Episode 5: Deep Dive into ADHD and Reduced Life Expectancy. Henry Shelford and Dr. Shyamal Mashru commenting on newly published UK research. 

Henry and Dr. Shyamal talking about the newly published UK research on the link between ADHD and reduced life expectancy. Watch as they break down the findings and their impact. Dr. Shyamal is a consultant psychiatrist practicing both in the NHS in Adult ADHD service and in his private clinic, ADHDHealthClinic. You can contact him through his website: adhdhealthclinic.co.uk. The clinic also has its own page on RSD.

You can watch the video interview on YouTube here. 

TRANSCRIPT:

Henry Shelford: Hi. Welcome to this. I’m Henry Shelford CEO and co-founder of ADHD UK and I have ADHD. And apparently, I’m going to die early. And, that is, British Journal of Psychiatry report. That was out. It was being published in newspapers today. And, honestly, I want to know more. I imagine you do, too.

The report is that people with ADHD die. Significantly, younger than people without. I’ve got, Dr Shy Mashru. Well, you should know from other videos you can watch them. And, he’s the one who’s going to tell us actually all about it. So, you know, like, I feel like I look healthier than you, and, like, apparently you’re going to die older than me.

That doesn’t seem fair. Okay.

Dr. Shyamal Mashru: I think I didn’t lose the weight, but. Yes. No. Look, this is a very, very interesting article, that we’re going to talk about today. Part of the press.

Henry Shelford: Is it a big deal or is it news?

Dr. Shyamal Mashru: Yeah. Well, it’s already in the news, so I was actually doing a bit of homework.

Henry Shelford: They also publish a lot of nonsense. It’s like everyone with ADHD knows that I. It’s, This is like, people thought that people with ADHD didn’t, I thought there was an understanding, which I did, you know. Yeah. But I think, to be honest, I thought it was because the risk of addiction and drug taking is that. No, this is not what I this is saying.

This is different.

Dr. Shyamal Mashru: So this. Well, yes. This doesn’t go into this doesn’t necessarily go into the causes. Right. It just looks at the mortality data. But there is a similar study which I’m going to talk about as well, which was done six years ago by a very clever chap called Russell Berkeley. You might be a Professor Russell Barkley. By the way, and I don’t know if I’m allowed to plug other people on, on your audio channel.

But anyway, here. Anyone who wants, you know, obviously come here for the, for the facts. But if you’re very, interested in very heavy, intense research type stuff, if that floats your boat. Russell Berkeley channel does that as well. And the reason I’m bringing him up is because.

Henry Shelford: He’s one of the grandees of ADHD I think.

Dr. Shyamal Mashru: He’s one of the godfathers of it. And, I think he’s probably retired now, but, he, he did a very similar study which yielded similar results six years ago and which we’ll talk about afterwards. And he looked at some of the risk factors that might be attributing to the the lower life expectancy as well. So let’s talk about this study.

So this was a very big study done. So one thing I want to introduce the concept of to the audience, if you don’t already know, is the concept in statistics of something called power. Power of a study. Yeah. So the power of a study refers to the probability of correctly detecting a difference between two groups when a true difference actually exists in the population.

So so what that means, what that means in this is, the authors of this study are saying that we hypothesize that people with ADHD are going to the nuts and bolts of this study, but the overall summary is people with ADHD, men and women, women more than men in this study, will have a lower life expectancy than the same, not the same that than a group of people without ADHD who have similar baseline characteristics.

Henry Shelford: Yeah.

Dr. Shyamal Mashru: Okay

Henry Shelford: I didn’t do the headline thing. So what is the actual use I think like on figures.

Dr. Shyamal Mashru: So first of all, looking at the power of this, they looked at 792 GP surgeries in the UK, which is about 10% of all of GP surgeries. They looked at 9.5 million records. That is massive high power.

Henry Shelford: Yeah. And records in this getting these people. So it’s nine a half million people reduction by that 10% of GP surgeries. Right.

