valuable
structured and normed information to further support
conclusions,</i> <i>diagnoses, and
treatment decisions when the parent, teacher, and
self-report</i> <i>scales are
combined</i></font> </font></li>
</ul>
<font face="Garamond"><font face="Garamond"><i>Key
Features</i> <br>
<i>Based on the
original <span style="font-weight: bold;">Conners’
Rating Scales</span>, the CRS-R has many advantages, including:</i> <br>
</font> </font></blockquote>
<ul>
<li><font face="Garamond"><font face="Garamond"><i>A
large normative database
to help
support the
instrument’s reliability
and validity </i></font> </font></li>
<li><font face="Garamond"><font face="Garamond"><i>Multidimensional
scales that
help
assess <span style="font-weight: bold;">ADHD</span>
and comorbid disorders
with
links to</i></font> </font></li>
<li><font face="Garamond"><font face="Garamond"><span style="font-weight: bold; font-style: italic;">DSM-IV</span><i>
diagnostic categories</i></font> </font></li>
<li><font face="Garamond"><font face="Garamond"><i>Teacher,
parent, and
self-report
scales in long
and short formats</i></font> </font></li>
<li><font face="Garamond"><font face="Garamond"><i>Applicability
to managed
care
situations through
the quantification and</i> <i>measurement of a variety of
behavior
problems.</i></font></font></li>
</ul>
<font face="Garamond"><font face="Garamond">To
order a
specific
assessment or
talk with a client
relations representative: <br>
Call 1-800-627-7271, ext. 3225 or 952-681-3225 Fax: 1-800-632-9011 or
952-681-3299 <br>
E-Mail: </font><b style="font-style: italic;"><font face="Garamond"><br>
</font> </b> </font>
<h3><a name="contradicted_clinical_research"></a>Initially
Stronger Effects
in Highly Cited Clinical Research</h3>
<table style="background-color: rgb(230, 233, 255); width: 650px; text-align: left;" border="2" cellpadding="2" cellspacing="2">
<tbody>
<tr style="font-style: italic;">
<td style="vertical-align: top;"><nobr><font face="Garamond">John
P. A.
Ioannidis, MD</font></nobr><font face="Garamond"> <a href="http://jama.ama-assn.org/cgi/content/abstract/294/2/218" style="font-weight: bold;">JAMA 2005;294:218-228</a>.<br style="font-family: garamond;">
</font>
<div style="background-color: rgb(230, 233, 255);">
<div align="justify"><font face="Garamond"><span style="font-weight: bold;">Context<br>
</span>Controversy and
uncertainty ensue when the results
of clinical research on the effectiveness of interventions are
subsequently contradicted. Controversies are most prominent when
high-impact research is involved.</font><br style="font-family: garamond;">
<font face="Garamond"> <span style="font-weight: bold;">Objectives</span>
To
understand how
frequently highly cited studies are contradicted or find effects that
are stronger than in other similar studies and to discern whether
specific characteristics are associated with such refutation over time.
</font><br>
<font face="Garamond"> <span style="font-weight: bold;">Design</span>
All original clinical research studies published in 3 major
general clinical journals or high-impact-factor specialty journals
in 1990-2003 and cited more than 1000 times in the literature
were examined.</font><br style="font-family: garamond;">
<font face="Garamond"> <span style="font-weight: bold;">Main
Outcome
Measure</span> The results of highly cited articles
were
compared against subsequent studies of
comparable or larger sample size and similar or better
controlled designs. The same analysis was also performed
comparatively for matched studies that were not so highly
cited.</font><br style="font-family: garamond;">
<font face="Garamond"> <span style="font-weight: bold;">Results</span>
Of 49 highly cited original
clinical research studies,
45 claimed that the intervention was effective. Of these, 7
(16%) were contradicted by subsequent studies, 7 others (16%)
had found effects that were stronger than those of subsequent studies,
20 (44%) were replicated, and 11 (24%) remained largely unchallenged.
