in adults, a reality that can cost millions
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Mardomingo Professor at the Complutense University, Madrid.
Chief, Child Psychiatry and Psychology.
Hospital GU Gregorio Marañón, Madri d. In recent days ADANA held in Barcelona, \u200b\u200bwhere Chief, Child Psychiatry and Psychology.
commemorating the tenth anniversary of its foundation, a person in the audience
does it make sense to devote so much time and effort to carry out the treatment psychiatric disorders, improve treatment and even cure clinical raised during the symposium an important question: is it worth
The question, apparently simple, based on the following reasoning : whether ADHD is a psychiatric disorder with a high genetic component
, and when the genes can not be changed a large number of patients. The way to do this is 
modify the mechanisms involved in the genesis and development of
disorder, these provisions do not necessarily eliminate a specific, identifiable cause modify the mechanisms involved in the genesis and development of . This is, among other reasons, because disease rarely respond to a single cause. 
Even in cases where that happens, as in infectious diseases, the response to treatment depends on other factors such as complementary
individual's immune defenses and other personal and environmental circumstances Even in cases where that happens, as in infectious diseases, the response to treatment depends on other factors such as complementary .
So back to the question, is it worth treating ADHD?
The answer is yes, because it supports the evolution so different from the patients when compared with untreated patients.
children are treated much better in school, feel happy
in relationships with peers, have less conflict with parents
and teachers feel more secure and confident with a more positive self-image, feel able to face life and the future and suffer less depression and anxiety. They also have a lower risk of having serious problems
behavior and drug use in adolescence. improvement rates with treatment are not negligible and
exceed those found in many other diseases. According to the study
the clinical forwards MTA in 59% of cases
treated with medication and 68% of cases
treated with medication and behavioral therapy.
In other studies, 70% of patients improve when treated with dopaminergic and noradrenergic drugs
.
Response to treatment depends on clinical and family
environmental, educational and social. The
therapeutic intervention must take into account the circumstances. The severity of symptoms and suffering
other related psychiatric disorders, also called comorbid
-worsens the prognosis, and the IQ
limit, the parents suffer
psychiatric disorders or who are unable to apply the criteria
educational facilities. Another key factor is that the patient and parents meet
treatment, based medication correctly
and engaging in therapeutic commitments acquired.
According to the MTA study
treatment response depends not only on the type of therapy that is applied but also on factors
called mediators and moderators. Mediate,
assistance to medical appointments, which is an essential aspect of
-compliance, prescription of medication by the medical and educational effectiveness
parents. Moderators factors
response to treatment the patient's sex, comorbidity, socioeconomic status
disadvantaged, the severity of the symptoms, the
parents suffer psychiatric disorders and Intellectual Quotient
child. The choice of one form or another
therapeutic intervention must take into account these circumstances, so that treatment
be customized.
analysis of the MTA results shows that in view
parents of children with comorbid depression
respond better to cognitive-behavioral therapy than those who suffer from anxiety.
teachers also believe that children from a disadvantaged socioeconomic
level, the most effective treatment is the
combines medication with behavioral therapy.
On the other hand, parental depression is one of the factors that
more clearly contributes to decrease the effectiveness of treatment
considerably worse prognosis.
Another point to note is that the sex of children is not a
factor in determining the efficacy of treatment nor the fact that
and previously treated with stimulant drugs.
children to improve more in the study are those that satisfy three conditions:
taking medication, following a behavior therapy and having parents
able to implement educational criteria
aimed at controlling the child's behavior and discipline.
Authors This study concluded that
can identify five groups of patients between those who are treated well only
medication or with medication and behavior therapy:
Group A:
children with mild initial symptoms of ADHD and low depressive symptoms
parents. 73% have an excellent response to treatment
.
Group B:
children with mild initial symptoms of ADHD and depression of moderate-severe
parents. 59% have an excellent response to treatment
.
Group C:
children with initial symptoms of moderate to severe ADHD and Intellectual Quotient
high, and parents with depression moderate to severe. The excellent response rate to treatment
al48% down.
Group D:
children with initial symptoms of moderate to severe ADHD and mild depression
parents. Excellent response in 48%.
Group F:
children with initial symptoms of moderate to severe ADHD and Intellectual
ratio low, and parents with moderate to severe depression. The excellent response rate with
is only 10%.
In conclusion it worth treating ADHD? Yes, it's worth,
but the effectiveness of treatment depends on many factors, some
the patient, other family and others from the expertise of the doctor who
must know how to choose the most appropriate therapeutic interventions for each patient
. References
- Owens EB, Hinshaw SP, Arnold LE, et al. Which
Treatment for ADHD with Whom? Moderator of Treatment response in the MTA. J.
Consult Clin Psaychol. 2003, 71:540-552.
- Hinshaw SP.
Moderators and Mediators of Treatment outcome for youth
with ADHD: Understanding for Whom and how interventions work
. J Ped Psychol. 2007, 32:664-675.
Source:
http://edu.jccm.es/cpr/valdepenas/index.php?option=com_remository&Itemid=100002&func=startdown&id=504
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