What Is ADHD?

EM GLOBAL MEDICAL EDUCATION PRESENTS WHAT IS ATTENTION DEFICIT HYPERACTIVITY DISORDER? hyperactivity SADHD treatment attention behavior deficit WHAT IS ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)? ADHD ADHD is a neurodevelopmental disorder that occurs in children and adolescents that can persist into adulthood. It is characterized by symptoms of inattention and/or hyperactivity-impulsivity starting before the age of 12: INATTENTION SYMPTOMS HYPERACTIVITY-IMPULSIUITY SYMPTOMS 11% of school aged children in the US have received 7 Inattention to details and careless mistakes in schoolwork or other work M Often fidgets or leaves seat in situations when not warranted a diagnosis of ADHD M Difficulty remaining M Inappropriate running about, climbing, and inability to play quietly focused on lectures or conversations Worldwide prevelence M Does not listen when V Talks excessively or spoken to or does not follow through on instructions of ADHD is 5% acts "like driven by a motor" M Difficulty organizing tasks and activities particularly those that require M Has difficulty waiting his turn and blurts out answers sustained mental effort M Interrupts or intrudes on others M Often loses things or is distracted by extraneous stimuli Risk of ADHD is 4-6 times greater in first degree relatives of patients 6х States with the highest rates of ADHD diagnosis: Arkansas, Kentucky, Louisiana, Tennessee, South Carolina, North Carolina. 41% rise in ADHD diagnosis in the US in the past decade The Ratio of ADHD in males vs females is 2:1 Adults with ADHD Heritability estimates of ADHD from twin studies is around 80% who have been diagnosed or treated is less than 20% ATTENTION DEFICIT HYPERACTIVITY DISORDER IS COMMONLY COMORBID WITH: Learning and conduct problems Depressive Anxiety Disorders Disorders HOW DOES ADHD AFFECT CHILDREN VERSUS ADULTS? Pre-schoolchildren with ADHD are more Adults with ADHD are more likely likely to present with hyperactivity to have inattention rather than hyperactivity COMMON MYTHS ABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER: It is just a way to explain bad behavior ADHD is caused FALSE watching too much TV or eating the wrong foods FALSE FALSE Children will grow out of ADHD Did you know that Global Medical Education www.gmeded.com has more than 40 videos on the diagnosis and treatment of ADHD? EM GLOBAL MEDICAL EDUCATION THE HISTORY OF ADHD 1790 1798 The first example of a disorder that appears to be similar to ADHD was given by Sir Alexander Crichton in 1798. 1844 In 1844, the German physician Heinrich Hoffmann created some illustrated children's stories, which is nowadays a popular allegory for children with ADHD. 1902 The Goulstonian Lectures of Sir George Frederic Stll in 1902 are by many authors considered to be the scientific starting point of the history of ADHD. 1937 The first treatment of hyperactivity. 1944 Methylphenidate is first synthesized. It is regarded by now as a very effective psychostimulant and is the most frequently prescribed drug in the treatment of ADHD. 1968 In 1968, a definition of the concept of hyperactivity was incorporated in the official diagnostic nomenclature (DSM-II). DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FIFTH EDITION 1980 Attention deficit disorder: with and without Did You Know? DSM-5 Studies have shown a hyperactivity is added to the third edition of the DSM-II. link between 2013 The DSM-5 makes new environmental factors and an increased risk of ADHD. changes to ADHD. Present Day AMERICAN PSYCHIATRIC ASSOCIATION ADHD IN THE DSM-5 DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FIFTH EDITION DSM-5 CHANGES IN DSM-5 CRITERIA FOR ATTENTION DEFICIT HYPERACTIVITY DISORDER: AMERICAN PSYCHIATRIC ASSOCIATION Older adolescents and adults need only 5 symptoms of inattention or hyperactivity for diagnosis (children need at least 6) Age of onset of symptoms is now defined as several symptoms before age 12 O ADHD can now be comorbid with autism spectrum disorder HOW IS A PERSON DIAGNOSED WITH ADHD? There is no accepted single diagnostic test for ADHD. Therefore, several steps are taken to diagnose a person with ADHD. For example, one step could involve a health professional who performs a thorough mental status examination and medical evaluation. Computer based tests of attention and memory, EEG including a FDA approved scan that relies on readings of theta and beta waves, and 1+2 functional MRI can all be The diagnosis can be based on symptoms and signs with input from parents and teachers combined with rating scales. used to confirm the diagnosis. The common differential diagnosis of ADHD includes: Bipolar disorder, major depression, learning disorders and autism spectrum disorders (even though they may coexist in some patients.) WHAT CAUSES ADHD? The exact, single-cause of ADHD is not fully known, but a number of factors appear to contribute to its development. TOXIC BRAIN INJURIES Some children with brain injuries can exhibit ADHD-like symptoms. ENVIRONMENT Studies have shown a link between smoking and alcohol use in pregnant mothers and an increased risk of ADHD in GENETICS Studies have shown that ADHD runs in families. Several genes have been identified that may increase the risk of developing the disorder. their children. Preschoolers exposed to lead have a higher risk of developing ADHD. HOW DO DOCTORS TREAT ADHD? 75% Roughly 75% of patients with ADHD respond well to medication treatment. Up to 25% of patients are non-responders or adverse responders to medications. Use Medication NON-MEDICATION TREATMENTS MEDICATION TREATMENTS Psychostimulants like dextroamphetamine or methylphenidate should be first line treatment followed by atomoxetine, guanfacine, bupropion and other antidepressants and modafinil. Emerging medication treatments for ADHD include nicotinic agents, histaminergic agents, cholinesterase inhibitors, atypical antipsychotics and newer antidepressants. Proven non-medication treatments for children with ADHD include behavioral parent training, and summer treatment programs Proven non-medication treatments for adults with ADHD include CBT, dialectical behavior therapy and time management training. Sales of stimulants have $$s$$$ doubled in the last five years to $9 billion in 2012. COMMON MYTHS ABOUT MEDICATION TREATMENT OF ADHD: ADHD medications will ADHD medication will make cause my child to become a drug addict FALSE my kid into a zombie GGG FALSE ADHD medication FALSE increases the risk of sudden death CAN SOMEONE WITH ADHD STILL LEAD A There are many successful people who have ADHD SUCCESSFUL LIFE? Paris Hilton Michelle Rodriguez RDE INT THEIR Jim Carrey James Carville Ty Pennington Justin Timberlake Will Smith Michael Phelps PAR VER Karina Smirnoff THIS INFOGRAPHIC WAS BROUGHT TO YOU BY GLOBAL MEDICAL EDUCATION For more information on ADHD from the world's leading experts visit: www.gmeded.com Use Discount Code gmeinfo for free access SOURCES: American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC: American Psychiatric Association. Brown, T.E. (Ed.) (2000). Attention-deficit disorders and comorbidities in children, adolescents, and adults. Washington, DC: American Psychiatric Press. Goldstein, S., & Teeter Ellison, A. (Eds.) (2002). Clinician's Guide to Adult ADHD: Assessment and Intervention. New York: Academic Press. Nadeau, K.G. & Quinn, PO. (2002). Understanding Women with ADHD. Washington, DC: Advantage Books. http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern http://www.gmeded.com/categories/attention-deficit-hyperactivity-disorder-adhd http://www.nimh.nih.gov/health/publ http://help4adhd.org/ ns/attention-deficit-hyperactivity-disorder/index.shtmi tention inatte pooe