copii energici
Raspunsuri - Pagina 5
anamari spune:
quote:
Are vreo 15 motive pentru care nu este considerat in societatea medicala un studiu valid printre care:
E ciudat ca eu am auzit o multime de medici care il citeaza....
eu cred ca lumea medicala e impartita...
quote:
nu are grup placebo, nu e double-blinded (cu asta inseminind ca toti subiectii stiau ce se asteapta de la ei si ce medicatie iau),5000 de copii au aplicat dar numai 500 au fost alesi,
Eu inteleg ca studiul a fost gandit sa dureze o perioada de 6 ani in care au fost observati copii din patru grupuri de tratament- terapie medicamentoasa cu vizite lunare si evaluari ale eficacitatii medicatiei , comportamental(terapeut, profesori,familie), combinat si in cadrul mediciniei de familie si familiei.S-au evaluat rezultatele dupa 3,9, 14 si 24 luni(studiul original)si apoi s-a continuat cu evaluari la 36,60 si 84 de luni... De aceea nu a existat grup placebo-care ar fi insemnat ca unul din grupuri nu primeste nici un fel de tratament timp de 6 ani dar traieste cu impresia ca primeste- ceea ce nu ar fi etic...din acelasi motiv subiectii erau constienti de medicatie.Cat priveste criteriul de selctie a celor 579 de copii- nu as putea sa ma pronunt din moment ce nu il cunosc.
quote:
nu a existat o diferenta in fapt intre tratamentul comportamental si cel medicamentos (cei care evaluau copiii ii observau in clase si i-au clasificat pe toti la fel daca te uiti pe grafic
Dat fiind fatul ca nu sunt de specialitate trebuie sa spun ca nu m-as baga sa interpretez materialul brut de capul meu, dar promit sa ma mai gandesc la acest aspect.
quote:
15% dintre subiecti au avut efecte secundare de la usoare la severe, fapt neconstatat in concluzie
Pentru ca nu era un studiu al efectelor secundare ci al eficientei tratamentului medicamentos. In cazul oricarui medicament un procentaj dintre cei tratati va nota efecte secundare de la usoare la severe-procentajul variaza in functie de medicatie si cred ca aici trebui intrebat cineva care lucreaza in domeniu cat de mare trebuie sa fie ca sa fie considerat relevant...
quote:
nu s-a observat nici o imbunatatire a performantelor academice sau sociale,
la care dintre grupuri te referi acum?
eu nu inteleg ca tratmentul combinat-medicatie + terapii comportamentale s-a dovedit mult mai eficace atunci cand existau conditii co-existente-tulburari de comportament si dizabilitati de invatare. De asemnea a imbunatatit relatiia cu parintii si profesorii.
quote:
si in final parintii au fost expusi inainte de clinical trials la propaganda firmelor respective.
asta nu am citit in lucrarea cu pricina...
artar spune:
Spuneti-mi si mie ,va rog, in ce consta terapia comportamentala sau unde pot gasi ceva date despre ea!(un link sau o carte..orice..)
Multumesc!
simali spune:
Eu de regula daca citesc simtomele unei boli incep sa fiu convinsa ca o am (afara de cazul in care boala nu presupune aparitia de manifestari exterioare clare de tipul pustule, unflaturi, singerari, etc.). Si cum copilul meu e o extensie a mea, incep sa cred ca are boala respectiva si el. De regula "paranoia" ma tine cateva zile bune. Asa ca acum mi-a intrat in cap ca sufar de AD/HD. Nu fac nimic special cand descopar ca "sufar" de o boala. Doar ma informez despre ea si ma comport ceva timp ca si cum as avea "simptomele" respective. Sper sa intelegeti ca multi oameni au cate o doaga sarita. Ca in rest sun normala...Dorm, mananc, ma rog...
Acum, ca "partenera" de suferinta:
- terapia medicamentoasa a avut ca rezultat la cineva imbunatatirea capacitatii de concentrare?
