ADHD Associated With Lower Weight at Birth, but Obesity in Childhood

Children with attention-deficit/hyperactivity disorder (ADHD) weighed less at birth but were significantly more likely to have obesity after age five compared with those without ADHD, according to a study issued by the Journal of the American Academy of Child & Adolescent Psychiatry. However, elevated ADHD symptoms were not predictive of increased obesity risk until age 7 in females and age 11 in males.

“The relationship between ADHD and body weight, despite being largely investigated, is still unclear,” wrote Claire Reed, M.Sc., of the University of Southampton, and colleagues. “Children with increased ADHD symptoms are typically lighter at birth than their peers but are later more likely to have obesity. Research into the ‘when and why’ regarding this turning point is scarce.”

Reed and colleagues used data from the Millennium Cohort Study, which included 7,908 children born between 2000 and 2002. Families provided data when children were 9 months old and again at ages 3, 5, 7, 11, 14, and 17. The 442 children with ADHD were identified either when they received a diagnosis or by the results of the Strengths and Difficulties Questionnaire (SDQ) hyperactivity/inattention subscale. Parents completed the SDQ during each data collection wave between the ages of 3 and 17. Children who scored high or very high on the subscale during at least five of the six waves were considered to have ADHD. The control group included 5,398 children without an ADHD diagnosis who never scored high on the hyperactivity/inattention subscale.

All children were weighed during each wave of data collection, and parents reported birth weights at the first wave.

Though children in the ADHD group weighed less on average at birth compared with the control group, the difference in weight between the two groups was not significant at 9 months or 3 years. However, those in the ADHD group were significantly more likely to have obesity from age 5 onwards, after excluding children taking stimulants. Further, higher ADHD symptoms as measured on the SDQ scale at ages 7, 11, and 14 were significantly associated with higher body mass index (BMI) scores at the next data wave among girls. This association was only seen in boys at ages 11 and 14.

The findings suggest that there may be a sensitive period between the ages of 3 and 5 during which higher ADHD symptoms become associated with obesity, the authors wrote. Additionally, the later association between higher ADHD symptoms and higher BMI scores may relate to increasing independence regarding food choices as children age, the authors posited. “Those with higher levels of impulsivity may be less likely to make healthier choices,” they wrote.

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Excessive Screen Time in Toddlers Linked to Autism Diagnosis in Early Adolescence

Toddlers who have more than 14 hours per week of screen time have nearly twice the odds of having a diagnosis of autism spectrum disorder when they are 12 years old, a research letter in JAMA Psychiatry has found.

Ping-I. Lin, M.D., Ph.D., of St. Louis University, and colleagues examined data amassed from parents of 5,107 children in the Longitudinal Study of Australian Children, a study examining how children's social, economic, and cultural environments affect their wellbeing over the life course. The researchers defined early childhood screen time as the weekly number of hours of exposure to television, videos, or other internet-based programs at 2 years of age.

A total of 145 children had a parent-reported diagnosis of autism spectrum disorder at 12 years. Children who had more than 14 hours of weekly screen time when they were two years old had 1.79 times the odds of having a diagnosis of autism spectrum disorder when they were 12 years old than those who had less than 14 hours of weekly screen time. Children were more likely to have more than 14 hours of screen time when they were 2 years old if they were boys, their mothers had less than 13 years of education or less, or they lived in households with a family income of $60,000 or less.

“Although our findings suggest that the association between screen time and ASD risk is not causal, there are still important clinical and policy implications,” the researchers wrote. “Screen time can be a useful marker for identifying families needing additional support. Interventions should address underlying socioeconomic factors, providing resources to reduce adverse health impacts of screen time.”

For related information, see the Psychiatric News Alert “Early Childhood Tablet Use Linked to Angry Outbursts.”

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Cognitive Remediation Plus Transcranial Stimulation May Slow Cognitive Decline in At-Risk Patients

Treating older adults with cognitive remediation (CR) plus transcranial direct current stimulation (tDCS) was effective in slowing cognitive decline in older adults with remitted major depressive disorder, according to a study issued by JAMA Psychiatry.

“Older adults with mild cognitive impairment (MCI) or a major depressive disorder (MDD) constitute two overlapping groups that are at high risk for cognitive decline and dementia,” wrote Tarek K. Rajji, M.D., at the Centre for Addiction and Mental Health in Toronto, and colleagues. “There is also a substantial body of evidence supporting that a depression occurring in early or mid-life, even if it has been in remission for years or even decades, can double or triple the risk of dementia in late life. Thus, interventions that could reduce this risk are needed.”

