Is ADHD Being Over-Diagnosed For Cash?
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Is ADHD Being Systematically Overdiagnosed?
The BBC’s investigative “Panorama” program all so recently did a documentary in which one of their journalists—who does not have ADHD—went to three private clinics and got an ADHD diagnosis from each of them:
- The BBC documentary: Private ADHD Clinics Exposed (28 mins)
- Their “5 Minutes” version: ADHD Undercover: How I Was Misdiagnosed (6 mins)
So… Is it really a case of show up, pay up, and get a shiny new diagnosis?
The BBC Panorama producers cherry-picked 3 private providers, and during those clinical assessments, their journalist provided answers that would certainly lead to a diagnosis.
This was contrasted against a three-hour assessment with an NHS psychiatrist—something that rarely happens in the NHS. Which prompts the question…
How did he walk into a 3-hour psychiatrist assessment, when most people have to wait in long waiting lists for a much more cursory appointment first with assorted gatekeepers, before going on another long waiting list, for an also-much-shorter appointment with a psychiatrist?
That would be because the NHS psychiatrist was given advance notification that this was part of an investigation and would be filmed (the private clinics were not gifted the same transparency)
So, maybe just a tad unequal treatment!
In case you’re wondering, here’s what that very NHS psychiatrist had to say on the topic:
Is it really too easy to be diagnosed with ADHD?
(we’ll give you a hint—remember Betteridge’s Law!)
❝Since the documentary aired, I have heard from people concerned that GPs could now be more likely to question legitimate diagnoses.
But as an NHS psychiatrist it is clear to me that the root of this issue is not overdiagnosis.
Instead, we are facing the combined challenges of remedying decades of underdiagnosis and NHS services that were set up when there was little awareness of ADHD.❞
~ Dr. Mike Smith, Psychiatrist
The ADHD foundation, meanwhile, has issued its own response, saying:
❝We are disappointed that BBC Panorama has opted to broadcast a poorly researched, sensationalist piece of television journalism.❞
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What is childhood dementia? And how could new research help?
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“Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around 1,400 Australian children and young people live with currently untreatable childhood dementia.
Broadly speaking, childhood dementia is caused by any one of more than 100 rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same.
Half of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die before turning 18.
Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure.
More about the causes
Most types of childhood dementia are caused by mutations (or mistakes) in our DNA. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia.
Two-thirds of childhood dementia disorders are caused by “inborn errors of metabolism”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail.
As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs.
Childhood dementia is linked to rare genetic disorders. maxim ibragimov/Shutterstock What happens to children with childhood dementia?
Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia progressively lose all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning.
Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures.
The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around two years old. The symptoms are caused by significant, progressive brain damage.
Are there any treatments available?
Childhood dementia treatments currently under evaluation or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, gene-modified cell therapy and protein or enzyme replacement therapy. Enzyme replacement therapy is available in Australia for one form of childhood dementia. These therapies attempt to “fix” the problems causing the disease, and have shown promising results.
Other experimental therapies include ones that target faulty protein production or reduce inflammation in the brain.
Research attention is lacking
Death rates for Australian children with cancer nearly halved between 1997 and 2017 thanks to research that has enabled the development of multiple treatments. But over recent decades, nothing has changed for children with dementia.
In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for childhood dementia. This is despite childhood dementia causing a similar number of deaths each year as childhood cancer.
The success for childhood cancer sufferers in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes.
Dementia is not just a disease of older people. Miljan Zivkovic/Shutterstock Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An analysis published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia.
Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves.
That said, we’ve seen a slowing in the establishment of clinical trials for childhood dementia across the world in recent years.
In addition, we know from consultation with families that current care and support systems are not meeting the needs of children with dementia and their families.
New research
Recently, we were awarded new funding for our research on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments.
More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions.
Dr Kristina Elvidge, head of research at the Childhood Dementia Initiative, and Megan Maack, director and CEO, contributed to this article.
