to this article may be agents and shills (liars) working for the pharmaceutical industry. They will definitely try to bring some excuse up to smear me and put some self-proclaimed moderators to bother me on my page about a "controversial post" or something to make it feel like I am some troll or something, I won't be even reading it save your time and effort. Xowets (talk) 17:07, 8 August 2013 (UTC)

Edit request on 28 May 2012
It is written: "The pathophysiology of ADHD is unclear and there are a number of competing theories.[92] Research on children with ADHD has shown a general reduction of brain volume, but with a proportionally greater reduction in the volume of the left-sided prefrontal cortex."

A lot of data suggests that the decrease of RIGHT PFC can be observed due to impairment of mesocortical dopamine pathway. For confirmation please read: Ron M. Sullivan and Wayne G. Brake, 2003, Behavioural Brain Research 146: 43-55.

jj
lots of people with ADHD can read nonverbal communication. — Preceding unsigned comment added by 2601:2:2380:BF:4916:9FCD:6A7F:602B (talk) 22:21, 12 August 2013 (UTC)
 * True. But our article clarifies that only some ADHD people are impaired.-- MrADHD  |  T@1k?  21:22, 17 August 2013 (UTC)

jjk
people with adhd are able to read nonverbal communication and people with adhd can read between the lines. It's not rocket science. ADHD is not autism and not aspergers. Stop making believe it is. Adhd people do get married as much as non adhdh people.This article sucks big time. There is no proof that ADHD people have harder times in relationships. S — Preceding unsigned comment added by 2601:2:2380:BF:95D3:C6DF:52F5:76D8 (talk) 01:05, 13 August 2013 (UTC)
 * I don't have problems reading non-verbal communications nor do I have any problems reading between the lines and have sympathy for your viewpoint but it is what the source says. The impairments of ADHD in social situations and such like is of a different cause and is much less severe than autism spectrum disorder. Asperger's no longer exists now anyway and is diagnosed as autism spectrum disorder. What I am going to do is ask for the opinion of a psychologist who could provide better input into this - perhaps we need to clarify our article better regarding the nature of the impairments. -- MrADHD  |  T@1k?  21:18, 17 August 2013 (UTC)
 * Many studies have shown that ADHD people tend to have problems with non-verbal communicattion, so unless there is a reliable source saying the opposite it should stay. This does not mean that all ADHD patients have these problems or that they are anything similar to autism either qualitatively or quantitatitevely. Regarding ADHD people having problems with relationships, there is even clearer consensus. --Garrondo (talk) 08:50, 20 August 2013 (UTC)

(Outdent) Further thoughts and comments on the ip editor's original post. It is very true that ADHD is not autism spectrum disorder and by pointing out to our readers that some ADHD people have impairments with social skills and nonverbal communication will actually help our readers lay and professional alike to understand that these impairments can be due to ADHD rather than autism. So actually our article is if anything preventing people wrongly believing that said symptom is autism when it is actually ADHD. This article is actually doing the opposite of what you claim it is doing. Ultimately though it requires the skill of an experienced professional of course to properly differentiate between the two disorders and on occasion both disorders are present/comorbid in the same individual. All we can do is to summarise the facts as a general overview and leave it at that.-- MrADHD  |  T@1k?  20:24, 20 August 2013 (UTC)
 * There is considerable evidence that those with ADHD (especially untreated ADHD) are overly represented in divorce, domestic violence, assault convictions, ... drunken drivers, the list is almost endless. Individuals may not be in any of those groups and still have ADHD, of course; and may be in those groups and not have ADHD. ADHDers are more than their share likely to be in them than non-ADHDers. htom (talk) 18:48, 27 October 2013 (UTC)

Some people are now actually including ADHD on the Autistic spectrum. Recent studies show they are genetically related, 70% of those with Aspergers also have ADHD, and more and more evidence now points to a connection between the two conditions, including the fact that Aspergers and ADHD share about 2/3 of symptoms, including social problems, nervous system complications, etc. Most definitely, this information should stay, for as we find out more and more about the link between autism and ADHD, I am certain that we will only find that the two are much closer than previously thought-some even now believe they are actually only variations or levels of severity of the same thing. Also, keep in mind that not every person with ADHD has every symptom of ADHD. We all have different symptoms, some are overly talkative while some are very quiet. Just because one person may have ADHD and yet be extremely quiet does not mean that over talkativeness is not a symptom of ADHD, because it is. ADHD affects the executive functions and prefrontal cortex of the brain, which control social skills and are also the areas affected by autism. Further studies in neuroscience should soon reveal the causes of both and just exactly how ADHD works. Keep in mind just because social skills and verbal communication is affected with ADHD and autism and often harms relationships does not mean one cannot succeed and be popular with ADHD, and many of those with ADHD have many friends, especially friends who share the condition, because of their lively personality. Consider Adam Levine, Britney Spears, Adam Young, etc. Don't worry so much about this, it is most definitely a challenge for ADHDers, but not like a death sentence or something. You can still have a great social life and have ADHD. — Preceding unsigned comment added by 67.142.165.26 (talk) 21:20, 25 November 2013 (UTC)

There is evidence from realiable sources that indicate that people with ADHD have relationship and social skill difficulties. It should be kept because it is a commonly discussed topic about ADHD that people with it have relationship and social skill problems too.

