What is Attention Deficit Hyperactivity Disorder (ADHD)?

From the Guidelines

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. These symptoms typically begin in childhood and can continue into adulthood, affecting academic performance, work productivity, and social relationships. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as referenced in the study by Scoten 1, there must be an ongoing pattern of inattentive and/or hyperactive-impulsive symptoms, multiple symptoms present in two or more settings, and evidence that these symptoms interfere with functioning.

Key Characteristics of ADHD

• Inattention: difficulty sustaining attention, following through on tasks, and organizing
• Hyperactivity: excessive fidgeting, talking, interrupting others
• Impulsivity: difficulty controlling impulses, leading to impulsive behaviors

Diagnosis and Treatment

The diagnosis of ADHD involves a comprehensive clinical interview, behavioral observation, and the use of assessment tools such as rating scales and semi-structured interviews, as outlined in the study by Faraone et al. 1. Treatment usually involves a multimodal approach including behavioral therapy and, when appropriate, medication.

Medication Options

Common medications for ADHD include:

• Stimulants: methylphenidate (Ritalin, Concerta) at doses ranging from 10-60mg daily, amphetamine-based medications (Adderall, Vyvanse) at 5-70mg daily
• Non-stimulants: atomoxetine (Strattera), guanfacine (Intuniv), clonidine (Kapvay) The American Academy of Pediatrics recommends FDA-approved medications for ADHD, along with parental training in behavior management and behavioral classroom interventions, as stated in the study by Arnold et al. 1.

Importance of Early Treatment

Early diagnosis and treatment of ADHD are crucial to prevent long-term negative outcomes, such as poor academic achievement, employment difficulties, and increased risk of mental health disorders, as highlighted in the study by Harpin et al. 1.

Conclusion is not allowed, so the answer will be ended here.

From the FDA Drug Label

A diagnosis of ADHD (DSM-IV) implies the presence of hyperactive-impulsive or inattentive symptoms that cause impairment and that were present before age 7 years. The symptoms must be persistent, must be more severe than is typically observed in individuals at a comparable level of development, must cause clinically significant impairment, e.g., in social, academic, or occupational functioning, and must be present in 2 or more settings, e.g., school (or work) and at home. For the Inattentive Type, at least 6 of the following symptoms must have persisted for at least 6 months: lack of attention to details/careless mistakes, lack of sustained attention, poor listener, failure to follow through on tasks, poor organization, avoids tasks requiring sustained mental effort, loses things, easily distracted, forgetful For the Hyperactive-Impulsive Type, at least 6 of the following symptoms must have persisted for at least 6 months: fidgeting/squirming, leaving seat, inappropriate running/climbing, difficulty with quiet activities, “on the go,” excessive talking, blurting answers, can’t wait turn, intrusive. For a Combined Type diagnosis, both inattentive and hyperactive-impulsive criteria must be met.

ADHD is a behavioral syndrome characterized by the presence of hyperactive-impulsive or inattentive symptoms that cause impairment and were present before age 7 years. The symptoms must be:

• Persistent
• More severe than typically observed in individuals at a comparable level of development
• Cause clinically significant impairment in social, academic, or occupational functioning
• Present in 2 or more settings, such as school and home Key symptoms for diagnosis include:
• Inattentive Type: lack of attention to details, lack of sustained attention, poor listener, etc.
• Hyperactive-Impulsive Type: fidgeting, leaving seat, inappropriate running, etc.
• Combined Type: both inattentive and hyperactive-impulsive criteria must be met 2

From the Research

Definition of ADHD

• Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by developmentally inappropriate levels of inattention and hyperactivity/impulsivity, resulting in functional impairment in academic, social, and emotional function 3, 4.
• ADHD is described as a group of symptoms representing a final common behavioral pathway for a range of emotional, psychological, and/or learning problems 5.

Prevalence and Comorbidity

• The prevalence of ADHD is estimated to be around 1.4-3.0% 4.
• ADHD is more common in boys than girls 4.
• Comorbidity with childhood-onset neurodevelopmental disorders and psychiatric disorders is substantial 4.
• Children with ADHD often have co-occurring learning, cognitive, language, motor, and mental health disorders 3.

Diagnosis and Treatment

• The diagnosis of ADHD can be ascertained by a review of the risks for the condition, consideration of masquerading conditions, a careful history and physical examination, and the recognition of co-occurring disorders 3.
• Management of ADHD is largely limited to behavioral and pharmacologic interventions, with a focus on guiding primary care pediatricians 3.
• Randomised controlled trials show short-term benefits of stimulant medication and atomoxetine 4.
• Non-pharmacological approaches to treatment have proven less effective than previously thought 6.

Emotional and Behavioral Problems

• Methylphenidate and atomoxetine are efficacious in reducing core symptoms of ADHD and improving emotional/behavioral problems among youths with ADHD 7.
• Both treatments showed significant improvements in hyperactive and conduct subscales for parent ratings, and the externalizing subscale for teacher ratings 7.