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Attention deficit disorders. With/Without hyperactivity Dr. Kersi Chavda. Fact:. This is one of the most common diagnosed and treated paediatric mental health problems, and is increasingly being diagnosed in adults as well
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Attention deficit disorders With/Without hyperactivity Dr. Kersi Chavda
Fact: • This is one of the most common diagnosed and treated paediatric mental health problems, and is increasingly being diagnosed in adults as well • There is a persistent pattern of inattention and/or hyperactive/impulsive behaviours that are developmentally inappropriate, chronic and interfere with normal function.
Also • Some features should have been present before seven years of age • The ADHD features should have affected at least two domains of function>>>academic/functional/social/ occupational • They should have persisted for at least six months
Etiology Genetic: Heritability in ADHD is amongst the highest of psychiatric disorders Neurological: Functional imaging suggests abnormality of the prefrontal cortex Cathecholamine hypothesis: attributes ADHD to dysregulation of dopamine or norepinephrine in the CNS or PNS
Co-morbidity: • SLD(60%) • CD and ODD (40%) • Depression(15 to 32%) • Anxiety Disorder(25%) • High incidence of substance abuse
Clinical Features Inattention: might include poor attention to details, tendency to make careless mistakes , easy distractibility , difficulty in sustaining attention, poor listening, poor task completion disorganization, avoidance of tasks requiring sustained attention, tendency to lose things necessary for tasks, forgetfulness
Hyperactivity/Impulsive Symptoms might include Fidgetiness, inability to stay seated, running or climbing inappropriately, noisiness in play, seeming “on the go” or as if driven by a motor, excessive talkativeness, prematurely blurting out answers, inability to take turns, interrupting others
Subtypes • Predominantly Inattentive : with at least six inattentive symptoms • Predominantly Hyperactive/Impulsive :with at least six hyperactive/impulsive symptoms • Combined : with at least six symptoms from both categories
Outcome Hyperactive and impulsive symptoms may remit with maturity Inattentive symptoms often persist
Adults with ADHD • Substantial impairments in multiple domains • Higher arrest rates, more marital problems, involved in more car accidents, academic and occupational underachievement • Substance abuse is very common