Dr. Shyamal Mashru: And they found within that they looked at more than 30,000 individuals with ADHD in those records. Sorry, I say records.

Henry Shelford: Yeah. People watching you might be part of this. Like this is part of the government’s push for anonymized data to be also used in research. It’s big deal. This is the sort of stuff that comes out of it.

Dr. Shyamal Mashru: So when, when when someone is using such high numbers, the power of that study is extremely high. And what that means is the, the, the findings that come out of that highly correlate with what is actually going on in the population, because you’re capturing so much of the population.

Henry Shelford: Yeah. So I think what you’re if I try and summarize like to the public, essentially you’re saying, look, there’s so many people here, people think this is right. Yes. And what you’ll see with all of the statistical surveys, which frankly, news media disproportionately go to these very small sample sizes that aren’t so predictive, that are really the start of bigger, bigger research.

But actually on, you know what? You can’t be sure of an this you can be, you know, if you open one pack of Smarties and it’s all orange Smarties, you can either conclude, all Smarties orange, or you can conclude which is the right conclusion. You should open more smarty packets, because that’s just a good idea.

And I wish you could discover there are many more colors and, and so this is, this is open 10% of all the Smarties in the world and gone. You guys are dying out. Yeah, great.

Dr. Shyamal Mashru: So you’ve got 30,000 of those with ADHD matched with 300,000 without ADHD. And then they looked at the mortality rates of people 18 years and older with and without ADHD. And they looked at that across different age spans 18 to 24, 24 to 30. And I can’t remember the other group, but it goes up. So this is called I mean, this is probably even bit beyond me, but this is called modeling in statistics.

And essentially what the outline summary was from this report was that males with ADHD had a life expectancy that was 6.8 years less than their counterparts who don’t have ADHD, meaning we take. Person A with ADHD who might be 21 years old, who doesn’t have any physical health problems fit and well x y z wait x y z height compared to the same, to a different person without ADHD 21 years old, no physical health problems x, y, z height which is the same x y, z weight.

So basically physically identical. If you like, and then follow that across the lifespan. So males with ADHD meaning ADHD being the significant difference factor between the groups, had a life expectancy that was 6.8 years less than their counterpart without ADHD, and females with ADHD had a life expectancy that’s 8.6 years less than their female counterpart.

Without ADHD. So that’s the headline figure in this. But then there’s lots of things we can take from this. So that’s a that’s very significant because you know, this becomes very significant when we’re looking at something like we were talking about just before this episode, which is around ADHD needed to be treated very seriously from a government perspective in terms of the funding or lack of that’s being put into ADHD currently.

Henry Shelford: Yeah. And right now, from this a peer has talked about ADHD being a fashion like great, like just terminate in particular like, you know, going to be out of fashion for the people of Sheffield are going to get seen in 2000 years because it’s failing NHS that like to completely. Yeah. That’s. Yeah.

Dr. Shyamal Mashru: So, there was another just on what you’ve raised. There was another important finding in this study which is not in the headlines, but it’s very important. Okay. There’s been a lot of talk about is ADHD being overdiagnosed right.

Henry Shelford: Yeah

Dr. Shyamal Mashru: However, this study showed and remember how many people they’ve looked at now. Yeah, I keep emphasizing this. What the study was showing was that according to global prevalence figures, ADHD was being underdiagnosed. Yeah, I can’t really I can’t exactly remember the figures now, but these are the concluding remarks when they’re looking at the total.

Henry Shelford: I think it’s a main important headline. ADHD is underdiagnosed, full scale.

Dr. Shyamal Mashru: ADHD has been underdiagnosed. Right. Yeah. And interestingly, and I’m bringing this up with Russell Barkley again because he has done a also a video on this area. He is saying that looking at our UK data from this study, this is where the US were 20 years ago. In their diagnostic reporting 20 years ago.

