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Atomoxetine has been approved for the treatment of attention deficit/hyperactivity disorder in both adults and children. However, it is also being examined for several off-label uses in adults including mood disorders, eating disorders, cognitive dysfunction, and the treatment of addictions. Prior to such use it is important to examine the reported adverse events to see if this represents an appropriate level of risk. This is particularly important in the light of recent warnings from several regulatory bodies about an increase in blood pressure in a significant percentage of patients taking atomoxetine. To understand the risks a literature review was performed, and which identified the following potential problems. The first is that this drug should not be given in patients with known cardiovascular problems, and that all adult patients who receive atomoxetine should be monitored for changes in blood pressure throughout treatment. Secondly, there are several clinical situations in which atomoxetine should be closely monitored, or avoided, including patients who have a history or risk of narrow angle glaucoma, epileptic seizures, Tourette's syndrome, a history of urinary outflow obstruction, or who are pregnant or lactating. In conclusion, the current literature suggests that atomoxetine can be safely used off-label provided the above precautions are taken.

This is the first study to evaluate ADHD-hyperactive/impulsive subtype in a large clinical sample of adults with ADHD. The Quality of Life, Effectiveness, Safety and Tolerability (QuEST) study included 725 adults who received clinician diagnoses of any ADHD sub-type. Cross-sectional baseline data from 691 patients diagnosed with the hyperactive/impulsive (HI), inattentive (IA) and combined sub-types were used to compare the groups on the clinician administered ADHD-RS, clinical features and health-related quality of life. A consistent pattern of differences was found between the ADHD-I and combined subtypes, with the combined subtype being more likely to be diagnosed in childhood, more severe symptom severity and lower HRQL. Twenty-three patients out of the total sample of 691 patients (3%) received a clinician diagnosis of ADHD -hyperactive/impulsive subtype. Review of the ratings on the ADHD-RS-IV demonstrated, however, that this group had ratings of inattention comparable to the inattentive group. There were no significant differences found between the ADHD-HI and the other subtypes in symptom severity, functioning or quality of life. The hyperactive/impulsive subtype group identified by clinicians in this study was not significantly different from the rest of the sample. By contrast, significant differences were found between the inattentive and combined types. This suggests that in adults, hyperactivity declines and inattention remains significant, making the hyperactive/impulsive sub-type as defined by childhood criteria a very rare condition and raising questions as to the validity of the HI subtype in adults.

This paper aims to outline and evaluate a pilot partnership programme – an Occupational Therapy–led gymnastics group intervention for children aged eight to twelve with a diagnosis of attention deficit hyperactivity disorder (ADHD).

The overall aim of this programme was to increase participation in a valued leisure occupation. Based on the needs of the children, a physical-activity-based intervention was chosen that was challenging, novel and motivating. The intervention was then developed to target executive functioning and processing skills; enhance motor coordination skills; develop social skills; and primarily provide a positive experience. Seventeen children attended 75-minute sessions weekly for eight weeks. The programme was evaluated using non-standardised qualitative measures – parent, child and coach evaluation questionnaires were developed by the occupational therapist for this purpose.

Children engaged well in the programme with results showing increased participation and enjoyment of a new leisure occupation; improvement in social interaction levels and a sense of belonging; and development of motor and process skills. The results demonstrate the benefit of a partnership approach and suggest sustainability of the programme as well as the gains made.

The results of this evaluation suggest that the programme met its aims and supports further research into the efficacy of this type of partnership approach and intervention in supporting children with ADHD attending Child and Adolescent Mental Health Services.

Children with Autism Spectrum Disorder (ASD) show reduced attention to social stimuli. The reasons for these impairments are still being debated by researchers. The aim of this study is to analyse if reduced attention towards social stimuli is determined by initial underlying difficulties in the control of visual attention. Among the variables that could produce these difficulties, the authors considered geometric complexity and typology of geometric figures.

To test this hypothesis, in this paper, an eye-tracker paradigm was used for assessing visual exploration and recognition memory towards geometric figures (curved vs rectilinear) with two levels of geometric complexity (low and high) in 17 children with ASD matched with 17 children with typical development (TD).

The results showed that the ASD group seemed indifferent to both the geometric complexity and the typology of figures (curved and rectilinear), whereas the TD group showed higher performances with highly complex and curved geometric figures than with low complex and rectilinear geometric figures.

Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed hypotheses further.

