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Joseph Biederman , James Chan , Thomas J. Spencer , K. Yvonne Woodworth , Tara Kenworthy , Ronna Fried , Pradeep Bhide , Stephen V. Faraone (2015). Evidence of A Pharmacological Dissociation Between The Robust Effects of Methylphenidate on Adhd Symptoms and Weaker Effects on Working Memory. Journal of Brain Sciences, 1(2): 43-53. DOI: 10.18488/journal.83/2015.1.2/188.8.131.52
Working memory (WM) deficits often co-occur with, but do not define, attention deficit hyperactivity disorder (ADHD). Preclinical and neuroimaging studies show that ADHD and WM deficits are dissociated at the level of individual dopamine receptor function. We hypothesized that there would also be a pharmacological dissociation of the effects of stimulants on ADHD and WM. ADHD subjects were derived from three prospective clinical trials involving treatment with OROS methylphenidate for at least 6 weeks. Subjects were adolescents and adults with DSM-IV ADHD with systematic assessments of WM and ADHD symptoms. Cohen’s d was used to evaluate effect size between baseline and week 6 for all assessments, and Pearson correlations were used to evaluate the relationship between assessments at baseline and between change scores for assessments from baseline to week 6. Cohen’s d estimates for the Cambridge Neuropsychological Test Automated Battery spatial working memory measures differed significantly by 1.8 standard deviations (t= -10.8, df= 70, p < 0.001) and 1.9 standard deviations (t= -11.1, df= 70, p < 0.001) for the strategy and total between errors subcategories respectively. Confidence intervals did not overlap with those of the Adult ADHD Investigator Symptom Rating Scale (AISRS). A similar effect was observed for changes in AISRS and the Behavior Rating Inventory of Executive Function working memory scale where the Cohen’s d estimates differed significantly by 1.1 standard deviations (t= -2.5, df= 137, p = 0.015) and confidence intervals did not overlap. These findings provide further evidence for the dissociation between ADHD and WM deficits.
This study documents that responses to methylphenidate in ADHD symptoms and working are dissociated, indicating that a sizeable number of ADHD subjects may continue to struggle with residual working memory impairments despite good clinical response to methylphenidate.
Suicides and Factors Associated With Suicides-A Study in a Rural Setup of Pondicherry in South India
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The aim of this study was to find out the suicide rate and possible factors associated with suicides in a rural area in Pondicherry. Information was collected regarding suicides within the last two years, using a pretested questionnaire by house to house survey in the study area which is a rural set up in the south Indian union territory of Pondicherry. We found that the annual average suicide rate in this village was 110.64/100,000 population which is very high compared to the national average. The majority of suicides were committed by married males (75%). Commonest age of suicide is 15-45 years (46.16%). The reasons found for suicide were family problems leading to stress 9(78.84%) and health problems 4(30.76%). The commonest mode of suicide was by hanging 6(46.15%) and least by burning 3(23.07%). Maximum suicide occurred in the month of November to December 4(36.36%). The findings imply the need for a holistic community based approach to tackle this complex issue of suicide.
The paper’s primary contribution is finding that the suicide rates in our study area are very high compared to the national average. The key target group for suicide prevention initiatives emerges as married, middle aged males working as a daily wage worker who have the habit of consuming alcohol.