- in Romania, in reclamele TV, producatorul de GhincoPrim a asociat problemele de concentarre cu picioarele reci si deci cu o mai slaba circulatie periferica (creierul neirigat are un reandament sacazut). Stie cineva ceva despre asta? Eu am luat ceva vreme GhincoPrim (ghinco biloba) si mi se parea ca devin mai atenta la detalii... Dar eu ma si autosugestionez mult.
anamari spune:
quote:
eu nu inteleg ca tratmentul combinat-medicatie + terapii comportamentale s-a dovedit mult mai eficace atunci cand existau conditii co-existente-tulburari de comportament si dizabilitati de invatare. De asemnea a imbunatatit relatiia cu parintii si profesorii.
scuze, vroiam sa spun ca eu inteleg ca tratamentul comportamental a fost mult mai eficient in cazurile mai sus mentionate....
PS. o sa revin cu un comentariu la comentariul Andradei la articolele despre volumul creierului...
PPS. ceea ce vroiam sa ii transmit Ellei in finalul mesajului e ca experienta noastra personala nu e relevanta inttr-o discutie despre realitatea unei conditii(nu poate fi generalizata), doar ca poate explica interlocutorului de ce am ales o anumita pozitie in discutie...
anamari spune:
artar
singurul tip de tratament comportamental de care am auzit eu in RO ca se face in mod mai riguros e ABA- autism.ro.ABA nu e "conceput" pentru AD/HD dar poate fi adaptat, cred...
anamari spune:
simali
si eu sunt ipohondra nitel. De aceea chiar si in Ro am cautat pana am gasit doctori care sa imi raspunda la intrebari.
Medicatie
Fiul meu cel mare ia o varianta de Ritalin de 3 ani si in cazul lui functioneaza(mai am auzit si de alte cazuri, dar pe acesta il cunosc personal).E adevarat ca noi am adugat si terapie si educatie speciala atunci cand s-a putut -deci e o combinatie de factori.
Eu am avut dubii la inceput si am evitat cat s-a putut mai mult medicatia, dar o colega a sotului mi-a povesti despre efectul pozitiv asupra copilului ei asa ca am zis ca merita macar sa incerc pentru doua luni...si pentru ca rezultatele au fost foarte bune, iar efectele secundare minore am ales sa continuam tratamentul.
De ce Ritalin? Pentru ca e folosit din anii 20-deci de circa 80 de ani. In tratamentul AD/HD e folosit din anii 60 si pana acum nu am auzit de nici un scandal major. Sunt sigura ca exista efecte secundare asa cum exista in orice tratament medicamentos de intretinere-de aceea il monitorizez pe cat posibil (analize anuale,vizite de 3-4 ori pe an la doctor, anul trecut cand au spus ca s-au inrgistratat cazuri de moarte subita prin stop cardiac l-am dus la cardiolog pentru o evaluare cat mai completa...).
Daca ar face parte din acea sutime,miime de procent care au murit subit, fara sa existe vre un avertisment as fi devastata. Dar asta nu mi-ar schimba decizia, pentru numai eu stiu cat am plans in pumni cand nu vorbea, nu facea progrese, ma intrebam daca va invata vreodata sa scrie si sa citeasca, era calul de bataie al tuturor copiilor din jur,era marginalizat-un paria. Acum privesc un alt copil -un copil cu prieteni si succese scolare, un copil cu responsabilitati, cu sperante si sanse...un copil care din punctul meu de vedere are o viata mai buna decat cea dinainte. Si pentru mine calitatea vietii primeaza asupra lungimii ei.
Ginko-Bilboa
nu e un stimulat al circulatiei ci al sistemului nervos central-ca si Ritalinul. Numai ca nu face parte din "medicatia acreditata" si ca urmare nu se cunosc prea bine efectele secundare...aici nu se recomanda la copii.
da, anumite probleme "de circulatie" pot duce la probleme de concentratie , memorie etc.
Andrada spune:
quote:
Originally posted by anamari
[b] Si pentru mine calitatea vietii primeaza asupra lungimii ei.
Wow, putine mame au curajul sa spuna asta. Jos palaria!
