Attention deficient hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders of childhood and adolescent. Often this condition persists into adulthood for many people. Current studies claim at up to 4.4 percent of the population has ADHD (Kessler et al. 716). Often, patients with ADHD have an increased chance of being diagnosed with other psychological disorders, such as mood, anxiety, substance use disorders, or intermittent explosive disorder (Kessler et al. 716).
The exact pathogenesis of ADHD is still unknown. However, through imaging, scientists believe that there is a dysfunction of the right frontocortical and parietal areas in ADHD patients (Kasparek, Theiner, & Filova 931). These cortical dysfunctions can be due to decreased activity of the neurotransmitters dopamine and norepinephrine (Arnsten 7).
Patients with ADHD present with symptoms of inattention, impulsiveness, restlessness, executive dysfunction, and emotional dysregulation. However, children will tend to exhibit hyperactivity and impulsivity more overtly than adults. If a physician or therapist thinks that a patient has symptoms of ADHD, they can use one of two screening tools: The Conners’ Adult ADGD Rating Scale (CAARS) or the Adult ADHD Self-Report Scale (ASRS). The CAARS is the more detailed screening system and incorporated an observer and a self-report section. The ASRS is the more widely used test and incorporated elements from the DSM-IV.
Diagnosis is based on the DSM-V. ADHD is diagnosed differently in adult and children based on the newest edition of the DSM. In children, they need to exhibit six symptoms of inattention and six symptoms of hyperactivity or impulsivity for at least six months. These symptoms also have to be present in both the school and home setting, occur before the age of twelve, and interfere with functioning (APA 2013). In adults, they only have to show five symptoms of inattention and hyperactivity/impulsivity. Also, their symptoms have to occur before the age of seventeen (APA 2013). Furthermore, patients with ADHD can be classified as either predominantly inattentive, primarily hyperactive/impulsive, or have a combined presentation. Lastly, the diagnosis is complete when the physician assesses the severity of the disease (mild, moderate, or severe) regarding the degree of impairment.
There are many treatment modalities for patients suffering from ADHD based on their age of diagnosis and the severity of symptoms. Treatments involve behavior therapy, where a patient and their caregiver can shape their environment to eliminate distractions and maintain daily schedules to limit inattention. Another treatment option is pharmacotherapy. Methylphenidate is the most commonly prescribed medication for ADHD (Wolraich et al. 1007). Many schools offer interventions for their ADHD students and provide stimulus-free environments and extra time to complete tests. Patients also can undergo social skills training and psychotherapy interventions to limit symptoms. Also, a small proportion of patients has found success with elimination diets, where food additives and other problematic foods are restricted from the diet. Younger children should first try behavior therapy and limit the exposure to pharmacotherapy if possible. Older children and adults can use medications and other forms of therapy to treat their condition.
While still considered a psychiatric condition, the prognosis of children and adults with ADHD is fairly good. A third to two-thirds of children with ADHD will manifest symptoms as an adult (Barbaresi et al. 637). Patients with ADHD fare just as well with controls regarding employment and functioning later on in life (Barbaresi et al. 637). ADHD is a condition that affects many children and adults. With proper diagnosis and treatment, these patients will function within the general population.
Works Cited
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), American Psychiatric Association, Arlington 2013. Print
Arnsten, Amy F. “Fundamentals of attention-deficit/hyperactivity disorder: circuits and pathways.” Journal of Clinical Psychiatry. 67.8 (2006): 7-12. Print
Barbaresi William J. et al. “Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study.” Pediatrics. 131.4 (2013): 637-644. Print
Kessler Ronald C., et al. “The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication.” American Journal of Psychiatry. 163.4 (2006):716-723. Print
Kasparek, Tomas, Theiner, Pavel, Filova, Alena. “Neurobiology of ADHD From Childhood to Adulthood: Findings of Imaging Methods.” Journal of Attention Disorder 19.11 (2015): 931-943. Print
Wolraich, Mark, et al “ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents.” Pediatrics. 128.5 (2011): 1007-1022. Print
