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Alasdair L A Vance

Publications and source records attributed to Alasdair L A Vance.

4 recordsLinked to original sources
PubMed2003

Attention deficit hyperactivity disorder, combined type: better executive function performance with longer-term psychostimulant medication.

OBJECTIVE: Executive function deficits are evident in primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT) and are possibly improved by longer-term psychostimulant medication. In contrast, a substantial subgroup of children with ADHD-CT become symptomatic despite longer-term psychostimulant medication use. We investigated the hypothesis that better executive function performance is associated with the use of longer-term psychostimulant medication in primary school-age children with ADHD-CT who are again symptomatic of ADHD-CT, despite its use. METHOD: A cross-sectional study of 40 primary school-age psychostimulant medication-naïve children with ADHD-CT, 26 with symptomatic ADHD-CT and treated with psychostimulant medication, and 26 control children without ADHD-CT was conducted. Nonverbal tasks of executive function were compared across the three groups. RESULTS: The longer-term psychostimulant medication-treated group had a better executive function performance, despite being symptomatic for ADHD-CT, than the psychostimulant medication-naïve group. CONCLUSION: Improved executive function may be a marker of psychostimulant medication effect in children with ADHD-CT treated in the longer term. This improvement may not correlate with that of the ADHD-CT symptoms. Longitudinal studies are required.

Attention Deficit Disorder with Hyperactivity↗
PubMed2003

Prescribing of psychotropic medications for children by Australian pediatricians and child psychiatrists.

OBJECTIVE: To describe the pattern of prescribing of psychotropic medications for Australian children. DESIGN: Australia-wide cross-sectional postal survey conducted in 2000. PARTICIPANTS: All registered general pediatricians and child and adolescent psychiatrists. RESULTS: The survey was completed by 435 general pediatricians and 187 child and adolescent psychiatrists (response rates 72% and 70%, respectively). Stimulants and clonidine were the most frequently prescribed medications. Seventy-two percent of practitioners reported that they had prescribed a combination of medications. Frequent combinations included a stimulant and clonidine (64% of pediatricians, 51% of child psychiatrists) and a stimulant and a selective serotonin reuptake inhibitor (SSRI; 29% of pediatricians, 36% of child psychiatrists). Pediatricians were more likely than child psychiatrists to report prescribing clonidine for sleep problems (67% vs 36%). Child psychiatrists were more likely than pediatricians to report prescribing SSRIs (93% vs 75%) and mood stabilizers (45% vs 11%) for depression, and SSRIs (74% vs 50%) and tricyclic antidepressants (37% vs 12%) for obsessive compulsive disorder. Off-label prescribing (indication or age not included in the product information) was reported by 40%. Over 5% of practitioners in this study had prescribed clonidine, methylphenidate, dexamphetamine, and typical neuroleptics for children under 3 years of age. CONCLUSIONS: A broad range of psychotropic medications are being prescribed for Australian children, with some medication groups being prescribed frequently. Combinations of psychotropic medications are used regularly, and there is some prescribing for very young children. The safety and efficacy of several of the agents prescribed have not been adequately researched in children. There is an urgent need for pediatric psychopharmacology research to inform current prescribing practice.

Adult↗
PubMed2002

Attention deficit hyperactivity disorder in children: moving forward with divergent perspectives.

Current controversy about diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) reflects the divergence between developmental and non-developmental approaches. While there is growing evidence for biological vulnerabilities associated with ADHD, we believe that environmental factors, including early problems in parental attachment, are also important in determining the type and timing of deficit that a child develops, the risk to academic and social performance and eventual outcome. We warn against labelling children with ADHD simply because they fulfil the cross-sectional diagnostic symptom criteria of the Diagnostic and statistical manual of mental disorders - 4th edition (DSM-IV). We advocate an integrated biopsychosocial approach to diagnosis and management with a thorough developmental assessment to identify developmental factors, such as deficits in early attachment, contributing to the presentation.

Attention Deficit Disorder with Hyperactivity↗