A
PS Asta nu inseamna ca daca mi-ai fi vecina nu ne-am contrazice toata ziua si ne-am pumed si webmed si clinicaltrials.gov pina seara
.A
www.desprecopii.com/chatnew/Desprecopiichat/PaginapersonalaView.asp?nickname=Andrada" target="_blank">Camera lui Marcu
anamari spune:
multumesc Andrada
poate ca-i mai bine ca nu suntem vecine si ne pubmed, webmed pe forum.asa au acces si cei din Ro la mai multa informatie.
artar
la subiectul deprecopii altfel...a postat Paula un subiect pe ultimile pagini. poate te ajuta...
anamari spune:
quote:
Studiile genetice de genul asta nu spun in general mare lucru, si dupa cum spune si linkul tau materia respectiva a fost observata in mai multi subiecti nu numai cei ADHD si rude.
Si motivul pentru care studiile genetice de genul asta nu confirma nimic este tocmai pentru ca restul populatiei nu a participat in studiu, deci este posibil ca o multime de alti oameni sa aiba materia respectiva formata fara sa fie diagnosticati, pe cind cei care participa deja stiu ca au si sint pe medicatie (ceea ce deja poate schimba structura chimica a creierului).
Studiile cu pricina sustineau din ce am inteles eu ca se observa un volum mai mic de materie cenusie si alba din anumite zone ale creierului la persoanele cu simptome ADHD si rudele lor in comparatie cu grupul de control si ca aceasta diferenta este asociata cu prezenta unor modificari ale genelor dopaminice...(sa reamintim ca dopamina este unul dintre neurotransmitatorii generali-si anume o substanta chimica cu rol fundamental in transmiterea informatiei in sistemul nervos central).
Urmatorul studiu, face parte dintr-un grup ce urmaresc sa arate ca modificarile de volum nu se datoreaza medicatiei:
Un exemplu: http://www.nimh.nih.gov/Press/pradhdmri.cfm
acest studiu sustine ca in cazul copiilor medicati volumul materiei albe este mai apropiat de cel al grupului de control spre deosebire de copii care nu sunt medicati.
Studii in favoarea unei predispozitii genetice a AD/HD s-au facut si pe gemeni/frati care nu au crescut in aceeasi familie.
Cat despre faptul ca la aceste studii nu a participat toata populatia-la nici un studiu genetic nu participa toata populatia dar asta nu exclude toate ipotezele geneticii ca stiinta. Ce e considerat ca "grup relevant de studiu" din nefericire nu pot disputa pentru ca nu lucrez in cercetare medicala. as putea sa intreb insa...
anamari spune:
si uite aici o listuta cu cativa membri a societatii medicale si nu numai care accepta studiul despre tratamentul multi-modal.(e vorba de cei care au elaborat o declaratia interantionala care sustine ca AD/HD e o conditie reala , neurologica etc.etc.....).
David J. Kupfer, M.D.
Panel and Conference Chairperson
Thomas Detre Professor and Chair of Psychiatry
Western Psychiatric Institute and Clinic
Department of Psychiatry
University of Pittsburgh
Pittsburgh, Pennsylvania
Robert S. Baltimore, M.D.
Professor of Pediatrics, Epidemiology, and Public Health
Division of Infectious Diseases
Department of Pediatrics
Yale University School of Medicine
New Haven, Connecticut
Donald A. Berry, Ph.D.
Professor
Institute of Statistics and Decision Sciences
Duke University Medical Center
Durham, North Carolina
Naomi Breslau, Ph.D.
Director of Research
Department of Psychiatry
Henry Ford Health System
Detroit, Michigan
Everett H. Ellinwood, M.D.
Professor of Psychiatry and Pharmacology
Duke University Medical Center
Durham, North Carolina
Janis Ferre
Past Chair
Utah Governor's Council for People With Disabilities
Salt Lake City, Utah
Donna M. Ferriero, M.D.
Associate Professor of Neurology
Division of Child Neurology
Department of Neurology
University of California, San Francisco
San Francisco, California
Lynn S. Fuchs, Ph.D.