Five of 6 highly-cited nonrandomized studies had been
contradicted or had found stronger effects vs 9 of 39 randomized
controlled
trials (P = .008). Among randomized trials, studies
with contradicted or stronger effects were smaller
(P = .009)
than replicated or unchallenged studies although
there was no statistically significant difference in their
early or overall citation impact. Matched control studies
did not have a significantly different share of refuted
results than highly cited studies, but they included more
studies with "negative" results.</font><br style="font-family: garamond;">
</div>
<font face="Garamond"> <span style="font-weight: bold;">Conclusions</span>
Contradiction and initially stronger effects are not
unusual in highly cited research of clinical
interventions and their outcomes. The extent to which high
citations may provoke contradictions and vice versa needs
more study. Controversies are most common with highly cited
nonrandomized studies, but even the most highly cited
randomized trials may be challenged and refuted over time,
especially small ones.<br>
</font>
<div style="text-align: right;"><font style="font-style: italic;" face="Garamond"><b>Author
Affiliations:</b> <a href="http://www.dhe.med.uoi.gr/index.php" style="font-weight: bold;">Department of Hygiene and
Epidemiology,
University of Ioannina School of Medicine, Ioannina, Greece</a>,
and
the <a href="http://inside.tufts.edu/announce/index.php?t=id&id=70" style="font-weight: bold;">Institute for Clinical Research
and Health
Policy Studies, Department
of Medicine, Tufts-New England Medical Center, Boston, Mass</a>.</font><font style="font-family: garamond;" color="#033660" face="Garamond"><strong><span style="font-style: italic;">
RELATED ARTICLES IN YAMA<br>
</span></strong></font></div>
</div>
</td>
</tr>
</tbody>
</table>
<div style="margin-left: 40px;"><font face="Garamond"><font face="Garamond"><span name="pmid_green_17671282" id="pmid_green_17671282"><br>
Am
J Psychiatry.
2007 Aug ;164 (8):1198-205 17671282</span><br>
</font> </font>
<div style="text-align: center;"><font face="Garamond"><font face="Garamond"><a href="http://www.ncbi.nlm.nih.gov/pubmed/17671282" class="css_title" title="Show full info about paper" style="font-weight: bold; font-style: italic;"><span name="pmid_17671282" id="pmid_17671282">Spillover
Effects on Treatment of Adult Depression in Primary Care After FDA
Advisory on Risk of Pediatric Suicidality With SSRIs</span></a><br>
</font> </font></div>
<div align="justify"><font face="Garamond"><font face="Garamond"><span name="pmid_17671282" id="pmid_17671282"><span style="font-style: italic;">OBJECTIVE:
In
2003, the U.S.
Food and Drug
Administration (FDA) issued
a public health advisory about the risk of suicidality in pediatric
patients taking selective serotonin reuptake inhibitors (SSRIs) for
depression, and in 2005, the agency mandated a black box warning and
medication guide indicating that pediatric and adult patients may be at
risk. The authors examine the effects of this pediatric policy on
treatment of adult depression in the community. METHOD: An adult cohort
with newly diagnosed episodes of depression was created from a large
national integrated claims database of managed care plans from October
1998 to September 2005 (N=475,838 unique episodes). Time-series
analyses were used to compare the post-FDA advisory trends to the
trends during the 5 years preceding the advisory. RESULTS: The rate of
diagnosed depression was significantly lower after the advisory than
would have been expected on the basis of the preadvisory historical
trend. The average percentage of adults with new (versus recurrent)
depressive episodes was 88.6% in the preadvisory period (declining at
an annual rate of 1.69%), and it decreased significantly to 77.5%
(declining more rapidly, at an annual rate of 7.70%). The percentage of
adults with depression who did not receive an antidepressant increased
from an average of 20% (declining at 0.45% annually) before the policy
action to an average of 30% (increasing at an annual rate of 20.6%).
The data did not show any compensatory increases in psychotherapy or
prescription of atypical antipsychotics or anxiolytics.</span></span></font></font><br>
<font face="Garamond"><font face="Garamond"><span name="pmid_17671282" id="pmid_17671282"><span style="font-style: italic;">CONCLUSIONS:
The FDA advisory had a significant spillover effect into community
treatment for adults with depression, despite the focus of the policy
on pediatric patients.<a href="http://www.ucdenver.edu/academics/colleges/pharmacy/Departments/ClinicalPharmacy/DOCPFaculty/Pages/ValuckRobertPhD.aspx">Robert
J Valuck</a>, http:=//www.psychiatrictimes.com/>Ross
J. Baldessarini</span></span></font><br>
</font></div>
<h3><font face="Garamond"><a name="handsoffthechildren"></a><font face="Garamond">Hands
off the children<br>
</font></font></h3>
<font face="Garamond"> </font>
<div align="justify"><font face="Garamond"><font face="Garamond">Banal,
hasty,
shallow
socio-behavioral diagnosis and therapy? With obtuse sets of questions