Henry Shelford: And it’s like, you know, when you’ve got wait times of decades, in many cases it’s like it’s just it’s not like we’re going to catch up any time seeing like we’ve got this massive problem and we’ve got a huge lump of people who had no chance getting picked up in school, have ADHD, not recognized by the NHS for adults until 2008, children’s year 2000.

 And and so there’s this lump of people and yeah, I’m..

Dr. Shyamal Mashru: Just to correct that. Right. Sorry. Just to clarify, it’s not NHS not recognizing the nice guidance didn’t recognize it as, an adult condition.

Henry Shelford: So I do do shorthand on that because the nice guidelines what the NHS follows individual NHS areas could do different things. They weren’t and that’s actually what nice sets up and creates guidelines to change what’s happening. But the reality was it was a very, very, very small number of people being diagnosed before 2000, just children. My understanding is in 1999, it was from we’re in the mid 40s, but I was told me by someone who thought they were one of that sort of 40 odd people, kids.

But it’s, you know, I see change because it, it’s a common condition, roughly, as you said, 1 in 20. And if you’ve got a common condition, you need to scan appropriately. And one of the things we’re seeing is how people are being failed, with ADHD. And that’s been leading to poor outcomes, particularly being failed in education, falling into crimes that we’re seeing more people in the justice system.

Dr. Shyamal Mashru: And to stuff in a minute. Okay. But I think I think so this is.

Henry Shelford: I think it’s important. These are the things that are happening that are out of our control in many respects. Like in school, a school will have a single discipline program, which is just you’re going to detention, you’re going to detention, you’re going to detention and not helping people with ADHD, with their traits new, you know, good kids are giving up and that’s these days things are in these figures.

 And, yeah, back to you on talking about this.

Dr. Shyamal Mashru: Okay. So I know there’s also another impact which is not discussed in this study, but it has been been shown in other census statements and studies. Is the also the economic burden of ADHD and primarily around the inability to either remain in employment or gain or get employment. Big problem, big problem. They’ve looked at it in a big way in the US, not so much here in the UK.

 Now.

Henry Shelford: Here we get articles blaming people for benefits and and actually having article in the Daily Mail just a few days ago complaining about people, providing support to claim access to work, which is to help people with things like ADHD stay in the workplace. And it has incredible economic benefit for the country and individual, because then you’ve got an employee person paying taxes rather than and it got attacked.

 It’s one of the most successful interventions. The real problem with it is it takes too long to get but just outrageous.

Dr. Shyamal Mashru: And also, you know, with the access to work thing, just to touch on that, not everyone with ADHD diagnosis gets gets that funding. Yeah, from my experience. So what that means is that they’re still assessing the level of severity. Why I’m saying that is.

Henry Shelford: Because you don’t technically need a diagnosis to get good support for this work, but it obviously, you know.

Dr. Shyamal Mashru: Impermanent thing. Right. And so what I’m saying is, is that that, that that headline really distorted thing because it made it look like, well, people are just going to seek out these diagnoses to get money, right?

Henry Shelford: Yeah.

Dr. Shyamal Mashru: Anyway, so I guess what I’m trying to say is this is a massive study that’s showing about impact on life expectancy and mortality. But there are other also big studies in the US, particularly that showing the economic burden of ADHD. So all of this together as a package is showing why governments need to take this condition very seriously.

I want to go into another similar study that was done by Russell Barkley that was published six years ago, and they were looking at life expectancy, and they actually yielded very similar results to this study. They did a longitudinal study, so they followed people over time. They followed children up to the age of 27 years. Again, it was big numbers.

And they did something which was called predicted life expectancy. So they were looking at factors, or information from insurance companies, etc. this was done in the US where, you know, if you’re a smoker, if you’re got x, y, z problems in your health was predicted life expectancy. And interestingly, it showed very similar results to the to this British study, of about eight and a half years lower life expectancy in general.

Now, the important thing with the Russell Barkley study, which this study hasn’t touched on, is why is that happening? Why do people with ADHD have a reduced life expectancy compared to their counterparts who don’t have ADHD with other similar baseline characteristics? So Russell Barkley has come, you know, looked into that and found certain commonalities in those people with ADHD.

