Attention-deficit/hyperactivity disorder (ADHD) is a
neurological disorder, usually diagnosed in childhood, which
manifests itself with symptoms such as hyperactivity,
forgetfulness, mood shifts, poor impulse control, and
distractibility.[1] In neurological pathology, ADHD is currently
considered to be a chronic syndrome for which no medical cure is
available. Pediatric patients as well as adults may present with
ADHD, which is believed to affect between 3-5% of the human
population.[2]
Much controversy surrounds the diagnosis of ADHD, such as over
whether or not the diagnosis denotes a disability in its
traditional sense or simply describes a personal or neurological
property of an individual. Those who believe that ADHD is a
traditional disability or disorder often debate over how it should
be treated, if at all. According to a majority of medical research
in the United States, as well as other countries, ADHD is today
generally regarded to be a non-curable neurological disorder for
which, however, a wide range of effective treatments are available.
Methods of treatment usually involve some combination of
medication, psychotherapy, and other techniques. Many patients are
able to control their symptoms over time, even without the use of
medication. Some individuals who meet the diagnostic criteria of
ADHD, according to the guidelines of the Diagnostic and Statistical
Manual of Mental Disorders, do not consider themselves to be
mentally ill, as the manual suggests,[3] and therefore may remain
undiagnosed or, after a positive diagnosis, untreated.
ADHD is most commonly diagnosed in children. When diagnosed in
adults, it is regarded as adult attention-deficit disorder (AADD).
It is believed that anywhere between 30 to 70% of children
diagnosed with ADHD retain the disorder as adults.
The symptoms of ADHD fall into the following two broad
categories:[4]
Inattention:
Failing to pay close attention to details or making careless
mistakes when doing schoolwork or other activities
Trouble keeping attention focused during play or tasks
Appearing not to listen when spoken to
Failing to follow instructions or finish tasks
Avoiding tasks that require a high amount of mental effort and
organization, such as school projects
Frequently losing items required to facilitate tasks or activities,
such as school supplies
Excessive distractibility
Forgetfulness
Hyperactivity-impulsive behavior
Fidgeting with hands or feet or squirming in seat
Leaving seat often, even when inappropriate
Running or climbing at inappropriate times
Difficulty in quiet play
Frequently feeling restless
Excessive speech
Answering a question before the speaker has finished
Failing to await one's turn
Interrupting the activities of others at inappropriate times
A positive diagnosis is usually only made if the patient presents
with at least six of the above symptoms. In addition, a positive
diagnosis is made if six or more of these symptoms presented before
the age of seven; the symptoms usually begin to appear between the
ages of four and six. Symptoms must appear consistently in varied
environments. (Ex: At home, school, and in public.) One of the
difficulties in diagnosis is the incidence of co-morbid conditions,
especially the presence of Bipolar Disorder which is being reported
at earlier ages than previously described.
Children who grow up with ADHD often continue to have symptoms as
they grow into adulthood. Adults face some of their greatest
challenges in the areas of self-control and self-motivation, as
well as executive functioning (also known as working memory). If
the patient is not treated appropriately, co-morbid conditions,
such as depression, anxiety and self-medicating substance abuse may
present as well. If a patient presents with such conditions as
well, the co-morbid condition may be treated first, or
simultaneously.
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