Health Worlds

Zhongshan Hospital, Fudan University Psychological Medicine, Ji Jianlin
1. A conceptual model of adult ADHD
The model that the inhibition of 4 execution system supports the development and effective operation. These capabilities are considered to be a self-behavior, gradually internalized into the social adaptation self-regulation methods. ADHD suppression by limiting the ability of the individual to undermine this development to the detriment of future events based on ability to effectively guide the behavior of the individual satisfaction.
2. Neurobiology of adult ADHD
Neurobiology of the adult ADHD study was not as good as the younger of the proband. However, the use of positron emission tomography and single photon emission computed tomography screening out almost independently of adult ADHD. These techniques can be used for ADHD and is the only study of neuropharmacology strict standards. Current research focuses on non-invasive and the use of radiolabeled neuroimaging techniques.
3. Adult ADHD, neuropsychological
ADHD children often have cognitive patients - nerve damage mental function, especially attention and executive function, and in adult patients also found a similar performance. Clearly the core of adult ADHD neuropsychological function defects empirical studies of adaptation is important, but also on the frontal lobe hypothesis of striatal system, changes in brain function is important. The current study directly related to the drugs rever


sibly by reducing brain damage.
4. Adult ADHD in the family genes Prospect
Family, twin studies suggest that ADHD children and foster care is a highly hereditary disease, although many of these studies were limited to children. Family genetic studies suggest the two brothers and their children in adult ADHD a high incidence of ADHD. Another longitudinal family studies suggest that when ADHD adults persisting into adolescence or early, it is more family-oriented performance. From the perspective of genetic research, the diagnosis rate of adult ADHD may start from here.
5. Adult ADHD drug treatment
Methylphenidate (MPH) and amphetamine in the treatment can be fast acting, and relatively pemoline, antidepressants and norepinephrine reuptake inhibitor (NRs) slow onset. Control studies suggest that nicotinic drugs and awaking / cholinergic complex potential. Short-term treatment studies suggest that stimulants, NRIs and specificity of the antidepressant treatment of adults with ADHD have a clinical and statistically significant effect, but further in-depth study aimed at assessing their long-term efficacy, functional and neuropsychological effects, tolerance the extent and effectiveness of specific subtypes and so on.1. Pregnancy and schizophrenia in offspring of infected
Prenatal infection and an increased risk of schizophrenia. A case-control study of 64 patients with schizophrenia and 125 controls who control including birth date, gender, participation time, maternal serum and so on. Research by hemagglutination inhibition test to count sets of influenza virus IgG antibodies. The results showed that pre-pregnancy exposure to influenza virus in March, the risk of schizophrenia increased by 7 times, while the first half of pregnancy, exposure to the influenza virus, the risk of schizophrenia increased by 3 times. 14% of schizophrenia cases of influenza virus infection by avoiding be prevented. Therefore, prenatal exposure to influenza virus may be one of the causes of schizophrenia during pregnancy to avoid exposure to influenza virus may reduce the incidence of schizophrenia part.
2. Prenatal viral infection, brain development and schizophrenia
A large number of epidemiological evidence that pregnancy occurred in March and June prior to virus infection and future generations of schizophrenia. Two studies were of C57BL 6 and Balb / c mice to study their infection during pregnancy No. 9. The results showed that offspring of type C57BL 6 abnormal brain development, causing occurrence of abnormal cortical pyramidal cell atrophy, and Reelin protein, nitric oxide synthase, synaptic associated protein 25 and glial fibrillary acidic protein levels. Before the onset of adult animals, reduce the level of impulse inhibition, and other abnormal behavior; and Bal / c type was the expression of glial fibrillary acidic protein increases protein glutamic acid decarboxylase 65 and 67 increased. These are tips prenatal viral infection may be similar to brain dysfunction of schizophrenia is one potential cause.
3. Parental age and schizophrenia risk
With the birth parents age, the greater the risk of schizophrenia. And <25-year-old father of child care compared to more than 40 years of age increased by 2-fold risk, more than 50 years old up to 3 times. This correlation may be interpreted as the age increased chances of mutation, because the human gene mutation rate showed linear correlation with age. Another male gamete DNA occurs outside the gene modification may also have such devastating effects. Except of course, can not carry the father of schizophrenia susceptibility gene in the possibility of delay. There is evidence that 1 / 4 of schizophrenia cases may be the parents of age-related schizophrenia (PARS), such cases the symptoms may have its own subtype, neuropsychological defects and physiological mechanisms, yet to be discussed.
4. Trimester radiation primate animal model of schizophrenia
Early exposure to X rays can damage the neurological development primate hypothalamus. Study found that the monkey thalamus during early pregnancy radiation volume is smaller, third trimester monkey prefrontal gray matter volume of radiation is smaller, both in the frontal white matter and hippocampal volume are reduced. Meanwhile, a monkey early pregnancy radiation anomalies and the task of operating their behavior is more obvious delay. These studies suggest that schizophrenia fetal radiation can reproduce the key features of anatomy and behavior.Choose the best drug abuse treatment program
1. The correct treatment of opioid dependence
Acetyl methadone methadone and opioid can reduce the use of and improve the psychological and social effects, but the application of alcohol and cocaine at the same time, doctors are required to follow-up, withdrawal, increasing ventricular tachycardia torsades risk requires attention. Tolerance of difference of naltrexone, and buprenorphine although better than the first three respiratory depression was mild, easy withdrawal to prevent the transfer, and shared with naloxone. Progress of these drugs, including research and development of naltrexone injection, which can block the heroin to 5 weeks; R & D implants, can block to March to December. The new detoxification methods include lofexidine, can reduce patient discomfort.
2. Choose the best treatment of cocaine dependence
Recent pharmaceutical research, including disulfiram, it ketone amphetamine, modafinil and topiramate. The research also extended to the effects of medication use excitatory and inhibitory amino acid neurotransmission, HPA axis function as well as the method of active immunization against cocaine into the brain. Disable the use of behavior induced by cocaine treatment applications to prevent the recurrence of drug maintenance treatment is also widespconcern.
3. To select the best regimen in the treatment of cannabis abuse
Current marijuana drug interventions include treatment of mood stabilizers and drug withdrawal symptoms. Treatment strategies for these conditions focus on prevention and psychosocial intervention. In recent years, extensive research related to the basic mechanism of action of cannabis, pharmacology, and neurophysiology; also includes endogenous ligands and endogenous cannabis resin. With in-depth research on cannabis, the new treatment is expected to develop and establish the corresponding hypothesis.
4. The treatment of comorbid conditions
For psychoactive substance abuse, mental disorder comorbidity including major depression, bipolar disorder, anxiety disorder, attention deficit low and schizophrenia / schizophreniform disorder and so on. The current study focused primarily on the specific barriers around patients about proper use of drug therapy; should avoid the use of drugs may be abused; if comorbid conditions treated with drugs, whether to reduce the use of psychoactive substances; Can I use non-pharmacological interventions to address comorbid conditions.
5. Psychosocial intervention the best option
Cognitive behavior therapy skills training can also be independent of joint intervention with drug psychoactive substance abusers. Interventions focused on access to interrupt drug use, sense of achievement, to encourage lifestyle changes, and improve medication compliance. These methods of treatment, including relapse prevention study, fortuitous event processing technology, motivational enhancement therapy and 12-step promotion methods. Long-term efficacy of behavioral intervention studies are inconsistent, and the method of transformation and integration of these theories applied to the community after it is the main topic for future research.
TAG: Adult ADHD neurobiology and psychology


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