to enroll definitively children on a psychiatric list? or - sometime
even worse - to disregard to consider and care somatic illnesses?</font><br>
<font face="Garamond">How
seriously
has to be treated body and its diseases? How
socio-behavioral hasty and shallow pseudo-results can misinterpret
physical symptoms: <a href="/testim.htm" style="font-weight: bold;">at first the ones</a> often
so easily
sharing not only past ill-treatments but injuries happening also at
present - as "simple" lesions from hits or accidents or <a href="/belgio.htm" style="font-weight: bold;">from
sexual abuse</a>? How to ignore that there are also true, even
potentially dangerous, illnesses which main signs give back on
movements and then apparently on behavior?</font></font><br>
</div>
<font face="Garamond"> <font face="Garamond"> <a href="http://www.handsoffthechildren.org/"><img src="glm.jpg" title="" alt="giulemanidibambini ©" style="border: 0px solid ; width: 154px; height: 183px;" align="left" hspace="5" vspace="10"></a><br>
<br>
<br>
<a href="http://www.handsoffthechildren.org/"><img src="giulemanidaibambini.jpg" alt="giulemanidaibmbini" style="border: 0px solid ; width: 234px; height: 60px;" hspace="10" vspace="10"></a><br>
<font face="Garamond">Go to the English
pages of <a href="http://www.handsoffthechildren.org/" style="font-weight: bold; font-style: italic;">http://www.handsoffthechildren.org</a>
</font><br>
<br>
<br>
</font> </font>
<hr style="width: 100%; height: 2px;"><font face="Garamond"><font face="Garamond"><font face="Garamond"><font face="Garamond"><b>1: </b><span title="Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata"><a href="javascript:AL_get(this, 'jour', 'Psychiatr Hung.');"><span style="font-weight: bold; font-style: italic;">Psychiatr Hung</span>.</a></span>
2005;20(4):293-8.<br>
</font> <font face="Garamond" size="+1"><b>[<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16462006&query_hl=1&itool=pubmed_docsum" style="font-style: italic;">Comorbidity in child psychiatry:
is the
comorbidity of pediatric mania and ADHD really that high?</a>]</b></font><font face="Garamond">[Article
in Hungarian] <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_Abstract&term=%22Balazs+J%22%5BAuthor%5D" style="font-weight: bold;">Balazs J</a>, <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16462006&query_hl=1&itool=pubmed_docsum" style="font-weight: bold;">Gadoros</a> style="font-weight: bold;"> .<br>
<span style="font-weight: bold; font-style: italic;">J.Vadaskert
Gyermekpszichiatriai Korhaz es Szakambulancia</span>; Beregszasz
u.
145, Budapest, 1112 Hungary.
<span style="font-family: garamond;"><br>
<div style="margin-left: 40px;">
<div align="justify"><span style="font-weight: bold; font-style: italic;">OBJECTIVE</span><span style="font-style: italic;">:
The purpose of our study was to investigate possible reasons of
diagnosing comorbidity in child psychiatric disorders, with special
attention to the comorbidity of mania and attention
deficit-hyperactivity syndrome (<span style="font-weight: bold;">ADHD</span>).</span><br style="font-style: italic;">
<font face="Garamond"><font face="Garamond"> <span style="font-family: garamond;"><span style="font-weight: bold; font-style: italic;">METHOD</span><span style="font-style: italic;">: Using a structured
interview the </span></span><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9881538&dopt=Abstract" style="font-style: italic;"><span style="font-family: garamond; font-weight: bold;">Neuropsychiatric
Interview Kid (M.I.N.I. Kid</span></a><span style="font-family: garamond; font-style: italic;">, </span>we
examined 112
consecutive admitted
children aged under
18 in the Vadaskert <span style="font-weight: bold;">Children's
Psychiatric Hospital</span>. For all children,
best-estimated diagnoses were made by an independent child-psychiatrist
as well, who was blind to the diagnoses of the <span style="font-weight: bold;">M.I.N.I. Kid</span>. Six
children were diagnosed as having pervasive developmental disorder by
the independent clinician, their data were excluded. In this way the
data of 106 children were included in the statistical analysis.</font></font><br>
<font face="Garamond"><font face="Garamond"> <span style="font-weight: bold;">RESULTS</span>:
Comorbidity: Based on the <span style="font-weight: bold;">M.I.N.I.
Kid</span> test comorbid diagnoses
were found in <span style="font-weight: bold;">74.53%</span>
of the
children and <span style="font-weight: bold;">51.90%</span>
of the
children with
comorbid diagnoses had three or more concomitant diagnoses. The maximum
number of diagnoses obtained concomitantly by the <span style="font-weight: bold;">M.I.N.I. Kid</span> was 9.
The <span style="font-weight: bold;">M.I.N.I. Kid</span>
produced <span style="font-weight: bold;">2.58</span>
diagnoses for one child on
average. The
independent child-psychiatrist found comorbid diagnoses in 25.47% of
the children. The maximum number of diag<font face="Mistral">noses
made
by the independent
child-psychiatrist for 1 child was 2. The independent
child-psychiatrist established 1.25 diagnoses for one child on average.
