Treating Attention Deficit Disorder

A carefully monitored medication program is more effective than intensive behavioral treatment for children with attention-deficit/hyperactivity disorder (ADHD), according to a new study.

The study also concludes that a combination of medicine and behavioral therapy can be even better.

The study's main findings apply to a child's ADHD symptoms, including concentration problems and impulsiveness. But when it comes to non-ADHD symptoms, such as anxiety, poor social skills and academic performance, combining medicine and psychosocial treatments was most effective.

ADHD is the most commonly diagnosed disorder in children, affecting an estimated 3 percent to 5 percent of school-age children.

The study, published in the December issue of the American Medical Association's Archives of General Psychiatry, tracked about 600 7- to 10-year-olds over 14 months at six locations across the country. The lead author of the study, done in concert with Columbia University, was Peter Jensen of the National Institute of Mental Health.

A second, related study found that for children with anxiety disorders as well as ADHD, behavioral treatments alone can be just as effective as medicine. That study, which asked which treatments worked best for specific groups of children, was written by Stephen P. Hinshaw, a psychologist at the University of California at Berkeley.

He concluded that Jensen's findings applied to all children studied regardless of gender, medication history or history of disruptive disorders. The only significant exception was children with anxiety disorders.

The Strain of Ailing Spouses

The strain of caring for an ailing spouse can be deadly for the elderly. Elderly husbands or wives who are strained by providing such care are 63 percent more likely to die within four years than other spouses, a study found.

Richard Schulz, a psychiatry professor and director of the University Center for Social & Urban Research at the University of Pittsburgh and colleagues tracked 819 spouses, age 66 to 95. A total of 317 were responsible for helping a spouse move around the house, eat or go to the bathroom, or handled the partner's laundry, housework or shopping.

Of those 317 caregivers, 179 reported strain. The strained caregivers had higher levels of depression and were less likely than other spouses to get enough exercise and rest or to see a physician when they were sick.

"My hunch is that these people are frail. They're relatively old. They have their own health problems generally," Schulz said.

Past studies have suggested that loss, prolonged distress, the physical demands of caregiving and the biological vulnerability of older people may lead to health problems in elderly caregivers, the researchers noted in today's Journal of the American Medical Association.

The spouses who needed care suffered from such ailments as arthritis, congestive heart failure, strokes and Alzheimer's disease.

The strained caregivers, like the spouses studied, died of such things as heart disease, stroke, cancer, pneumonia and kidney failure.