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Attention-deficit hyperactivity disorder
Classification and external resources
ICD-10 F90.
ICD-9 314.00, 314.01
OMIM 143465
DiseasesDB 6158
MedlinePlus 001551
eMedicine med/3103 ped/177
MeSH D001289
.Attention-Deficit Hyperactivity Disorder (ADHD or AD/HD) is a neurobehavioral[1] developmental disorder.^ Adult manifestations of attention-deficit/hyperactivity disorder section of Attention-deficit disorders.

^ Attention-deficit disorders.

^ Attention-Deficit Hyperactivity Disorder, 2nd.
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  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[2] ADHD is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone."[3]
.ADHD is the most commonly studied and diagnosed for children psychiatric disorder in children, affecting about 3 to 5% of children globally with symptoms starting before seven years of age.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Studies evaluating therapies for ADHD in adults (> 18 years of age).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ ADHD is most often diagnosed in children between ages 6 and 12 .

[4][5] .ADHD is a common chronic disorder in children[6] with 30 to 50% of those individuals diagnosed in childhood continuing to have symptoms into adulthood.^ Half the children with ADHD continue to have symptoms through adulthood.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Symptoms of attention deficit disorder may also persist into adulthood.
  • CORK Bibliography: Attention Deficit/Hyperactivity Disorder 11 September 2009 3:50 UTC www.projectcork.org [Source type: Academic]

^ Approximately 60% to 85% of children with ADHD continue to have symptoms into the teen years .

[7][8] .Adolescents and adults with ADHD tend to develop coping mechanisms to compensate for some or all of their impairments.^ Some coping strategies for teens and adults with ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ While child and adolescent physicians are familiar with the treatment of attention-deficit/hyperac-tivity disorder (ADHD), many adult physicians have had little experience with the disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[9]
.Though previously regarded as a childhood diagnosis, ADHD can continue throughout adulthood.^ Half the children with ADHD continue to have symptoms through adulthood.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Subjects were adults who met criteria for ADHD, met Utah criteria for ADHD in adulthood, had a definite childhood history of ADHD, had no psychiatric disorder, and were unmedicated prior to the study.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[10] .4.7 percent of American adults are estimated to live with ADHD.[11] ADHD is diagnosed two to four times as frequently in boys as in girls,[12][13] though studies suggest this discrepancy may be due to subjective bias of referring teachers.^ Two to three times more boys than girls are affected.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ ADHD is most often diagnosed in boys.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ If so, the child may be diagnosed with ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

[14] .ADHD management usually involves some combination of medications, behavior modifications, lifestyle changes, and counseling.^ Methods of treatment usually involve some combination of medications, behaviour modifications, life style changes, and counseling.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ ADHD has also been classified as a behavior disorder and a neurological disorder or combinations of these classifications such as neurobehavioural or neurodevelopmental disorders .
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ Some experts are focusing on deficits in "executive functions" of the brain to understand and describe all ADHD behaviors.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

.Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed[15] or vice versa.^ Differential diagnosis and treatment of adult ADHD and neighboring disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Can other disorders accompany ADHD ?
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^ Certain social critics are highly skeptical that the diagnosis denotes a genuine impairment and question virtually all that is known about ADHD. The symptoms of ADHD are not as profoundly different from normal behavior as are those of other chronic mental disorders .
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

.Additionally, most clinicians have not received formal training in the assessment and treatment of ADHD, particularly in adult patients.^ There are many alternative treatments for ADHD, most of them heavily disputed or relegated to adjunct status with medication treatment.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Additionally, the FDA recommended "that children, adolescents, or adults who are being considered for treatment with ADHD drug products work with their physician or other health care professional to develop a treatment plan that includes a careful health history and evaluation of current status, particularly for cardiovascular and psychiatric problems (including assessment for a family history of such problems)."
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[15]
.ADHD and its diagnosis and treatment have been considered controversial since the 1970s.^ ADHD in adolescents: Diagnosis and treatment .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Successful treatment of attention deficit hyperactivity disorder (ADHD) begins with an accurate diagnosis and understanding of a child's weaknesses and strengths.

^ The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[16] .The controversies have involved clinicians, teachers, policymakers, parents and the media.^ ADHD has been surrounded by great controversy involving clinicians, teachers, policymakers, parents, and the media.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ For student with severe difficulties, daily or weekly progress reports to parents can assist teachers to involve parents in ongoing support.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ The effect of Adderall was significant for clinician and parent ratings but not for teacher ratings and was significant for both fixed-dose and best-dose designs.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Opinions regarding ADHD range from not believing it exists at all to believing there are genetic and physiological bases for the condition as well as disagreement about the use of stimulant medications in treatment.^ The range of opinion regarding the validity of ADHD extends from those who do not believe it exists and regard it as a myth, to those who believe that there is genetic and physiological evidence supporting its existence.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There is also variation and controversy around the treatment of ADHD, which often includes stimulant medication.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There are many alternative treatments for ADHD, most of them heavily disputed or relegated to adjunct status with medication treatment.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[17][18][19] .Most healthcare providers accept that ADHD is a genuine disorder with debate in the scientific community centering mainly around how it is diagnosed and treated.^ How is ADHD diagnosed?

^ Many adults with ADHD have not been diagnosed and treated.

^ How is ADHD identified and diagnosed?
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[20][21][22] The AMA Council on Scientific Affairs concluded in 1998 that "diagnostic criteria for ADHD are based on extensive empirical research and, if applied appropriately, lead to the diagnosis of a syndrome with high interrater reliability, good face validity, and high predictability of course and medication responsiveness."[23]

Classification

.ADHD may be seen as one or more continuous traits found normally throughout the general population.^ Children who have ADHD usually have at least one close relative who also has ADHD. And at least one-third of all fathers who had ADHD in their youth bear children who have ADHD. Even more convincing: the majority of identical twins share the trait.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ Speculation exists to explain the higher diagnostic quota in the U.S. One theory suggests that due to the high-risk traits of ADHD-affected people, it can be suggested that there was a higher prevalence for ADHD in the immigrants heading for America in former centuries than in the general population.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
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^ One of the most painful events a parent may experience is an abrupt and aggressive attack that may occur after cuddling a young ADHD child.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[24] .ADHD is a developmental disorder in which certain traits such as impulse control lag in development.^ The term "developmental" means that certain traits such as impulse control significantly lag in development when compared to the general population.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
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^ Objective: This pilot study examined the effects of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms and autistic features in children with pervasive developmental disorders (PDD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Child psychologists are also qualified to diagnose and treat ADHD. They can provide therapy for the child and help the family develop ways to deal with the disorder.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]

