Pediatric Annals this month is devoted to attentiondeficit /hyperactivity disorder (ADHD), a remarkably common syndrome responsible for a considerable number of pediatrician office visits. The articles in this issue provide various perspectives on this important problem, with practical information that will be of value to caregivers. The etiology of this and many other behavioral disorders is far from clear, but principles of effective treatment have emerged, including pharmacologie as well as behavioral modalities. It certainly does seem odd that stimulant therapy is beneficial in ADHD, but this is not really disputed.
The contribution in this issue by Dr. Arthur Robin regarding ADHD in the adolescent, and even the young adult, is of particular interest to me, as I am not sure that I had fully appreciated the connection between this condition and increased risk for behaviors such as alcoholism, smoking, and drug abuse.
I have chosen as stamps to illustrate this issue three that relate to the behaviors just mentioned that are associated with adolescent ADHD, one that illustrates two ostensibly normal, healthy children, and one that honors the great Russian physiologist/ psychologist, Ivan Ferrovieri Pavlov (or Pavloff or Pawlow). Pavlov (1849-1936) is portrayed on the brown and white Hungarian stamp. He served as the director of the Institute for Experimental Medicine in Leningrad (St. Petersburg) and received the Nobel Prize in Physiology and Medicine in 1904. Skillfully creating gastric, pancreatic, and salivary fistulae to the skin in dogs, he studied the influence of various stimuli on digestive secretions. These observations led Pavlov to the concepts of conditioned and unconditioned reflexes, and this had very significant impact on the field of digestive physiology as well as on psychological thought.
The multicolored stamp from Senegal shows two (apparently well-adjusted) children reading a book, with both a large globe and a palm-tree-studded beach close at hand. This 1979 stamp was issued in recognition of the International Year of the Child. The other three colorful stamps graphically portray the triple evils of drugs, alcohol, and smoking, each associated with the ADHD adolescent. The Chilean stamp celebrates the 1996 International Day Against the Consumption and Trafficking of Drugs. The 1996 stamp from the French colony of Wallis and Futuna for the Campaign against Alcoholism shows fear and distress on the part of a mother and her two children while the father is imbibing to excess. The blue and green stamp from Thailand states pictorially, in Thai and in English, "Smoking or Health, The Choice is Yours." Note the smoking figure at the right, with the brain, nose and throat, lungs, and heart pictured, all organs that are impacted adversely by cigarettes.