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Mental health problems in women, children, and adolescents are a significant public health issue. Given current barriers to the effective treatment of these problems, researchers are looking to the field of nutrition for potential alternatives to better understand and address mental health issues. The purpose of this article was to review current evidence on the relation between zinc and mental health disorders with a focus on 2 mental health problems that commonly affect women and children: depression and attention-deficit hyperactivity disorder (ADHD). A literature search of the databases Medline and PsychInfo was conducted with the use of key terms. The review included articles from 1975 to May 2008, but focused on articles published in recent years. Relations between zinc concentrations and behavior in animals; the relation between zinc deficiency, depression, and ADHD in patient and community samples; and the potential biological mechanisms for these relations were explored. The data support a relation between low concentrations of zinc and mental health problems, especially in at-risk populations. Evidence for the potential use of zinc in treating mental health problems comes mainly from patient populations and is strongest when zinc is given in combination with pharmacologic treatment. Less conclusive evidence exists for the effectiveness of zinc alone or in general community samples. Recommendations for further research in this area are provided.

Mental health problems in women and children represent a significant public health problem worldwide, especially in developing countries. The role of nutrition as a cost-effective approach in the prevention and management of these conditions has received recent attention, particularly nutrients such as iron, zinc, and n-3 (omega-3) fatty acids, which play a role in brain structure and function. The objective of this article was to review current evidence on the relation between n-3 fatty acids, especially docosahexaenoic acid (DHA), and maternal and child mental health disorders. Human studies published in English were identified from Medline databases (1966 to June 2008) by using key search terms and review articles. A summary of the role of DHA in the human brain is followed by a review of human studies, both observational and intervention trials, that examine the relation between n-3 fatty acids such as DHA and depression and child mental health disorders. Observational studies support a direct association between poor n-3 fatty acid status and increased risk of maternal depression and childhood behavioral disorders such as attention-deficit hyperactivity disorder (ADHD). However, evidence from intervention trials is weak. Most of the studies reviewed had small sample sizes and were conducted in clinically diagnosed samples, with no placebo-controlled groups. Little is known about the benefits of DHA in the prevention of maternal depression and ADHD. Large, well-designed, community-based prevention trials are needed.

Attention Deficit Hyperactivity Disorder (ADHD) ADHD is a chronic neurobehavioral mental-health disorder with functional impairments as a result of concentration/attention or impulsivity/hyperactivity. (1) The disorder affects one in every 20 [...]

Objective: Children with very low birth weight ( Method: A total of 162 very-low-birth-weight subjects (small for gestational age: N=52; appropriate for gestational age: N= 110) and 172 term comparison subjects 18 to 27 years of age completed the Adult Problem Questionnaire, which yielded six exploratory factor analysis-derived subscales. Participants were also asked about substance use. Results: Very-low-birth-weight adults in the small for gestational age subgroup scored higher on the executive dysfunctioning and emotional instability subscales of the Adult Problem Questionnaire than did those in the appropriate for gesrational age subgroup and the comparison group. The appropriate for gestational age and comparison groups had similar scores on these subscales. On the alcohol use subscale of the Adult Problem Questionnaire, both the appropriate and small for gestational age subgroups scored lower than comparison subjects and also reported fewer risk-taking behaviors (alcohol, smoking, and use of recreational drugs) than did comparison subjects. Conclusions: Rather than very low birth weight per se, intrauterine growth retardation, as reflected by small for gestational age status in the very-low-birth-weight subjects, confers a risk for behavioral and emotional adversity related to ADHD in young adulthood.

Children with fetal alcohol spectrum disorder (FASD) are often diagnosed with attention-deficit/ hyperactivity disorder (ADHD). These children show increases in reaction time (RT) variability and false alarms on choice reaction time (CRT) tasks. In this study, adult rats prenatally exposed to ethanol were trained to perform a CRT task. An analysis of the distribution of RTs obtained from the CRT task found that rats with a history of prenatal ethanol exposure had more variable RT distributions, possibly because of lapses of attention. In addition, it was found that, similar to children with FASD, the ethanol-exposed rats had more false alarms. Thus, rats with prenatal ethanol exposure show attention deficits that are similar to those of children with FASD and ADHD.

