Monthly Archives: April 2008

In a landmark study from Holland researchers found that putting children on elimination diets significantly improved ADD symptoms.  The abstract is below.

Eur Child Adolesc Psychiatry. 2008 Apr 21 A randomised controlled trial into the effects of food on ADHD.Pelsser LM, Frankena K, Toorman J, Savelkoul HF, Pereira RR, Buitelaar JK.ADHD Research Centre, Liviuslaan 49, 5624 JE, Eindhoven, The Netherlands 

The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder (ADHD). Dietary studies have already shown evidence of efficacy in selected subgroups.

Twenty-seven children (mean age 6.2) who all met the DSM-IV criteria for ADHD, were assigned randomly to either an intervention group (15/27) or a waiting-list control group (12/27). Primary endpoint was the clinical response, i.e. a decrease in the symptom scores by 50% or more, at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale.

The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [parent ratings 11/15 (73%) versus 0/12 (0%); teacher ratings, 7/10 (70%) versus 0/7 (0%)]. The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 (cohen’s d) and a scale reduction of 69.4%. Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens’s d 1.1, scale reduction 45.3%).

A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children’s behaviour.

Can some anxiety be good?  Of course! Anxiety is what prevents you from driving 125 miles per hour down the freeway in the rain.  Anxiety prevents you from giving someone you just met in the bar your home phone number.  Remember the movie Fatal Attraction? 

I think I have been a fairly anxious person most of my life.  When I was little I had an older brother who pounded me on a regular basis, which may have set up a sense in my brain that something bad is about to happen.  I used to bite my finger nails and often carried a lot of tension in my shoulders.  But anxiety is not all bad. 

After medical school I went back into the Army as an officer so I could do my psychiatry training at Walter Reed in Washington, DC.  But first I had to go to several weeks of officer training school at Fort Sam Houston in Texas.  One day we were doing a ropes course.  We had to traverse a ravine, hand over hand using a rope anchored to each end.  It was about fifty feet across and 30 feet above a dry rock bed.  The physical part didn’t bother me.  But they tied us to the rope with a Swiss seat, a rope around our waist and through our legs.  When we got out into the middle of the ravine we were instructed to let go and let the Swiss seat hold us up.  For some reason I did not trust it.  When I got out into the middle of the ravine I did not want to let go.  I felt like a scared little bunny rabbit.  I knew my friends would be laughing at me and it caused quite an internal crisis.  But that day the scared bunny rabbit won. I didn’t let go and scurried to the other side.  With my friends razzing me I climbed up on the other side of the ravine only to turn around and see my best friend at the course let go of the rope.  They had mistied his Swiss seat and I watched him fall 30 feet to the rocks below, where he broke his neck and punctured his lungs.  From that moment on I have been grateful for my anxiety.  It often helps prevent bad things from happening. 

Clearly some anxiety is good, but what can you do when it gets out of control.  As in ADD, depression and bipolar disorder, there are different types of anxiety disorders, so knowing which type you have is essential to getting the best treatment.  Certain medications and supplements can be very helpful. With anxiety disorders I tend to use supplements first because I do not like what I have seen on scans.  Some of the anti-anxiety medications, like Xanax, work like alcohol on the brain.  Supplements such as 5-HTP, GABA, kava kava and green tea have been found to be helpful.  Plus, I really like hypnosis, guided imagery and meditation to calm anxiety and teaching people how to rid themselves of the anxious ANTs that provide the seeds of anxiety disorders.