August 28, 2024
Antipsychotic medications are used to treat a variety of psychiatric disorders, including schizophrenia, bipolar disorder, sleeping problems, major depression, and severe anxiety.
Untreated maternal mental illness is associated with poor health outcomes for both mothers and their offspring. On the other hand, one must guard against any potential direct harms of medications on development – including neurological development – of the fetus.
Because prenatal use of antipsychotics is infrequent, previous observational studies have suffered from small sample sizes that have not enabled precise and reliable assessment of risk. The clinical decision about whether to continue antipsychotic treatment in patients who become pregnant has therefore remained inconclusive.
In search of more reliable guidance, an international study team conducted a systematic search of the peer-reviewed medical literature to perform the first meta-analysis on this topic.
They evaluated study quality and only included studies rated “good” or better.
Identification of ADHD was determined by clinical diagnosis.
Meta-analysis of four studies encompassing over eight million participants found a slight association. Children exposed to maternal antipsychotics during pregnancy were 11% more likely to be diagnosed with ADHD subsequently.
But even in observational studies with millions of participants, such associations – especially when slight to begin with – could be due to unmeasured confounders.
The team therefore compared children with gestational exposure to siblings from the same mother who were not exposed, to address shared genetic and social factors at the family level.
Meta-analysis of two population-based sibling-matched studies with a combined total of over 4.6 million participants in Denmark, Norway, Sweden, Finland, Iceland, and Hong Kong found no significant association between gestational exposure to antipsychotic medications and subsequent diagnosis of ADHD.
The team concluded, “Our systematic review and meta-analysis of observational studies indicates that the heightened risks of ADHD and ASD observed in children gestationally exposed to antipsychotics appear to be attributable to maternal characteristics, rather than having a causal relation to the antipsychotic itself.”
Zixuan Wang, Andrew SC Yuen, Kirstie HTW Wong, Adrienne YL Chan, David Coghill, Emily Simonoff, Wallis CY Lau, Ian CK Wong, Sohee Park, and Kenneth KC Man, “Association between prenatal antipsychotic exposure and the risk of attention-deficit/hyperactivity disorder and autism spectrum disorder: a systematic review and meta-analysis,” Neuroscience and Biobehavioral Reviews (2024), 160:105635, https://doi.org/10.1016/j.neubiorev.2024.105635.
A recent study published in Alpha Psychiatry sheds light on the connection between ADHD, empathy, and narcissistic traits. Researchers aimed to evaluate how pharmacological treatments—specifically psychostimulants—affect empathy deficits and pathological narcissism in adults with ADHD. These findings could have important implications for enhancing treatment outcomes and improving social functioning.
Study Overview
The study involved 75 adult ADHD patients who were treated with either methylphenidate or atomoxetine. Researchers assessed levels of narcissistic traits and empathy using validated tools such as the Pathological Narcissism Inventory (PNI) and the Empathy Quotient (EQ). Measurements were taken before treatment and after three months of therapy.
Key Findings
Why It Matters
Adults with ADHD often struggle with social interactions, partly due to empathy deficits and personality traits like narcissism. By addressing these challenges through psychostimulant treatment, patients may experience better social and emotional well-being. This study underscores the importance of viewing ADHD treatment as not just a way to manage symptoms but also a means to improve overall quality of life.Takeaway
Effective ADHD treatment goes beyond managing attention and hyperactivity. By improving empathy and reducing narcissistic traits, psychostimulants can foster healthier relationships and enhance social functioning. This research highlights the need for comprehensive care that considers the broader psychological and interpersonal effects of ADHD.
According to Fosco et al. (2019), “Inhibitory control has long been considered a central neurocognitive process in ADHD, with ADHD groups typically showing medium-sized impairments relative to their typically-developing peers on common inhibition paradigms.”
Learning to play a musical instrument requires effective coordination of physical movements and sound signals to produce music. Musical training involves repetitive practice, perfecting connections between perceptions, muscular actions, and cognition.
Noting that listening to music activates the brain’s reward circuits in both children and adults, that “Being internally motivated during learning experiences increases learning capacity and efficiency, and this greater engagement is reflected in increased electrical brain activity following musical training,” and that “Training music in a social environment increases positive feelings of bonding through shared emotions and group synchrony,” a Montreal-based research team carried out a systematic review and meta-analysis of the peer-reviewed medical literature from 1980 to 2023 to learn what effect music training might have on inhibition control.
Outcomes:
The team found eight randomized controlled trials (RCTs) and 14 other longitudinal studies that met search criteria, including:
Meta-analysis of all 22 longitudinal studies with a combined total of 1,734 participants yielded a small-to-medium effect size improvement in inhibitory control. Variation (heterogeneity) in outcomes between individual studies was small, and there was no sign of publication bias. Restricting the analysis to the eight RCTs with a combined total of 641 participants, however, yielded a medium-to-large effect size improvement, with negligible heterogeneity, meaning the outcome was consistent across RCTs.
The Take-Away: The team concluded, “Music training plays a privileged role compared to other activities (sports, visual arts, drama) in improving children’s executive functioning, with a particular effect on inhibition control.” I cannot, however, recommend this as a therapy for ADHD until RCTs show it reduces symptoms of ADHD and/or real world impairments associated with the disorder.
Organic farming aims to protect biodiversity, promote animal welfare, and avoid using pesticides and fertilizers made from petrochemicals. Some pesticides are designed to target insects’ nervous systems but can also affect brain development and health in larger animals, including humans.
Many people believe organic food is healthier than conventionally produced food, which might be true for certain foods and health factors. But does eating organic food during pregnancy impact the chances of a child developing ADHD or autism spectrum disorder (ASD)?
In Norway, researchers can use detailed national health records to study these connections on a population-wide level, thanks to the country’s single-payer healthcare system and national registries.
The Norwegian Mother, Father, and Child Cohort Study (MoBa) invites parents to participate voluntarily and has a 41% participation rate. The study includes:
For this research, a team tracked 40,707 mother-child pairs from children born between 2002 and 2009. They used questionnaires to measure how much organic food mothers consumed during pregnancy. ADHD and ASD symptoms in children were assessed using validated rating scales.
The final analysis included:
The researchers adjusted for factors like maternal age, education, previous pregnancies, BMI before pregnancy, smoking and alcohol use during pregnancy, birth year and season, and the child’s sex.
The researchers concluded that eating organic food during pregnancy has no meaningful effect on the likelihood of a child developing ADHD or ASD. They stated, “The results do not indicate any clinically significant protective or harmful effects of eating organic food during pregnancy on symptoms of ADHD and ASD in the offspring. Based on these findings, we do not recommend any specific advice regarding intake of organic food during pregnancy.”
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