Objective: This study examined the effect of gender in mediating the association between environmental adversity and the risk of attention deficit hyperactivity disorder (ADHD) and associated impairments. Method: The authors studied 280 ADHD and 242 healthy comparison probands of both genders who were between the ages of 6 and 17 years. They tested the association between Rutter's indicators of adversity (including family conflict, social class, family size, maternal psychopathology, and paternal criminality) and ADHD, comorbidity, and functioning. Results: Greater levels of environmental adversity were associated with a greater risk for ADHD and other comorbidity in both genders in a dose-dependent fashion. However, learning disability and global functioning were modified by gender, with more detrimental effects observed in boys than in girls. Low social class, maternal psychopathology, and family conflict were significantly associated with psychopathology and functional impairment in the probands, with control for gender, parental ADHD, proband ADHD status, and maternal smoking during pregnancy. Conclusions: Psychosocial adversity in general and low social class, maternal psychopathology, and family conflict in particular increased the risk for ADHD and associated morbidity independently of gender and other risk factors, but gender modified the risk for adverse cognitive and interpersonal outcomes; boys were more vulnerable to the disorder than girls. Because of the difficulties in separating the effects of genetics from environment, these results must be interpreted as provisional until confirmation from twin and adoption studies.

There appears to be no association between the risk of attention-deficit/hyperactivity disorder (ADHD) and psyoactive substance abuse disorders (PSUD). Researchers analyzed the risks of both disorders in the first-degree relatives of 131 children and teenagers with ADHD and the first-degree relatives of 106 healthy volunteers. The risk of ADHD was greatest in relatives of ADHD patients, regardless of whether the patients also had PSUD. The risk of PSUD was greatest in relatives of those with PSUD regardless of whether they also had ADHD.

Objective: This study investigated the role of maternal smoking during pregnancy in the etiology of attention deficit hyperactivity disorder (ADHD). Method: Subjects were 6-17-year-old boys with DSM-III-R ADHD (N = 140) and normal comparison subjects (N = 120) and their first-degree biological relatives. Information on maternal smoking was obtained from mothers in a standardized manner by raters who were blind to the proband's clinical status. Results: Twenty-two percent of the ADHD children had a maternal history of smoking during pregnancy, compared with 8% of the normal subjects. This positive association remained significant after adjustment for socioeconomic status, parental IQ, and parental ADHD status. Significant differences in IQ were found between those children whose mothers smoked during pregnancy and those whose mothers did not smoke (mean IQ = 104.9, SD = 12.3, and mean = 115.4, SD=12.2, respectively). Conclusions: These findings suggest that maternal smoking during pregnancy is a risk factor for ADHD. If confirmed, these findings will stress the importance of programs aimed at smoking prevention in nonsmoking women and smoking cessation in smoking women of childbearing age.

Objective: To evaluate whether a pediatric family history obtained via a brief parent interview would reveal a high prevalence of psychiatric and developmental disorders in the family members of children with attention-deficit hyperactivity disorder (ADHD) compared with a group of children with another chronic developmental disability, Down syndrome (DS). Design: A controlled cross-sectional group comparison study. Setting: An interdisciplinary hyperactivity and learning problem clinic and a DS clinic located in a large, urban tertiary care teaching hospital in Chicago, Ill. Participants: A total of 140 children with ADHD and 163 children with DS of comparable socioeconomic status. Measures: Using a screening questionnaire and parent interview, the developmental pediatricians obtained a family history. Results: By parent report, children with ADHD were significantly more likely than the control children with DS to have a parent affected by alcoholism (P=.007), other drug abuse (P, Relatives of children with attention-deficit hyperactivity disorder (ADHD) may be more likely to have psychiatric or developmental disorders. Researchers compared family histories between the families of 140 children with ADHD and the families of 163 children with Down syndrome. Most families in both groups were middle to high income. The parents of children with ADHD were more likely to have experienced alcoholism, drug abuse, depression, a nervous breakdown, delinquency, learning disabilities and ADHD. The siblings of ADHD children were more likely to have experienced alcoholism, drug abuse, delinquency, behavior problems, ADHD, and learning disorders. Grandparents were more likely to have experienced alcoholism and depression. Aunts and uncles were more likely to have experienced alcoholism, drug abuse, and learning disorders.

