ADHD and fetal alcohol spectrum disorders (FASD).

This multi-author book will discuss the history and clinical presentation of Foetal Alcohol Spectrum Disorders(FASD) i.e Fetal Alcohol Syndrome (FAS) and Alcohol Related Neurodevelopmental Disorder (ARND). These developmental neuropsychiatric disorders result from prenatal exposure to alcohol during any gestational period of pregnancy. The book will particularly address the co-occurring presence of ADHD in patients with FASD. ADHD is the most frequent neuropsychiatric presentation of FASD throughout the lifespan and it is particularly difficult to manage because the underlying pathophysiology is related to prenatal neurotoxic brain injury. Although prenatal alcohol exposure , and the resulting FASD, is recognised as the commonest preventable cause of intellectual disability, many clinicians and educators are not aware that 75 to 80% of the patients with FASD have I.Q.s over 70. Thus, the neuropsychiatric presentation of FASD can often be unrecognised or misunderstood. FASD are the true clinical ' masqueraders' and ADHD is their most likely disguise! The authors are all experienced professionals from a wide range of disciplines working throughout the USA and Canada. They have been involved in the diagnosis, research and management of FASD for many years and this book will bring their collective knowledge regarding management from infancy to adulthood to an inter-professional audienceThis resource was contributed by The National Documentation Centre on Drug Use.

Personality Disorder: A Diagnosis for Inclusion - The Northern Ireland Personality Disorder Strategy - The Way Forward - June 2010

Personality Disorder: A Diagnosis for Inclusion - The Northern Ireland Personality Disorder Strategy - The Way Forward - June 2010

A Comparative Study of Healthcare Professionals' Attitudes towards Clients with Dual Diagnosis.

The aim of this study was to explore the attitudes of Healthcare Professionals who work in the Substance Misuse Services compared to Healthcare Professionals who work in the Acute Mental Health Services towards clients with a dual diagnosis. A Likert type questionnaire was carried out between the two services, (n=45) from Substance Misuse and (n+54) from Mental Health Services of the multidiscipline teams. The results showed that there was a significant difference between the attitudes of the Healthcare Professionals in both Services. The Healthcare Professionals from the Substance Misuse Services displayed a more positive attitude towards clients with duel diagnosis, than professionals from the Acute Mental Health Services. These negative attitudes may affect the quality of care given to clients with a dual diagnosis. Healthcare Professionals need more knowledge and understanding about effective treatment for this client group. It is important that through collaboration from both services the care and treatment for clients with a dual diagnosis can be at optimal level.This resource was contributed by The National Documentation Centre on Drug Use.

A guide for the management of dual diagnosis for prisons.

Dual diagnosis, the co-extistence of mental health and substance misuse problems, has a higher prevalence in prisons than in the general community. This document provides good practice guidance to commissioners and practitioners on for the management of dual diagnosis within a prison setting.This resource was contributed by The National Documentation Centre on Drug Use.

Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults.

Attention Deficit Hyperactivity Disorder (ADHD) is a childhood onset psychiatric disorder that can persist into adulthood in up to 50% of patients. From a clinical point of view, ADHD is characterized by hyperactivity, mood instability, irritability, difficulties in maintaining attention, lack of organization and impulsive behaviours. The presence of other disorders occurring at the the same time is also common, especially mood disorders and substance abuse. It seems that amphetamines could reverse the underlying neurological problems that feature in ADHD, and so improve ADHD symptoms. We found seven studies, which enrolled 1091 patients. These studies compared amphetamines to placebo and three of them also compared amphetamines with other drugs: guanfacine, modafinil and paroxetine. Three amphetamine derivatives were investigated: dexamphetamine, lisdexamphetamine and mixed amphetamine salts (MAS). Treatment length ranged from two to 20 weeks. All amphetamines improved ADHD symptoms but overall they did not make people more likely to stay in treatment and were associated with a higher risk of treatment ending early due to adverse events. One type of amphetamine, mixed amphetamine salts, did, however, increase retention in treatment. We found no evidence that higher doses worked better than lower ones. We did not find any difference in effectiveness between immediate-release and sustained-release formulations. Therefore, it appears that short-term treatment with amphetamines reduces ADHD symptoms, but studies assessing the effects of amphetamines for longer periods of time are needed.This resource was contributed by The National Documentation Centre on Drug Use.