Robert (talk) 05:34, 4 December 2013 (UTC)

EEG
Not sure what source you are looking for for this:


 * In July 2013, the U.S. FDA approved an EEG test to aid in diagnosis.

Do you not trust the Boston Globe to relay a press release? -- Beland (talk) 16:40, 5 October 2013 (UTC)
 * Is of undue weight. We should be using proper secondary sources rather than the popular press. Maybe in a section on research. Will start. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:59, 5 October 2013 (UTC)

can you delete the photo?
Hello there, can author delete the photo in this page? You put a photo of children from Laos for the ADHD subject, which is inappropriate because it may suggest that children from Laos and Asia may have this problem more than other children. A photo of children is also inappropriate because it has nothing to do with ADHD, it's just a photo of a child.

Thanks. — Preceding unsigned comment added by Wangnanwei (talk • contribs) 17:04, 27 October 2013 (UTC)
 * See the previous discussion. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 02:20, 28 October 2013 (UTC)

Image
I sort of like the previous image of the student studying, especially since school performance is such a key symptoms of ADHD. Wondering if we should look for another one? Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:59, 19 August 2013 (UTC)
 * I have the image that was changed a couple of months ago — Preceding unsigned comment added by Leahp12345678 (talk • contribs) 03:30, 14 November 2013 (UTC)

Which part of the ref supports (can you please quote here)
In addition to inattention, hyperactivity, and impulsivity, other symptoms that are common in people with ADD/ADHD include:
 * anxiety
 * low mood and poor self-image,
 * mood swings
 * easily annoyed
 * anger management issues

Thanks Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:48, 14 November 2013 (UTC)
 * Just to add a link to the paper European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD dolfrog (talk) 15:24, 14 November 2013 (UTC)
 * Would need a careful read and some rewrite, but I think the Handbook of Attention Deficit Hyperactivity Disorder p.43 et sequelia covers each of those under symptoms and common comorbidities
 * We already discuss many of these under comorbities. Do not need mentioning twice. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:40, 15 November 2013 (UTC)

Edit request on November 25, 2013
"ADHD is approximately three times more frequent in boys than in girls." -- Add the word "diagnosed" after "frequent" and add a "ly" at the end of that. More accurate. Many people believe it is more frequently diagnosed in boys than in girls because boys' symptoms tend to be more obvious (more hyperactivity) but occurs just as commonly in girls, only without being diagnosed. The reason for this is still not fully understood, but the above statement is not yet known to be entirely accurate, so "ADHD is approximately three times more frequently diagnosed in boys than in girls." would be more appropriate. — Preceding unsigned comment added by 67.142.165.26 (talk) 21:36, 25 November 2013 (UTC)


 * I agree that this change should be made. As an elementary school teacher I've experienced that it is difficult to get (some) psychologists/physicians to even consider diagnosing ADHD in girls.  The school (often together with the parents) has to put in much more time and effort demonstrating (trying to prove) a girlchild's needs in this area.  Hordaland (talk) 09:01, 26 November 2013 (UTC)
 * Good point and done. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:09, 26 November 2013 (UTC)

Social skills section
Should there be a mini section title on social skill deficits? There is realiable sources that clearly indicate that social skills is a problem with many people with ADHD and there can be a paragraph discussing it?

Robert (talk) 05:38, 4 December 2013 (UTC)
 * At this point, no-- the article is not well enough developed to support sections. As/if the article grows and approaches FA standard, then perhaps (see for example the FA Autism).  Sandy Georgia  (Talk) 14:44, 4 December 2013 (UTC)

Semi-protected edit request on 10 December 2013
See: At least 30 percent of children with a traumatic brain injury latter develop ADHD[71]
 * Please change "latter" to "later"

See: with most diagnosis begun after a teacher raises concerns.[72]
 * Please change "diagnosis" to "diagnoses"

68.186.22.216 (talk) 02:21, 10 December 2013 (UTC)


 * Done Doc James  (talk · contribs · email) (if I write on your page reply on mine) 02:50, 10 December 2013 (UTC)

Image of PET
Have removed this image For one it is a primary source. For two it gives undue weight to one aspect of the topic. We have discussed it in the past. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:18, 15 December 2013 (UTC)
 * Agree with the removal of that image for the reasons stated, in particular the image would give far too much weight for a primary source.  05:07, 15 December 2013 (UTC)

An odd review
This passage of text is cited by a rather sketchy source : "The long-term effects of stimulants generally are unclear with one study finding benefit, another finding no benefit and a third finding evidence of harm.[117]" Ignoring the fact that the author is implying 1 of the sources isn't peer-reviewed in the abstract, there's only three studies in the review. I've seen primary comparative studies include more external data than that when drawing conclusions on their findings. Ex: this one used four (table 2):. I think it would be best to look for an actual review of literature to cite a statement on this topic.  Seppi  333  (Insert 2¢) 14:14, 18 December 2013 (UTC)
 * This is looking at long term effects. Most trials are short term. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 16:49, 18 December 2013 (UTC)
 * I agree with both those statements - that's not really relevant to the issue I'm raising though. This review is ignoring all older studies and is looking at only new literature, per the abstract.  That's basically an intentional loss of statistical power (assuming the paper even used stats - I don't really care to read it) and induces a recency bias.  Seppi  333  (Insert 2¢) 17:13, 18 December 2013 (UTC)