Kim Hemsley, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University; Nicholas Smith, Head, Paediatric Neurodegenerative Diseases Research Group, University of Adelaide, and Siti Mubarokah, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Managing [E-word] Dysfunction Reactions
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!
As for questions we’re answering today…
Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?
When it comes to that particular issue, one or more of these three factors are often involved:
- Hormones
- Circulation
- Psychology
The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.
To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:
Hormones
Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.
This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.
Circulation
Look after your heart health; eat for your heart health, and exercise regularly!
Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.
Psychology
[E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!
Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).
So, to recap, we recommend:
- Have your hormones checked
- Look after your circulation
- Make the decision to have fun!
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What Different Kinds of Hair Loss/Thinning Say About Your Health
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Dr. Siobhan Deshauer shows us different kinds of hair loss, what causes them, and what can be done about them:
Many different causes
Here’s how to tell them apart:
- Alopecia areata is an autoimmune condition where the immune system mistakenly attacks hair follicles, causing hair loss that can occur at any age and affects about 1 in 50 people. It often presents as smooth patches of hair loss and can be treated with steroid injections. Severe cases may require high-dose prednisone, which can restore hair growth over time.
- Discoid lupus is an autoimmune disease that affects the skin, leading to inflammation, scarring, and permanent hair loss. Unlike alopecia areata, it causes visible damage to the scalp and hair follicles. This type of lupus typically does not involve internal organs, unlike systemic lupus.
- Telogen effluvium occurs when a major systemic shock, such as an infection, surgery, or significant stress, triggers many hair follicles to enter the resting phase simultaneously, resulting in delayed hair shedding. The condition is diagnosed with a “hair pull test” and is typically temporary, as the resting phase is followed by normal hair growth phases.
- Allergic reactions to products, such as hair dye containing PPD, can cause hair loss due to scalp irritation and inflammation. An allergic response may trigger hair follicles to enter a resting phase, leading to hair loss by the same mechanism as telogen effluvium. Treatment with steroids can calm the reaction, and hair usually regrows after recovery.
- Syphilis, a sexually transmitted infection, can present with varied symptoms, including hair loss in a distinct moth-eaten pattern. Hair loss due to syphilis is reversible and curable with penicillin treatment, with hair regrowth typically occurring a few months after treatment.
- Biotin deficiency is rare due to its production by gut bacteria and presence in foods such as nuts, seeds, and beans such as soybeans. Deficiency can result from excessive consumption of raw egg whites, which block absorption. Severe deficiency causes hair loss and skin issues but can be treated effectively with biotin supplements.
- Iron deficiency anemia can cause hair thinning along with symptoms like fatigue and breathlessness. It often results from inadequate dietary intake, but can also occur after heavy menstrual bleeding. Treatment with iron supplements, or blood transfusions in severe cases, can restore both hair and energy levels, leading to significant improvements.
- Trichotillomania is a psychological condition marked by an uncontrollable urge to pull out one’s hair, often associated with anxiety or depression. Hair patches may show different stages of regrowth. While it can be challenging to manage, the condition can be treated with appropriate psychological and medical support.
- Traction alopecia results from hairstyles that exert prolonged tension on the hair, causing it to thin or fall out. This type of hair loss can be prevented by reducing the strain on the hair. Loosening hairstyles and giving the scalp a break can help hair regrow over time.
- Hypothyroidism causes symptoms like fatigue, dry skin, and hair thinning due to insufficient thyroid hormone production—however, it can be managed with diet, and if necessary, thyroid medications.
- Zinc deficiency may also cause hair loss and a characteristic rash. Treatment with zinc supplements can significantly improve hair growth and other symptoms.
- Medications, such as chemotherapy drugs, Accutane, and anti-seizure medications like valproic acid, are known to cause hair loss as a side effect. This type of hair loss is often reversible once the medication is stopped.
- Male pattern hair loss, or androgenic alopecia, is influenced by testosterone and genetic risk factors—which, contrary to popular belief, can come from either or both sides of the family. Early onset, especially before age 40, is linked to an increased risk of heart disease. However, effective treatments are available, and early intervention is beneficial.