Manic/hypomanic episode: </font><span style="font-weight: bold; color: rgb(204, 0, 0);"><font face="Mistral">Based
on
the
M.I.N.I. </font>Kid manic episode was
diagnosed in 14.15% of the children and hypomanic episode in 6,60% of
them, while the independent psychiatrist did not diagnose these
conditions in any of the children</span>. 99.33% of the children
with
manic
episode were diagnosed together with ADHD by the M.I.N.I. Kid. In
57.14% of those cases, where the M.I.N.I. Kid diagnosed a hypomanic
episode, it found an ADHD at the same time. The independent
psychiatrist found ADHD in 73.33% of the children with the diagnoses of
manic episode and in 57.14% of the children with hypomanic episode
determined by the M.I.N.I. Kid.</font></font><br>
</div>
<font face="Garamond"><span style="font-weight: bold;">CONCLUSIONS</span>:
The
considerable
differences found in the number of diagnoses made by using the M.I.N.I.
Kid and by the independent child psychiatrist may indicate the possible
<span style="font-weight: bold; color: rgb(204, 0, 0);">over-sensitivity
of structured interviews and the characteristics of
diagnostic systems</span>: several disorders have overlapping
symptoms,
making
the differential diagnoses difficult. PMID: 16462006 [<span style="font-weight: bold;">PubMed</span> - indexed
for <span style="font-weight: bold;">MEDLINE</span>] <br>
</font> <span style="font-family: garamond;"><font face="Garamond"><span style="font-style: italic;">Publication
Types</span>: <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16462006&query_hl=1&itool=pubmed_docsum"><span style="font-weight: bold; font-style: italic;">English
Abstract</span></a></font><br>
</span></div>
</span></font></font></font></font></div>
</td>
</tr>
<tr>
<td style="vertical-align: top;"> <br>
<font face="Garamond">A
Front Group
for the Psycho-Pharmaceutical Industrial Complex</font><font face="Garamond"><br style="font-family: garamond;">
</font> <br>
<font style="font-style: italic; font-family: garamond;" face="Garamond"><u>U</u>pdated:
January
1, 2006 3:35 PM EST <i><a href="http://www.psychsearch.net/teenscreen.html"><b>TeenScreen</b></a>
is a very controversial so-called <span style="font-weight: bold;">'diagnostic
psychiatric service</span>' aka
suicide survey; done on children who are then referred to psychiatric
treatment. The evidence suggests that the objective of the
psychiatrists who designed TeenScreen is to place children so selected
on <a href="http://www.psychsearch.net/teenscreen_psychotropic_medication.htm" style="font-weight: bold;">psychotropic
drugs</a>. </i></font><i><br>
</i>
<div style="margin-left: 40px;"><i><font style="font-family: mistral;" size="+2">It's just a
way to
put more people on prescription drugs</font>, </i><br>
</div>
<div style="margin-left: 40px; text-align: justify;"><i><font face="Garamond">said <a href="http://www.nybooks.com/authors/10553" style="font-weight: bold;">Marcia
Angell</a>, a medical ethics lecturer at <a href="http://hms.harvard.edu/" style="font-weight: bold;">Harvard
Medical School</a> and author
of The
Truth About Drug
Companies</font>.
