Thursday, June 19, 2008

Diagnosing ADHD in Brazil - (post under construction)

It seems that Brazil is following US parameters to diagnose ADHD. According to this review -it's an English version - the Rio Grande do Sul Psychiatry Magazine:

"For the diagnosis of the adult, it is necessary to evaluate whether there are comorbidities that may justify the reported symptoms and impairment. The presence of psychiatric comorbidities is extremely common in ADHD, in children and adolescents and in adults as well, and significantly changes the clinical presentation of the prognosis.73 In the National Comorbidity Survey-Replication,71 the diagnosis of other psychiatric disorders in adults with ADHD was significantly higher than what is expected by the respective prevalence in the general population.74 In our country, a study with children and adolescents showed that the profile of comorbidities in the ADHD is similar even in different sociocultural contexts.75 Many symptoms of the DMS-IV listed for the ADHD are identical or similar to symptoms listed in the diagnosis of other disorders, and the differential diagnosis demands a specialized evaluation.65 Inattention, for example, is one of the symptoms listed for the diagnosis of mood disorder in the DSM-IV system.

65. Milberger S, Biederman J, Faraone SV, Chen L, Jones J. ADHD is associated with early initiation of cigarette smoking in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1997;36(1):37-44. [ Links ]

71. Biederman J, Kwon A, Aleardi M, Chouinard VA, Marino T, Cole H, et al. Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects Am J Psychiatry. 2005;162(6):1083-9. [ Links ]

72. Grevet EH, Bau CH, Salgado CAI, Fischer AG, Kalil K, Victor MV, et al. Lack of gender effects on subtype outcomes in adults with attention-deficit/hyperactivity disorder: support for the validity of subtypes. Eur Arch Psychiatry Clin Neurosci. In press. [ Links ]

73. Biederman J. Impact of comorbidity in adults with attention deficit/hyperactivity disorder. J Clin Psychiatry. 2004;65 Suppl 3:3-7. [ Links ]

74. Biederman J, Faraone SV, Monuteaux MC, Bober M, Cadogen E. Gender effects on attention-deficit/hyperactivity disorder in adults, revisited. Biol Psychiatry. 2004;55(7):692-700. [ Links ]

The review has the following footnote:

* Some authors are part of the consulting board, are lecturers or received research funds from the following laboratories: Biosintética, Bristol-Meyers-Squibb, Glaxo, Janssen-Cilag, Lilly, Lundbeck, Novartis, Pfizer, and Wyeth.

"What Dick Cheney is to the U.S. invasion of Iraq, psychiatrist Joseph Biederman is to the explosion of psychiatric medications in American children."
Bruce Levine said.

I just hope that all criticism of Mr. Biederman's work in US is spread all over the world for the drugs that are used in these diseases are global.

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