- Female pattern hair loss is basically the same thing as male pattern hair loss (indeed, it is literally still androgenic alopecia), just a) almost always much less severe and b) with a gender-appropriate name. It affects up to 40% of women by age 50 and is characterized by thinning hair at the top of the head. It’s related to hormonal imbalances involving testosterone, such as those seen in PCOS and menopause, amongst other less common causes. Early treatment can be effective, and research is ongoing to develop more targeted therapies.
Dr. Siobhan Deshauer advises, if you’re experiencing hair loss, to monitor other symptoms too if applicable, take photos for tracking, and consult a doctor early for diagnosis and potential treatment.
For more on all of this plus visual illustrations, enjoy:
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Want to learn more?
You might also like to read:
Take care!
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Moringa Oleifera Against CVD, Diabetes, Alzheimer’s & Arsenic?
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The Healthiest Drumstick
Moringa oleifera is a tree, whose leaves and pods have medicinal properties (as well as simply being very high in nutrients). It’s also called the drumstick tree in English, but equally often it’s referred to simply as Moringa. It has enjoyed use in traditional medicine for thousands of years, and its many benefits have caught scientists’ attention more recently. For an overview before we begin, see:
Now, let’s break it down…
Anti-inflammatory
It is full of antioxidants, which we’ll come to shortly, and they have abundant anti-inflammatory effects. Research into these so far has mostly beennon-human animal studies or else in vitro, hence the guarded “potential” for now:
Potential anti-inflammatory phenolic glycosides from the medicinal plant Moringa oleifera fruits
Speaking of potential though, it has been found to also reduce neuroinflammation specifically, which is good, because not every anti-inflammatory agent does that:
Antioxidant
It was hard to find studies that talked about its antioxidant powers that didn’t also add “and this, and this, and this” because of all its knock-on benefits, for example:
❝The results indicate that this plant possesses antioxidant, hypolipidaemic and antiatherosclerotic activities and has therapeutic potential for the prevention of cardiovascular diseases.
These effects were at degrees comparable to those of simvastatin.❞
~ Dr. Pilaipark Chumark et al.
Likely a lot of its benefits in these regards come from the plant’s very high quercetin content, because quercetin does that too:
Quercetin reduces blood pressure in hypertensive subjects
For more about quercetin, you might like our previous main feature:
Fight Inflammation & Protect Your Brain, With Quercetin
Antidiabetic
It also has been found to lower fasting blood sugar levels by 13.5%:
Anti-arsenic?
We put a question mark there, because studies into this have only been done with non-human animals such as mice and rats so far, largely because there are not many human volunteers willing to sign up for arsenic poisoning (and no ethics board would pass it anyway).
However, as arsenic contamination in some foods (such as rice) is a big concern, this is very promising. Here are some example studies, with mice and rats respectively:
- Protective effects of Moringa oleifera Lam. leaves against arsenic-induced toxicity in mice
- Therapeutic effects of Moringa oleifera on arsenic-induced toxicity in rats
Is it safe?
A popular food product through parts of Africa and (especially) South & West Asia, it has a very good safety profile. Generally the only health-related criticism of it is that it contains some anti-nutrients (that hinder bioavailability of its nutrients), but the nutrients outweigh the antinutrients sufficiently to render this a trifling trivium.
In short: as ever, do check with your doctor/pharmacist to be sure, but in general terms, this is about as safe as most vegan whole foods; it just happens to also be something of a superfood, which puts it into the “nutraceutical” category. See also:
Review of the Safety and Efficacy of Moringa oleifera
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Maximize Your Misery! (7 Great Methods)
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Let’s imagine that instead of being healthily fulfilled in life, you wanted to spend your days as miserable as possible. What should you do?
Here are a few pointers:
Stay still
Avoid physical activity and/or outdoor exposure, to avoid any mood-lifting neurochemicals. In fact, remain indoors as much as possible, preferably in the same room.