So number one was around. Lower education levels and lower socioeconomic status. Now this is quite a controversial thing to say and I do I’m not trying to offend anyone that’s watching. This this is these are terms that are used in research. But what they’re showing is and we know that if you pick people who have been brought up with less and impoverished environments, their life expectancy is less for a multitude of reasons.

Okay. Other factors that were looked at people with ADHD can tend to consume more alcohol. Now, again, this is not saying that all people with ADHD are alcoholics. That’s not what I am saying here. This is saying that when we look at millions of people, these are trends that we are seeing. Yeah, other risk factors. And this was a big one.

Higher likelihood of smoking, especially more than 20 cigarettes a day. So using that nicotine as a stimulant effect, that’s a massive factor for reduced life expectancy. Naturally.

Henry Shelford: Just to bring in because those are important factors. Well, on alcohol. So they do they have broken out some of that in this study. So we have some UK figures. And for smoking there’s a propensity of roughly two times. And the data shows that in comparison, males only 20% of them. The smoking.

ADHD males, it’s 40%. Yeah. Potentially harmful alcohol use, 3.5% in the comparison in the control group, males with ADHD, 7% between one point nearly double, so there’s definitely that in terms of the economic impacts, like one of the arguments I try and make when talking with government for change is that ADHD creates generational poverty.

But, if it’s a genetic condition and, people who are struggling, you know, find them, the parents are struggling, the kids are struggling, and it’s hard for the to to change that without the support that we know is needed. It’s, you know, it’s something that government intervention could massively change. And one of the things we’ve not talked about is a within that control group for obviously a whole load of people with ADHD.

So what are the how wide is the actual gap once you took those undiagnosed ADHD is and put them across into the diagnosis, this gap is going to get wider. Yeah.

Dr. Shyamal Mashru: Yeah, absolutely. And and which we’ve mentioned before. So they were looking at the, the, the years they were looking at was 2000 to 2020. We know that up until 2008 nice guidance didn’t have it there as a condition. So what about all the misdiagnosed people. Yeah right. So that’s a good good just coming back to the risk factors, obviously, we’ve said just to recap about education, socioeconomic status, alcohol consumption, smoking.

 I want to be.

Henry Shelford: Clear, this research does, for people watching. It does, the control groups, it matches people of the same economic group to understand that mortality rates. So it does isolate for that reason.

Dr. Shyamal Mashru: So let’s just explain that to the audience a little bit more actually. What is matching mean. Matching in what matching is trying to say is, If I don’t have ADHD Henry has ADHD. Right. But we’re the same age with the same ethnicity. Obviously all these things are not the same, but we the same ethnicity with the same weight, with the same height, with the set.

We have the same or lack of physic, other physical health problems. We smoke the same number of cigarettes a day, we drink the same number of drinks a day, etc. therefore what that does is it removes the argument that no, but Henry Spit is, no, but shy smokes ten more cigarettes than Henry, so that’s not. What about that?

It could be the smoking then it’s not. The ADHD is the smoking they’ve matched for all of those different factors, so that ADHD and not ADHD is the only difference. And that’s what the importance of matching what they’re doing.

Henry Shelford: And it’s in terms of this research it’s very important because then people take it seriously. Otherwise they pull it apart. So you’ve got this necessary. There’s this weakness I’m not going to care. This kind of high level serious research is the stuff that changes people’s minds because because it’s so well proven.

Dr. Shyamal Mashru: Yeah. I mean, this should be going to the, you know, this should be going to NHS England like this, this, this is really high level data.

Henry Shelford: Definitely where it is. And I could and certainly we’re raising it. But I know for a fact I think it’s, it’s a.

Dr. Shyamal Mashru: So other factors that Russell Barkley was looking at six years ago worse physical health, people with ADHD and being worse physical health and poor chronic poor sleep. Over time, the effects of that. Now, the next interesting thing that that that Russell Barkley talked about in his study, I’m only bringing this up just because the the parallels are there with this.

