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Daily Mail
17 minutes ago
- Daily Mail
Study finds medication lowers risk of dangerous behaviors in people with ADHD
ADHD affects around five per cent of children and 2.5 per cent of adults globally and is linked increased risks of suicidal behaviors, substance abuse, transport accidents, and criminality if people do not seek treatment. An international team of researchers wanted to fin out if taking medication would mitigate these risks. Researchers from the University Of Southampton, UK and the Karolinska Institute in Sweden found that during two years of treatment with ADHD medication, people who took the drugs were less likely to experience these harmful incidents than those weren't medicated. Around 22 million Americans are estimated to have ADHD and just over half of these are prescribed medication to manage their symptoms. Medications are classified into two main categories: stimulants and non-stimulants. Stimulants, the most common type, include methylphenidate and amphetamine-based medications that improve the transmission of the brain chemical dopamine which affects mood, motivation and movement. Non-stimulant options like atomoxetine, clonidine, and guanfacine can also be used, if stimulants are not effective or well tolerated. These help improve the transmission of norepinephrine, a hormone that helps with alertness and focus. Exactly why the condition occurs is not completely understood, but ADHD tends to run in families, suggesting genes may play a part. In the new study, researchers examined multiple population and health records in Sweden. The team used a novel study design called a 'trial emulation' to simulate a trial using existing real-world data from 148,581 people with ADHD. Comparing those who had started any type of ADHD medication within three months of diagnosis with those who hadn't, they looked at the records over the following two years. They found any form of medication reduced the first occurrence of four of the five incidents (with accidental injury being the exception) and all five outcomes when considering recurring incidents. Those taking stimulant medication were associated with the lowest incident rates, compared to non-stimulant medications. Methylphenidate was the most commonly prescribed drug, the researchers found. The likelihood was most reduced amongst people exhibiting a recurring pattern of behavior, such as multiple suicide attempts, numerous drug relapses or repeat offending. Medication didn't reduce the risk of a first-time accidental injury, but did reduce the risk of recurring ones. The study is the first of its kind to show the beneficial effect of ADHD medication on these broader clinical outcomes using a novel statistical method and data representative of all patients in routine clinical care from a whole country. Dr Zheng Chang, senior author of the study from the Karolinska Institute said: 'This finding is consistent with most guidelines that generally recommend stimulants as the first-line treatment, followed by non-stimulants. 'There is an ongoing discussion regarding whether methylphenidate should be included in the World Health Organization model list of essential medications, and we hope this research will help to inform this debate.' Co-senior author on the paper Samuele Cortese, a National Institute For Health And Care Research (NIHR) Research Professor at the University of Southampton added: 'The failure form clinical services to provide timely treatments that reduce these important outcomes represents a major ethical issue that needs to be addressed with urgency, with the crucial input of people with lived experience.'
Daily Mail
17 minutes ago
- Daily Mail
Scientists note HSPs are most likely to have mental health problems
Up to one in three people may be what experts call a 'highly sensitive person' (HSP) - often dismissed as thin-skinned or a 'drama queen'. But HSPs could be wired differently, British scientists have said. In world-first research involving more than 12,000 people, experts found those with high sensitivity were more likely to experience mental health issues, including anxiety and depression, than their less sensitive counterparts. Experts labeled the discovery 'important' but stressed further research is needed to explore how sensitivity affects the success of different mental health treatments. Tom Falkenstein, a psychotherapist at Queen Mary University of London and study co-author, said: 'We found positive and moderate correlations between sensitivity and various mental health problems such as depression, anxiety, post-traumatic stress disorder, agoraphobia, and avoidant personality disorder. 'Our findings suggest that sensitivity should be considered more in clinical practice which could be used to improve diagnosis of conditions. 'In addition, our findings could help improve treatment for these individuals. 'HSPs are more likely to respond better to some psychological interventions than less sensitive individuals. 