 * Here's 2 paywalled secondary sources from 2013 that have a discussion on long term effects: one's a meta-analysis with 21 and 13 aggregated datasets for its analysis, the other is a review with 29 datasets.  Seppi  333  (Insert 2¢) 17:36, 18 December 2013 (UTC)

Neither ref says anything about long term treatments effects on hard endpoints. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:50, 18 December 2013 (UTC)


 * The paper you linked to in that pubmed search is apparently WP:MEDRS, because it's a meta-analysis. I'm pretty sure permanent structural changes in the brain aren't a short-term effect, especially considering there's a section title in the meta analysis that says "EFFECT OF LONG-TERM STIMULANT MEDICATION USE" (emphasis in original) which controls for age as a factor. Why are we even arguing over this?  Seppi  333  (Insert 2¢) 18:00, 18 December 2013 (UTC)

Structural changes are a surrogate marker. Hard endpoints would be things like employment and academic achievement. What do you wish to use those refs to say? Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:02, 18 December 2013 (UTC)


 * I don't know; with exception of reading the abstract and using ctrl-F to search for "long-term" and skimming the sections it found the term in, I haven't read them. I just did a literature search with MEDRS filters after you first responded and those were the 2 most relevant ones that popped up. I just know that whatever their conclusion is, it's going to be more valid than the current paper cited in the article due to much higher statistical power.  Seppi  333  (Insert 2¢) 18:12, 18 December 2013 (UTC)
 * Given that the text on the page is completely vague, I don't really see why it's necessary to place a restriction on what the dependent variable is.  Seppi  333  (Insert 2¢) 18:14, 18 December 2013 (UTC)

This review looks more applicable  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:20, 18 December 2013 (UTC)
 * Give me a minute and I'll download it.  Seppi  333  (Insert 2¢) 18:24, 18 December 2013 (UTC)
 * K, it's hosted here.  Seppi  333  (Insert 2¢) 18:28, 18 December 2013 (UTC)

The study that begun this discussion was looking at treatment for 5 years or longer. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:37, 18 December 2013 (UTC)
 * I don't understand why you of all people would rather go with a crappy source than one that's literally 1 notch down from a Cochrane review on the MEDRS scale (i.e. both a review and a meta-analysis). I frankly don't care what text is cited on the page so long as it's backed up by a source that isn't garbage. Seriously, look at the journal it's published in.  Seppi  333  (Insert 2¢) 18:45, 18 December 2013 (UTC)
 * The refs are not asking / answering the same questions. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:55, 18 December 2013 (UTC)
 * I think you and I should return to this conversation later - this is a pointless back-and-forth.  Seppi  333  (Insert 2¢) 18:58, 18 December 2013 (UTC)

, after thinking about this more, I think it would be best to simply summarize all relevant, quality pubmed secondary sources from the last 2-5 years to state what long-term effects are known to result from psychostimulant use. Given that three high-quality papers - including two meta-analyses and two broad reviews of literature - indicate definitive long-term effects exist, it's contradictory to state "the long-term effects of stimulants generally are unclear" without any qualification. If you really want to keep that paper in there, I'm fine with it so long as it's indicated that the paper stating this is a very limited or editorial review of literature. I'm still not sure what the "beneficial effects" and "harm" are that the review is referring to though - that should be clarified if its kept.  Seppi  333  (Insert 2¢) 20:11, 20 December 2013 (UTC)
 * There is evidence for up to two years. After that I have not seen any evidence of effect. So I guess it depends on how one defines "long term". What wording do you propose? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 20:19, 20 December 2013 (UTC)
 * I actually wanted to work that part out with you - we have two studies on changes in brain structure relative to controls and one on academic outcomes for children. I can look for more just to be thorough, but I think it would be best just to paraphrase the conclusions of the studies that are included.  I'll come up with something and post it here in a few minutes after going through the three we have so far.  Seppi  333  (Insert 2¢) 20:27, 20 December 2013 (UTC)

Conclusions This review aimed to describe and analyse the effects of methylphenidate, dexamfetamine, mixed amfetamine formulations and atomoxetine on children’s classroom learning behaviour and academic performance. Despite the potential risk of confounding and bias introduced by limitations of the included studies, the meta-analysis provides support for positive effects of psychopharmacological interventions on academic success in children with ADHD. The ﬁndings indicate that drug treatment for ADHD improves the school experience for children both in terms of their classroom behaviour and their academic performance.

In conclusion, patients with ADHD have cognitive domain–specific dissociated dysfunctions in distinct fronto-basal ganglia-thalamic networks, involving the right IFC, SMA, and anterior caudate for inhibition functions and the right DLPFC, posterior basal ganglia, and parietal areas for attention functions. Furthermore, long-term stimulant medication use appears to be associated with a gradual normalization of right caudate deficits during attention.

Despite the limitations and heterogeneity of the available MRI studies, our qualitative review supports the notion that therapeutic oral doses of stimulants are associated with attenuation of abnormalities in brain structure, function, and biochemistry in subjects with ADHD. We suggest that these are medication-associated brain changes that most likely underlie the well-established clinical benefits of these medications.


