SHARE With her long dark hair flying, Saorla Meenagh, 10, pictured above can execute a perfect switch leap, one leg out, one tucked under, her arms glued to her sides in classic Irish step-dancing style. Saorla, whose blue eyes, white skin, and sprinkle of freckles helped win her a modeling contract with a New York agency—on hold until her braces come off —also plays softball and Gaelic football, a soccer-like game her father, Seamus, a contractor, enjoyed when he was growing up in County Tyrone, Northern Ireland. She sits on her knees, then jiggles, then rocks, then circles photos in a stack of food magazines with a pen, turning off the TV, turning up the TV, turning down the TV, and making part of a bracelet on a Rainbow Loom before she finally loses interest. She rarely finishes a task and being with her can be as disconcerting as watching television with someone pressing the channel changer every 10 seconds.
Faculty Affiliation and Disclosure Dr. Faraone and by funds from Ortho-McNeil. Please direct all correspondence to: However, because the disruptive outward manifestations of ADHD eg, hyperactivity decrease with age, adult ADHD remains somewhat hidden and underdiagnosed.
One source of confusion about adult ADHD is the controversy about the validity of the disorder, which has been exaggerated by the media but has also found its way into the medical literature. In psychiatry, assertions about the validity of a disorder derive not from a single study, but from a converging pattern of evidence from multiple domains.
Some researchers assert that ADHD usually remits in adulthood. If such assertions are correct, adult ADHD should be rare and of little concern to the practicing clinician.
But others claim many cases of ADHD persist into adulthood. They stress the diagnostic continuity of ADHD throughout the life span and claim that clinically-referred adults have the same syndrome seen in children. This article first briefly reviews the wide range of data addressing the validity of ADHD and then focuses on studies that have yielded insights into its etiology and pathophysiology.
In childhood, pediatricians and family practitioners routinely screen for ADHD and are the primary source of first diagnosis. This occurs because the disorder is a common public health issue and pediatricians and family practitioners see mostly children. Unfortunately, there is no similar system in place for adults.
In contrast to the standard of care in pediatrics, screening of adults for ADHD is not routine in primary care; there the disorder is undertreated, despite the fact that it is a substantial source of morbidity in primary care settings.
Therefore, more education and training of primary care practitioners is necessary so that they may better serve the vital role of screening for and treating ADHD in adults. One source of confusion surrounding adult ADHD is the controversy about the validity of the disorder, which has been exaggerated by the media but has also found its way into the medical literature.
But others argue that many cases of ADHD persist into adulthood. This article briefly reviews the wide range of data addressing the validity of ADHD and then focuses on studies that have yielded insights into its etiology and pathophysiology.
Understanding the Validity of Adult ADHD In psychiatry, assertions about the validity of a disorder derive not from a single study, but from a converging pattern of evidence from multiple domains. According to the widely-accepted method of Robins and Guze,7 to assess the validity of a syndrome, one must address the following questions: Does the syndrome have a characteristic clinical presentation that shows content validity?
Is the syndrome divergent from other syndromes ie, does it show divergent validity? Does the syndrome have a characteristic treatment response? Does the syndrome predict clinically meaningful outcomes in prospective studies ie, does it have predictive validity?
Do laboratory tests confirm the presumed pathophysiology of the syndrome? This article first provides a brief overview of the first four criteria and then addresses the last two in more detailed discussions of the neurobiology of adult ADHD.
In another study, adult ratings of childhood ADHD symptoms agreed well with reports by their parents; adult ratings of their own current ADHD symptoms agreed well with ratings by their partners.
These include studies of nonreferred adult relatives of ADHD children,10 clinically-referred ADHD adults,11,12 surveys of college students, participants in treatment protocols,16 and adults from the general population selected for extreme responses on an ADHD rating scale.
For example, in early studies of adult ADHD, Borland and Heckman20 reported high rates of antisocial personality, anxiety, depression, and substance use disorders and Morrison21,22 showed that outpatient ADHD adults had higher rates of antisocial personality disorder compared to psychiatric controls.
More recent studies have confirmed these earlier reports in larger samples using contemporary diagnostic criteria.
|Attention-deficit hyperactivity disorder - Simple English Wikipedia, the free encyclopedia||Adderall - Clinical Pharmacology Pharmacodynamics Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity.|
|ATTENTION DEFICIT DISORDER (ADD) ~ ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)||Twenty-four publications met inclusion criteria for synthetic food colors; 10 additional studies informed analysis of dietary restriction.|
Several studies show ADHD adults to be at risk for lower socioeconomic status, more work difficulties, more frequent job changes, divorce, speeding violations, traffic accidents, and underachievement in college.
Biederman and colleagues11 reasoned that if adult ADHD was secondary to other disorders it should rarely present without a comorbid psychiatric disorder, though this was not the case in their pilot study of adult ADHDAbstract.
Attention-deficit/hyperactivity disorder (ADHD) in adults is a common disorder associated with global and significant impairments in occupational, academic. Pelsser LM, Frankena K, Toorman J, et al. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial.
A single-entity amphetamine product combining the neutral sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and d, l-amphetamine aspartate.
INTRODUCTION — Attention deficit hyperactivity disorder (ADHD) is a disorder that manifests in childhood with symptoms of hyperactivity, impulsivity, and/or inattention. The symptoms affect cognitive, academic, behavioral, emotional, and social functioning . (See 'Diagnostic criteria' below.).
This topic review focuses on the clinical features and evaluation of ADHD. No More Psychiatric Labels: A child and adolescent psychiatrist, Sami Timimi writes about the Critical Psychiatry movement, an international network of doctors (primarily psychiatrists) who critique current mainstream practice in mental health and are hoping to reform it.
Attention deficit hyperactivity disorder (ADHD), which is characterised by age-inappropriate and impairing levels of inattention, hyperactivity, and impulsivity, affects around 5% of school-age children and 2·5% of adults worldwide.