If you want to absolutely maximize your misery, make your bedroom the sole space for all activities that it’s possible to do there.
Disrupt your sleep
Keep an irregular sleep schedule by varying your bedtime and wake-up times frequently. Sleep in as much as possible, and make up for it by staying up late to ensure ongoing exhaustion.
Maximize screentime
Use digital entertainment as much as possible to distract you from meaningful activities and rest—as a bonus, this will also help you to avoid self-reflection.
Begin and end your day with a device in hand.
Fuel negative emotions
If you’re going to focus on something, focus on problems you cannot control, to stoke the fires of anger and angst.
A good way of doing this is by staying informed about distressing events, while avoiding meaningful actions to address them. Contribute only in token gestures, and then lament the lack of change.
Follow your impulses
Act on short-term desires without considering long-term consequences, while avoiding behaviors that you know might improve your mood or wellbeing.
Trust that doing the same things that have not previously resulted in happiness, will continue to reliably deliver unhappiness.
Set goals to miss
It’s important that your goals should be vague, and overly ambitious in their scope and/or deliverability. Ideally you should also disregard any preparatory work that a person would normally do before embarking on such a project.
Bonus tip: you can further sabotage any chances of progress, by waiting for motivation to strike before you take any action.
Pursue happiness
Focus on chasing happiness itself, instead of improving your situation or skills. Treat happiness as an end goal, instead of a by-product of worthwhile activities.
Want to learn more?
If you’d like to know many more ways to be miserable, we featured these 7 from this book of 40, which we haven’t reviewed yet, but probably will one of these days:
How to Be Miserable: 40 Strategies You Already Use – by Dr. Randy Paterson
Alternatively…
If for some strange reason you’d rather not do those things, you might consider a previous article of ours:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Enjoy!
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More research shows COVID-19 vaccines are safe for young adults
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What you need to know
- Myocarditis, or inflammation of the heart muscle, is most commonly caused by a viral infection like COVID-19, not by vaccination.
- In line with previous research, a recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young people.
- A COVID-19 infection is much more likely to cause inflammation of the heart muscle than a COVID-19 vaccine, and those cases are typically more severe.
Since the approval of the first COVID-19 vaccines, anti-vaccine advocates have raised concerns about heart muscle inflammation, also called myocarditis, after vaccination to suggest that vaccines are unsafe. They’ve also used concerns about myocarditis to spread false claims that vaccines cause sudden deaths, which is not true.
Research has consistently shown that cases of myocarditis after vaccination are extremely rare and usually mild, and a new study from the CDC found no association between sudden cardiac death and COVID-19 vaccination in young adults.
Read on to learn more about myocarditis and what the latest research says about COVID-19 vaccine safety.
What is myocarditis?
Myocarditis is inflammation of the myocardium, or the middle muscular layer of the heart wall. This inflammation weakens the heart’s ability to pump blood. Symptoms may include fatigue, shortness of breath, chest pain, rapid or irregular heartbeat, and flu-like symptoms.
Myocarditis may resolve on its own. In rare cases, it may lead to stroke, heart failure, heart attack, or death.
What causes myocarditis?
Myocarditis is typically caused by a viral infection like COVID-19. Bacteria, parasites, fungi, chemicals, and certain medications can also cause myocarditis.
In very rare cases, some people develop myocarditis after receiving a COVID-19 vaccine, but these cases are usually mild and resolve on their own. In contrast, a COVID-19 infection is much more likely to cause myocarditis, and those cases are typically more severe.
Staying up to date on vaccines reduces your risk of developing myocarditis from a COVID-19 infection.
Are COVID-19 vaccines safe for young people?
Yes. COVID-19 vaccines have been rigorously tested and monitored over the past three years and have been determined to be safe for everyone 6 months and older. A recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young adults.
The benefits of vaccination outweigh any potential risks. Staying up to date on COVID-19 vaccines reduces your risk of severe illness, hospitalization, death, long COVID, and COVID-19-related complications, such as myocarditis.
The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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