ĪDHD, its diagnosis, and its treatment have been considered controversial since the 1970s. Medications are the most effective pharmaceutical treatment, although there may be side effects and any improvements will be reverted if medication is ceased. Canadian and American guidelines recommend medications and behavioural therapy together, except in preschool-aged children for whom the first-line treatment is behavioural therapy alone. If symptoms persist, parent-training, medication, or psychotherapy (especially cognitive behavioural therapy) can be recommended based on age. The British guideline emphasises environmental modifications and education about ADHD for individuals and carers as the first response. ĪDHD management recommendations vary and usually involve some combination of medications, counseling, and lifestyle changes. ADHD has a negative impact on patient health-related quality of life that may be further exacerbated by, or may increase the risk of, other psychiatric conditions such as anxiety and depression. The condition can be difficult to tell apart from other conditions, as well as from high levels of activity within the range of normal behaviour. In adults, hyperactivity is usually replaced by inner restlessness, and adults often develop coping skills to compensate for their impairments. About 30–50% of people diagnosed in childhood continue to have ADHD in adulthood, with 2.58% of adults estimated to have ADHD which began in childhood. ADHD is diagnosed approximately twice as often in boys as in girls, and 1.6 times more often in men than in women, although the disorder is overlooked in girls or diagnosed in later life because their symptoms sometimes differ from diagnostic criteria. Rates are similar between countries and differences in rates depend mostly on how it is diagnosed. It affects about 5–7% of children when diagnosed via the DSM-IV criteria, and 1–2% when diagnosed via the ICD-10 criteria. Toxins and infections during pregnancy as well as brain damage may be environmental risks. Genetic factors play an important role ADHD tends to run in families and has a heritability rate of 74%. Later in life, there is no biologically distinct adult onset ADHD except for when ADHD occurs after traumatic brain injury. In some cases a single event might cause ADHD such as traumatic brain injury, exposure to biohazards during pregnancy, a major genetic mutation or extreme environmental deprivation early in life. The environmental risks for ADHD most often exert their influence in the early prenatal period. For most people with ADHD, many genetic and environmental risk factors accumulate to cause the disorder. The precise causes of ADHD are unknown in the majority of cases. Although people with ADHD struggle to sustain attention on tasks that entail delayed rewards or consequences, they are often able to maintain an unusually prolonged and intense level of attention for tasks they do find interesting or rewarding this is known as hyperfocus. ADHD is associated with other neurodevelopmental and mental disorders as well as some non-psychiatric disorders, which can cause additional impairment, especially in modern society. In children, problems paying attention may result in poor school performance. ĪDHD symptoms arise from executive dysfunction, and emotional dysregulation is often considered a core symptom. alpha-2a agonists ( guanfacine XR, clonidine XR)Ġ.8–1.5% (2019, using DSM-IV-TR and ICD-10) Īttention deficit hyperactivity disorder ( ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate.non-stimulants ( atomoxetine, viloxazine).CNS stimulants ( methylphenidate, amphetamine).
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