[25] .Using magnetic resonance imaging of the prefrontal cortex, this developmental lag has been estimated to range from 3 to 5 years.^ Brain scans using imaging techniques, including magnetic resonance imaging (MRI) or single photon emission computed tomography (SPECT) may eventually help confirm a diagnosis.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ The reported developmental delays hit a peak of five years in regions at the front of the cortex .
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^ Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[26] .These delays are considered to cause impairment.^ This developmental lag has been estimated to range between 30-40 percent in ADHD sufferers in comparison to their peers; consequently these delayed attributes are considered an impairment.
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^ Assessment must consider all possible causative factors and the consistency of these symptoms over time and in a variety of settings.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

.ADHD has also been classified as a behavior disorder.^ Even though ADHD primarily affects a person's behavior, having the disorder has broad emotional repercussions.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ Attention deficit hyperactivity disorder (ADHD) is a chronic behavioral disorder characterized by persistent hyperactivity, impulsivity, and inattention that impairs educational achievement and/or social functioning.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ BACKGROUND: Learned self-control of slow cortical potentials (SCPs) may lead to behavioral improvement in attention-deficit/hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[27] .A diagnosis of ADHD does not, however, imply a neurological disease.^ However, there is no scientific evidence to support this treatment at this time nor does it appear to be consistent with current evidence on the causes of ADHD. .
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
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^ Remember, taking a drug such as Ritalin does not automatically imply that the child has AD/HD, nor does having a diagnosis of AD/HD imply that the student will automatically qualify for special education services.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Such evidence however supports the role of the cerebellum in ADHD but does not support treatments like the DORE program that claim to alter functioning of the cerebellum.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[24]
.ADHD is classified as a disruptive behavior disorder along with oppositional defiant disorder, conduct disorder and antisocial disorder.^ Opposition defiant disorder: .
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ ADHD with comorbid oppositional defiant and/or conduct disorder is the most prevalent comorbidity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ ODD: oppositional defiant disorder .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[28]

Subtypes

ADHD has three subtypes:[29]
.
  • Predominantly hyperactive-impulsive
    • Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
    • Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
  • Predominantly inattentive
    • The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.
    • Children with this subtype are less likely to act out or have difficulties getting along with other children.^ ADHD children with the inattentive subtype are more likely to be picked on and to spend time alone.
      • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

      ^ Hyperactive-impulsive ADHD subjects may be more disruptive and aggressive.
      • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

      ^ Some signs of hyperactivity and impulsivity are: .
      • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
      • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

      .They may sit quietly, but they are not paying attention to what they are doing.^ For many people, this is what it's like to have Attention Deficit Hyperactivity Disorder, or ADHD. They may be unable to sit still, plan ahead, finish tasks, or be fully aware of what's going on around them.
      • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
      • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

      ^ Their problems have to do with what they are paying attention to, for how long, and under what circumstances.
      • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

      ^ Fact : Stimulants allow many people to focus and pay better attention, whether or not they have ADHD .
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      Therefore, the child may be overlooked, and parents and teachers may not notice symptoms of ADHD.
  • Combined hyperactive-impulsive and inattentive
    • Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
    • Most children with ADHD have the combined type.

Childhood ADHD

.Attention-deficit hyperactivity disorder or ADHD is a common childhood condition that can be treated.^ Attention-Deficit Hyperactivity Disorder, 2nd.
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^ PubMed ] Lie N. Follow-ups of children with attention deficit hyperactivity disorder (ADHD).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Basal ganglia volumes in children with attention-deficit hyperactivity disorder.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.It is a health condition involving biologically active substances in the brain.^ Among the various vitamin E components (tocopherols and tocotrienols), only alpha-tocopherol is actively uptaken by the brain and is directly involved in nervous membranes protection.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.January 2010" style="white-space:nowrap;">[citation needed] In childhood ADHD, and some cases of adult ADHD, biological active chemicals in the brain are in the state of equilibrium and disequilibrium.^ Therefore, research has been directed towards determining if the treatment of ADHD with stimulant medications can be safe and effective for the individual with active SUD and concomitant ADHD. An initial trial of methylphenidate in a population of adults with active cocaine dependence and ADHD indicates that this is the case.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Some research has shown an association between mild symptoms of ADHD and sleep-disordered breathing, including snoring and obstructive sleep apnea in children and adults.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Given the dearth of research evidence in this area, more studies are needed to establish the effectiveness and adverse effects of different interventions for the treatment of ADHD in adults.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.January 2010" style="white-space:nowrap;">[citation needed] ADHD may affect certain areas of the brain that allow problem solving, planning ahead, understanding others’ actions, and impulse control.^ Understanding the Problem What are the symptoms of ADHD? Can any other conditions produce these symptoms?
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ For many people, this is what it's like to have Attention Deficit Hyperactivity Disorder, or ADHD. They may be unable to sit still, plan ahead, finish tasks, or be fully aware of what's going on around them.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ The child's social skills are resources for solving the specific problems that arise from ADHD. Interpersonal problems and difficulties with peers may occur secondary to impulsivity (i.e., unpredictable behavior).
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[30]
The American Academy of Child Adolescent Psychiatry (AACAP) considers it necessary that the following be present before attaching the label of ADHD to a child:
.
  • The behaviors must appear before age 7.
  • They must continue for at least six months.
  • The symptoms must also create a real handicap in at least two of the following areas of the child’s life:
    • in the classroom,
    • on the playground,
    • at home,
    • in the community, or
    • in social settings.^ Six or more of the symptoms of inattention and six or more of the symptoms of hyperactivity-impulsivity have persisted for at least six months in a child's behavior.
      • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

      ^ Such behaviors should have been harmful for the child academically or socially for at least 6 months.
      • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

      ^ Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings.
      • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
      • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

      [30]
.If a child seems too active on the playground but not elsewhere, the problem might not be ADHD. It might also not be ADHD if the behaviors occur in the classroom but nowhere else.^ Treatment for ADHD is based on your or your child's symptoms and problem behaviors.

^ One of the most painful events a parent may experience is an abrupt and aggressive attack that may occur after cuddling a young ADHD child.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.A child who shows some symptoms would not be diagnosed with ADHD if his or her schoolwork or friendships are not impaired by the behaviors.^ If so, the child may be diagnosed with ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ So someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ If so, the child may be diagnosed with ADHD. .
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

[30]
.Even if a child’s behavior seems like ADHD, it might not actually be ADHD; careful attention to the process of differential diagnosis is mandatory.^ Which ADHD -like behaviors listed in the DSM does the child show?
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Bringing up an ADHD child, like bringing up any child, is a process.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Which ADHD-like behaviors listed in the DSM does the child show?
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

Many other conditions and situations can trigger behavior that resembles ADHD. For example, a child might show ADHD symptoms when experiencing:
  • A death or divorce in the family, a parent’s job loss, or other sudden change
  • Undetected seizures
  • An ear infection that causes temporary hearing problems
  • Problems with schoolwork caused by a learning disability
  • Anxiety or depression[30]
  • Insufficient or poor quality sleep
  • Child abuse

