Thursday, December 07, 2006
ADHD looked at in adults as well as children

By Dr. Anthony Policastro

I spend a lot of time treating patients with Attention Deficit Hyperactive Disorder (ADHD). The estimate is that about 5 percent of the population has ADHD. Many people think that ADHD is something that is ultimately outgrown. That is not true. About 5 percent of the adult population still has ADHD. It is just that outside the school setting the symptoms are not as obvious. It is important to treat ADHD in childhood. If it goes untreated, children are at high risk for developing other psychiatric problems. About 30 percent of children with ADHD will show signs of Oppositional Defiant Disorder. About 25 percent will develop a Conduct disorder. Some children will develop depression. Some will develop anxiety problems. One question I am often asked by parents of ADHD children is whether their child will get addicted to the drugs used to treat the problem. In reality, it appears that untreated ADHD is associated with a higher risk of substance abuse. Since ADHD is not outgrown, we should expect adults with it to have some of the other psychiatric problems that we see in children. A recent study in the American Journal of Psychiatry supports this. They looked at a group of individuals with various psychiatric diagnoses. They then looked to see how many in this group of individuals had ADHD. The thinking was that if the number was higher than the expected 5 percent, then the two were likely related. Since we know that ADHD is always present first in childhood, then the ADHD had to be there before the other problems. Since we know that untreated ADHD causes many of these problems, it was likely that the ADHD was one of the causes of the adult psychiatric problems. They looked at mood disorders. In patients with Major Depressive Disorders, 9.4 percent of them had ADHD. This is about twice the expected 5 percent rate. In patients with bipolar disorder, 21.2 percent of them had ADHD. This is about four times the expected rate. They looked at anxiety disorders. In patients with Post Traumatic Stress Disorder, 11.1 percent had ADHD. In patients with Generalized Anxiety Disorder, 11.9 percent of them had ADHD. There was no significant increase in ADHD in patients with Obsessive-Compulsive Disorder. They looked at substance abuse. The incidence of ADHD in patients with substance abuse was 10.8 percent. This is also about double what would be expected. They also looked at impulse control disorders. Patients with intermittent explosive disorder had a 12.3 percent incidence of ADHD. The study raised two questions. The first was whether the ADHD was the cause of the other psychiatric problem. The second was whether the psychiatric problem would improve if the ADHD were also treated. Neither of these questions was answered in the report. However, there is a suggestion that ADHD is indeed not something only to be considered in children.

Dr. Anthony Policastro is medical director at Nanticoke Memorial Hospital.

Public Health flu vaccination
Delaware's Division of Public Health announces its influenza vaccination schedule for Delawareans without a healthcare provider or whose insurance does not cover flu shots. While many DPH adult clinics accept walk in clients, DPH will vaccinate children by appointment only on scheduled days. Medicare Part B and donations are accepted.

Sussex County adult clinics
Dec. 7, Thursday, Blades Fire Hall, 200 East 5th St., Blades, 9 a.m.-1 p.m. Walk In Children under the age of 18 will be seen by appointment only at the DPH Clinics and State Service Centers. Parents or guardians interested in making appointments for flu shots may call one of these DPH clinics.
Sussex County, Georgetown State Service Center, 856-5213
Sussex County, Shipley State Service Center, 628-2006
For more about flu clinic locations and dates, go to

Grotto Festival of Trees
The Alzheimer's Association Delaware Valley Chapter is participating in the Grotto Festival of Trees. LifeCare at Lofland Park's Memory Walk Team for 2007 will sponsor a tree at the Grand Slam in Seaford. Make plans to visit one of this location before January 1 to make your donation in support of the Alzheimer's Association to fund local programs and services. Each store will donate an additional $250 to the charity whose tree receives the most donations. For more information, call the Georgetown Office at 854-9788.

Keep your Kitchen prepared for Winter Storms
Severe winter storms can knock out electricity, making it difficult to prepare meals at home. But you can be ready for anything Old Man Winter dishes up with a little planning and an emergency pantry of canned and packaged goods, says Maria Pippidis, family and consumer sciences educator for University of Delaware Cooperative Extension. Follow the items below to keep your kitchen prepared for power outages. Buy foods that are designed to have an extended shelf life, such as milk in aseptic cartons, which can last up to 6 months. Date containers at time of purchase and rotate emergency foods into the regular food supply to prevent them from getting beyond their use-by-date. To ensure adequate protein intake, include canned tuna, chicken, spaghetti with meat sauce, beans and peanut butter. Protein powders and protein bars, made from soy or whey, also are good options. For fiber and carbohydrates, stock up on canned fruits and vegetables, applesauce, soups and securely packaged whole-grain cereals and crackers. Bottled water and juices, as well as long-shelf milk, make better choices than sodas or sugary powdered juice mixes. Include a hand-operated can opener in your emergency pantry supplies. Keep a supply of paper plates, cups and utensils as well as hand sanitizer and soap. Remember to put aside water jugs for clean-up purposes.