You know, the outcomes were the same. Yeah. The results with this I and he said that behavioral disinhibition and impulsivity are the greatest risk factors for mortality in ADHD.

So if we look at a lot of the things that we’re talking about here, this can be looked at into a couple of ways that self-medication with these different things, but also behavioral impulsivity in a lot of these behaviors, car accidents, big one, they’ve looked at that hugely in the US especially, and the important thing about all of these risk factors is that they are what we call dynamic risk factors, meaning that they can be treated and modified, meaning that if you treat the impulsive elements of the ADHD, you can reduce these risk factors and potentially improve life expectancy.

And that’s the critical thing. Because if it was just a matter of you’ve got a condition and you’re just going to die younger, then that’s it.

Then that’s it.

Henry Shelford: You’re going to die younger. Something like, what is the what are the factors in ADHD that we know impacts you from the start of your day to the end to even night and sleep. And so it’s impacting it impacts everything. And it’s then how does it touch these things to to create that. You know there’s a lot of reduction in life.

And I think what we’re getting to is it does differ for different people. So you’ve got a much higher propensity. And that’s going to yeah. You’re going to see that that those impacts. I met with the briefly and we’re going to be more with the CEO of diabetes UK and, I think gives me the absolute fear being ADHD and managing something on a day to day.

But if I don’t do right is going to have profound impacts because it’s just I’m going to lock that up. And, it’s a difference of support that’s needed. We’re always looking to we’re keen to do something in that, in that area. One of the things, to be honest, I think people with ADHD should get, the, automatic monitoring probably by default because, well, not just wait for it to get.

Don’t wait for us to muck it up.

Dr. Shyamal Mashru: Never even with the other general medications, your blood pressure, etc., etc. like does it boxes. You know, you need reminders. You know if you they can, you can just forget to take your pills and your blood pressure’s going out of control.

Henry Shelford: Yeah, right. And it’s, Yeah, that’s it was one of the classic defenses of ADHD medication people are saying is wildly addictive. And people like you look back and go, this is a group of people we have to remind to take that medication like, and, and I have real problems going to tell you how many people forget the first cigarette of the day.

 I mean, it’s not like it’s just not it’s not that kind of we’re not seeing that behavior in that way. So.

Dr. Shyamal Mashru: Just other elements on this. Right. And I think this is the one of the key messages here for me is, and why I brought up the Russell Barkley study is because. The if we treat the ADHD, we could likely see a reduction in a lot of these behaviors. And I do in my own practice. Right. And I.

Henry Shelford: Tend to know this doesn’t isolate for people receiving medication like it’s.

Dr. Shyamal Mashru: No, no, no, I’m talking about treatment as a whole. Right. But but which I always do. Right. But what I’m trying to say is these are modifiable things. You know, if you treat the underlying cause, you will reduce these risk, babies and you can improve life expectancy.

Henry Shelford: Yeah. The other in this, I thought was an important point that the intention of of treatment, which is supporting many different ways, 1 to 1 support behavioral changes and in supporting that. So to. See things like medication and other scenarios is a whole. Yeah okay.

Dr. Shyamal Mashru: And that but but but that’s the point that this is treatable right. And therefore it needs to be treated and picked up detected. And the other thing that was interesting in this study, which probably needs more evaluation, is why females have even more shorter life expectancy compared to males counterparts, because that was something that Russell Barkley had found interesting in this study, in that he had predicted it would have been the other way around because males, typically with ADHD are more have more propensity to the impulsive behaviors compared to females.

Henry Shelford: I know what people have said when that point has been raised before, which is the problem of diagnosis and being the challenges that so many women face. I mean, those who do get a diagnosis, are more impacted by their university or you know, I don’t know what do you think of that meaning.

Dr. Shyamal Mashru: You have to be more impaired before you get picked up. Is that what you trying to say?