Adult ADHD

.Researchers found that 60% of the children diagnosed with ADHD, continue having symptoms well into adulthood.^ Half the children with ADHD continue to have symptoms through adulthood.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ About 60% of children diagnosed with ADHD retain the disorder as adults.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ Persistence of ADHD into Adulthood .
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[31] .This accounts for eight million adults in the United States.^ Statistics show that 40% of adults in the United States set at least one New Year's Resolution, so if you do, you are not alone.
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

[32] Many adults, however, remain untreated.[31] .Untreated adults with ADHD often have chaotic lifestyles, may appear to be disorganized and may rely on non-prescribed drugs and alcohol to get by.^ ADHD may also be underdiagnosed in adults.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ In such cases, methylphenidates may reduce the need to self-medicate ADHD symptoms using nicotine, alcohol, or illegal drugs.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ One report suggested that treating sleep apnea in adults with both conditions may help reduce ADHD symptoms.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[33] .They often have such associated psychiatric comorbidities as depression, anxiety disorder, bipolar disorder, substance abuse, or a learning disability.^ Comorbidity with psychiatric disorders such as anxiety disorder, depression, oppositional defiant disorder and conduct disorder; and with specific learning disability is not uncommon.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The majority of adults with ADHD exhibit at least 1 comorbid psychiatric disorder, such as major depressive disorder, anxiety disorder, personality disorder, substance abuse disorder, or bipolar disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Children with ADHD have increased risk for depression, anxiety disorders, conduct disorder, and substance abuse.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[33] .A diagnosis of ADHD may offer adults insight into their behaviors and allow patients to become more aware and seek help with coping and treatment strategies.^ ADHD in adolescents: Diagnosis and treatment .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Startled flies may provide insight into ADHD .
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

^ ADHD may also be underdiagnosed in adults.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[32] .There is controversy amongst some experts on whether ADHD persists into adulthood.^ In many cases, symptoms persist into adolescence and adulthood, causing significant lifelong impairments in academic, career, and social functioning.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ ADHD often continues into adolescence and adulthood, and can cause a lifetime of frustrated dreams and emotional pain.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Schubiner H. Department of Internal Medicine, Providence Hospital, Southfield, Michigan 48075, USA. Howard.Schubiner@providence-stjohnhealth.org Attention-deficit hyperactivity disorder (ADHD) is a common disorder in children that frequently persists into adulthood.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Recognized as occurring in adults in 1978, it is currently not addressed separately from ADHD in childhood.^ Next, Frederick W. Reimherr, MD, reviews comorbidity of ADHD and describes the Utah Criteria as a method of diagnosing adults through recollection of childhood problems.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Subjects were adults who met criteria for ADHD, met Utah criteria for ADHD in adulthood, had a definite childhood history of ADHD, had no psychiatric disorder, and were unmedicated prior to the study.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Adult ADHD often presents differently from childhood ADHD. Because adult ADHD can be comorbid with other disorders and has symptoms similar to those of other disorders, it is important to understand differential diagnoses.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

Obstacles that clinicians face when assessing adults who may have ADHD include developmentally inappropriate diagnostic criteria, age-related changes, comorbidities and the possibility that high intelligence or situational factors can mask ADHD.

Symptoms

.Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin.^ Research indicates that girls with ADHD are often inattentive but not hyperactive or impulsive.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ The core symptoms of AD/HD are developmentally inappropriate levels of inattention, hyperactivity, and impulsivity.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Other patients will have a diagnosis other than ADHD that largely accounts for the behavioral symptoms of inattention, impulsivity, and/or hyperactivity.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[15] .To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.^ That is, do they occur more often than in other people the same age?
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ At this stage of the process, the clinician must consider diagnoses other than ADHD in one of two paradigms.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ III. Some impairment from the symptoms is present in two or more settings (e.g.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[34]
The symptom categories of ADHD in children yield three potential classifications of ADHD—predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type if criteria for both subtypes are met:[15]:p.4
Predominantly inattentive type symptoms may include:[35]
  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another
  • Have difficulty focusing on one thing
  • Become bored with a task after only a few minutes, unless they are doing something enjoyable
  • Have difficulty focusing attention on organizing and completing a task or learning something new
  • Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
  • Not seem to listen when spoken to
  • Daydream, become easily confused, and move slowly
  • Have difficulty processing information as quickly and accurately as others
  • Struggle to follow instructions.
Predominantly hyperactive-impulsive type symptoms may include:[35]
  • Fidget and squirm in their seats
  • Talk nonstop
  • Dash around, touching or playing with anything and everything in sight
  • Have trouble sitting still during dinner, school, and story time
  • Be constantly in motion
  • Have difficulty doing quiet tasks or activities.
and also these manifestations primarily of impulsivity:[35]
  • Be very impatient
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
  • Have difficulty waiting for things they want or waiting their turns in games
.Most people exhibit some of these behaviors, but not to the degree where such behaviors significantly interfere with a person's work, relationships, or studies.^ PubMed ] Cadoret RJ, Stewart MA. An adoption study of attention deficity/hyperactivity/aggression and their relationship to adult antisocial personality.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Cognitive-behavioral therapy helps people work on immediate issues.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Cadoret RJ, Stewart MA. An adoption study of attention deficit/hyperactivity/aggression and their relationship to adult antisocial personality.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

The core impairments are consistent even in different cultural contexts.[36]
.Symptoms may persist into adulthood for up to half of children diagnosed with ADHD. Estimating this is difficult as there are no official diagnostic criteria for ADHD in adults.^ Half the children with ADHD continue to have symptoms through adulthood.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Although it is now recognized that ADHD often persists into adulthood, the current diagnostic criteria is geared toward symptom identification in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ A number of alternative approaches may benefit children and adults with mild ADHD symptoms.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[15] .ADHD in adults remains a clinical diagnosis.^ Is adult ADHD a clinical reality.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The clinical efficacy of atomoxetine in the treatment of ADHD has been evaluated in six published clinical trials of children and adolescents and two studies enrolling only adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The ADHD diagnosis is based on history and clinical examination.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The signs and symptoms may differ from those during childhood and adolescence due to the adaptive processes and avoidance mechanisms learned during the process of socialisation.^ Other research is seeking to identify conditions of pregnancy and early childhood that may cause or contribute to these differences in the brain.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Researchers are also searching for other differences between those who have and do not have ADHD. Research on how the brain normally develops in the fetus offers some clues about what may disrupt the process.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ At the same time it is those same four diagnostic entities that may most often be misdiagnosed as ADHD due to the commonality of many of the symptoms.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[37]
.A 2009 study found that children with ADHD move around a lot because it helps them stay alert enough to complete challenging tasks.^ RESULTS: 223 children completed the study.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[38]

ADHD and other medical conditions

.ADHD may accompany other disorders such as anxiety or depression.^ Can other disorders accompany ADHD ?
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Q: My daughter has ADHD and an anxiety disorder.
  • Attention Deficit Disorder (ADD) - Parenting Special Needs - Parenting/Family - AllExperts.com 9 February 2010 12:45 UTC en.allexperts.com [Source type: Original source]

