Pregnant women with obesity and diabetes may be more likely to have a child with ADHD

New knowledge about the link between infection during pregnancy and autism
New knowledge about the link between infection during pregnancy and autism

Children of women with gestational diabetes and obesity may be twice as likely to develop attention-deficit/hyperactivity disorder (ADHD) compared to those whose mothers did not have obesity, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

The estimated number of children aged 3–17 years ever diagnosed with ADHD is 6 million, according to data from 2016-2019. A major risk factor for ADHD in children is maternal obesity. Roughly 30% of women have obesity at their first doctor’s visit during pregnancy, and this number increases to 47% in women with gestational diabetes. Excessive weight gain during pregnancy in this population is a risk factor for children developing ADHD.

“Our study found pregnant women with obesity and gestational diabetes had children with long-term mental health disorders such as ADHD,” said Verónica Perea, M.D., Ph.D., of the Hospital Universitari MutuaTerrassa in Barcelona, Spain. “We did not find this association when these women gained a healthy amount of weight during pregnancy.”

The researchers studied 1,036 children born to women with gestational diabetes. Thirteen percent of these children were diagnosed with ADHD. The researchers found children of women with gestational diabetes and obesity were twice as likely to have ADHD compared to those born to mothers without obesity.

The researchers only found this association in women with gestational diabetes, obesity and excessive weight gain during pregnancy. The researchers did not observe a higher risk of ADHD in children of women with gestational diabetes and obesity if the amount of weight these women gained during pregnancy was within the normal range.

“It’s important for clinicians to counsel their patients on the importance of healthy weight gain during pregnancy,” Perea said.

When it comes to ADHD and Autism the eyes could reveal all

Eye


Can the eyes help understand the brain? CREDIT Per Jensen

It’s often said that ‘the eyes tell it all’, but no matter what their outward expression, the eyes may also be able to signal neurodevelopmental conditions such as autism and ADHD according to new research from Flinders University and the University of South Australia.

In the first study of its kind, researchers found that recordings from the retina could identify distinct signals for both Attention Deficit Hyperactivity Disorder (ADHD) and Autism ) providing a potential biomarker for each condition.

Using the ‘electroretinogram’ (ERG) – a diagnostic test that measures the electrical activity of the retina in response to a light stimulus – researchers found that children with ADHD showed higher overall ERG energy, whereas autistic children showed less ERG energy.

Research optometrist at Flinders University, Dr Paul Constable, says the preliminary findings indicate promising results for improved diagnoses and treatments in the future.

“Autism and ADHD are the most common neurodevelopmental disorders diagnosed in childhood. But as they often share similar traits, making diagnoses for both conditions can be lengthy and complicated,” Dr Constable says.

“Our research aims to improve this. By exploring how signals in the retina react to light stimuli, we hope to develop more accurate and earlier diagnoses for different neurodevelopmental conditions.

“Retinal signals have specific nerves that generate them, so if we can identify these differences and localise them to specific pathways that use different chemical signals that are also used in the brain, then we can show distinct differences for children with ADHD and autism and potentially other neurodevelopmental conditions.”

“This study delivers preliminary evidence for neurophysiological changes that not only differentiate both ADHD and ASD from typically developing children, but also evidence that they can be distinguished from each other based on ERG characteristics.”

According to the World Health Organizationone in 100 children has autism, with 5-8 per cent of children diagnosed with ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition characterised by being overly active, struggling to pay attention, and difficulty controlling impulsive behaviours. Autism is also a neurodevelopmental condition where children behave, communicate, interact, and learn in ways that are different from most other people.

Co-researcher and expert in human and artificial cognition at the University of South Australia, Dr Fernando Marmolejo-Ramos, says the research has the potential to extend across other neurological conditions.

“Ultimately, we’re looking at how the eyes can help us understand the brain,” Dr Marmolejo-Ramos says.

“While further research is needed to establish abnormalities in retinal signals that are specific to these and other neurodevelopmental disorders, what we’ve observed so far shows that we are on the precipice of something amazing.

“It is truly a case of watching this space; as it happens, the eyes could reveal all.”

Autism, ADHD and school absence are risk factors for self-harm, according to new study

Depression and chronic pain

Research led by King’s College London and South London and Maudsley NHS Foundation Trust has analysed factors associated with self-harm in over 111,000 adolescents aged 11-17 years old.

Published in BMC Medicine the study found that the risk for self-harm presenting to hospital emergency departments was nearly three times higher for boys with autism spectrum disorder (ASD) compared to boys without ASD. 

Attention Deficit Hyperactivity Disorder (ADHD) was a strong predictor of self-harm for both boys and girls with approximately a four-fold increased risk for self-harm amongst those with ADHD. 

Absence from school was also associated with increased risk for self- harm: for those young people with less than 80 per cent attendance the risk of hurting themselves was three times greater.

Part-funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre and the Wellcome Trust, this is the first long-term investigation of adolescent self-harm and ASD using linked school and hospital data in England. The research provides valuable insight into those groups most at risk, representing an important step in developing preventative strategies for self-harm.  

Dr Johnny Downs, Consultant Child & Adolescent Psychiatrist at South London and Maudsley and NIHR Clinician Scientist at the Department of Child & Adolescent Psychiatry, King’s College London and senior author on the paper said: “By linking these large-scale datasets, we have been able to understand which groups of young people may be most vulnerable to self-harming. Crucially we are using local data, so it has direct implications for the NHS Trust where I work and can improve our targeting of mental health interventions within South London schools. Another important aspect of this study is that any region in England could use the same approach, as the school and hospital data already exist and can be linked.” 

Self-harm is common in adolescents and research suggests about 1 in 5 self-harm. Around 12 per cent of episodes of adolescent self-harm are seen at emergency departments and these are the young people most likely to be at risk of suicide.

