Attention Deficit Hyperactivity Disorder (ADHD)

ADHD

Attention Deficit Hyperactivity Disorder (ADHD) affects both children and adults. People with ADHD have problems with attention at school, at home, and at work. It was formerly known as attention deficit disorder (ADD).  The disorder is characterized by developmentally inappropriate hyperactivity, inattention and impulsiveness. These symptoms must be
of early onset, present in more than one setting
and associated with impairment in functioning
(eg, peer relationships, educational achievement). Even when they attempt to focus, they have difficulty paying attention. Children with ADHD may be more energetic or impulsive than their friends their age. These habits disrupt friendships, learning, and behavior. As a result, children with ADHD are commonly labeled as “difficult” or having behavioral issues. It commonly co-occurs with specific and global developmental and learning problems that include autistic spectrum
disorders (ASDs), difficulties with speech and language, motor co-ordination and reading, as well as with a range of psychiatric disorders notably oppositional defiant disorder, conduct disorder and tic disorders.

What are the causes of Attention deficit hyperactivity disorder(ADHD)?

There are no known causes of ADHD, although there are various variables that may have a role in the disorder’s development, including:

  • Genetics- dopamine D4 receptor gene ( DRD4), DRD5, DAT1, COMT
  • Environmental factors- Maternal smoking/alcohol/stress/anxiety during pregnancy
  • Low birth weight and prematurity
  • Toxins and Diet- pesticides, sugar, artificial food coloring agents

What are the symptoms of Attention deficit hyperactivity disorder(ADHD)?

Symptom onset before 12 years and the symptoms should be present for at least 6 months.

Symptoms of Inattention: Difficulty paying attention to details and consequent careless mistakes, Difficulty sustaining attention in tasks or activities, Struggling to listen when spoken to, Struggling to accomplish and to finish tasks or activities, Difficulty organizing tasks and activities, Avoidance of tasks that need more mental effort, Misplacing objects needed to perform tasks or activities, Distractibility by external stimuli, Forgetfulness about daily activities

Symptoms Of Hyperactivity/Impulsivity: Fidgeting or tapping hands or feet or squirming in seat, Standing up when expected to remain seated, Running about or climbing (mostly in children) or subjective feelings of restlessness (mostly in adolescents and adults), Inability to play quietly, Often “on the go”, “driven by a motor”, Inappropriate talkativeness, Blurting out answers before a question has been finished, Difficulty waiting their turn in games or activities, Interrupting others or intruding 

 

How to diagnose attention deficit hyperactivity disorder (ADHD)?

Currently, the diagnosis of ADHD, usually following a classification system, predominantly DSM-5 relies exclusively on a clinical assessment

What is the treatment for  ADHD?

ADHD therapy involves medications, psychological counseling, education, training. The combination of these treatments aids in the relief of ADHD symptoms.

Medications for ADHD

  • Stimulants: methylphenidate and amphetamine are the most typically given medications. All stimulants are thought to act, at least in part, through their impact on dopamine and/or noradrenaline pathways. Both neurotransmitters are key
    modulators of the brain circuits that support attention, reward processing and activity.
  • Non-stimulants: Atomoxetine, Clonidine, Guanfacine. Atomoxetine is noradrenaline reuptake inhibitor and clonidine is the the ɑ2-adrenergic agonists. Others- tricyclic antidepressants (imipramine), bupropion (another antidepressant), and modafinil (usually administered to treat narcolepsy).

Psychoeducation

Non-pharmacologic: Behaviour and psychosocial treatment, Neurofeedback, Computerized cognitive training