 * I think to summarize all the limitations and benefits of the three studies above, wording along the lines of this would be adequate:
 * "Despite the potential biases, limitations, and data heterogeneity endemic to studies on the long-term effects of ADHD stimulants, the results appear to suggest that these drugs normalize brain structure abnormalities in ADHD and improve classroom behavior and academic performance in children."
 * I'd need to download the paper currently being cited to include that.  Seppi  333  (Insert 2¢) 20:49, 20 December 2013 (UTC)
 * Can we try some generally accessible language? We need to try to write for grade 12 students "Despite the potential biases, limitations, and data heterogeneity endemic to studies on the long-term effects" is fairly difficult language. People do not care really about brain structure. What they care about is 1) will this improve the persons quality of life 2) will this improve their education achievements 3) will this improve their future job prospects 4) will this decrease the chance of them being put in jail 5) will this change their chance of getting married. Brain structure is a surrogate marker. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:19, 20 December 2013 (UTC)

This review appear to be looking at short turn changes in academics. Which is good information but is not dealing with long term outcomes. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:25, 20 December 2013 (UTC)


 * That's fair enough - how about just "Despite the limitations of studies on the long-term effects..."? I'd agree that brain structure abnormalities are a proxy variable for social, academic, and occupational aptitude, but there are methods to use a proxy to project statistical inference onto a desired outcome.  Although they didn't use this method in any of those papers, it's a possibility for future research given these results, so that's worth knowing.   Seppi  333  (Insert 2¢) 21:35, 20 December 2013 (UTC)


 * This section seems, to me, to suggest the authors consider their work to be on long term outcomes, since they're stating it runs contrary to previous papers on long-term outcomes.
 * "Findings from previous reviews assessing the effects of drugs on educational outcomes for children with ADHD have been inconsistent. The ﬁndings of this review are contrary to some reviews, including Schachar [23] and Jadad et al. [22], who found that studies of long-term treatment with stimulants provided little evidence for improved academic performance. However, the review by Schachar [23] was based on only 17 studies with the authors rating only ﬁve as of adequate methodological quality, and with insufﬁcient data for meta-analysis. Similarly, Jadad et al. [22] included only twenty-three studies that compared drug differences, and did not combine these studies quantitatively. The present review includes a number of papers published post-Schachar’s [23] review, focuses on both seatwork completed and accuracy, and most notably is able to present a quantitative analysis of studies suggesting an overall improvement in academic performance with drugs."
 *  Seppi  333  (Insert 2¢) 21:50, 20 December 2013 (UTC)
 * We could say "Stimulants appear to normalize brain structure."
 * With respect to educational outcomes it appears that this review is assuming that evidence of short term improvements will result in long term improvements. They do not say this explicitly though. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:16, 20 December 2013 (UTC)


 * I think your version sounds fine. I'll let you decide the wording on the academics paper - I don't really have a preference to be honest.  Seppi  333  (Insert 2¢) 22:23, 20 December 2013 (UTC)
 * Okay have added and the education review I added a few days ago. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 22:32, 20 December 2013 (UTC)

focus on atomoxetine (strattera)
the medication section of the article lists only atomoxetine (Strattera) and "stimulants." This seemed very incomplete for a section on medication for an illness that is usually medicated. In good faith I laboriously added the information (With Citations!) The visible text amounted to two sentences.

I took a phone call, came back and my changes were reverted with an "I don't think we need this."

If you prefer not to list any medication names in this article, then you should remove the random references to atomoxetine as well. I see no reason for it to receive special treatment. Ukrpickaxe (talk) 19:20, 10 January 2014 (UTC)
 * We mention stimulates first and state they are the pharmaceutical treatment of choice. I do not think we need an exhaustive list here as it is on the management subpage and when you click stimulants. We do not mention brand names for atomoxetine.
 * We generally do not mention brand names at all as these vary by country and we are global in nature. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 19:33, 10 January 2014 (UTC)
 * Per Doc James, we don't need all the brand names or the extensive list of different stimulants, but we do need the list of other medications used; for example, guanfacine, clonidine, and the tri-cyclics are frequently used in children with comorbid tics. Sandy Georgia  (Talk) 20:10, 10 January 2014 (UTC)
 * Certainly and added. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:04, 10 January 2014 (UTC)
 * Sorry, I do not see how the non-stimulant drugs require mention if the stimulants do not. (Clicking the "stimulant" link under Medication does not take us to an ADHD page, it goes to a page about "uppers" with various charts of chemical compositions.) Per the logic you are all claiming, non-stimulants belong on the management page also. (FWIW I'm aware of comorbity. Still goes on management page according to your logic.) I don't see how your committee can have it both ways. Ukrpickaxe (talk) 22:11, 11 January 2014 (UTC)
 * Stimulants are a drug class. Clonidine is a different class.  Atomoxetine is a different class.  Sandy Georgia  (Talk) 22:16, 11 January 2014 (UTC)
 * Possible miscommunication:
 * I believe the relevant article is Attention deficit hyperactivity disorder management (not Stimulant). This is concealed linked two sections above, under Management.
 * I believe the relevant article is Attention deficit hyperactivity disorder management (not Stimulant). This is concealed linked two sections above, under Management.