Researchers connected data on hospital attendance for self-harm to educational data. This enabled examination of education factors such as school attendance, special educational needs and free school meal status as well as data on mental health service use. The study assessed data from 113,286 young people from four boroughs in South London collected between 2009-2013.

By analysing data from the National Pupil Database on whether children had been assigned special educational needs for ASD, the study showed that boys with ASD were at greater risk of self-harm than boys without ASD. This pattern was not observed amongst girls with ASD but in general the risk of self-harm was higher in girls than in boys (1.5% compared to 0.3% in boys).

Emily Simonoff, Professor of Child & Adolescent Psychiatry at King’s College London, and Theme Lead for Child Mental and Neurodevelopmental Disorders in the NIHR Maudsley Biomedical Research Centre who is a co-author on the paper said: “We know that autistic adults have higher rates of premature death, including increased rates of suicide.  Self-harming behaviours, like those explored in the present study, may be the precursor to more serious suicide attempts, so early identification and proactive intervention when self-harm first appears is very important. Autistic people often have more difficulty regulating their emotions, which can contribute to high levels of distress and, because of the communication impairments experienced by many autistic people, professionals may not appreciate the level of distress they are experiencing and the seriousness of these behaviours.”

The study also found adolescents who had attended mental health services for ADHD were at four times the risk of self-harm than those who had not attended services for ADHD. School exclusion and absence were also identified as risk factors.

Joint first author Dr Emily Widnall who conducted the research while at King’s and is now Senior Research Associate in Public Health at University of Bristol said: “Our research has shown that adolescents who spent time away from school, either through exclusion or absence, have an increased risk for self-harm compared to young people who are in school most of the time. Linking educational data to mental health data has an important role to play in answering public health research questions in child and adolescent mental health and can help identify where more support is needed within schools.”

The study also revealed findings that may need further research to unpick the possible underlying mechanisms. For example, the finding that girls with ASD were at no higher risk to self-harm than those without ASD could be explained by underdiagnosis of ASD in girls.

The study also found that those who spoke English as a second language were at a lower risk to self-harm than those with English as their mother tongue.

“Taken at face value the results suggest young people who are resident in London but non-native English speakers, have less mental health difficulties,” commented Dr Downs.  “But there could be other influences at work which could mean that these young people are self-harming and not presenting to services or are expressing their distress through other means such as misusing substances.”

Two in five adults with ADHD are in excellent mental health

A new nationally representative study published online in the International Journal of Applied Positive Psychology found two in five adults (42%) with attention deficit hyperactivity disorder (ADHD) were in excellent mental health. To be considered in excellent mental health, participants had to report: freedom from mental illness in the previous year (i.e., substance use disorders, depression, anxiety, suicidality); almost daily happiness or life satisfaction in the past month; and high levels of social and psychological well-being in the past month.

“This finding provides a very hopeful message for both individuals struggling with ADHD and their loved ones,” says lead author Esme Fuller-Thomson, professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work and director of the institute for Life Course and Aging.

“This research marks a paradigm shift. Most previous research, including my own, has focused on mental illness among those with ADHD so to focus on those who are thriving mentally is refreshing and very heartening.”

Investigators examined a nationally representative sample of 480 respondents with ADHD and 21,099 respondents without ADHD from Statistics Canada’s Canadian Community Health Survey-Mental Health.

The study identified several factors that were associated with complete mental health among those with ADHD. Individuals who were free from chronic pain and had no lifetime history of depression or anxiety were more likely to be thriving.

“Our findings emphasize the importance of addressing comorbid mental health issues when providing care to individuals with ADHD” says co-author Bradyn Ko, a recent graduate of the Master of Social Work (MSW) program at the University of Toronto. “Those with ADHD who also struggle with depression and anxiety face substantial barriers to achieving complete mental health, and may benefit from targeted care.  Cognitive Behavioral Therapy is a very promising intervention that has been shown to be effective for those with ADHD”

Other factors that were associated with complete mental health include being married, being physically active, and using spirituality to cope with daily challenges.

“These results highlight potentially modifiable risk factors to support the well-being of adults with ADHD,” says co-author Lauren Carrique, a recent MSW graduate from the University of Toronto “When compared to being sedentary, engaging in optimal levels of physical activity approximately quadrupled the odds of complete mental health. This underlines the potential value of physical activity in helping individuals with ADHD achieve excellent mental health.”

The study also identified specific subpopulations of adults with ADHD who may be less likely to be in complete mental health, such as women.

“The finding that female respondents were less likely to be in flourishing mental health highlights the specific vulnerabilities among women with ADHD,” says co-author Andie MacNeil, a recent Master of Social Work graduate from the University of Toronto. “This aligns with other research that has found higher rates of depression, anxiety, and suicidality among women with ADHD, which may partially explain this gap in mental well-being.”

The prevalence of complete mental health among those without ADHD was 73.8%, which was significantly higher than the 42.0% of individuals with ADHD who were in complete mental health.

“Although we were surprised and delighted to find that two in five adults with ADHD were in excellent mental health, they are still lagging far behind their peers without ADHD, for whom 74% were thriving. There is still a long way to go in closing the mental health gap between those with and without ADHD,” says Fuller-Thomson.  “This study calls attention to this gap, while also emphasizing potential mechanisms to reduce this discrepancy.”

Attention Regulation: The Difference Between ADHD and Autism (Explaining The Neurodiversity Rainbow)

Attention Regulation: The Difference Between ADHD and Autism (Explaining  The Neurodiversity Rainbow) - YouTube


This video explains in pictures the difference between adhd and autism and the neurodiversity rainbow. When looking at autism vs adhd both have issues with attention regulation, executive function, emotional regulation, social challenges and many more, yet there are some key differences between them.