'Therefore, sensitivity should be considered when thinking about treatment plans for mental health conditions.' An HSP is clinically defined as someone with 'increased central nervous system sensitivity to physical, emotional or social stimuli'. The term was coined in the mid-1990s by psychologist Elaine Aron, who published The Highly Sensitive Person. She theorized that HSPs may have a hyper-evolved sense of danger, likely the result of inherited genes, allowing them to 'read' other human emotions to an extraordinary degree. Later research suggested HSPs may have higher levels of neurotransmitters such as dopamine, contributing to heightened responsiveness to stimuli, while other studies have cited childhood trauma as a potential cause. Several high-profile figures, including actors Nicole Kidman and Miranda Hart, and most recently David Bowie's artist daughter Lexi Jones, have spoken publicly about identifying as HSPs. In the new research, scientists analysed 33 studies involving 12,697 adults and children over 12 years of age, with an average participant age of 25. They found HSPs were most likely to suffer depression and anxiety. Writing in the journal Clinical Psychological Science, the researchers said: 'Sensitivity is significantly correlated with common mental-health outcomes. 'It is also noticeable that we found moderate and positive correlations with agoraphobia and avoidant personality disorder,' the researchers said. One explanation for the higher likelihood of HSPs experiencing anxiety may be their 'depth of processing or their tendency to respond with overstimulation', they added. 'Depth of processing might reflect a tendency to worry about future outcomes or could lead to imagining possible future scenarios in a given situation that could account for some anxiety. 'Depression, on the other hand, might be more dependent on the environmental factors.' Professor Michael Pluess, an expert in developmental psychology and study co-author, said: 'It is important to remember that highly sensitive people are also more responsive to positive experiences, including psychological treatment. 'Our results provide further evidence that sensitive people are more affected by both negative and positive experiences and that the quality of their environment is particularly important for their well-being.' The researchers, however, acknowledged the study had 'several limitations' including the fact the average age of study participants was 25 and most were 'highly educated young women'. This 'overrepresentation of women' may make it 'difficult to predict whether the correlations observed could apply to a more diverse population', they added. Heightened sensitivity may also be a 'consequence of mental health problems', researchers noted, which requires further research. Finally, all studies analysed relied on participants self-reporting their feelings which could skew results, given they may have been 'influenced by the participant's specific level of introspection'.
The Guardian
an hour ago
- The Guardian
Why antibiotics are like fossil fuels
In 1954, just a few years after the widespread introduction of antibiotics, doctors were already aware of the problem of resistance. Natural selection meant that using these new medicines gave an advantage to the microbes that could survive the assault – and a treatment that worked today could become ineffective tomorrow. A British doctor put the challenge in military terms: 'We may run clean out of effective ammunition. Then how the bacteria and moulds will lord it.' More than 70 years later, that concern looks prescient. The UN has called antibiotic resistance 'one of the most urgent global health threats'. Researchers estimate that resistance already kills more than a million people a year, with that number forecast to grow. And new antibiotics are not being discovered fast enough; many that are essential today were discovered more than 60 years ago. The thing to remember is that antibiotics are quite unlike other medicines. Most drugs work by manipulating human biology: paracetamol relieves your headache by dampening the chemical signals of pain; caffeine blocks adenosine receptors and as a result prevents drowsiness taking hold. Antibiotics, meanwhile, target bacteria. And, because bacteria spread between people, the challenge of resistance is social: it's as if every time you took a painkiller for your headache, you increased the chance that somebody else might have to undergo an operation without anaesthetic. That makes resistance more than simply a technological problem. But like that British doctor in 1954, we still often talk as if it is: we need to invent new 'weapons' to better defend ourselves. What this framing overlooks is that the extraordinary power of antibiotics is not due to human ingenuity. In fact, the majority of them derive from substances originally made by bacteria and fungi, evolved millions of years ago in a process of microbial competition. This is where I can't help thinking about another natural resource that helped create the modern world but has also been dangerously overused: fossil fuels. Just as Earth's geological forces turned dead plants from the Carboniferous era into layers of coal and oil that we could burn for energy, so evolution created molecules that scientists in the 20th century were able to recruit to keep us alive. Both have offered an illusory promise of cheap, miraculous and never-ending power over nature – a promise that is now coming to an end. If we thought of antibiotics as the 'fossil fuels' of modern medicine, might that change how we use them? And could it help us think of ways to make the fight against life-threatening infections more sustainable? The antibiotic era is less than a century old. Alexander Fleming first noticed the activity of a strange mould against bacteria in 1928, but it wasn't