DIVING MEDICINE Any personal enquiries can be sent to [email protected] ATTENTION DEFICIT DISORDER AND DIVING
distractibility, and impulsivity. For the
Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) as it is also called, is a relatively common difficulty in children that continues to present problems in
symptoms have to be relatively severe. 30% - 70% of these children when they are adults. Individuals who suffer from this disorder frequently have symptoms that make it dangerous for them to dive and they often need to
To be able to dive safely, a person has to
take medications that also make diving risky.
be able to keep track of several things at
effects that are incompatible with diving
AttentionDeficitDisorderisvery disruptatleasttwoofschool,familyor diagnosisofADDcanbeaccurately
orientation, tank pressure, time required
one other psychiatric diagnosis and their
peer relationships. Everyone suffers from
to complete the dive, gas supply required
‘other’ problem may make it unsafe for
result it is very difficult to decide who
of buddy, other divers, boat or shore, etc.
headache, nausea, dizziness, insomnia >
Antisocial personality features are found
can easily result in death due to arterial
well controlled with medication, so is it
are in children. Treatment often requires
DAVID SAWATZKY, S.C., C.D., To be able to dive safely, a B.Med.Sc., M.D., M.Sc., is a diving
controlled drugs. To further complicate the
person has to be able to keep medical specialist who was on contract at track of several things at the Defence Research and Development Toronto
present to their physician believing they
same time. People with ADD from 1998 to 2005. Previously he was the Canadian Forces Staff Officer in Hyperbaric often make careless mistakes.
partial complex seizures, hearing deficits,
Medicine at DCIEM (1986-1993) and later In diving they not only put the Senior Medical themselves at risk but their Officer at Garrison actions might result in the Support Unit
some evidence that they are less effective
A central feature of ADD is ‘disinhibition’. death of their dive partner. Toronto (1993-
and 5.0% of adults experience difficulties
This can be seen as poor self-regulation,
injury can also suffer from problems with
1998). He’s written a monthly column
inability to prevent immediate responses,
attention, concentration and memory. on diving medicine
difficulty with focused attention and goal-
in Canada’s Diver
There is relatively little data available on
Magazine since
hyperactivity in children is often seen as
1993, has been on
restlessness, difficulty relaxing and feeling
children, treatment is primarily drugs.
their actions might result in the death of
the Board of
chronically ‘on edge’ in adults. Adults
Advisors for the International
kinds of drugs that seem most effective in
Impulsivity is a common feature of ADD. Association of
while failing to complete important tasks. Nitrox and Technical Divers (IANTD) since
They blurt out inappropriate thoughts that
2000, and is an active cave, trimix and closed circuit rebreather diver/instructor/instructor trainer. David’s
for life. Stimulants are highly addictive
first love is cave diving exploration and he’s been exploring and surveying underwater
norepinephrine activity is increased.
pain, rashes, pruritus, urticaria, fever,
passages in Canada since 1985. David was
suggest antidepressants be tried first.
arthralgias, and scalp hair loss. They also
responsible for the exploration and
ADD but no clear link has been identified
mapping of almost 11 kilometres of
counselling, and life skills training are
underwater passages in the Ottawa River Cave System. In 1995, he executed the first
identical to those of ADD. In the field of
successful rescue of a missing trained cave diver. David received the Canadian Star of Courage for this rescue which took place in
with ADD may be at increased risk if they
higher doses of stimulants than children. the chilly Canadian waters of Tobermory, Ontario. He still dives as much as possible,
with substance abuse is so difficult that
converted into the active chemical inside
but admits his six year old son Lukas, five
can function effectively in life they most
year old daughter Emeline and wife (Dr
because of the slower onset of action. Debbie Pestell) are currently higher priorities than diving! s p o r t d i v i n g m a g a z i n e d e c e m b e r / j a n u a r y 2 0 1 0 / 1 1
and others. It also has stimulant effects.
controlled drug in the USA approved forthe treatment of ADD but it can cause
The bottom line is that most adults with a
dyspepsia, sleep disturbance, and others.
medications to help control the symptoms,
for the rest of their lives. They should not
because virtually all of the medicationsused to treat ADD are incompatible with
effects are incompatible with diving. Inaddition, many of them cause sedation. Nitrogen narcosis also causes CNSdepression and it is highly likely that thesedation caused by any drug will bemade much worse by nitrogen narcosis. Most of these drugs also cause CNSstimulation and as a result can beexpected to dramatically increase the riskof an oxygen convulsion if a diver isexposed to elevated partial pressures of
s p o r t d i v i n g m a g a z i n e d e c e m b e r / j a n u a r y 2 0 1 0 / 1 1
Cholesterol Lowering, Cardiovascular Diseases, and the Rosuvastatin-JUPITER Controversy A Critical Reappraisal Michel de Lorgeril, MD; Patricia Salen, BSc; John Abramson, MD; Sylvie Dodin, MD; Tomohito Hamazaki, PhD;Willy Kostucki, MD; Harumi Okuyama, PhD; Bruno Pavy, MD; Mikael Rabaeus, MD Background: Among the recently reported cholesterol- tality from stroke and myocardial infarcti
El-Tawassol n°24 Juin 2009 Aicha-beya Menai Abid L’énurésie et ses thérapies Département de Psychologie Université Badji Mokhtar- Résumé L’énurésie traduit selon un mode psychosomatique, des difficultés, que rencontre l’enfant, au cour de son développement. On lui attribuait une éthiopathogénie essentiellement physiologique, l’aspect psychologique