Cannabis
I was diagnosed with ADHD at IQ 138 in the 1980s, and forced against my will as a nine-year old child to take legally prescribed speed, in the form of Ritalin and later Amphetamines. The medicine has helped, in the right circumstances, but the side effects can be unpleasant, severe, and potentially deadly, with a high potential for life-threatening abuse. I have also had negative experiences with prescribed antidepressants, which are known to cause a host of unpleasant and sometimes life threatening side effects in some patients.

Last month I saw a lecture by Dr Allan Frankel (his website is http://www.greenbridgemed.com/) in Copenhagen, Denmark on the subject of medical cannabis, popularly known as the increasingly less illegal drug marijuana. Looking around the web in follow up, I can see that this is a major emerging direction in treating ADHD, but outside the scope of the corporate pharmaceutical industry and thus the mainstream treatment of ADHD in most places.

Yet cannabis is currently being prescribed for ADHD, and lauded both for its efficacy and its safety— in fact, according to the state of the art in the research, it is actually impossible to suffer a life-threatening overdose from cannabis alone. So it's high time for us to begin a new section on Cannabis as a treatment for ADHD in this article, so we can all benefit from details of treatments in the field and the the developing research as this new approach widens. Thank you for your time and attention. Kaecyy (talk) 12:03, 16 January 2014 (UTC)
 * High quality secondary sources are required per WP:MEDRS. As these were not provided the content you have added has been removed. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 14:37, 16 January 2014 (UTC)


 * ADHD is pretty well established as a dysfunction of dopaminergic and noradrenergic function in corticolimbic regions, which is why stimulants work so well. CB1 and CB2 receptor agonists wouldn't directly address this.  Seppi  333  (Insert 2¢) 14:59, 16 January 2014 (UTC)


 * Anyone who cares to read the text I drafted will probably find it very good linguistically, with excellent primary sources, so it should probably serve as the basis of a first draft, as we add in this section together.


 * But I am not at all adept at the minutia of Wikipedia and I have to get the hell out of Dodge at the moment, so— if someone with a constructive approach could edit the text I just posted and Doc James just deleted, to help meet the requirements Doc James states, it would be very much appreciated— on behalf of myself and others who suffer from this terrible affliction.


 * Doc James? You're practically the king of this page, why don't you have a go, my man? Kaecyy (talk) 15:12, 16 January 2014 (UTC)
 * Not able to right now. Will take a look to see if anything exists in a bit. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:31, 17 January 2014 (UTC)
 * The text you drafted is synthesis from low-quality primary sources, including a youtube and truthonpot.com; please review our medical sourcing guidelines. To my knowledge, there are no sources that would indicate anything about cannabis as treatment should be added to this article (although there are plenty of reviews about cannabis as a substance dependency issue in persons with ADHD).  Sandy Georgia  (Talk) 14:59, 17 January 2014 (UTC)

Tourette syndrome
The deleted defintion of Tourette syndrome was not so far off. You could have a look at syndrome and obsessive-compulsive disorder. Which as cited in Cortical excitability and neurology: insights into the pathophysiology dolfrog (talk) 15:28, 18 January 2014 (UTC)
 * There is also The prognosis of Tourette syndrome: implications for clinical practice dolfrog (talk) 15:37, 18 January 2014 (UTC)

Addition
I have reverted this as we already say the same with a newer ref just a couple of lines above. Also formatting is poor. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:40, 21 January 2014 (UTC)

Page Should be Updated with Information from the DSM-5
This article currently contains diagnostic criteria from the DSM-IV-TR. The DSM-5 came out in 2013 and so the diagnostic criteria should be updated to reflect this.

For information on the changes made for ADD/ADHD in the DSM-5, please refer to this page: http://www.dsm5.org/Documents/ADHD%20Fact%20Sheet.pdf Lmathison (talk) 14:42, 28 January 2014 (UTC)
 * Yes, it should. And if it's not done soon, the article should not be listed as a good article.  Sandy Georgia  (Talk) 15:20, 28 January 2014 (UTC)
 * People are crazy about the DSM 5. It has changed very little. Will edit soon. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:43, 28 January 2014 (UTC)

Okay read the DSM 5, have updated. Little has changed other than the time symptoms need to start before. DSM 5 states before 12 years of age. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:48, 30 January 2014 (UTC)

Propose merging articles, and major conceptual changes to article organization
The Adults subsection under "Special populations" reads to me a bit like "The prognosis for children with ADHD is horrible!". It's pretty unbalanced. I also don't understand the intention behind having an "Adults" section under "Special Populations". What kind of info was meant to go in this section? Especially since most children with ADHD continue to have symptoms in adulthood. I would say adults are not a "special" population at all--they're the same population as the rest of the article. So, I'd like the delete this subsection altogether and disperse the content into the different sections of the article so that it's side-by-side with info about ADHD in childhood.