Rajji and colleagues recruited 375 participants from five academic hospitals in Toronto, who had remitted MDD, MCI, or both. Some were randomized to receive CR plus tDCS targeting the prefrontal cortex for eight weeks, five days a week, followed by twice-a-year five-day booster sessions of tDCS plus CR; participants were also asked to do at-home CR exercises daily. For the CR, a therapist trained participants on completing computerized exercises and provided them with ways to apply these skills to everyday difficulties. Other participants received sham tDCS and sham CR. Researchers conducted assessments at baseline, two months, and then yearly for three to seven years (median follow-up time was four years).

The primary outcome was the participants’ change in global composite cognitive score; secondary outcomes included change in short-term cognition and delayed progression to MCI or dementia.

The study showed that CR and tDCS did slow cognitive decline—particularly executive function and verbal memory—in participants over five years, though the effect was stronger in adults with remitted MDD (with or without MCI) than those with just MCI. The researchers found CR plus tDCS did not have any short-term effects on cognition relative to sham treatment, nor did it delay the progression from MCI to dementia.

“Our study was not designed to determine whether the observed benefits are due to CR plus tDCS or one of them alone,” Rajji and colleagues wrote. “Still, given the small and nonsignificant effects of CR on global cognition in [other] long-term studies, including in patients with mood disorders, our findings suggest that adding tDCS to CR augmented its procognitive effects.”

For more information see the Psychiatric News article, “New Medication, Staging Criteria Signal a Potential Shift in Alzheimer’s Care.”

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Poll Finds Many Americans Experience Changes in Mood as Winter Approaches

As autumn renders the daylight hours shorter and winter creeps closer, a significant percentage of Americans will experience changes in mood, according to the latest APA Healthy Minds poll.

Two-fifths of Americans (41%) said their mood declines during the winter months. This is especially true in the Midwest and Northeast, where 52% and 46% of respondents, respectively, said they experience a decline in mood.

The poll was conducted on behalf of APA by Morning Consult from October 18-20, 2024, among a sample of 2,201 adults.

While the “winter blues” are usually mild, a small percentage of people may experience a form of depression, known as seasonal affective disorder (SAD). The symptoms—including sadness, loss of interest in pleasurable activities, and changes in appetite and sleep—usually occur during the fall and winter months when there is less sunlight and then improve with the arrival of spring. While it is much less common, some people may experience SAD in the summer.

SAD can be effectively treated in several ways, including light therapy, antidepressant medications, and/or psychotherapy.

“The winter months have less light, the time change can feel abrupt, and the holidays for some are overwhelming,” said APA President Ramaswamy Viswanathan, M.D., Dr.Med.Sc. “It’s helpful to keep tabs on your mood…. If you’re feeling very poorly, consider talking to a mental health clinician, and also know that spring is only a few months away.”

When asked about what behaviors and feelings they noticed during winter, Americans reported sleeping more (41%), feeling fatigued (28%), feeling depressed (27%), and losing interest in things they like (20%). When asked which activities helped them cope with winter weather, Americans were most likely to select talking with friends and family (46%), sleeping more (35%), and going outside (35%).

Some other findings from the poll:

• More women (45%) than men (37%) said their mood declined in winter.
• The time change also had a greater impact on women—33% of women said it was bad for their mental health versus 26% of men.
• Urbanites were less likely to report a winter decline in mood (36%) compared with people in rural areas (46%).
• The time change was also more likely to affect the mental health of people in rural areas (31%) than their counterparts in cities (24%).

For related information, see the Psychiatric News article “This Winter Pandemic May Intensify Seasonal Depression.”

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APA Announces Candidates for 2025 Election

The APA Nominating Committee, chaired by Immediate Past President Petros Levounis, M.D., M.A., reports the following slate of candidates for APA’s 2025 election. This slate has been approved by the Board of Trustees and is considered official.

President-Elect
Rahn Bailey, M.D.
Mark Rapaport, M.D.
Harsh Trivedi, M.D., M.B.A.

Secretary
Gabrielle Shapiro, M.D.
Eric Williams, M.D.

Minority/Underrepresented Representative Trustee
Mansoor Malik, M.D.
Kamalika Roy, M.D., M.C.R.

Area 3 Trustee
Kenneth Certa, M.D.
Mandar Jadhav, M.D.

Area 6 Trustee
Lawrence Malak, M.D.
Adam Nelson, M.D.

Resident-Fellow Member Trustee-Elect
Craig Perry, M.D.
Tariq Salem, M.D.

The deadline for petition candidates is November 13, 2024. APA voting members may cast their ballots from January 2, 2025, to January 31, 2025.

For more details on the candidates and election process, please visit the “Election” section of APA’s website. Also look for more information on APA’s 2025 election in the December issue of Psychiatric News.

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