^ Other forms of depression may also be present.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

.Such combinations can greatly complicate diagnosis and treatment.^ The search for coexisting conditions that may make the diagnosis more difficult or complicate treatment planning.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

.Academic studies and research in private practice suggest that depression in ADHD appears to be increasingly prevalent in children as they get older, with a higher rate of increase in girls than in boys, and to vary in prevalence with the subtype of ADHD. Where a mood disorder complicates ADHD it would be prudent to treat the mood disorder first, but parents of children who have ADHD often wish to have the ADHD treated first, because the response to treatment is quicker.^ Research indicates that girls with ADHD are often inattentive but not hyperactive or impulsive.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ ADHD is most often diagnosed in boys.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Girls with ADHD and emotional disorders may also still have a higher risk.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[39]
.Inattention and "hyperactive" behavior are not the only problems in children with ADHD. ADHD exists alone in only about 1/3 of the children diagnosed with it.^ Hyperactive only alone .
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

^ About 60% of children diagnosed with ADHD retain the disorder as adults.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ ADHD exists alone in only about one-third of children.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

.Many co-existing conditions require other courses of treatment and should be diagnosed separately instead of being grouped in the ADHD diagnosis.^ ADHD in adolescents: Diagnosis and treatment .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Data that do exist suggest that long-term treatment with psychostimulants in appropriately diagnosed patients may be associated with salutary effects as well as relatively modest risks.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

Some of the associated conditions are:
.
  • Oppositional defiant disorder (35%) and conduct disorder (26%) which both are characterized by antisocial behaviors such as stubbornness, aggression, frequent temper tantrums, deceitfulness, lying, or stealing,[40] inevitably linking these comorbid disorders with antisocial personality disorder (ASPD); about half of those with hyperactivity and ODD or CD developing ASPD in adulthood.^ In addition to displaying inattentive and impulsive behavior, these children demonstrate aggression, have frequent temper tantrums, and display antisocial behavior.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ About 35% of children diagnosed with ADHD also have oppositional-defiant disorder (ODD).
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ Opposition defiant disorder: .
    • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

    [41]
  • .
  • Borderline personality disorder, which was according to a study on 120 female psychiatric patients diagnosed and treated for BPD associated with ADHD in 70% of those cases.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Within each specialty, individual doctors and mental health professionals differ in their experience with ADHD. So in selecting a specialist, it's important to find someone with specific training and experience in diagnosing and treating the disorder.
    • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
    • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

    ^ Scientists, however, do need to study causes in an effort to identify better ways to treat, and perhaps some day, prevent ADHD .
    • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

    [42]
  • .
  • Primary disorder of vigilance, which is characterized by poor attention and concentration, as well as difficulties staying awake.^ Primary disorder of vigilance is a term for a syndrome that includes poor attention and concentration as well as difficulties staying awake.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ METHODS: Children with attention-deficit/hyperactivity disorder were evaluated in a laboratory school to characterize onset and duration of the effect of a variety of methylphenidate regimens.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ But because it can interfere with concentration and attention, ADHD can make it doubly hard for a child with LD to do well in school.
    • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
    • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
    • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

    .These children tend to fidget, yawn and stretch and appear to be hyperactive in order to remain alert and active.^ People with vigilance disorder tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert; they typically have kind and affectionate temperaments.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ These events tend to appear early in the course of treatment with atomoxetine and then decline.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    [40]
  • Mood disorders. .Boys diagnosed with the combined subtype have been shown likely to suffer from a mood disorder.^ The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) distinguishes among a primarily inattentive subtype, a hyperactive-impulsive subtype, and a combined subtype ( American Psychiatric Association, 1994 ).
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Nevertheless, combinations may be warranted in certain severe cases, such as in children who are also suffering from an accompanying emotional disorder, such as bipolar or anxiety disorder.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ The sample included 16 boys who were hospitalized with ADHD and mood disorder.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    [43]
  • Bipolar disorder. .As many as 25% of children with ADHD have bipolar disorder.^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Many ADHD children are particularly lured by the computer, which is a very promising tool.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    .Children with this combination may demonstrate more aggression and behavioral problems than those with ADHD alone.^ MPH may reduce behavioral disturbance in children with ADHD while it is taken.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ The results showed that only those children in the two medication treatment conditions demonstrated improvement in both attentional and behavioral ratings and that the combination therapy was not any more effective than MPH alone.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ The challenges that all children face, like changing schools or entering puberty, may be even more stressful for a child with ADHD. Some doctors recommend that children be taken off a medication now and then to see if the child still needs it.
    • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]

    [40]
  • .
  • Anxiety disorder, which has been found to be common in girls diagnosed with the inattentive subtype of ADHD.[44]
  • Obsessive-compulsive disorder.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ CONCLUSIONS. There is a clear correlation between ADHD and sleep disorders and they are very common in visits to the neuropaediatric department.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Although speech and learning disorders are common in children with ADHD, the disorder does not affect intelligence.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    .OCD is believed to share a genetic component with ADHD and shares many of its characteristics.^ Many experts now believe that an essential feature in ADHD, as well as in learning disabilities, is an impaired working (also called short-term) memory.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ Some experts theorize that the genetic variants may have first appeared thousands of years ago, and affect as many as half of ADHD children.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    ^ In one study, although children with probable ADHD were able to self-report many ADHD symptoms, they tended to believe they used their time wisely, in contrast to reports by their teacher.
    • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

    [40]

Causes

.A specific cause of ADHD is not known.^ It has been known for some decades that head injuries can cause a person to experience and display ADHD-like symptoms.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ While ADD/ADHD is a known psychiatric condition, there are various theories about the cause and some controversy over the number of persons diagnosed and the cost of medications.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[45] .There are, however, a number of factors that may contribute to ADHD. They include genetics, diet and social and physical environments.^ Main article: ADHD - Genetic factors .
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ Giftedness and ADHD may coexist, however.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ They may even be genetically linked.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

Genetic factors

.Twin studies indicate that the disorder is highly heritable and that genetics are a factor in about 75% of ADHD cases.^ Main article: ADHD - Genetic factors .
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Evans SW, Vallano G, Pelham W. Treatment of parenting behavior with a psychostimulant: A case study of an adult with attention-deficit hyperactivity disorder.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[24] .Hyperactivity also seems to be primarily a genetic condition; however, other causes do have an effect.^ Other research is seeking to identify conditions of pregnancy and early childhood that may cause or contribute to these differences in the brain.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ A condition which is caused by overabundance of thyroid hormone and may include hyperactivity as one symptom.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ These remain purely correlational findings, however, that cannot be used to infer cause or the exact direction of the effects between these agents and ADHD symptoms.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[46]
.Researchers believe that a large majority of ADHD cases arise from a combination of various genes, many of which affect dopamine transporters.^ Many experts now believe that an essential feature in ADHD, as well as in learning disabilities, is an impaired working (also called short-term) memory.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ NIMH and the U.S. Department of Education are cosponsoring a large national study--the first of its kind--to see which combinations of ADHD treatment work best for different types of children.
  • Psych Central: Dr. Grohol's Mental Health Page - Attention Deficit/Hyperactivity Disorder 19 January 2010 8:47 UTC psychcentral.com [Source type: FILTERED WITH BAYES]
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