I see there's also a link further up on the page to a Wiki article on Adult attention deficit hyperactivity disorder. I glanced at that article and it has quite a bit of info on ADHD in childhood, anyway. It also repeats a lot of the info that's already in this article. I propose we merge the two articles, since ADHD is not just (or even primarily) a disease of childhood. We could talk somewhere in the merged article about ADHD through the lifespan; typical presentation by age group; and just include more info on differences between age groups throughout the rest of article. Thoughts? Nimptsch3 (talk) 23:04, 20 January 2014 (UTC)
 * The medical literature divides it like this. Thus so do we. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:38, 21 January 2014 (UTC)
 * There's a distinction in symptoms between childhood and adult ADHD-(C/PI/H), so it's worth have a separate treatment of the topics. Perhaps a reformatting/reorganization of material for summary style is in order though, since adult ADHD is a sub-article of this one.  Seppi  333  (Insert 2¢) 01:26, 21 January 2014 (UTC)
 * The prognosis for a child with untreated ADHD is not good. They become adults with ADHD. Changes in the brain as the patient ages makes it more difficult to successfully teach the ADHD patient the skills that were not learned in childhood. There is going to be overlap between the articles; there is too much at the moment, but that's not a good reason to merge the articles. htom (talk) 03:20, 21 January 2014 (UTC)
 * In half ADHD goes away. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:52, 30 January 2014 (UTC)

Off label
Have removed this terminology. It is US centric while we are trying to write for a global audience  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:36, 31 January 2014 (UTC)

inconsistency? percentage into adulthood; sources 1 and 13 do not match?
The introductory paragraphs and the "Prognosis" section both cite source 13 which says 30-50% of children will still have adhd as an adult. (I'm approximating the words here, please see article for precision.) Source 13 is only cited these two times. The beloved Source 1, used many times in the article, is cited in "Special populations: Adults" section stating that 2/3 of child sufferers will have it as an adult.

Since I don't want to fight the ADHD Powers That Be on this one, I leave it up to you to adjust one way or the other. Ukrpickaxe (talk) 09:46, 31 January 2014 (UTC)
 * Thanks. The DSM5 states that half outgrow it. Thus added the DSM5 ref. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:39, 31 January 2014 (UTC)

No more donnations to wikipedia!!!!!
After noticing that this article on Attention deficit hyperactivity disorder as been blocked, I will no more donate any money to wikipedia. Everyone intelligent knows that Attention deficit hyperactivity disorder is not a disorder per se. At least, an section of this article should be open to stimulate the controversy and the debate. By closing the article, the wikipedia is supporting the position of the medical professionals and pharmaceutical companies that have their own interests. — Preceding unsigned comment added by 188.37.19.133 (talk) 01:52, 19 March 2014 (UTC)


 * Thank you for your comment. I'm afraid you may have misunderstood Wikipedia's purpose. We do not use articles to debate the article's subject. Rather, a Wikipedia article seeks to "... [represent] fairly, proportionately, and, as far as possible, without bias, all of the significant views that have been published by reliable sources on a topic." (WP:NPOV) If you have some information from a reliable source that is not covered in the article, and you are unable to edit the article yourself, you are welcome to cite that source here on the talk page, and request an edit. Alternatively, you could create an account. After four days and ten edits, you would be able to edit a semi-protected page yourself. It is important, though (especially when editing articles on sensitive or controversial topics), to make every effort to follow Wikipedia's policies and guidelines. Thank you. – Wdchk (talk) 02:35, 19 March 2014 (UTC)


 * "Everyone intelligent knows that Attention deficit hyperactivity disorder is not a disorder per se." - Well, in that case, I must be openly affirming my stupidity on my user page.  Seppi  333  (Insert 2¢ &#124; Maintained) 03:24, 19 March 2014 (UTC)

Sluggish cognitive tempo
Should this be added to the associated disorders section? At the bottom of the page it's also listed in the "other" section. Robert4565 (talk) 13:11, 25 February 2014 (UTC)


 * Ref needed. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 18:11, 25 February 2014 (UTC)

Jmh649, What if I use this reference? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278310/ Robert4565 (talk) 16:19, 16 March 2014 (UTC)
 * That is a primary source. We want a review article. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:13, 19 March 2014 (UTC)

ADHD
Hey Jmh, I figured it might be worth updating the article with additional (and newer) sources, particularly the Cochrane reviews on ADHD meds that I used in the amphetamine article, but aren't used in this one. I think it would be better if you decided on what parts of this to add, based upon your judgement of the text/refs, since this is the (only) part of the article in which I have a potential COI (favoring psychostimulants for ADHD). That said, 6 reviewers went through this part so far at the FAC (it's been HEAVILY edited/reviewed), so you probably wont need to worry about the writing quality if you just want to copy/paste parts you decide to use.

In any event, I color coded the text by my personal view on reference quality:
 * Yellow - above average, clear citations to primary or secondary sources in refs
 * Orange - Very high quality - large pubmed reviews, meta-analyses, or systematic reviews
 * Light blue - Cochrane reviews

I put the highlighting templates on separate lines in the source, so it should be easy for you to read the source code.

Magnetic resonance imaging studies suggest that long-term treatment with amphetamine or methylphenidate can decrease the abnormalities of brain structure and function found in subjects with ADHD, and improve the function of the right caudate nucleus. Reviews of clinical stimulant research have established the safety and effectiveness of long-term amphetamine use for ADHD.