Professor
Department of Special Education
Peabody College
Vanderbilt University
Nashville, Tennessee
Samuel B. Guze, M.D.
Spencer T. Olin Professor of Psychiatry
Department of Psychiatry
Washington University School of Medicine
St. Louis, Missouri
Beatrix A. Hamburg, M.D.
Visiting Professor
Department of Psychiatry
Cornell University Medical College
New York, New York
Jane McGlothlin, Ph.D.
Assistant Superintendent for Curriculum and Instruction
Scottsdale Unified School District
Phoenix, Arizona
Samuel M. Turner, Ph.D., ABPP
Professor of Psychology
Director of Clinical Training
Department of Psychology
University of Maryland
College Park, Maryland
Mark Vonnegut, M.D.
Pediatrician
Milton Pediatrics
Quincy, Massachusetts
Speakers
Howard Abikoff, Ph.D.
"Matching Patients to Treatments"
Professor of Clinical Psychiatry
Director of Research
NYU Child Study Center
New York University School of Medicine
New York, New York
Sheila Anderson
"Individual and Family Barriers"
Immediate Past National President
Children and Adults With Attention Deficit Disorders
Plantation, Florida
L. Eugene Arnold, M.D., M.Ed.
"Treatment Alternatives for ADHD"
Professor Emeritus of Psychiatry
Ohio State University, Columbus
Sunbury, Ohio
Russell A. Barkley, Ph.D.
"ADHD: Long-Term Course, Adult Outcome, and Comorbid Disorders"
Director of Psychology
Department of Psychiatry
University of Massachusetts Medical Center
Worcester, Massachusetts
Joseph Biederman, M.D.
"Pharmacotherapy of ADHD: Nonstimulant Treatments"
Professor of Psychiatry, Harvard Medical School
Chief, Joint Program in Pediatric Psychopharmacology
Massachusetts and McLean General Hospitals
Boston, Massachusetts
Hector R. Bird, M.D.
"The Prevalence and Cross-Cultural Validity of ADHD"
Professor
Clinical Psychiatry
Columbia University
Deputy Director
Child Psychiatry
New York State Psychiatric Institute
New York, New York
Peter R. Breggin, M.D.
"Risks and Mechanism of Action of Stimulants"
Director
Center for the Study of Psychiatry and Psychology
Bethesda, Maryland
William B. Carey, M.D.
"Is ADHD a Valid Disorder?"
Clinical Professor of Pediatrics
University of Pennsylvania School of Medicine
Division of General Pediatrics
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania
Betty Chemers, M.A.
"The Impact of ADHD on the Juvenile Justice System"
Director of Research and Program Development
Office of Juvenile Justice and Delinquency Prevention
Washington, D.C.
C. Keith Conners, Ph.D., M.A.
"Overview of Attention Deficit Hyperactivity Disorder (ADHD)"
Director, ADHD Program
Department of Psychiatry
Duke University Medical Center
Durham, North Carolina
James R. Cooper, M.D.
"Availability of Stimulant Medications: Nature and Extent of Abuse and Associated Harm"
Associate Director for Medical Affairs
Division of Clinical and Services Research
National Institute on Drug Abuse
National Institutes of Health
Bethesda, Maryland
Louis Danielson, Ph.D.
"Educational Policy: Educating Children With Attention Deficit Disorders"
Director, Division of Research to Practice
Office of Special Education Programs
Office of Special Education and Rehabilitative Services
U.S. Department of Education
Washington, D.C.
Gretchen Feussner
"Diversion, Trafficking, and Abuse of Methylphenidate"
Pharmacologist
Drug and Chemical Evaluation Section
Office of Diversion Control
Drug Enforcement Administration
Arlington, Virginia
Steven R. Forness, Ed.D.
"The Impact of ADHD on School Systems"
Professor of Psychiatry and Biobehavioral Sciences
Neuropsychiatric Hospital
University of California, Los Angeles
Los Angeles, California
Laurence L. Greenhill, M.D.