^ Some experts theorize that the genetic variants may have first appeared thousands of years ago, and affect as many as half of ADHD children.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

.Candidate genes include dopamine transporter, dopamine receptors D2/D3,[47] dopamine beta-hydroxylase monoamine oxidase A, catecholamine-methyl transferase, serotonin transporter promoter (SLC6A4), 5-hydroxytryptamine 2A receptor (5-HT2A), 5-hydroxytryptamine 1B receptor (5-HT1B),[48] the 10-repeat allele of the DAT1 gene,[49] the 7-repeat allele of the DRD4 gene,[49] and the dopamine beta hydroxylase gene (DBH TaqI).^ Mapping susceptibility loci in attention deficit hyperactivity disorder: preferential transmission of parental alleles at DAT1, DBH and DRD5 to affected children.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Also consistent with this is that DAT1 gene expression has been found to preferentially affect caudate volume, whereas DRD4 gene expression preferentially affects prefrontal gray matter volume ( Durston et al., 2005 ).
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Selegiline (Eldepryl, Movergan, Zelepar), also known as deprenyl, metabolizes into compounds found in methamphetamine and blocks monoamine oxidase B (MAO-B), an enzyme that degrades dopamine.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[50]
.The broad selection of targets indicates that ADHD does not follow the traditional model of "a genetic disease" and should therefore be viewed as a complex interaction among genetic and environmental factors.^ More efforts should be made to understand the implications that different diagnostic models for ADHD and comorbid disorders could have on the outcomes of treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This combination does not appear to be a distinct genetic subtype of ADHD ( Biederman, Faraone, and Keenan, 1992 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Scientific investigation supports a primary genetic contribution, but the relationship of molecular bases and environmental exposures appears intricate and complex.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

Even though all these genes might play a role, to date no single gene has been shown to make a major contribution to ADHD.[51]

Evolutionary theories

The hunter vs. farmer theory is a hypothesis proposed by author Thom Hartmann about the origins of ADHD. The theory proposes that hyperactivity may be an adaptive behavior in pre modern humans[52] and that those with ADHD retain some of the older "hunter" characteristics associated with early pre-agricultural human society. .According to this theory, individuals with ADHD may be more adept at searching and seeking and less adept at staying put and managing complex tasks over time.^ The technique works well with all children, although children with ADHD may need more frequent rewards.
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ In fact, according to a major analysis, Ritalin or other stimulants used to treat ADHD may help protect such patients against substance abuse.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ This decision depends on the complexity of the comorbid condition and its relationship to the ADHD symptoms, as well as on the individual clinician's own threshold of expertise and knowledge.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[53] .Further evidence showing hyperactivity may be evolutionarily beneficial was put forth in 2006 in a study which found it may carry specific benefits for a society.^ Nicotinic medications may provide beneficial therapeutic treatment for cognitive dysfunction such as Alzheimer's disease, schizophrenia and attention deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Indeed, DAT binding specifically in the striatum has been found to be related to motor hyperactivity but not to inattentive symptoms ( Jucaite, Fernell, Halldin, Forssberg, & Farde, 2005 ).
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Some animal studies suggest that children exposed to lead may develop symptoms associated with ADHD, but only a few cases have actually been found.
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]

[54]

Environmental factors

.Twin studies to date have also suggested that approximately 9% to 20% of the variance in hyperactive-impulsive-inattentive behavior or ADHD symptoms can be attributed to nonshared environmental (nongenetic) factors.^ Research indicates that girls with ADHD are often inattentive but not hyperactive or impulsive.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Other patients will have a diagnosis other than ADHD that largely accounts for the behavioral symptoms of inattention, impulsivity, and/or hyperactivity.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ The word often appears before each symptom of inattention, hyperactivity, and impulsivity in the DSM-IV-TR. In order to be considered a symptom of AD/HD, a behavior can't be "a once in a while" problem.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[55][56][57][58]
.Environmental factors implicated include alcohol and tobacco smoke exposure during pregnancy and environmental exposure to lead in very early life.^ Environmental factors that have been most consistently associated with ADHD include maternal smoking during pregnancy, 21,22 emotional distress or family adversity during pregnancy and early in life, 21,23,24 birth weight <1500 g, 24 hypoxemia, 25 encephalitis, 26 trauma, 27 lead exposure, 28 and brain injury from some metabolic disorders.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ A group of symptoms attributed to prenatal exposure to alcohol which include patterns of delayed growth, developmental delay or intellectual disability, learning disabilities, and/or attention disorders.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Provides information on the risks of alcohol during pregnancy, and fetal alcohol syndrome .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

[59] .The relation of smoking to ADHD could be due to nicotine causing hypoxia (lack of oxygen) to the fetus in utero.^ Although such findings should certainly not encourage anyone to smoke, some studies are focusing on benefits of nicotine therapy in adults with ADHD. .
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[60] .It could also be that women with ADHD are more likely to smoke[61] and therefore, due to the strong genetic component of ADHD, are more likely to have children with ADHD.[62] Complications during pregnancy and birth—including premature birth—might also play a role.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The technique works well with all children, although children with ADHD may need more frequent rewards.
  • Cross Creek Family Counseling | ADHD | Attention Deficit Hyperactivity Disorder | ADD 9 February 2010 12:45 UTC www.crosscreekcounseling.com [Source type: FILTERED WITH BAYES]
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

[63] .ADHD patients have been observed to have higher than average rates of head injuries;[64] however, current evidence does not indicate that head injuries are the cause of ADHD in the patients observed.^ Scientists, however, do need to study causes in an effort to identify better ways to treat, and perhaps some day, prevent ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The studies available indicate consistently that stimulants (particularly MPH) may be more effective than nonpharmacological interventions when compared head to head.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[65] .Infections during pregnancy, at birth, and in early childhood are linked to an increased risk of developing ADHD. These include various viruses (measles, varicella, rubella, enterovirus 71) and streptococcal bacterial infection.^ Environmental factors that have been most consistently associated with ADHD include maternal smoking during pregnancy, 21,22 emotional distress or family adversity during pregnancy and early in life, 21,23,24 birth weight <1500 g, 24 hypoxemia, 25 encephalitis, 26 trauma, 27 lead exposure, 28 and brain injury from some metabolic disorders.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Other research is seeking to identify conditions of pregnancy and early childhood that may cause or contribute to these differences in the brain.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ The members of the AAP Subcommittee on ADHD were especially helpful during the formulation of the research questions and the development of the data extraction forms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[66][67]

