PSYCHIATRIC TREATMENT OF CHILDREN & ADOLESCENTS - PART 6

Experts claim that approximately 20% of children in the U.S. have mental disorders with some functional impairment, including about 5-9% of children and adolescents between the ages of 9 and 17 who are defined by federal regulations as having "serious emotional disturbance" (Friedman et al., 1996b). "Serious emotional disturbance" (SED) refers to children under age 18 with a diagnosable mental health problem that disrupts their ability to function.  SED is not a diagnosis, but rather a catchall legal term entitling a child so designated to a host of government-mandated services.

Cardiovascular effects of therapeutic doses of tricyclic antidepressants in children and adolescents.
Wilens TE, et al.
J Am Acad Child Adolesc Psychiatry 1996 Nov;35(11):1491-501.

This study reviewed available literature on the effects of tricyclic antidepressants on the cardiovascular system after several reports of cases of sudden death in children and adolescents on treatment with these drugs. Indeed, analysis of 24 studies conducted on 730 children, documented electrocardiographic changes and abnormalities, increased diastolic and systolic blood pressure, and increased heart rate during exposure to this class of drugs.

Synthetic food coloring and behavior: a dose response effect in a double-blind, placebo-controlled, repeated-measures study.
Rowe KS, Rowe KJ.
J Pediatr 1994 Nov;125(5 Pt 1):691-8.

The results of this study show that intake of tartrazine (synthetic food coloring) is associated with behavioral changes typical of attention-deficit disorder (ADD) in a significant number of children. The study was conducted on 200 children referred for suspected attention-deficit disorder to a children's hospital. They were started on a 6-week period of synthetic food coloring-free diet. One hundred-fifty mothers reported that their children's behavior improved with diet, and worsened when synthetic food coloring was re-introduced. In addition, the researchers conducted a three-week long, double- blind, placebo-controlled trial, to test the behavioral responses of children with ADD and controls, to escalating doses of tartrazine or placebo. Twenty-two of 34 children with suspected ADD and 2 of 20 controls were found to have clear reactions to tartrazine, manifested by restlessness, irritability, and sleep disturbances. All doses produced behavioral responses, and the response was prolonged in children who received higher doses. These results indicate that intake of synthetic food coloring induces behavioral disturbances typical of attention deficit disorder in a significantly high number of children diagnosed with this condition. The symptoms are reproducible, and the responses are dose-related. Based on these results, it seems consequential that dietary approaches entailing removal of artificial food coloring be attempted in every child with suspected ADD, before any other form of treatment is pursued.

Does oligoantigenic diet influence hyperactive/conduct-disordered children--a controlled trial.
Schmidt MH, et al.
Eur Child Adolesc Psychiatry 1997 Jun;6(2):88-95.

This double-blind, placebo-controlled, crossover study, evaluated the impact of an oligoantigenic diet in 49 children with attention-deficit hyperactive disorder, and compared the effects of diet with those obtained by treatment with Ritalin. Twenty-four percent of children responded to diet, and 44% responded to Ritalin. Both treatments yielded the same amount of positive changes. This study indicates that the benefits of a dietary treatment equal those of a regimen based on psychotropic drugs in 1 out of 4 children diagnosed with hyperactive/disruptive disorder. In addition, these results indicate that psychotropic drugs improve behavior in less than half of treated children. The authors conclude that a dietary approach cannot be neglected as potentially effective treatment for this condition.

Synthetic food colourings and 'hyperactivity': a double-blind crossover study.
Rowe KS.
Aust Paediatr J 1988 Apr;24(2):143-7.

The results of this study show that artificial food colors induce behavioral changes typical of attention-deficit hyperactive disorder (ADHD) in susceptible children. Fifty-five children with suspected ADHD were put on the Feingold diet for a 6-week period. Approximately three-quarters of them exhibited significant behavior improvements, which lasted for 3-6 months after discontinuation of the diet. In 14 of these children hyperactive symptoms seemed to be triggered by artificial food coloring.

Effect of artificial food colours on childhood behaviour.
Pollock I, Warner JO.
Arch Dis Child 1990 Jan;65(1):74-7.

The results of this study show that artificial food coloring adversely affect behavior in susceptible children. The double-blind, placebo-controlled study was conducted on 19 of 39 children who had been reported by their parents to react to these food additives. Artificial food colors adversely affected behavior in all children.

Effects of a few food diet in attention deficit disorder.
Carter CM, et al.
Arch Dis Child 1993 Nov;69(5):564-8.

The results of this study indicate that diet is an effective treatment in some children with attention-deficit hyperactive disorder. The study was conducted on 78 children who were started on a food elimination diet for hyperactivity disorder. Behavior improved in 59 (75%) of them. In 19 of the diet-responsive children, specific foods or additives were identified that triggered an adverse response. A double-blind placebo-controlled crossover trial, showed that exposure to reactive substances was significantly associated with hyperactive behavior and with impaired psychological test performance, highlighting that diet is a common cause of hyperactive disorder in children.

Foods and additives are common causes of the attention deficit hyperactive disorder in children.
Boris M, Mandel FS.
Ann Allergy 1994 May;72(5):462-8.

The results of this study indicate that diet is a frequent cause of attention-deficit hyperactive disorder (ADHD) in children. Twenty-six children diagnosed with ADHD underwent a food elimination diet. Improved behavior was observed in 19 (73%) of them. All children reacted adversely when re-challenged with specific foods, dyes, and/or preservatives. A double-blind, placebo controlled food challenge confirmed significant behavior improvement in children randomized to receive placebo, compared to those who received the reactive food or food additive. According to the authors' own conclusions, diet may have an important causative role in the majority of children diagnosed with ADHD.

The role of diet and behaviour in childhood.
Breakey J.
J Paediatr Child Health 1997 Jun;33(3):190-4.

This article reviewed the results of the most important research published in 1985-1995, on the relationship between diet and behavior in children. Particular emphasis was placed on double-blind, placebo controlled studies. A definite connection between diet and behavior was found in some children. A wide range of foods and foods additives were found to adversely affect behavior, and the symptoms triggered were typical of those of attention-deficit disorder, attention-deficit hyperactive disorder, sleep disturbances and mood swings.

Relative effects of drugs and diet on hyperactive behaviors: an experimental study.
Williams JI, Cram DM, Tausig FT, Webster E.
Pediatrics 1978 Jun;61(6):811-7.

The results of this study show that food additives adversely affect behavior in a significant number of children. Of 26 children with hyperactivity disorder who were challenged with synthetic food colorings, 7 were no longer hyperactive when the food additives were removed. According to the authors, these results are in support of Feingold's hypothesis that additives present in foods trigger hyperactive behavior in susceptible children.

Use our to find a doctor in your area.