An evidence review by Gordon Millichap noted the findings of a randomized controlled trial of amphetamine treatment for ADHD in Swedish children following 9 months of amphetamine use. During treatment, the children experienced improvements in attention, disruptive behaviors, and hyperactivity, and an average change of +4.5 in IQ. He noted that the population in the study had a high incidence of comorbid disorders associated with ADHD and suggested that other long-term amphetamine trials with less comorbidity could find greater functional improvements. Approximately 70% of those who use these stimulants see improvements in ADHD symptoms. Children with ADHD who use stimulant medications generally have better relationships with peers and family members, generally perform better in school, are less distractible and impulsive, and have longer attention spans.

The Cochrane Collaboration's review on the treatment of adult ADHD with amphetamines stated that amphetamines improve short-term symptoms, but have higher discontinuation rates than non-stimulant medications due to their adverse effects.

A Cochrane Collaboration review on the treatment of ADHD in children with comorbid tic disorders indicated that stimulants in general do not exacerbate tics, but high therapeutic doses of dextroamphetamine in such people should be avoided.

Citations

American Academy of Child and Adolescent Psychiatry (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child and Adolescent Psychiatry, 41(2, Suppl): 26S–49S.

Greenhill LL, Hechtman LI (2009). Attention-deficit/hyperactivity disorder. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3560–3572. Philadelphia: Lippincott Williams and Wilkins.

Upadhyaya HP (2008). Substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: Implications for treatment and the role of the primary care physician. Primary Care Companion Journal of Clinical Psychiatry. 10(3): 211–221.

Regards,  Seppi  333  (Insert 2¢ &#124; Maintained) 03:09, 24 March 2014 (UTC)
 * Not sure what you are suggesting? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 03:15, 24 March 2014 (UTC)


 * Merge whatever parts you think are worth including. That section needs an update - if only the Cochrane reviews.  Seppi  333  (Insert 2¢ &#124; Maintained) 03:18, 24 March 2014 (UTC)

First paragraph is looking at none clinical markers. Thus not really the questions people care about.

The second paragraph uses poor refs including webmed. We should add the conclusions of the Cochrane review. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:20, 24 March 2014 (UTC)


 * Just to be upfront about it, I have ADHD. I use amphetamine. I'm just trying to avoid including my biases in the section, so I was hoping you'd do it instead.  Seppi  333  (Insert 2¢ &#124; Maintained) 03:21, 24 March 2014 (UTC)
 * To be fair, the WebMD ref is the only borderline ref in that text.  Seppi  333  (Insert 2¢ &#124; Maintained)

In case you care to read anything in more detail, they're all hosted here.  Seppi  333  (Insert 2¢ &#124; Maintained) 04:15, 24 March 2014 (UTC)
 * Okay have added "and improve symptoms, at least in the short term" based on . However this was only looking at adults.
 * This review is just about those with ADHD and tic disorders therefore not really relavent for the general article.
 * Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:24, 24 March 2014 (UTC)
 * Fair enough. I only added it because Sandy thought it important to add something on it to stimulant articles.  Seppi  333  (Insert 2¢ &#124; Maintained) 05:32, 24 March 2014 (UTC)
 * Yes would be appropriate in that article. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:44, 24 March 2014 (UTC)

Semi-protected edit request on 9 April 2014
Change "maybe" to "may be" in header of table: "ADHD symptoms which maybe related to other disorders."

Grammarish (talk) 17:23, 9 April 2014 (UTC)
 * Yes check.svg Done thanks for the eye Cannolis (talk) 19:58, 9 April 2014 (UTC)

Origin Confirmed?
New findings allege to confirm a neurobiological origin in the the superior colliculus structure (in mice). If someone qualified could please check this out and include it (if relevant)? Here's one article: http://www.sciencedaily.com/releases/2014/04/140411091727.htm Ernest Ruger (talk) 10:42, 14 April 2014 (UTC)
 * Currently no suitable secondary medical sources cover it, so it doesn't meet our citation requirements.  Seppi  333  (Insert 2¢ &#124; Maintained) 01:26, 15 April 2014 (UTC)

Addition

 * I would like to add this to the section titled genetics as I feel it adds a bit more information to the section. Not a major addition, but I do feel that it gives a little more background which is beneficial.
 * "Siblings of children with ADHD are three to four times more likely to develop the disorder than siblings of children without the disorder. [1]
 * References:
 * Nolen-Hoeksema, Susan (2013). "10". Abnormal Psychology (6th ed.). McGraw-Hill Education. p. 267. ISBN 978-0-07-803538-8." (Crpaul (talk) 04:08, 19 April 2014 (UTC))
 * Moved here Doc James  (talk · contribs · email) (if I write on your page reply on mine) 06:57, 19 April 2014 (UTC)
 * Addedn Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:01, 19 April 2014 (UTC)

Semi-protected edit request on 7 May 2014
I would like to request that...