Diet

.A study[68] conducted by researchers at Southampton University in the United Kingdom and published in The Lancet on November 3, 2007 found a definitive link between children’s ingestion of many commonly used artificial food colors, the preservative sodium benzoate and hyperactivity.^ PubMed ] Rose TL. The functional relationship between artificial food colors and hyperactivity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Mattes JA, Gittelman R. Effects of artificial food colorings in children with hyperactive symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ New guidelines to assess cardiac risk before using stimulant medication in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) were published concurrently in 3 Canadian medical society journals in November.
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

In response to these findings, the British government took prompt action. .According to the Food Standards Agency, the food regulatory agency in the UK, food manufacturers are being encouraged to voluntarily phase out the use of most artificial food colors by the end of 2009. Following the FSA’s actions, the European Commission ruled that any food products containing the “Southampton Six” (The contentious colourings are: sunset yellow FCF (E110), quinoline yellow (E104), carmoisine (E122), allura red (E129), tartrazine (E102) and ponceau 4R (E124)) must display warning labels on their packaging by 2010. In the US, little has been done to curb food manufacturer’s use of specific food colors, despite the new evidence presented by the Southampton study.^ Any artificial colorings (particularly yellow, red, or green) Other chemical additives -- for example, BHT or BHA Milk Chocolate Eggs Wheat Foods containing salicylates, including all berries, chili powder, apples and cider, cloves, grapes, oranges, peaches, peppers (bell & chili), plums, prunes, tomatoes.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ The studies available provide little evidence for improvement in academic performance with stimulants, even though MPH treatment appears to produce consistent behavior improvement.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In 2004 the U.S. Food and Drug Administration (FDA) issued a paper advising health professionals about a new warning regarding Strattera.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

.However, the existing US Food Drug and Cosmetic Act[69] had already required that artificial food colors be approved for use, that they must be given FD&C numbers by the FDA, and the use of these colors must be indicated on the package.^ These drugs have a number of side effects.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[70] This is why food packaging in the USA may state something like: "Contains FD&C Red #40."

Social factors

.The World Health Organization states that the diagnosis of ADHD can represent family dysfunction or inadequacies in the educational system rather than individual psychopathology.^ Thus, in 1998, the National Institutes of Health consensus panel on the diagnosis and treatment of ADHD concluded that the costs associated with ADHD were large, stating that individuals with ADHD "consume a disproportionate share of resources and attention from the health care system, criminal justice system, schools, and other social service agencies."
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In this article, experts give tips for people with ADHD who want to make New Year's resolutions to change their health, their organizational plans, and their lives.
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

[71] .Russell Barkley however disagrees and finds no compelling evidence that social factors alone can cause ADHD.[25] Other researchers believe that relationships with caregivers have a profound effect on attentional and self-regulatory abilities.^ Scientists, however, do need to study causes in an effort to identify better ways to treat, and perhaps some day, prevent ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ The findings in this report agree with those in the AMA report in relation to the evidence available on adverse effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ "This is the first time that we have direct evidence that this connectivity is missing in ADHD," said Ali Mazaheri, postdoctoral researcher at the Center for Mind and Brain ...
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

.A study of foster children found that a high number of them had symptoms closely resembling ADHD.[72] Researchers have found behavior typical of ADHD in children who have suffered violence and emotional abuse.^ Children who have ADHD usually have at least one close relative who also has ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[24][73] .Furthermore, Complex Post Traumatic Stress Disorder can result in attention problems that can look like ADHD.[74] ADHD is also considered to be related to sensory integration dysfunction.^ Attention deficit hyperactivity disorder (ADHD) .
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Attention-deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ For many people, this is what its like to have Attention Deficit Hyperactivity Disorder, or ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

[75]

Neurodiversity

.Proponents of the neurodiversity theory assert that atypical (neurodivergent) neurological development is a normal human difference that is to be tolerated and respected just like any other human difference.^ Other tests are available to test neurologic, intellectual, and emotional development problems.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ A child like Mark might learn to see how his behavior affects others and develop new ways to respond when angry or pushed.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ PubMed ] Just MA, Carpenter PA. A capacity theory of comprehension: Individual differences in working memory.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Social critics argue that while biological factors may play a large role in difficulties with sitting still in class and/or concentrating on schoolwork in some children, these children could have failed to integrate others' social expectations of their behavior for a variety of other reasons.^ Children may be referred for an ADHD evaluation by a variety of individuals for a variety of reasons.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Review of the available data suggests that some of the children who died may have had the specific types of cardiac lesions that predispose to SCD. Others who died were not known to have any of these risk factors, but few data are available because these data were provided voluntarily through the FDA Adverse Event Reporting System by a variety of reporters, including parents, doctors, coroners, pharmacists, other health professionals, and media reporters, resulting in possible underreporting or limited reports.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[76] It has been said that ADHD has a link with creativity.[77] .As genetic research into ADHD proceeds, it may become possible to integrate this information with the neurobiology in order to distinguish disability from varieties of normal or even exceptional functioning in people along the same spectrum of attention differences.^ Various diagnostic models may well define samples that differ in natural history, severity, comorbidity, ADHD subtype, and response to treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Infant malnutrition is a strong risk factor of ADHD. Even if children receive enough food later on, infants who suffer from malnutrition may develop behavior problems, the most prevalent being attention-deficit disorder.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ Given the dearth of research evidence in this area, more studies are needed to establish the effectiveness and adverse effects of different interventions for the treatment of ADHD in adults.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[78]

Social construct theory of ADHD

.Social construction theory states that it is societies that determine where the line between normal and abnormal behavior is drawn.^ Barkley RA. Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Review Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ See more articles cited in this paragraph Review Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Thus society members including physicians, parents, teachers, and others are the ones who determine which diagnostic criteria are applied and thus determine the number of people affected.^ The behavior ratings included Diagnostic and Statistical Manual of Mental Disorders criteria, number of problems, and social behavior at school and were conducted by parents and teachers.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ No studies were designed to determine the proportion of adults with ADHD who will use, and benefit from, other interventions, particularly nonpharmacological.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This may include other teachers, including those who have previously worked with the student, the Consulting Teacher (or special education supervisor if needed), and/or the Resource Teacher, the School Counselor, and/or the Principal or other administrator.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

[79] This is exemplified in the fact that the DSM IV arrives at levels of ADHD three to four times higher than those obtained with use of the ICD 10.[13] Thomas Szasz, an extreme proponent of this theory, has gone so far as to state that ADHD was "invented and not discovered."[80][81]

Low arousal theory

.According to the low arousal theory, people with ADHD need excessive activity as self-stimulation because of their state of abnormally low arousal.^ Fact : Stimulants allow many people to focus and pay better attention, whether or not they have ADHD .
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ A: Not all people with ADHD need medical treatment, but if severe enough, then unfortunately the ...
  • Attention Deficit Disorder (ADD) - Parenting Special Needs - Parenting/Family - AllExperts.com 9 February 2010 12:45 UTC en.allexperts.com [Source type: Original source]

