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BackgroundHealthcare costs are skyrocketing, with mental health treatment amongst the most expensive, especially when hospitalization is involved. According to the Mental Health Commission of Canada, one in five Canadians is living with a mental disorder in any given year, at an annual cost of $50 billion. In light of this societal burden, alternative approaches are being evaluated, such as brief psychotherapy by phone, peer support, and, as part of the emerging field of nutritional mental health, treatment with micronutrients (minerals and vitamins). Effectiveness of micronutrients has been demonstrated for many types of psychiatric symptoms, in about 45 studies of formulas that are either multinutrient (e.g., several B vitamins) or broad-spectrum (usually over 20 minerals and vitamins). Although this literature demonstrates therapeutic benefits, the potential economic impact of micronutrient treatment has been evaluated in only one case study of childhood psychosis.MethodsThe current case study was initiated to evaluate mental health-related hospitalization costs from 1997 to 2003 for a female adult diagnosed with various mood and psychotic symptoms. She was treated for the first 5 years with conventional methods and then subsequently with a broad-spectrum micronutrient formula.ResultsThe patient's annual mental health hospitalization costs during conventional treatment averaged $59,864 across 5 years (1997-2001), with a peak annual cost of about $140,000. Since transitioning to broad-spectrum micronutrients, she has incurred no provincial hospitalization costs for mental health care, though her self-funded costs are currently $720/year for the micronutrients.ConclusionFurther exploration of the treatment of mental health problems with broad-spectrum micronutrient formulas has the potential to make two significant contributions: improved mental health, and decreased costs for governments.

Background: Vitamin D is critical for healthy pregnancies and normal fetal development. It is important to accurately ascertain vitamin D status in mothers and their newborns to establish the optimal vitamin D concentration during pregnancy. There are many different metabolites and epimers of vitamin D in peripheral blood and controversy as to the importance of epimers in estimating vitamin D status in maternal and infant health. Objectives: We undertook this study to measure 25-hydroxyvitamin D metabolites and epimers and their relations in maternal and cord blood and to evaluate the impact of the inclusion of epimers on assessing vitamin D status. Methods: We performed a substudy in a longitudinal cohort of pregnant women and their infants in Alberta, Canada [APrON (Alberta Pregnancy Outcomes and Nutrition) Study], Maternal and cord blood plasma collected at the time of newborn delivery was stored at -70[degrees]C until testing and assayed for 25-hydroxyergocalciferol [25(OH)[D.sub.2]], 25hydroxycholecalciferol [25(OH)[D.sub.3]], and 3-epi-25-hydroxycholecalciferol [3-epi-25(OH)[D.sub.3]] by using LC-tandem mass spectrometry. The effect of 3-epi-25(OH)[D.sub.3] on estimates of vitamin D adequacy was explored by using McNemar's chi-square test at both recommended thresholds of 50 and 75 nmol/L. Results: Ninety-two pairs of maternal and cord blood samples were obtained. 3-Epi-25(OH)[D.sub.3] was detected in all samples, comprising 6.0% and 7.8% of 25(OH)[D.sub.3] in maternal and cord blood, respectively. Positive correlations were found between 25(OH)[D.sub.3] and 3-epi-25(OH)[D.sub.3] for both maternal and cord blood (maternal blood: r = 0.34, P = 0.01; cord blood: r = 0.44, P = 0.01). In addition, regression analysis showed a significant association between vitamin D supplementation and 3-epi-25(OH)[D.sub.3] in maternal and cord blood ([beta]: 0.423; 95% CI: 0.173, 0.672). When 3-epi-25(OH)[D.sub.3] was not included in plasma vitamin D estimations, 38% of women and 80% of neonates were classified as having an insufficient concentration ( Conclusions: Using LC-MS/MS we showed the presence of 3-epi-25(OH)[D.sub.3] in all samples of pregnant women and their cord blood, and when the 3-epimer was included in the estimation of status the prevalence of vitamin D insufficiency ( Keywords: 25(OH)D, 3-epi-25(OH)[D.sub.3], pregnancy, cord blood, LC-MS/MS doi: 10.3945/jn,115.220095

The Developmental Coordination Disorder Questionnaire (DCDQ) is a parent-completed measure designed to identify subtle motor problems in children of 8 to 14.6 years of age. The purpose of this study was to extend the lower age range to children aged 5 to 7 years, revise items to ensure clarity, develop new scoring, and evaluate validity of the revised questionnaire. Additional items with improved wording were generated by an expert panel. Analyses of internal consistency, factor loading, and qualitative/quantitative feedback from researchers, clinicians, and parents were used to select 15 items with the strongest psychometric properties. Internal consistency was high (alpha = 0.94). The expanded questionnaire was completed by the parents of 287 children, aged 5-15 years, who were typically developing. Logistic regression modeling was used to generate separate cutoff scores for three age groups (overall sensitivity = 85%, specificity = 71%). The revised DCDQ was then compared to other standardized measures in a sample of 232 children referred for therapy services. Differences in scores between children with and without DCD (p less than 0.001) provide evidence of construct validity. Correlations between DCDQ scores and Movement Assessment Battery for Children (r = 0.55) and Test of Visual-Motor Integration (r = 0.42) scores support concurrent validity. The results provide evidence that the revised DCDQ is a valid clinical screening tool for DCD. (Contains 7 tables.)