Henry Shelford: I think well, actually do two, one, you have to be more impaired to get picked up. And two, maybe, other issues are happening in your life, which is the reason you’ve got picked up. And so you you have higher risk factors. You are the things which are the right way. You got to be noticed.

Dr. Shyamal Mashru: Yeah. Yeah, that definitely is happening. And then, you know, we see all the field trials and studies that that look at the diagnostic tools. And they’re geared towards little boys still.

Henry Shelford: And it’s still it’s still like that I genuinely find from new studies and they’re entirely male. It’s utterly shocking. Right.

Dr. Shyamal Mashru: Last thing I’m going to touch on. Right. So we’ve we’ve spoken about this high powered study which is showing about what they’re showing. It’s showing three things. Let’s just summarize number one, it’s showing a reduced life expectancy in people with ADHD versus people without ADHD. When you control for every other factor, right. No doubt about that. Number two, it’s showing looking at the UK data, 9.5 million people being studied ADHD is underdiagnosed.

There is no doubt about this compared to looking at populations and prevalence in other countries. It is underdiagnosed in the UK it is not overdiagnosed and it’s probably and I’ve said this before, it’s probably been misdiagnosed in many cases in the past. What and number three, the important point, if we then look at a comparable study six years ago in the US by Russell Barkley, which had similar outcomes, is that if you treat the ADHD in the full gambit of ways not just medication, coaching, therapy, etc. behaviors, etc., etc., you can reduce the risk behaviors and can improve life expectancy.

So those are three important points from this study. The last thing I want to add, which is the other important element or the the scale of the problem of the burden of ADHD is some studies that have been done in the US, these are massive and sort of again, high powered studies that showed the economic burden of ADHD.

The highlight figures that they showed this is from 2022. This was the most recent I could find. ADHD costs the US approximately $123 billion a year, the highest cost in that economic burden. Half of that is proportion to unemployment. So that whole thing where they’re talking about access to work, access to work is important, actually. It’s really important because unemployment is rife within ADHD or staying in employment or getting a job, etc.

So that is an area of.

Henry Shelford: Unemployment and underemployment. And I’m not not yeah. Nope. Not reaching your potential but actually working underneath it. To give you well, for many reasons from and yeah, and then you had to go forward to just keeping yourself capacity for when you have problems.

Dr. Shyamal Mashru: And then coming back to the economics, the health care costs that’s associated with these co-morbidities. Right. So that’s massive actually. Right. The health care implication financially, economically in not treating the ADHD is huge. So what that’s trying to say is the longer term cost to health care of untreated ADHD is is far greater. Actually, in the long run.

Henry Shelford: And they’ve got some numbers on that. Say you’re seeing higher levels of diabetes, of, hypertension, of heart disease, respiratory disease, epilepsy, you know mental health much higher on anxiety, on depression, on serious mental illness. Which is a serious mental illness for someone with ADHD. For male, it’s 6 to 7 times baseline. For a woman, it’s seven to nearly ten times based on, suicide and self-harm.

For males is 5 to 6 times baseline. For women, it’s, seven. To 5 or 5 times. Yeah. So it’s like and we’ve talked about smoking, but smoking, if you double and alcohol use again, I forgot what I’d say. These are all huge costs for individual wider economics into the health system, and we’re not getting support of them.

If you look at addiction services, for example, if you try and get support in addiction services and you miss an appointment with someone with ADHD who is, particularly if they’re struggling, you can it’s has a high probability of for a lot of people, if you miss even one appointment, you are removed from the service and put to the back of the queue.

So you’re trying to get help and the part of your ADHD makes it, gives you a problem and that is compounded by you then just being removed. And if you think you’ve got ADHD and you’re trying to get help with these wildly long wait times and, actually a coroner, in recent weeks issued a prevention of future death notice to NHS England because it said you are not monitoring, people in these wait lists.

We know there’s a higher risk of suicide and you’re doing nothing to monitor it. And this person struggled and has taken their own life whilst on the wait time wait list for an ADHD assessment in the sport that that would then unlock. What are you going to do about it. Because if you don’t, I as a coroner, I think there will be a few more deaths as a direct cause of this.