^ In such cases, methylphenidates may reduce the need to self-medicate ADHD symptoms using nicotine, alcohol, or illegal drugs.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[82][83] .The theory states that those with ADHD cannot self-moderate, and their attention can only be gained by means of environmental stimuli,[82] which in turn results in disruption of attentional capacity and an increase in hyperactive behaviour.^ Attention deficit hyperactivity disorder (ADHD) .
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Attention-deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[84]
.Without enough stimulation coming from the environment, an ADHD child will create it him or herself by walking around, fidgeting, talking, etc.^ It is a condition that is significantly related to each child's environment (home, school, etc.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Hinshaw SP, Buhrmester D, Heller T. Anger control in response to verbal provocation: Effects of stimulant medication for boys with ADHD. J Abnorm Child Psychol.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Pliszka SR. Effect of anxiety on cognition, behavior, and stimulant response in ADHD. J Am Acad Child Adolesc Psychiatry.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.This theory also explains why stimulant medications have high success rates and can induce a calming effect at therapeutic dosages among children with ADHD. It establishes a strong link with scientific data that ADHD is connected to abnormalities with the neurochemical dopamine and a powerful link with low-stimulation PET scan results in ADHD subjects.^ The results indicate that stimulant medication improved recognition memory for children with ADHD. .
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ They also noted that the effects of stimulant medication were noticeable while children were receiving it.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ New guidelines to assess cardiac risk before using stimulant medication in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) were published concurrently in 3 Canadian medical society journals in November.
  • Alltop - Top ADHD News 19 January 2010 8:47 UTC adhd.alltop.com [Source type: General]

[82]

Pathophysiology

Diagram of a human brain.
.The pathophysiology of ADHD is unclear and there are a number of competing theories.^ There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[85] .Research on children with ADHD has shown a general reduction of brain volume, but with a proportionally greater reduction in the volume of the left-sided prefrontal cortex.^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Aman MG, Kern RA, McGhee DE, Arnold LE. Fenfluramine and methylphenidate in children with mental retardation and ADHD: Clinical and side effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Aman MG, Kern RA, McGhee DE, Arnold LE. Fenfluramine and methylphenidate in children with mental retardation and ADHD: Clinical and side effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.These findings suggest that the core ADHD features of inattention, hyperactivity, and impulsivity may reflect frontal lobe dysfunction, but other brain regions particularly the cerebellum have also been implicated.^ Hyperactive-impulsive ADHD subjects may be more disruptive and aggressive.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Others may be mildly inattentive but overly impulsive.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ These differences in brain activity and structure are mainly evident in the prefrontal cortex, the basal ganglia, and the cerebellum (Castellanos & Swanson, in press).
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[86] .Neuroimaging studies in ADHD have not always given consistent results and as of 2008 are only used for research not diagnostic purposes.^ No studies were designed to determine the proportion of adults with ADHD who will use, and benefit from, other interventions, particularly nonpharmacological.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The clinical efficacy of atomoxetine in the treatment of ADHD has been evaluated in six published clinical trials of children and adolescents and two studies enrolling only adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Given the dearth of research evidence in this area, more studies are needed to establish the effectiveness and adverse effects of different interventions for the treatment of ADHD in adults.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[87] .A 2005 review of published studies involving neuroimaging, neuropsychological genetics, and neurochemistry found converging lines of evidence to suggest that four connected frontostriatal regions play a role in the pathophysiology of ADHD: The lateral prefrontal cortex, dorsal anterior cingulate cortex, caudate, and putamen.^ Evidence from neuroimaging studies.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Central Nervous System Involvement Converging evidence from neuropsychology, neuroimaging, neuropharmacology, and genetics suggests involvement of the frontostriatal dopaminergic circuits in the brain.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Converging evidence from animal and human studies implicates the dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits in the pathophysiology of ADHD, and molecular imaging studies suggest that abnormalities of the dopamine transporter lead to impaired neurotransmission.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[88]
.In one study a delay in development of certain brain structures by an average of three years occurred in ADHD elementary school aged patients.^ Studies evaluating therapies for ADHD in adults (> 18 years of age).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The studies have major methodological deficiencies which are compounded by their restriction to school-age children, relatively short followup, and few data on adverse effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Firestone, Crowe, Goodman et al., 1986 (stimulant vs. In this study, the use of parent training (PT) in the treatment of ADHD was evaluated in 73 children between 5 and 9 years of age.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

The delay was most prominent in the frontal cortex and temporal lobe, which are believed to be responsible for the ability to control and focus thinking. .In contrast, the motor cortex in the ADHD patients was seen to mature faster than normal, suggesting that both slower development of behavioral control and advanced motor development might be required for the fidgetiness that characterizes ADHD.[89] It should be noted that stimulant medication itself may affect growth factors of the central nervous system.^ A: ADHD patients may develope depression and Strattera may also cause it.
  • Attention Deficit Disorder (ADD) - Parenting Special Needs - Parenting/Family - AllExperts.com 9 February 2010 12:45 UTC en.allexperts.com [Source type: Original source]

^ Faster processing and improved executive function performance may covary because they both reflect more efficient neural processing and improved signal/noise ratios, either because of systemwide improvements in the nervous system or because a better functioning prefrontal cortex improves signal/noise ratios for diverse neural regions, permitting faster and more efficient cognitive processing.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[90]
.The same laboratory had previously found involvement of the "7-repeat" variant of the dopamine D4 receptor gene, which accounts for about 30 percent of the genetic risk for ADHD, in unusual thinness of the cortex of the right side of the brain; however, in contrast to other variants of the gene found in ADHD patients, the region normalized in thickness during the teen years in these children, coinciding with clinical improvement.^ The prevalence of these conditions in children with ADHD ranges from 15 to 30 percent.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Diagnosis of these patients is clinical.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ These differences in brain activity and structure are mainly evident in the prefrontal cortex, the basal ganglia, and the cerebellum (Castellanos & Swanson, in press).
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[91]
.Additionally, SPECT scans found people with ADHD to have reduced blood circulation (indicating low neural activity),[92] and a significantly higher concentration of dopamine transporters in the striatum which is in charge of planning ahead.^ CONCLUSION: In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ We have found that transdermal nicotine significantly improves attentional function in people with Alzheimer's disease, schizophrenia or ADHD as well as normal nonsmoking adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ In people with the disorder, these studies show that certain brain areas have less activity and blood flow and that certain brain structures are slightly smaller.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[93][94] .A study by the U.S. Department of Energy’s Brookhaven National Laboratory in collaboration with Mount Sinai School of Medicine in New York suggest that it is not the dopamine transporter levels that indicate ADHD, but the brain's ability to produce dopamine itself.^ In people with ADHD , the brain areas that control attention used less glucose, indicating that they were less active.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ Using one such technique, NIMH scientists demonstrated a link between a persons ability to pay continued attention and the level of activity in the brain.
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