"Stimulant Medications"
Research Psychiatrist II
New York State Psychiatric Institute
Columbia University
New York, New York
Stephen P. Hinshaw, Ph.D.
"Impairment: Childhood and Adolescence"
Professor of Psychology
Director of Clinical Psychology Training Program
Department of Psychology
University of California, Berkeley
Berkeley, California
Kimberly Hoagwood, Ph.D.
"A National Perspective on Treatments and Services for Children With ADHD"
Chief of Child and Adolescent Services Research
Services Research Branch
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Peter S. Jensen, M.D.
"Behavioral and Medication Treatments for ADHD: Comparisons and Combinations"
Associate Director for Child and Adolescent Research
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Charlotte Johnston, Ph.D.
"The Impact of ADHD on Social and Vocational Functioning in Adults"
Associate Professor
Department of Psychology
University of British Columbia
Vancouver, British Columbia
Canada
Peter W. Kalivas, Ph.D.
"Sensitization and the Risk of Exposure to Stimulant Medications"
Professor and Chair
Department of Physiology and Neuroscience
Medical University of South Carolina
Charleston, South Carolina
Kelly J. Kelleher, M.D., M.P.H.
"Use of Services and Costs for Youth With ADHD and Related Conditions"
Staunton Professor of Pediatrics and Psychiatry
Child Services Research and Development Program
University of Pittsburgh
Pittsburgh, Pennsylvania
Rachel G. Klein, Ph.D.
"Alcohol, Nicotine, Stimulants, and Other Drugs"
Director of Clinical Psychology
Department of Psychology
New York State Psychiatric Institute
New York, New York
Benjamin B. Lahey, Ph.D.
"Current Diagnostic Schema/Core Dimensions"
Professor of Psychiatry
Chief of Psychology
Department of Psychiatry
University of Chicago
Chicago, Illinois
Nadine M. Lambert, Ph.D.
"Stimulant Treatment as a Risk Factor for Nicotine Use and Substance Abuse"
Professor
Cognition and Development Area
Director, School Psychology Program
Graduate School of Education
University of California, Berkeley
Berkeley, California
Jan Loney, Ph.D.
"Risk of Treatment Versus Nontreatment"
Professor
Department of Psychiatry
State University of New York at Stony Brook
Stony Brook, New York
William E. Pelham, Jr., Ph.D.
"Psychosocial Interventions"
Professor and Director of Clinical Training
Department of Psychology
State University of New York at Buffalo
Buffalo, New York
Andrew S. Rowland, Ph.D.
"Public Health Perspectives and Toxicological Issues Concerning Stimulant Medications"
Epidemiologist
Epidemiology Branch
National Institute of Environmental Health Sciences
National Institutes of Health
Research Triangle Park, North Carolina
J
ames Swanson, Ph.D.
"Biological Bases of ADHD: Neuroanatomy, Genetics, and Pathophysiology"
Professor of Pediatrics
Department of Pediatrics
University of California, Irvine
Irvine, California
Rosemary Tannock, Ph.D.
"Cognitive and Behavioral Correlates"
Scientist
Associate Professor of Psychiatry
Brain and Behavior Program
Research Institute for the Hospital for Sick Children
University of Toronto
Toronto, Ontario
Canada
Timothy E. Wilens, M.D.
"ADHD and Risk for Substance Use Disorders"
Associate Professor of Psychiatry
Harvard Medical School
Massachusetts General Hospital
Boston, Massachusetts
Mark L. Wolraich, M.D.
"Current Assessment and Treatment Practices"
Professor of Pediatrics
Director, Division of Child Development
Department of Pediatrics
Vanderbilt University
Nashville, Tennessee
Planning Committee
James R. Cooper, M.D.
Planning Committee Co-Chairperson
Associate Director for Medical Affairs
Division of Clinical and Services Research
National Institute on Drug Abuse
National Institutes of Health
Bethesda, Maryland
Peter S. Jensen, M.D.