International ADHD in substance use disorders prevalence study.

Dr Van Hout has been invited by the ICASA network and IASP research team [Drs Geurt van de Glind; Trimbos Institute, The Netherlands; Dr Pieter-Jan Carpentier, ICASA; Josep Antoni Ramos-Quiroga, University of Barcelona, Spain, Professor Dr Frances Levin, University of Columbia, New York, USA and Professor Dr. Wim van den Brink, University of Amsterdam, The Netherlands] to undertake the research protocol for Ireland as part of this European study of the prevalence of ADHD in adult patients referred for treatment of addiction problems. The research team at Waterford Institute of Technology, School of Health Sciences will undertake this national study as part of the International Collaboration on ADHD and Substance Abuse [ICASA] â?~International ADHD in Substance Use Disorders Prevalence Studyâ?T [IASP study]. The International Collaboration on ADHD and Substance Abuse [ICASA] will provide Dr Van Hout and her team with full support from ICASA of the measurement instruments available and a central database at the University of Amsterdam, and will undergo training for procedures for data capture from Dr van de Glind, Trimbos Institute, The Netherlands. Eight European countries (Norway, Sweden, the Netherlands, Belgium, France, Spain, Switzerland and Hungary) USA and Australia have already participated in the first phase of the IASP study, which will close in September 2011. Over 2500 Substance Use Disorder [SUD] patients were sampled with approximately 38% scoring positive on the ADHD screener (ASRS). Of these 2500 patients over 1000 patients were evaluated on ADHD, Depression, Bipolar Disorder, Anti-Social Personality and Borderline Personality Disorder. A preliminary estimate of the prevalence of ADHD in SUD treatment seeking patients was recorded at 20 %. The second phase of study [IASP 2011] will commence in September 2011 for countries including Ireland, South Africa, Egypt and Brazil. Dr Van Hout has also been invited to partake in a systematic review paper on the risk factors for development of SUD in children/adolescents with ADHD in collaboration with the ICASA foundation.This resource was contributed by The National Documentation Centre on Drug Use.

Dual diagnosis in mental health inpatient and day hospital settings.

Many mental health patients also have substance misuse problems, so mental health service staff need to be skilled to provide simple prevention and treatment interventions, assisted by drug and alcohol specialists. This guidance covers the assessment and clinical management of patients with mental illness being cared for in psychiatric inpatient or day care settings who also use or misuse alcohol and/or illicit or other drugs*. It also covers organisational and management issues to help mental health services manage these patients effectively. The key message is that the assessment and management of drug and alcohol use are core competences required by clinical staff in mental health services. The guidance aims to: â?¢ encourage integration of drug and alcohol expertise and related training into mental health service provision; â?¢ provide ideas and guidance to front-line staff and manages to help them provide the most effective therapeutic environments; â?¢ help mental health services plan action on dual diagnosisâ? .This resource was contributed by The National Documentation Centre on Drug Use.

World Alzheimer Report 2011 - The benefits of early diagnosis and intervention

Alzheimer's Disease International released the World Alzheimer Report 2011 - The benefits of early diagnosis and intervention on the 13th September 2011. Key Findings:As many as three-quarters of the estimated 36 million people worldwide living with dementia have not been diagnosed and hence cannot benefit from treatment, information and care. In high-income countries, only 20-50% of dementia cases are recognized and documented in primary care. In low- and middle-income countries, this proportion could be as low as 10%.Failure to diagnose often results from the false belief that dementia is a normal part of aging, and that nothing can be done to help. On the contrary, the new report finds that interventions can make a difference, even in the early stages of the illness.Drugs and psychological interventions for people with early-stage dementia can improve cognition, independence, and quality of life. Support and counseling for caregivers can improve mood, reduce strain and delay institutionalization of people with dementia.Governments, concerned about the rising costs of long-term care linked to dementia, should “spend now to save later.” Based on a review of economic analyses, the report estimates that earlier diagnosis could yield net savings of up to US$10,000 per patient in high-income countries.��World Alzheimer Report 2011 - Executive Summary (PDF, 36 pages, 1128KB)World Alzheimer Report 2011 (PDF, 72 pages, 1710KB)����