She said such programs will boost the sale of antidepressants even
after the FDA in September ordered a '<a href="http://www.psychsearch.net/teenscreen.html"><span style="font-weight: bold;">black
box</span></a>' label warning that the
pills might spur suicidal thoughts or actions in minors. (The <a href="http://www.nypost.com/"><span style="font-weight: bold;">New
York
Post</span></a>, December 5, 2004)</i><br>
<i> </i></div>
<div style="text-align: justify;"> </div>
<hr style="width: 100%; height: 2px; margin-left: 0px; margin-right: 0px;">
<div style="margin-left: 40px; text-align: justify;"><i><a href:="http://www.youtube.com/watch?v=vqu5RtDh9sw"><span style="font-weight: bold;">Sydenham Chorea</span> in
10 year old boy</a> <font face="Garamond"><a href="http://patients.uptodate.com/topic.asp?file=ped_neur/7933"><span style="font-weight: bold;">Sydenham
chorea (SC)</span></a>, a major manifestation of <a href="http://www.faqs.org/health/Sick-V4/Rheumatic-Fever.html"><span style="font-weight: bold;">rheumatic fever (RF)</span></a>,
is thought to occur when antibodies directed against group A <a href="http://www.ninds.nih.gov/disorders/sydenham/sydenham.htm" style="font-weight: bold;">streptococcus (GAS)</a>
cross-react with
epitopes on neurons of the basal
ganglia. In earlier work with SC, Swedo and colleagues identified
children who, in addition to chorea, presented with
obsessive-compulsive behavior. <span style="font-weight: bold; color: rgb(204, 0, 0);">A
precipitous onset
of childhood </span><a href="http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml"><span style="font-weight: bold;">obsessive-compulsive disorder
(OCD)</span></a>
after <a href="http://emedicine.medscape.com/article/225243-overview" style="font-weight: bold;">streptococcal pharyngitis</a>
was
subsequently described that shared many
similarities to SC but did not have <span style="font-weight: bold;">chorea</span>
or clinical signs of RF such
as <span style="font-weight: bold;">arthritis</span>
and <span style="font-weight: bold;">carditis</span>. <a href="http://search.medscape.com/all-search?queryText=swedo" style="font-weight: bold;">Swedo and colleagues</a>
termed this
subtype of
childhood-onset OCD, <a href="http://www.nimh.nih.gov/health/publications/pandas/index.shtml"><i style="font-weight: bold;">pediatric autoimmune
neuropsychiatric disorders</i></a><i style="font-weight: bold; color: rgb(204, 0, 0);">
associated with
streptococcal infections</i><span style="font-weight: bold;"><a href="http://intramural.nimh.nih.gov/pdn/web.htm">(PANDAS)</a></span>.
Both
pathogen- and host-related
factors appear to influence the risk of acquiring RF, with only 2% to
3% of untreated individuals infected by GAS developing RF.
Susceptibility to RF is influenced by age, GAS serotypes, family
history, and environmental conditions. Children between the ages of 5
and 14 years show the highest rate of this complication. The
observation that RF is more prevalent among relatives of the probands
than unrelated controls supports the hypothesis that susceptibility to
RF is, in part, genetically determined. Environmental influences, such
as crowded living conditions, may contribute to the risk of developing
RF. Pathogen-mediated factors play a role as well, with specific <a href="http://search.medscape.com/all-search?queryText=GAS%20serotypes" style="font-weight: bold;">GAS
serotypes</a> conferring increased susceptibility to RF, although
genome-based analyses of GAS should lead to identification of more
specific virulence factors. In the absence of carditis and arthritis,
the diagnosis of SC is frequently a <a href="http://en.wikipedia.org/wiki/Diagnosis_of_exclusion" style="font-weight: bold;">diagnosis of exclusion</a>.
Elevated
streptococcal titers at the time of presentation suggest but do not
prove a causative role. Similarly, the association of streptococcal
illness with children presenting with <span style="font-weight: bold;">PANDAS</span>
may occur coincidentally.
Advances in identification of reliable clinical and/or biological
markers of these disorders could further our understanding of
pathophysiology and lead to increased specificity in diagnosis and
treatment.</font></i><br>
</div>
<i><font face="Garamond"> </font> <br>
<font style="font-weight: bold;" color="#993300" face="Garamond"><a href="http://www.aacap.org/">Acad
Child
Adolesc
Psychiatry</a>,<span style="color: rgb(204, 0, 0);"> 41:1,98-100
January
2002</span></font><span class="unnamed1"><font color="#663300" face="garamond"><i> <a href="https://books.google.it/books?id=IOcVXFYVNE0C&pg=PA97&lpg=PA97&dq=TanyaMurphy%3C/a%3E&source=bl&ots=fl1uQgLrl3&sig=3zfdKmoOidbQx6l0bqaPSev5NhI&hl=it&sa=X&ved=0ahUKEwjT3fWBtanTAhVLPxQKHVMYCu8Q6AEIRTAE#v=onepage&q&f=false" style="font-weight: bold;">Tanya
Murphy</a>, M.D., and </i></font><i><a href="http://www.mountsinai.org/about-us/newsroom/press-releases/wayne-k-goodman-md-renowned-expert-on-obsessive-compulsive-disorder-joins-mount-sinai-as-chair-of-psychiatry" style="font-weight: bold;">Wayne Goodman M.D</a>,</i></span><br>
</i></td>
</tr>
<tr>
<td style="vertical-align: top;">
<blockquote><br>
<font face="Garamond"><i><b><a href="http://www.medscape.com/viewarticle/495332?src=search">Dec.
6, 2004 =97 Iron deficiency</a></b></i><i> may
contribute to the physiopathology of attention deficit-hyperactivity
disorder
(ADHD) in children, according to the results of a controlled group