Conference facts and important ADHD research results

Finally: my presentation

I was told 3600 persons attended this conference; people from all over the world.

Each day there were dozens of presentations and I visited 4 out of 6 new research poster sessions. Each presenting roughly 45 posters with new research findings.
Some highlights:

* Paula Riggs presented her study in which she compared Stimulant treatment + Cognitive Behavioral Therapy (CBT) with Placebo + Cognitive Behavioral Therapy to adolescents with ADHD and Substance Use Disorders. It appeared that both groups had lower rates of both ADHD symptoms and (after one month follow up) lower number of days of substance use.

* On a poster I saw an intriguing finding: Level of Iron seems to have influence on the level of responding to stimulant treatment in children with ADHD. For me a new way of thinking about factors influencing effectiveness of medicinal treatment!

* In our symposium Patricia van Wijngaarden reported on under diagnosing ADHD in young girls and women.

And finally I had my presentation on the Prevalence of ADHD in adolescents and adults with Substance Use Disorders. Although our symposium was scheduled on Saturday at lunchtime, we still had over 50 attendees. It was an international audience, with people coming from Mexico, Norway, Spain, China etc.

The work is done. Tomorrow I will travel back home. Thank you for reading this blog!

PS – 2-4th December 2009 ICASA will have it’s seventh meeting. We will decide on ICASA’s future: becoming a formal foundation early in 2010. We will also discuss our first strategic plan, including short term directions (2010) and mid-term goals and actions (2011-2015).
During this period I will post news via this blog regularly. You are most welcome to visit this blog and send me your thoughts on research on ADHD and Substance Abuse.

Mixed news, mixed feelings

Preparing my presentation

Yesterday I attended the symposium “New research on ADHD”. New results were presented in the research on two groups of ADHD children who had been followed for 10 years.

In one group children were treated with stimulant medications, and in the other group they were not. In 2008 this research group already reported on the results towards development of Substance Abuse. After ten years no protective effect of stimulant treatment was found, nor an increase of substance abuse. After former claims of the same research group on the protective effect of stimulant medication on development of substance abuse, this was disappointing news.

Now results of stimulant treatment were presented on development of other psychiatric disorders. It proved stimulant treatment had a remarkable protective effect (not only significant but of clinical importance) on the development of mood disorders, anxiety disorders, conduct disorder and oppositional defiant disorder. This of course is very important news, and if supported in future research, it will be a landmark study.

For the link between ADHD and Substance Abuse, it is important to know that stimulant treatment might stop development of conduct disorder. Important, because the combination of ADHD and Conduct Disorder is a very strong indicator for development of severe Substance Abuse.

The day before yesterday I heard of the protective effect of Cognitive Behavioral Therapy in ADHD patients for development of SUD. Yesterday this news on the protective effect of stimulant treatment for development of conduct disorder. I am looking forward to the symposium on the treatment of adolescents with both ADHD and Substance Abuse with stimulants, organized by prof. Paula Riggs, which I will attend today.

Tomorrow I will present on the Prevalence of ADHD in Substance Use Disorders patients and on preliminary results of the European ADHD in Substance use disorders Prevalence (EASP) study. I am preparing this presentation, as you can see on the picture on the right. But sometimes this is really hard, for the sun and the ocean so close by are tempting…

Aloha!

Honolulu

Yesterday I travelled from Minneapolis via Los Angeles to Hawaii. In half a day I saw snow on the Rocky Mountains, the desert in Southern California, the endless pacific Ocean and Oahu Island. The Annual Conference of the American Academy of Child & Adolescent Psychiatry, AACAP, is held at the Hilton Hawaiian Village Resort. This resort is located at Waikiki Beach. Stepping out of the elevator means steppin’ out on the beach. I am a lucky guy…

So back to work. This morning at 6.30 my program started with a full day on ADHD research: ADHD: Neuroimaging, Psychopharmacology, and Comorbidity. And what a day it was…

Neuroimaging clearly shows the differences in brain functioning of patients with and without ADHD. And not only dopamine is involved in ADHD, but many other neurotransmitters. The knowledge on how a person deals with his inhibitions and the reward system is increasing. There are clear deficits in these systems. Interesting is that these systems also play an important role in substance use disorders.

This knowledge can lead to:
1) further research on the involved systems + related genes,
2) development of new treatments (mew medication, other treatment and combinations of these);

There is growing evidence that specific genes are involved in the effectiveness of medication for ADHD. In the future it will be possible to first test children genetically, before they get specific medication. Their genetic profile will tell us more about the expected response rate and what is the best treatment for individual patients.

I learned a lot about the MTA study on the short and longterm outcome of treatment of ADHD. It was interesting to hear that early cognitive behavioral therapy seemed to have a protective effect on the development of Substance Use Disorders! That is good news!