Little is known about the family relationships of adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Thus, the marital adjustment and family functioning of 33 married adults with ADHD and their spouses was compared to 26 non-ADHD control participants and their spouses. Results revealed that married adults with ADHD reported poorer overall marital adjustment on the Dyadic Adjustment Scale (DAS; Spanier, 1989) and more family dysfunction on the Family Assessment Device (FAD; Eptein, Baldwin, & Bishop, 1983) than control adults. The spouses of adults with ADHD did not differ from control spouses in reports of overall marital adjustment and family dysfunction. A greater proportion of their marital adjustment scores, however, fell within the maladjusted range. The ADHD adults' perceptions of the health of their marriages and families were more negative than their spouses' perceptions. The way in which spouses of ADHD adults compensated for their partners' difficulties were explored through clinical interviews. The findings in this study underscore the need for assessments and treatments to address marital and family functioning of adults with ADHD.

Discussion | Obesity changes the association between total body weight and fat-free mass. The volume of distribution of a medication is therefore variable, according to its lipid solubility, in patients with different BMIs. While alterations in the volume of distribution in individuals with obesity are the result of more complex interactions between drugs, protein binding, and tissue perfusion, this analysis shows that current methods of calculating IBW are an inconsistent surrogate for fat-free mass in children with obesity. For an 11-year-old child with a BMI of 31.0, IBW will be calculated as between 51% and 65% of total body weight. When applied to the prescribing of gentamicin, a hydrophilic drug with a narrow therapeutic index, the starting dose will vary by 27%. Because the lower end of this range is likely to be an underestimation of the child's weight, 6 this is likely to result, at least initially, in the patient receiving subtherapeutic levels of medication. To strive to provide safe, effective dosages of medication for every child, we should seek to develop models incorporating a compartmental approach using, for example, biological impedance. This would help clinicians provide medication dosages to children with obesity ideally.

No abstract