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Attention Deficit Hyperactivity Disorder (ADHD)

ADHD

The patient with attention deficit hyperactivity disorder has difficulty focusing his attention, engaging in quiet passive activities, or both. Some patients have an attention deficit without hyperactivity; they’re less likely to be diagnosed and receive treatment.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common reasons children are referred for mental health services.  It affects as many as one in every 20 children. This disorder occurs in roughly 3% to 5% of school­age children. Males are three times more likely to be affected than females. The presence of other psychiatric disorders also needs to be determined.

Causes

Attention deficit hyperactivity disorder is thought to be a physiologic brain disorder with a familial tendency. Some studies indicate that it may result from altered neurotransmitter levels in the brain.

Signs and symptoms

The kinds of symptoms professionals look for in diagnosing ADHD include

  • difficulty following instructions or completing tasks
  • difficulty ‘sticking to’ an activity
  • easily distracted and forgetful
  • Having trouble waiting his or her turn
  • Interrupting or intruding on others
  • difficulty playing quietly
  • always seeming to be “on the go”
  • blurts out answers without waiting for the question to finish
  • difficulty in waiting or taking turns

In order to be diagnosed with ADHD some of these problems would have been apparent before the age of six or seven years.

These behaviours must normally occur in more than one setting (for example at home as well as at school) for ADHD to be diagnosed.

Treatment

Education is the first step in effective treatment of attention deficit hyperactivity disorder. The entire treatment team (which ideally includes parents, teachers, and therapists as well as the patient and the doctor) must fully understand the nature of this disorder as well as the disorder’s effect on the individual’s ability to function.

Specific treatments vary, depending on the severity of signs and symptoms and their effects on the patient’s ability to function adequately. Behavior modification, coaching, external structure, use of planning and organizing systems, and supportive psychotherapy can all help the patient more effectively cope with the disorder.

Some patients benefit from medication to relieve symptoms. Ideally, the treatment team identifies the symptoms to be managed, selects appropriate medication, and then tracks the patient’s symptoms carefully to determine the effectiveness of the medication. Stimulants, such as methylphenidate and dextroamphetamine, are the most commonly used agents. However, other drugs, including tricyclic antidepressants (such as desipramine and nortriptyline), mood stabilizers, and beta blockers, sometimes help control symptoms. Tomoxetine, currently in clinical trials, has been found in preliminary studies to be effective; further research will involve extending the duration of treatment to determine the effects of the medication.

Special parenting skills are often required because children with AD/HD may not respond as well to typical parenting practices. Also, because ADHD tends to run in families, parents often have some problems with organization and consistency themselves and need active coaching to help learn these skills.

Prevention

Preventive measures to reduce the incidence of ADHD in adolescents are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the adolescent’s normal growth and development, and improve the quality of life experienced by children or adolescents with ADHD.

References

  1. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
  2. https://www.cdc.gov/ncbddd/adhd/index.html
  3. https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/
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