A PubMed review was conducted for papers reporting on attention-deficit/hyperactivity disorder (ADHD) in postsecondary students. The review was performed in order to determine the prevalence and symptomatology of ADHD in postsecondary students, to examine its effects on academic achievement, and discuss appropriate management. The prevalence of ADHD symptoms among postsecondary students ranges from 2% to 12%. Students with ADHD have lower grade point averages and are more likely to withdraw from courses, to indulge in risky behaviors, and to have other psychiatric comorbidities than their non-ADHD peers. Ensuring that students with ADHD receive appropriate support requires documented evidence of impairment to academic and day-to-day functioning. In adults with ADHD, stimulants improve concentration and attention, although improved academic productivity remains to be demonstrated. ADHD negatively impacts academic performance in students and increases the likelihood of drug and alcohol problems. Affected students may therefore benefit from disability support services, academic accommodations, and pharmacological treatment.

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Objective. To identify neurobehavioral effects of prenatal marijuana exposure on neonates in rural Jamaica. Design. Ethnographic field studies and standardized neurobehavior assessments during the neonatal period. Setting. Rural Jamaica in heavy-marijuana-using population. Participants. Twenty-four Jamaican neonates exposed to marijuana prenatally and 20 nonexposed neonates. Measurements and main results. Exposed and nonexposed neonates were compared at 3 days and 1 month old, using the Brazelton Neonatal Assessment Scale, including supplementary items to capture possible subtle effects. There were no significant differences between exposed and nonexposed neonates on day 3. At 1 month, the exposed neonates showed better physiological stability and required less examiner facilitation to reach organized states. The neonates of heavy-marijuana-using mothers had better scores on autonomic stability, quality of alertness, irritability, and self-regulation and were judged to be more rewarding for caregivers. Conclusions. The absence of any differences between the exposed on nonexposed groups in the early neonatal period suggest that the better scores of exposed neonates at 1 month are traceable to the cultural positioning and social and economic characteristics of mothers using marijuana that select for the use of marijuana but also promote neonatal development.

There are only 350 child psychiatrists in Canada. It is therefore unrealistic to expect them to be able to provide sufficient direct treatment, even in small densely populated communities with abundant resources. Such expectations are even more unrealistic in underserviced, sparsely populated areas. A review of the literature on psychiatric consultation in underserviced areas is presented along with a description of the consultation process, taking advantage of the "multiplier effect." Some of the realities of mental health consultation in underserviced areas are discussed, stressing the importance of consultation as a way of professional life. Some guidelines for the psychiatric consultant are outlined which would enhance the "multiplier effect". It is maintained that the training of psychiatric residents should include a supervised experience consulting in underserviced areas. Finally, it is hoped that psychiatric training programs, funding bodies, hospitals, and agencies, will recognize the value of this use of psychiatric expertise.