attention-deficit hyperactivity disorder

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attention-deficit hyperactivity disorder

,

ADHD

A persistent pattern of inattention, hyperactivity and impulsivity, or both, occurring more frequently and severely than is typical in those at a comparable level of development. ADHD is the most commonly reported neurobehavioral disorder of childhood. The illness may begin in early childhood but may not be diagnosed until after the symptoms have been present for many years. The prevalence is estimated to be 3% to 5% in children; 4% in adults.

Symptoms

Signs may be minimal or absent when the person is under strict control or is engaged in esp. interesting or challenging situations. They are more likely to occur in group situations. Although behaviors vary widely, affected people typically exhibit motor restlessness, impulsivity, and difficulty concentrating on a single task or chore. They tend to do more poorly in school than one might predict based on assessments of their intelligence alone. While characteristics of ADHD are found in many people at one time or another, a key feature of ADHD is the excessive or unusual pattern of behavior outside normal bounds of exuberance or excitement. The findings must be severe enough to be maladaptive and inconsistent with specified levels of development, and last at least six months.

Diagnosis

CAUTION!

ADHD may sometimes be confused with other disorders.

The disorder is difficult to diagnose in children under age 5. It is important to distinguish ADHD from age-appropriate behavior in active children and from disorders such as mental retardation, primary learning disabilities, alteration of mood, anxiety, petit mal seizures, or personality changes caused by illness, family stress, or drugs. The criteria determined by the American Psychiatric Association include specific limits concerning the duration and severity of symptoms of inattention and hyperactivity-impulsivity. The findings must be severe enough to be maladaptive and inconsistent with specified levels of development.

Treatment

In both children and adults, the domestic, school, social, and occupational environments are evaluated to determine contributing factors and their relative importance. Standard treatment includes behavioral and psychological therapy, environmental changes, and medication. Medications commonly used to treat ADHD include methylphenidate, dextroamphetamine, atomoxetine, and pemoline. These agents, with the exception of atomoxetine, are central nervous system (CNS) stimulants. Adverse reactions to CNS stimulants include decreased appetite, difficulty sleeping, anxiety, stomach ache, headache, jitteriness, and social withdrawal (the latter in children).

Behavior therapy for patients with ADHD includes positive reinforcement, time-out, response cost (loss of rewards or privileges for problem behaviors) and token economy (a combination of positive reinforcement and response cost). Combinations of drug therapy and behavioral therapies, or drug therapies alone, appear to have a more beneficial effect than behavioral therapy, psychotherapy, or parent skills training alone.

Attention-deficit hyperactivity disorder (ADHD)

A condition in which a person (usually a child) has an unusually high activity level and a short attention span. People with the disorder may act impulsively and may have learning and behavioral problems.
References in periodicals archive ?
Smoking patterns and abstinence effects in smokers with no ADHD, childhood ADHD, and adult ADHD symptomatology.
The American Academy of Pediatrics has designated neurofeedback as "Level 1 Best Support"--indicating that it is a safe, evidence-based treatment for childhood ADHD.
Furthermore, a seemingly overlooked area of risk in ADHD (risk of violence) has not been extensively explored in non-offending populations with ADHD, despite indicators that both perpetration and victimization of violence may be associated with childhood ADHD (Goodman et al.
19] Adult ADHD persists in 10% -60% of children diagnosed with childhood ADHD.
Furthermore, childhood ADHD has been linked to an increased risk of substance use in adolescence and adulthood (Carach et al.
Childhood ADHD has been linked to higher rates of emergency department visits, unintentional injuries, high school dropouts, and grade level retention.
While medical schemes routinely covered childhood ADHD, they seldom provided benefits for adults, who struggled to afford private treatment over and above their monthly medical aid costs.
This study suggests that exposure to PAH encountered in New York City air may play a role in childhood ADHD," says lead author Frederica Perera, DrPH, PhD, director of the Center and professor of Environmental Health Sciences at the Mailman School.
Our research finds that a set of genetic risks identified from UK patients with a clinical diagnosis of childhood ADHD also predicted higher levels of developmental difficulties in children from a UK population cohort, the ALSPAC," said Thapar.

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