until the late 1930s that the active ingredient – penicillin – was isolated. A daily dose was just 60mg, about the same as a pinch of salt. For several years it was so scarce it was worth more than gold. But after production was scaled up during the second world war, it ended up costing less than the bottle it came in. This abundance did more than tackle infectious diseases. Just as the energy from fossil fuels transformed society, antibiotics allowed the entire edifice of modern medicine to be built. Consider surgery: cutting people open and breaking the protective barrier of the skin gives bacteria the chance to swarm into the body's internal tissues. Before antibiotics, even the simplest procedures frequently resulted in fatal blood poisoning. After them, so much more became possible: heart surgery, intestinal surgery, transplantation. Then there's cancer: chemotherapy suppresses the immune system, making bacterial infections one of the most widespread complications of treatment. The effects of antibiotics have rippled out even further: they made factory farming possible, both by reducing disease among animals kept in close quarters, and by increasing their weight through complex effects on metabolism. They're one of the reasons for the huge increase in meat consumption since the 1950s, with all its concomitant welfare and environmental effects. Despite the crisis of resistance, antibiotics remain cheap compared with other medicines. Partly – as with fossil fuels – this is because the negative consequences of their use (so-called externalities) are not priced in. And like coal, oil and gas, antibiotics lead to pollution. One recent study estimated that 31% of the 40 most used antibiotics worldwide enter rivers. Once they're out there, they increase levels of resistance in environmental bacteria: one study of soil from the Netherlands showed that the incidence of some antibiotic-resistant genes had increased by more than 15 times since the 1970s. Another source of pollution is manufacturing, particularly in countries such as India. In Hyderabad, where factories produce huge amounts of antibiotics for the global market, scientists have found that the wastewater contains levels of some antibiotics that are a million times higher than elsewhere. Like the climate crisis, antibiotic resistance has laid global inequalities bare. Some high-income countries have taken steps to decrease antibiotic use, but only after benefiting from their abundance in the past. That makes it hard for them to take a moral stand against their use in other places, a dilemma that mirrors the situation faced by post-industrial nations urging developing nations to forgo the economic benefits of cheap energy. This may be where the similarities end. While we look forward to the day when fossil fuels are phased out completely, that's clearly not the case with antibiotics, which are always going to be part of medicine's 'energy mix'. After all, most deaths from bacterial disease worldwide are due to lack of access to antibiotics, not resistance. What we are going to need to do is make our approach to development and use much more sustainable. Currently, many pharmaceutical companies have abandoned the search for new antibiotics: it's hard to imagine a more perfect anti-capitalist commodity than a product whose value depletes every time you use it. That means we need alternative models. One proposal is for governments to fund an international institute that develops publicly owned antibiotics, rather than relying on the private sector; another is to incentivise development with generously funded prizes for antibiotic discovery. And to address the issue of overuse, economists have suggested that health authorities could run 'subscription' models that remove the incentive to sell lots of antibiotics. In one pilot scheme in England, two companies are being paid a set amount per year by the NHS, regardless of how much of their product is actually used. Finally, we have to remember that antibiotics aren't the only game in town. Supporting other, 'renewable' approaches means we get to use the ones we do have for longer. Vaccines are vital to disease prevention – with every meningitis, diphtheria or whooping cough vaccine meaning a potential course of antibiotics forgone. And the 20th century's largest reductions in infectious disease occurred not because of antibiotics, but thanks to better sanitation and public health. (Even in the 2000s, the threat of MRSA was addressed with tried-and-tested methods such as handwashing and cleaning protocols – not new antibiotics.) Given that antibiotics themselves emerged unexpectedly, we should also be investing more in blue-skies research. Just as we no longer burn coal without a thought for the consequences, the era of carefree antibiotic use is now firmly in the past. In both cases, the idea that there wouldn't be a reckoning was always an illusion. But as with our slow waking up to the reality of the climate crisis, coming to appreciate the limits of our love affair with antibiotics may ultimately be no bad thing. Liam Shaw is a biologist at the University of Oxford, and author of Dangerous Miracle (Bodley Head). Being Mortal: Medicine and What Matters in the End by Atul Gawande (Profile, £11.99) Infectious: Pathogens and How We Fight Them by John S Tregoning (Oneworld, £10.99) Deadly Companions: How Microbes Shaped our History by Dorothy H Crawford (Oxford, £12.49)