They are, they have I think it’s six weeks to respond to between 4 and 6 weeks to respond. And we’re in that wait period right now.

Dr. Shyamal Mashru: And I think from a, you know, from all aspects like what the kind of compounding message is, is we need to upgrade the actually diagnostic detection and we need to up the treatment. Right?

Henry Shelford: Yeah. Of the support. I think. This has been wonderful going through this has been very important. It’s obviously new news and it’s it’s a it’s it’s well it should be a sea change moment in in ADHD in the UK is important. Like when we’re talking about all the challenge to talk about that it it can be so different.

There are people absolutely thriving with ADHD and doing incredibly and in being absolutely world class. You know, you know, from just basically having a happy life to doing something extraordinary across the bounds of success and personal finance success. And I, the one thing I think everyone has in common in that is that they know they’ve got ADHD, they’ve got plans around their strategies for where they’ve got issues, and they use that to build themselves a life.

It’s the it’s the awareness. And then building around that awareness, we we talk about it being, you know, enlightening, getting that diagnosis. And it’s the enlightenment. The diagnosis isn’t enlightenment. It’s the knowledge of ADHD that comes with it and the learning that you do. And that can then unlock that success. But it’s not saying it’s not difficult. It’s definitely saying that it’s, you know, the people thriving and it’s not all doom and gloom and God damn it, I do not plan to die.

Yeah. And then I, I, you know, I see, like, I think all of us don’t like, even though we’re not.

Dr. Shyamal Mashru: But that’s the whole point, Henry. Right. That that we’re saying that. Yeah, but you won’t die earlier if you if you have all this managed hand in hand. Right. It’s it’s the modifiable risk factors that we’re talking.

Henry Shelford: We’re saying that, but do we have the core data. Like, I like I think we’ve got a strong understanding of that. But do we have data of this kind of strength that says that. So this is not in this is it.

Dr. Shyamal Mashru: It’s not in this, but this is this is the trusted more in that in that Russell Barkley study actually, which I think is an important one because just because his outcomes were actually very similar, to this study.

And that also shows you that this is not just a UK thing. You know, this is this is an ADHD thing, right? And it’s universal.

Henry Shelford: Without without. So it is an yeah, that’s true. Right. Any final thoughts you want to share with people? Or if I feel like you’ve covered everything to give that opportunity.

Dr. Shyamal Mashru: I hope this is dispelled. Submits. That’s going around in the newspapers.

Henry Shelford: Yeah. So yeah, it’s not a throw a fashion. It’s a serious condition. It’s going to change.

Dr. Shyamal Mashru: But it’s underdiagnosed. It’s underdiagnosed. Yeah

Henry Shelford: And so I think that’s important. Just tell me a little bit about your practice so that if people want to see directly they can.

Dr. Shyamal Mashru: Yeah. So my clinic, well, the website is www.adhdhealthclinic. It’s based in London. And. Yeah, you can book in to see me there or call in for inquiries.

Henry Shelford: I really thank you for sharing your expertise and your initial, you know, immediate reaction on this new research. It’s a big deal. And obviously very proud of you doing this and sharing us and your expertise generally. This is one of many deep dives we’ve done. And, looking forward to more to, very grateful for it.

Dr Shy Mashru. Thank you very, very much.

Dr. Shyamal Mashru: Thanks, Henry.

Henry Shelford:

Thank you, everyone, for joining. This series of for many details, a bit about the charity where we have charity, no funds and government wish that we did. We don’t take money from pharma. We can’t get money from anyone except direct donations. And, people like you said, please consider doing it. It’s tough running a, stigmatized condition charity raising money is tough. We do not have some great surplus of really at all. And, we live from month to month, and it’s tough and, any more you give, it makes a massive difference. Yeah. Thank you for watching. Yeah, exactly. What’s more, in the future, Bye.