Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental psychiatric disorder.
The disease is related to the following processes: endocrine and has an incidence of about 9 / 100.000.
Attention deficit hyperactivity disorder (ADHD) is a chronic condition that includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behaviour. ADHD is described as the most common neurobehavioural disorder of childhood , due to improper or delayed brain development. It occurs in children and may persist in adults as well.
According to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) of the American Psychiatric Association there are three different types of ADHD, depending on the presentation of the affected individual:
The exact etiology of ADHD is unknown. Many factors have been implicated in the development of this disease, one of which is genetics. Recent studies of twins link genes with ADHD . Many studies have shown that ADHD runs in families. Other factors include environmental triggers such as exposure to damaging radiation, toxins or undue stress. Maternal usage of alcohol, drugs or tobacco may also affect the child's developing brain. Lastly, idiopathic underdevelopment of the brain can cause ADHD to occur.
ADHD is estimated to affect about 6-7% of people aged 18 and under when diagnosed via DSM-5 criteria .
Studies show that it is almost 3 times more common in boys than in girls.
ADHD has no known predilection to any race and occurs worldwide with no known statistical difference.
Brain imaging studies have revealed that, in youth with ADHD, the brain matures at a normal pattern but is delayed, on average, by about 3 years . This delay is most apparent in brain areas involved in generating thoughts and plans. More recent studies have found that the outermost layer of the brain, the cortex, shows delayed maturation overall .
Current models involve the mesocorticolimbic dopamine pathway and the locus ceruleus-nonadrenergic system . So, the damage is clearly due to underdevelopment of the brain, be it just the prefrontal cortex, the posterior parietal cortex or the dopamine pathways. Due to this delayed or impaired development of the brain, the child appears to be slow, mentally impaired and 'abnormal'.
A recent meta-analysis of follow-up studies of children found that :
There is no clear cure of ADHD yet, so prognosis varies from person to person. Sometimes, the child may grow out of this condition but this rarely happens.
ADHD does not cause other disorders, but children suffering from this condition are more likely to have:
Children and youngsters with ADHD present with one or more of the following signs and symptoms:
Workup includes a detailed history from the child, his/her parents and sometimes even questioning from teachers and friends of the affected child, along with a physical examination. Laboratory tests are conducted to rule out any hidden abnormality or disorder which may be the cause behind the child's symptoms. Other examinations may include:
No single diagnostic test is available to confirm ADHD. The diagnosis is based on exclusion as well as on appropriate identification and judging of symptoms and signs.
Where drug treatment is considered appropriate, methylphenidate, atomoxetine and dexamfetamine are recommended . National Institute of Mental Health (NIMH)-funded research has shown that medication works best when treatment is regularly monitored by the prescribing doctor and the dose is adjusted based on the child's needs .
Cognitive behavioral therapy (CBT), behavior modification and intensive contingency treatment have been used. The latter two treatments are more effective than CBT in improving behavior and academic performance . Psychotherapy may prove to be useful and support group sessions may also help in making the child understand his condition better and not feel alone in this.
There is no exact preventive measure known but the following factors may contribute in the prevention of this condition:
Attention deficit hyperactivity disorder (ADHD) is a common disorder affecting children and often goes undiagnosed when parents simply label the child as 'simpleminded or dull' when in reality the child is suffering from ADHD. A child with ADHD needs to be given special care and support with which he/she may lead a normal health life. Contact should be made with a specialist if your child shows symptoms including: