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Developmental Dyslexia (DD), Attention Deficit Hyperactivity Disorder (ADHD), and Educational Attainment (EA) are highly prevalent conditions that have a significant impacton individuals' academic and social functioning. These conditions have a complex genetic basis and are often comorbid. To assess the polygenic architecture of these traits, psychiatric genetics researchers utilize a sophisticated tool known as polygenic scores (PGS). By combining numerous genes of individually modest effects, PGS summarizes an individual's genetic risk as a single score. In this study, we aimed to examine the association between PGS for ADHD and EA with typical DD traits. Using a meta-analytic approach, we analyzed data from earlier studies and found that PGS-ADHD accounts for 1.2% of the variance in DD, with a pooled effect size of r = -0.11 (95% CI = [-0.171, -0.050]). Similarly, PGS-EA accounted for 3.2% of the variance in DD, with a pooled effect size of r = 0.18 (95% CI = [0.070, 0.288]). Although these effect sizes are relatively small, it is important to note that PGS are not typically strong predictors on their own, but rather capture a small portion of the genetic variation that contributes to a trait or outcome. My findings suggest that PGS for ADHD and EA are associated with DD, indicating that DD has a complex genetic basis. However, these findings also raise questions about the impact of PGS on psychiatric research moving forward. To address these questions, I provide recommendations for future researchdirections.

No description available.

No description available.

Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed behavior disorder in children. With the frequency of ADHD diagnoses, primary care providers (PCP) are challenged with managing this chronic and complex concern in an efficient yet effective way, both in terms of time and money. Research indicates behavioral diagnoses and management take approximately five minutes longer than medical-only concerns. This can result in a revenue loss for primary care practices. However, an on- site behavioral health consultant (BHC) can help PCPs provide a high standard of care for children presenting with behavioral concerns without compromising cost effectiveness. This study’s aim was to assess the cost per minute in a small rural primary care practice that utilizes an on-site BHC by comparing data between ADHD appointments when the BHC was utilized versus ADHD appointments when the BHC was not utilized. This study used extant data consisting of a sample of 53 children with ICD-9-CM codes 314.00 or 314.01, indicating an ADHD diagnosis. Of the 53 children with these codes, 40 (75.5%) were billed using E/M codes 99213 or 99214. The first of these indicates a regular office visit with an established patient not exceeding 15 minutes while the latter is used if the visit lasts longer than 25 minutes. Both codes were combined and evaluated together. The database was then recoded to indicate whether or not a BHC was utilized. Using descriptive statistics, it was found that children with ADHD spent a max of 69 minutes (20.19 minutes on average) with the PCP when a BHC was not utilized and a max of 22 minutes (13.67 minutes on average) when a BHC was utilized. Furthermore, an average of $82.79 in insurance reimbursement was received by the practice for these types of visits, regardless of up-coding for physician time spent. Using these statistics, it was determined that the practice makes $4.10 per minute when a BHC is not utilized versus $6.06 per minute when a BHC is utilized for ADHD appointments, due to the time savings ratio. The results indicate that utilization of a BHC increases revenue with respect to minutes spent with the child, while still providing behavioral health time and attention to the patient. These findings have practical implications for the treatment and management of ADHD and support the use of BHCs in pediatric primary care settings. Given the nature of pediatric primary care, it would be more cost effective for PCPs to utilize an on-site BHC with all ADHD visits.

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No description available.

The adherence to published guidelines for diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD) by primary care pediatricians (PDs) and family practice physicians (FPs), particularly those in rural areas, has not been well documented. This study examined survey responses from PDs and FPs who serve southern Appalachia (northeast Tennessee, southwest Virginia and Kentucky, and western North Carolina) regarding key practice parameters in line with the current American Academy of Pediatrics guidelines. Results showed that both PDs and FPs reported adhering to most of the diagnosis and treatment guidelines. PDs were more likely than FPs to report using both parent and teacher input in diagnosis and reported prescribing different medications for ADHD to some degree. Both practice areas reported ongoing access to continuing medical education, which is a means to enhancing care of ADHD patients. Implications for primary care are given with attention to the limited availability of PDs in rural areas and future areas of research in rural mental healthcare are suggested.

The effects of sertraline and methylphenidate on attention and behavior in children with attention deficit hyperactivity disorder were compared. Thirty-two children were randomly assigned to treatment with methylphenidate 20 mg per day, sertraline 50 mg per day, or a waiting list control group. Baseline testing included the Wechsler Intelligence Scale for Children, Children's Depression Inventory, Conners Parent and Teacher Rating Scales (CPRS and CTRS), Gordon Diagnostic System (GDS), and the Test of Variables of Attention (TOV A). After at least 2 weeks of medication the CPRS, CTRS, GDS, and TOVA were repeated. Analyses ofthe data using repeated measures ANOVAs revealed no significant main effects of treatment group on any of the primary outcome variables. However, several significant interaction effects of treatment group and trial period were noted. Children given methylphenidate showed significant improvement on measures of both attention and impulsivity/hyperactivity. Children in the sertraline group improved significantly on subscale 3 ofthe CPRS which measures impulsivity/hyperactivity, and showed a trend toward improvement in attention. Children in the control group did not improve significantly on measures of attention or impulsivity/hyperactivity. Both medications were well tolerated. These results suggest that methylphenidate is a more effective medication for ADHD than sertraline. However, the trend toward improvement with sertraline suggests that further clinical trials are warranted.

With this study, we have chosen to continue our B-essay about dual-diagnosis.In the essay we have done some research on how this target group feels about the treatment from the dependent unit, psychiatry unit, social services unit and the housing environment. We wanted to know about the feelings because during the B-essay we found out that individuals whit the dual-diagnosis is skipped between different caregivers. We used a qualitative method with six interviews from two different housings in south of Sweden. The information we got we used in our result and analysis part, where we found out that the caretaker’s thought the treatment were fine and that it was the surroundings they found the most fault with.