This paper includes implications upon the presence of an unspecified visual attention deficit that is present from the early stages of the processing of stimuli.

The understanding of this deficit from the early stages of the processing of stimuli can help educators to intervene at an early stage when disturbances in social relationships are starting.

This study contributes to understanding the presence of dysfunctional perceptual antecedents that could determine general difficulties in paying attention to social stimuli in ASD subjects.

Attention deficit hyperactivity disorder (ADHD) is a neuro-developmental condition that has frequently been pathologised in career research and broader society to date. The study seeks to reframe such assumptions through a qualitative positive-focused exploration of career stories of ADHD adults, elicited through a strength-focused technique with wide applicability for coaching and other career-based development activities.

Situated in a strength-focused coaching psychology paradigm, the authors undertook semi-structured interviews with 17 participants, using an adapted feedforward interview technique (FFI) rooted in positive psychology (PP), to investigate individuals' strengths and successful career experiences.

Narrative thematic analysis of the transcripts identified two core themes: “the paradoxical nature of strengths” and “career success as an evolving narrative”. The participants described how they have achieved career success both “in spite of” and “because of” ADHD. The use of the FFI demonstrated a helpful and easily taught method for eliciting personal narratives of success and strengths, an essential foundation to any coaching process.

This research provides a nuanced overview, and an associated conceptual model, of how adults with ADHD perceive their career-based strengths and experiences of success. Further, the research shows the value of using a positive psychological coaching approach when working with neurominority individuals, using a successful adaptation of the FFI. The authors hope that the documentation of this technique and the resulting insights will offer important guidance for managers as coaches and internal and external career coaches, as well as providing positive and relatable narrative resources for ADHD adults.

The aims of the paper were to highlight the dearth of applied practitioner research concerning the expression of neurodiversity at work and develop an epistemological framework for a future research agenda.

A systematic empty review protocol was employed, with three a priori research questions, inquiring as to the extent of neurodiversity research within mainstream work psychology, psychology in general and lastly within cross-disciplinary academic research. The results of the final search were quality checked and categorized to illustrate where studies relevant to practice are currently located.

The academic literature was found to be lacking in contextualized, practical advice for employers or employees. The location and foci of extracted studies highlighted a growing science-practitioner gap.

The research focused on common neurominority conditions such as autism and dyslexia; it is acknowledged that the neurodiversity definition itself is broader and more anthropological in nature. A need for a comprehensive research agenda is articulated, and research questions and frameworks are proposed.

Guidance is given on applying disability accommodation to both individual and organizational targets.

The disability employment gap is unchanged since legislation was introduced. The neurodiversity concept is no longer new, and it is time for multi-disciplinary collaborations across science and practice to address the questions raised in this paper.

This paper offers an original analysis of the neurodiversity paradox, combining systematic inquiry with a narrative synthesis of the extant literature. The conceptual clarification offers clear directions for researchers and practitioners.

Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings.

Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.

A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed.

To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.

Subjective measurements of cognition have seldom been used in schizophrenia. This is mainly due to the assumption that such measurements lack sensitivity in a disorder characterized by poor insight. We investigated the capacity of BRIEF-A (Behavior Rating Inventory of Executive Function - Adult Version: a self-administered, ecological questionnaire) to identify executive deficits in adults with schizophrenia. The global score and each domain-specific score was significantly lower in patients than in healthy controls. BRIEF-A could be a useful complement to objective measurements, providing a subjective assessment of everyday consequences of executive dysfunction in patients with schizophrenia.

22q11.2 deletion syndrome (22q11DS) is a risk factor for psychiatric illnesses, including schizophrenia and anxiety. Small studies have shown that several neuroleptic medications are effective in treating psychosis in this population, but are also associated with an increased risk of adverse effects - particularly, seizures. In this case, we discuss a 34-year-old patient presenting with late onset schizophrenia, which ultimately led to her diagnosis of 22q11DS. Subsequent management of the patient's psychosis with asenapine was complicated by concurrent anxiety and panic disorder; thus, we examine the role of anxiolytic therapy in conjunction with antipsychotics in this patient population.

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. Despite mounting efforts to determine the biological background, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to 17 years. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction. Twelve overlapping cases with both same-sex attraction and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (P<0.0001, by Fisher's exact test). The association was also significant for each sex (P<0.0001, by Fisher's exact test). There is evidence that thyroid gland plays a crucial and decisive role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the off-spring.