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Editorials

Children with psychiatric disorders and learning disabilities

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7494.742 (Published 31 March 2005) Cite this as: BMJ 2005;330:742

Rapid Response:

Children with psychiatric disorders and learning disabilities have biochemical abnormalities

Professor Simonoff writes "Psychiatric disorders are two to four
times as common in children with learning disabilities, with 30-50% having
a mental disorder. While all psychiatric disorders are over-represented in
children with learning disabilities, autism and hyperkinetic disorder are
particularly increased. The relation between autism and low intelligence
quotient has long been recognised, but the eightfold increase in
hyperkinetic disorder has largely gone unnoticed. In general, psychiatric
disorders are also less likely to be detected in children with learning
disabilities than in the general population." Children with learning disabilities are more likely to have
biochemical abnormalities interfering with their brain function.

Psychiatrists could read the 299 citations for "zinc
deficiency and mental illness" and the 232 references
in Pub Med for "schizophrenia and polyunsaturated fatty acids".
Richardson writes that increasing evidence indicates that long chain
polyunsaturated fatty acids (PUFA) deficiencies or imbalances are
associated with childhood developmental and psychiatric disorders
including ADHD, dyslexia, dyspraxia, and autistic spectrum disorders.
These conditions show a high clinical overlap and run in the same
families, as well as showing associations with various adult psychiatric
disorders in which fatty acid abnormalities are already implicated, such
as depression, other mood disorders, and schizophrenia.2

Improvement in schizophrenic patients using EPA
treatment correlates with changes in arachidonic acid. The specific
behavioural symptomatology of schizophrenia is related mostly to the
effect of AA changes that regulates neurodevelopment, neurotransmitter
homeostasis, phosphatidylinositol signaling, and neuromodulatory actions
of endocannabinoids.3

Although the key role that lipids have in schizophrenia is not fully
understood, multiple lines of evidence implicate the lipid environment in
the behaviour of neurotransmitter systems. A problem is that zinc
deficiencies and copper imbalances can negate the beneficial effects of
supplementing with EPA and omega-6 essential fatty acids.4

Hopefully psychiatrists will soon start to look for deficiencies of
essential nutrients and excesses of toxic metals and institute appropriate
therapy for children with learning problems and mental illnesses. It is
very boring that so much important evidence keeps being ignored.

1 Simonoff E. Children with psychiatric disorders and learning
disabilities. BMJ 2005; 330: 742-743

2 Richardson AJ. Long-chain polyunsaturated fatty acids in childhood
developmental and psychiatric disorders. Lipids. 2004; 39(12): 1215-22.

3 Peet M. Eicosapentaenoic acid in the treatment of schizophrenia
and depression: rationale and preliminary double-blind clinical trial
results. Prostaglandins Leukot Essent Fatty Acids. 2003; 69: 477-84.

4 Grant ECG, Howard JM, Davies S, Chasty H, Hornsby B, Galbraith J.
Zinc deficiency in children with dyslexia: concentrations of zinc and
other minerals in sweat and hair. BMJ 1989;296:607-9.

Competing interests:
None declared

Competing interests: No competing interests

05 April 2005
Ellen CG Grant
physician and medical gynaecologist
Kingston-upon-Thames, KT2 7JU, UK