In this article, the authors explore the breadth and depth of published research linking dietary vitamins and minerals (micronutrients) to mood. Since the 1920s, there have been many studies on individual vitamins (especially B vitamins and Vitamins C, D, and E), minerals (calcium, chromium, iron, magnesium, zinc, and selenium), and vitamin-like compounds (choline). Recent investigations with multi-ingredient formulas are especially promising. However, without a reasonable conceptual framework for understanding mechanisms by which micronutrients might influence mood, the published literature is too readily dismissed. Consequently, 4 explanatory models are presented, suggesting that mood symptoms may be expressions of inborn errors of metabolism, manifestations of deficient methylation reactions, alterations of gene expression by nutrient deficiency, and/or long-latency deficiency diseases. These models provide possible explanations for why micronutrient supplementation could ameliorate some mental symptoms.

Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of psychosocial functioning. Results: Emotional abuse and neglect are more common among men and women with ADHD as compared to controls. Sexual abuse and physical neglect are more commonly reported by females with ADHD. Although childhood abuse is significantly correlated with depression and anxiety in adulthood, having ADHD is a better predictor of poorer psychosocial functioning in adulthood. Conclusion: Clinicians are alerted that patients with ADHD symptoms have a high probability of childhood abuse. (Contains 2 tables.)

This study examined whether family history of reading disability influences the efficacy of reading remediation. A retrospective review of children's performance in a reading remediation program was carried out along with parental interviews for 102 families. Significant improvements were found in the areas of nonword decoding, phonological awareness, and spelling following the reading remediation program. Younger children and children with lower IQs tended to receive less benefit from the remediation program. Having a paternal history of dyslexia was associated with smaller improvements in nonword decoding scores. Maternal history of dyslexia was not a significant predictor of changes in nonword decoding. These findings suggest that some reading skills may be most effectively integrated at later stages of development. They also point to the possibility of unique relationships that may exist between parents and children who have reading disabilities. (Contains 3 tables.)

Objective: To determine whether the presence of coexisting disorders affects memory, visual-motor skills, and daily functioning in children with ADHD. Method: Eighty-four boys and 18 girls (8 to 16 years old) participate in this study. Twenty children meet criteria for ADHD alone, 42 children for ADHD plus one other disorder, and 40 children for ADHD plus at least two other disorders (reading disability, developmental coordination disorder, oppositional defiant disorder, conduct disorder, anxiety, and depression). Children are assessed on memory and visual-motor skills. Parents complete measures of daily functioning. Results: No significant group differences emerge for age, socioeconomic status, or IQ. Poorer performance on tests of memory and visual-motor skills, more prevalent behavioral problems, and more impairment in everyday functioning are associated with a higher number of coexisting disorders in children with ADHD. Conclusion: The presence of coexisting disorders has a significant influence on cognition and behavior of children with ADHD. (Contains 1 table and 1 note.)

Parent-reported information on 159 children with learning or attention problems was obtained using the Parent Ratings of Everyday Cognitive and Academic Abilities (PRECAA) and compared to information from standardized psychometric assessments. The PRECAA was sensitive to group differences among children with reading disabilities, children with attention deficits, and combined disabilities. (Contains references.) (Author/CR)

This article criticizes the term "comorbidity" used to describe the overlap of developmental syndromes or disorders. Data from 179 school-age children are evaluated for criteria of seven disorders. Since fully 50 percent of the sample met the criteria for at least two diagnoses, the premise that these disorders are discrete categories on which the comorbidity concept rests is discredited. (Contains references.) (DB)

The vocabulary and block design short forms of the Wechsler Intelligence Scale for Children-Third Edition were administered to 63 children with attention deficit hyperactivity disorder (ADHD), 69 children with reading difficulties (RD), and 68 children with comorbid ADHD and RD. No significant differences were found. (Contains references.) (Author/CR)

This study analyzed the efficacy of sensory integration treatment by combining data from a study of 96 Canadian children (29 from Alberta and 67 from Ontario children and all aged 5-8). Results indicate that the therapeutic effect of sensory integration treatment is not greater than other, more traditional methods of intervention. (Author/JDD)