The statistic stating that "40-50% of people diagnosed in childhood continue to have symptoms into adulthood" be altered to "Approximately 60% of children who are diagnosed with the disorder at a young age continue to show symptoms into adulthood"

SIGNS AND SYMPTOMS I request that the following be added

The DSM-IV requires that 6 or more of nine symptoms of inattention, hyperactivity and impulsivity be present for at least 6 months in order to properly diagnose. Citation-

Attention Deficit Hyperactive Disorder is characterized by uninhibited responses, lack of sustained attention and hyperactivity Citation-

CAUSES Genetics-

Genetics play a key role in the likelihood of an individual to develop ADHD, it is estimated that the rate of heritability is between 75-91%. Citation-

Social-

Norwegian Behavioral neuroscientist Terje Sagvolden found that one of the causes of the deficiency in dopamine transmission that is seen in those with ADHD was a increase in the steepness of their delay in reinforcement gradient. What this means is that when children with ADHD are exposed to a stimuli immediate reinforcement proves to be even more effective than in children who do not have the condition, however almost any delay in the reinforcement leads to a drastic drop off in potency. This causes problems for the child in forming mental relations between actions and consequences. Citations-

PATHOLOGY Brain Structure-

Children diagnosed with ADHD have been found to have noticeably delayed growth of their Cerebral Cortex. It take until a child with ADHD is about the age of 10.5 before the cortical thickness is equal to that of and unaffected child at the age of 7.5. Citation-

Studies have show that ADHD is connected to abnormalities in parts of the brain involving the striatum as well as the prefrontal cortex. Both of these areas of the brain play key roles in the dopamine innervation leading researchers to believe that the proliferation of dopamine may play a key role in the change in brain functioning. Citations-

Neurotransmitters-

Recent studies have shown a relation to decreased levels of dopamine and norepinephrine to impaired performance on working memory tasks. These impairments mirror the symptoms shown in patients diagnosed with ADHD. Conversely the same study showed that by increasing both dopamine and norepinephrine levels in the prefrontal cortex served to alleviate symptoms. Citation-

MANAGEMENT Medication-

The most common form of medication offered to treat the symptoms of ADHD is Methylphenidate (Ritalin) which combats the symptoms of ADHD by increasing dopamine and norepinephrine levels in the prefrontal cortex. Citation-

The effectiveness of Methylphenidate in respect to dosage follows an inverted-U pattern, with not enough of it resulting in unaltered low levels of dopamine and too high levels working to actively suppress neural activity Citation-

Another type of drug used to treat the symptoms of ADHD are amphetamines, however the effects can vary from person to person. Studies have shown that a key factor in the effects of amphetamine on an individual depends on the level of Catechol-O-methyltransferase (COMT) in an individual's brain. COMT is an enzyme that affects dopamine levels and depending on the level of COMT the use of Amphetamines can have opposite effects of either raising or lowering positive mood. Citation-

Thank you for your time. -Richard Smullen

RSmullen (talk) 15:14, 7 May 2014 (UTC)
 * The current statement is referenced and you provide no ref for "The statistic stating that "40-50% of people diagnosed in childhood continue to have symptoms into adulthood" be altered to "Approximately 60% of children who are diagnosed with the disorder at a young age continue to show symptoms into adulthood"
 * Additionally please read WP:MEDRS with respect to sourcing. Some of the sources you mention are more than 5 years old and not secondary sources. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 19:55, 7 May 2014 (UTC)

why Chinese kids in the picture?
I find the picture rasist!93.219.150.101 (talk) 15:22, 18 May 2014 (UTC)
 * Ask the photographer. Unless there's some evidence that Chinese kids are less likely than others to have ADHD, I would just assume they were the ones in front of the camera. LeadSongDog come howl!  21:58, 18 May 2014 (UTC)
 * Oh wait, those kids are from Laos, according to the file descriptionLeadSongDog come howl!  22:02, 18 May 2014 (UTC)
 * What is wrong with non caucasian children studying? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:22, 19 May 2014 (UTC)

request for grammar edits 1 May 2014
In the section "Pathophysiology" sub-section "Brain Structure" it currently reads:

The brain pathways connecting the prefrontal cortex and the striatum also appears to be involved. This suggest that inattention, hyperactivity, and impulsivity may reflect frontal lobe dysfunction, with addition brain regions such as the cerebellum also being implicated.

"appears" should be "appear"; "suggest" should be "suggests"; "addition" should be "additional"

Also, in the section "Management", sub-section "Medication" it currently reads:

Stimulants but not atomoxetine appear to improve academic performance.[124]

This is a bit awkward as written - perhaps the "but not atomoxetine" should be in parentheses, or changed to "Stimulants other than atomoxetine..."

In the same section, there is a sentence that currently reads:

The long-term effects of stimulants generally are unclear with one study finding benefit, another finding no benefit and a third finding evidence of harm.[126] Their long term use does; however, appear to normalize brain structure.

The second sentence should read, "Their long-term use does, however, appear to normalize brain structure."

Thx --Red Pen Demon (talk) 14:02, 1 May 2014 (UTC)


 * Red Pen Demon (talk) 14:02, 1 May 2014 (UTC) has stated:
 * 'Also, in the section "Management", sub-section "Medication" it currently reads:
 * Stimulants but not atomoxetine appear to improve academic performance.[124]
 * This is a bit awkward as written - perhaps the "but not atomoxetine" should be in parentheses, or changed to "Stimulants other than atomoxetine..." '
 * I agree; as written it's not clear that the the sentence means "Stimulants, as well as atomoxetine" or "Stimulants and non-stimulants except for atomoxetine." From the Wikipedia article on atomoxetine, I gather that this drug acts like a stimulant. Can an expert review and correct the second and this sentence in this paragraph of the present article?
 * Mahnut 22:58, 10 June 2014 (UTC)


 * Fixed a couple. Red once you have made a few changes you will be able to fix these issues to. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:07, 10 June 2014 (UTC)