Planning Committee Co-Chairperson
Associate Director for Child and Adolescent Research
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Sheila Anderson
Immediate Past National President
Children and Adults With Attention Deficit Disorders
Plantation, Florida
Elaine Baldwin
Chief, Public Affairs and Science Reports Branch
Office of Scientific Information
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Cheryl Boyce, Ph.D.
Society for Research in Child Development Fellow
Developmental Psychopathology Research Branch
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Sarah Broman, Ph.D.
Health Science Administrator
Division of Fundamental Neuroscience and Developmental Disorders
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, Maryland
J.A. Costa e Silva, M.D.
Director
Division of Mental Health and Prevention of Substance Abuse
World Health Organization
Geneva, Switzerland
Dorynne J. Czechowicz, M.D.
Medical Officer
Division of Clinical and Services Research
National Institute on Drug Abuse
National Institutes of Health
Bethesda, Maryland
Jerry M. Elliott
Program Analysis and Management Officer
Office of Medical Applications of Research
National Institutes of Health
Bethesda, Maryland
John H. Ferguson, M.D.
Director
Office of Medical Applications of Research
National Institutes of Health
Bethesda, Maryland
Gretchen Feussner
Pharmacologist
Drug and Chemical Evaluation Section
Office of Diversion Control
Drug Enforcement Administration
Arlington, Virginia
Laurence L. Greenhill, M.D.
Research Psychiatrist II
New York State Psychiatric Institute
Columbia University
New York, New York
William H. Hall
Director of Communications
Office of Medical Applications of Research
National Institutes of Health
Bethesda, Maryland
John King
Deputy Assistant Administrator
Office of Diversion Control
Drug Enforcement Administration
Arlington, Virginia
David J. Kupfer, M.D.
Panel and Conference Chairperson
Thomas Detre Professor and Chair of Psychiatry
Western Psychiatric Institute and Clinic
Department of Psychiatry
University of Pittsburgh
Pittsburgh, Pennsylvania
Benjamin B. Lahey, Ph.D.
Professor of Psychiatry
Chief of Psychology
Department of Psychiatry
University of Chicago
Chicago, Illinois
Jan Loney, Ph.D.
Professor
Department of Psychiatry
State University of New York at Stony Brook
Stony Brook, New York
Reid Lyon, Ph.D.
Chief
Child Development and Behavior Branch
National Institute of Child Health and Human Development
National Institutes of Health
Bethesda, Maryland
Stuart L. Nightingale, M.D.
Associate Commissioner for Health Affairs
Food and Drug Administration
Rockville, Maryland
William E. Pelham, Jr., Ph.D.
Professor and Director of Clinical Training
Department of Psychology
State University of New York at Buffalo
Buffalo, New York
Elizabeth Rahdert, Ph.D.
Research Psychologist
Treatment Research Branch
Division of Clinical and Services Research
National Institute on Drug Abuse
National Institutes of Health
Bethesda, Maryland
Andrew S. Rowland, Ph.D.
Epidemiologist
Epidemiology Branch
National Institute of Environmental Health Sciences
National Institutes of Health
Research Triangle Park, North Carolina
Ellen Schiller, Ph.D.
Special Assistant
Division of Research to Practice
Office of Special Education Programs
U.S. Department of Education
Washington, D.C.
Bennett Shaywitz, M.D.
Professor of Pediatrics and Neurology
Department of Pediatrics
Yale University School of Medicine
New Haven, Connecticut
Charles R. Sherman, Ph.D.
Deputy Director
Office of Medical Applications of Research
National Institutes of Health
Bethesda, Maryland
Benedetto Vitiello, M.D.
Chief
Child and Adolescent Treatment and Preventive Intervention Research Branch
Division of Services and Intervention Research
National Institute of Mental Health
National Institutes of Health
Bethesda, Maryland
Timothy E. Wilens, M.D.
Associate Professor of Psychiatry
Harvard Medical School
Massachusetts General Hospital
Boston, Massachusetts
Lead Organizations
Office of Medical Applications of Research
John H. Ferguson, M.D.
Director
National Institute on Drug Abuse
Alan I. Leshner, Ph.D.
Director
National Institute of Mental Health
Steven E. Hyman, M.D.