In an effort to determine whether specific aspects of attention are impaired by lead, the performance of 79 subjects (aged 19 and 20 y) on a neuropsychologically based battery of tests of attention was examined in relation to lead levels in deciduous teeth (dentin), current blood, and tibia and patella bones measured by K-X-ray fluorescence. Dentin lead levels averaged 14 [mu]g/g. Most bone lead levels were less than 10 [mu]g/g. Dentin lead levels were related inversely to scores on two of four attention factors: focus-execute (ability to select and respond to critical information) and shift (ability to shift focus adaptively). Few significant associations were observed between bone lead levels and performance. Five individuals with the ALA-D 1-2 isozyme phenotype tended to achieve more optimal scores. Executive and self-regulation functions may be among the cognitive skills targeted by lead., THE MAJOR ENDPOINT examined in nearly all studies of low-level lead neurotoxicity is IQ, a familiar global index of impairment. IQ reflects largely neuropsychological product rather than process, performance rather [...]

Attention deficit disorder (ADD) involves persistent, developmentally inappropriate behavior related to an inability to be attentive. Investigators have noted high rates of ADD among children of parents with anxiety disorders. To test this observation, 356 first-degree relatives of 73 caucasian male children with ADD (aged 6 to 17 years) who had been referred to a clinic, and 26 non-ADD, healthy children who served as a comparison group were studied. The patients, the comparison group and their biological relatives were clinically evaluated by raters using structured diagnostic interviews. Parents of all the children were assessed for both childhood (e.g., separation anxiety and avoidant disorders) and adult (e.g., panic disorder, obsessive-compulsive disorder or agoraphobia) types of anxiety disorders. Twenty-two of the 73 ADD patients met criteria for additional childhood anxiety disorders. The rate of separation and divorce among parents of the children with ADD plus additional anxiety disorders was significantly higher than for the other children. The risk for anxiety disorder was approximately twice as high for relatives of ADD children with anxiety disorder as for relatives of the other groups. The significantly higher risk for anxiety disorders among parents of ADD children is not consistent with literature positing that ADD and anxiety disorders are independent of each other. However, findings of this study must be interpreted with caution, since clinically referred ADD children may be more ill than ADD children in the community, and parents who refer their ADD children to clinics may be more anxious than parents of other children with ADD. (Consumer Summary produced by Reliance Medical Information, Inc.)

Attention deficit disorder is a common psychological problem that may affect 6 to 9 percent of school-age children. It is two to nine times more common in boys than in girls. Most studies of attention deficit disorder have provided little or no information about girls. Overall ratings of disturbance are about the same for boys as for girls. However, it is suggested that girls with attention deficit disorder have higher rates of cognitive (memory and learning) impairment, depression, and low self-esteem than boys. In addition, depression in the mother and marital discord between parents seem to occur less often in families of girls with attention deficit disorder than in the families of such boys. Because family disruption and several behavioral disturbances are observed less frequently among girls with the disorder, they may be less likely to come to the attention of health care providers. Genetic studies in families of boys with attention deficit disorder have consistently found relatives of boys to be at greater risk for attention deficit disorder. This provides external validation for the diagnosis in boys and suggests genetic influences may be at work. The extension of these findings to girls would provide support for the validity of the attention deficit disorder diagnosis in girls. Twenty-one girls with attention deficit disorder and 20 normal controls were assessed along with their relatives. Both groups of girls and their relatives were evaluated on the basis of standard diagnostic interviews. The relatives of girls with attention deficit disorder had higher risks for the disorder, antisocial disorders, major depression, and anxiety disorders. These findings are consistent with earlier work done with boys, which was conducted with identical methods, and provide further support for the validity of the diagnosis of attention deficit disorder in girls. (Consumer Summary produced by Reliance Medical Information, Inc.)

Even though a child has symptoms of attention deficit hyperactivity disorder (ADHD), those symptoms may not cause the functional impairments that are characteristic of this condition. For a diagnosis of [...]