^ The assessment report, which was provided to the school, indicates that Jasmine has average overall cognitive ability.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

.The study was done by injecting 20 ADHD subjects and 25 control subjects with a radiotracer that attaches itself to dopamine transporters.^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Adjunctive treatment was controlled, and subjects received no medication or treatment other than that provided in the trial throughout the study.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ METHODS: Adults with ADHD received placebo, 2 mg, 4 mg, or 20 mg of ABT-089 for 2 weeks each in a randomized, double-blind, placebo-controlled, 4 x 4 Latin square design for a total of 8 weeks.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The study found that it was not the transporter levels that indicated ADHD, but the dopamine itself.^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Conclusions: Placebo-controlled studies are indicated to determine atomoxetine's efficacy for ADHD symptoms in PDDs.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Studies were not found that evaluated the effectiveness of nonpharmacological interventions for adults with diagnosis of ADHD. .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

ADHD subjects showed lower levels of dopamine across the board. .They speculated that since ADHD subjects had lower levels of dopamine to begin with, the number of transporters in the brain was not the telling factor.^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ If issues comorbid to ADHD are not identified and addressed they may complicate and worsen the child's level of functional impairment and lead to higher morbidity with a poorer prognosis.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.In support of this notion, plasma homovanillic acid, an index of dopamine levels, was found to be inversely related not only to childhood ADHD symptoms in adult psychiatric patients, but to "childhood learning problems" in healthy subjects as well.^ The children had been referred to a psychiatric clinic for disruptive behavior problems and met criteria for ADHD based on parent and teacher interviews.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The majority of adults with ADHD exhibit at least 1 comorbid psychiatric disorder, such as major depressive disorder, anxiety disorder, personality disorder, substance abuse disorder, or bipolar disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[95] .One interpretation of dopamine pathway tracers is that the biochemical "reward" mechanism works for those with ADHD only when the task performed is inherently motivating; low levels of dopamine raise the threshold at which someone can maintain focus on a task which is otherwise boring.^ Individuals with ADD have difficulty maintaining a sufficiently high level of motivation to complete a task and grow bored quickly, perhaps tiring because the working memory demands of the task exhaust them.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Poor school performance not only results in the child having a low self-esteem, but also causes significant stress to the parents.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Design tasks of low to moderate frustration levels.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[96]
.A 1990 PET scan study by Alan J. Zametkin et al. found that global cerebral glucose metabolism was 8% lower in medication-naive adults who had been hyperactive since childhood.^ Matochik JA, Liebenauer LL, King C, Szymanski HV, Cohen RM, Zametkin AJ. Cerebral glucose metabolism in adults with attention deficit hyperactivity disorder after chronic stimulant treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Matochik JA, Liebenauer LL, King C, Szymanski HV, Cohen RM, Zametkin AJ. Cerebral glucose metabolism in adults with attention deficit hyperactivity disorder after chronic stimulant treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Matochik JA, Nordahl TE, Gross M, Semple WE, King AC, Cohen RM, Zametkin AJ. Effects of acute stimulant medication on cerebral metabolism in adults with hyperactivity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[97] .Further studies found that chronic stimulant treatment had little effect on global glucose metabolism,[98] a 1993 study in girls failed to find a decreased global glucose metabolism, but found significant differences in glucose metabolism in 6 specific regions of the brains of ADHD girls as compared to control subjects.^ The aim of this article is to illustrate current treatment modalities(s), compare them to neurofeedback, and present the benefits of utilizing this method of treatment to control and potentially alleviate the symptoms of ADHD. In addition, this article examines the prevalence rates and possible etiology of ADHD, the factors associated with ADHD and brain dysfunction, the current pharmacological treatments of ADHD, Ritalin, and the potential risks and side effects.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ More observational studies are required (particularly case-control or cohort studies) to gain a better understanding of adverse effects associated with different treatments for ADHD. Knowledge of adverse effects may also improve through more creative use of existing drug databases.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The study also found that differences in one specific region of the frontal lobe were statistically correlated with symptom severity.^ Five of these studies did not report statistical significance of the differences between the groups.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RESULTS: In each study, atomoxetine was statistically superior to placebo in reducing both inattentive and hyperactive and impulsive symptoms as assessed by primary and secondary measures.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Abdominal pain ( Evidence Table H1e ): Nineteen studies provided data on abdominal pain, but 8 did not provide data on the statistical significance of the differences among the study groups at the p=0.05 level.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[99] .A further study in 1997 also failed to find global differences in glucose metabolism, but similarly found differences in glucose normalization in specific regions of the brain.^ Similarly, despite the overall heterogeneity of the studies comparing different stimulants, they showed few, if any, differences among MPH, DEX, and pemoline.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This study found both drugs to be better than placebo but found few differences in terms of effectiveness and adverse effects between them.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ However, further investigations and different doses of zinc are required to replicate these findings in children with ADHD. ----- Biol Psychiatry.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The 1997 study also noted that their findings were somewhat different than those in the 1993 study, and concluded that sexual maturation may have played a role in this discrepancy.^ The studies available indicate consistently that stimulants (particularly MPH) may be more effective than nonpharmacological interventions when compared head to head.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RECENT FINDINGS: Studies published in 2004 provide evidence to guide the treatment of AD/HD. The AD/HD literature continues to support the important role of genetics in its etiology.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Of the remaining 15 studies, 8 showed that patients receiving stimulants reported decreased appetite or were associated with anorexia more frequently than those receiving placebo.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[100] .The significance of the research by Zametkin has not been determined and neither his group nor any other has been able to replicate the 1990 results.^ The study did not include girls or boys in other ethnic groups, so it is not known if these results are generally applicable.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ A group of individuals, including the parents, meets to review the evaluation results and determine if the child meets eligibility criteria set forth in state and federal law.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[101][102][103]
.Critics, such as Jonathan Leo and David Cohen, who reject the characterization of ADHD as a disorder, contend that the controls for stimulant medication usage were inadequate in some lobar volumetric studies which makes it impossible to determine whether ADHD itself or psychotropic medication used to treat ADHD is responsible for the decreased thickness observed[104] in certain brain regions.^ Decreases in observing response latency and correct choice response latency occurred after taking stimulant medication.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Children are often treated with medication, usually stimulant medication such as methylphenidate.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Borden and Brown, 1989 (cognitive behavior therapy vs. This study was designed to determine whether those treated with combination of medication and CBT would tend to make external attributions for problem solutions or whether more internal attributions would be observed with CBT alone.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.While the main study in question used age-matched controls, it did not provide information on height and weight of the subjects.^ Abdominal pain ( Evidence Table H1e ): Nineteen studies provided data on abdominal pain, but 8 did not provide data on the statistical significance of the differences among the study groups at the p=0.05 level.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ DESIGN AND SUBJECTS: A placebo-controlled double-blind study with 40 AD/HD (including eight AD/HD-suspected) children of 6-12 y of age who were mostly without medication.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Adjunctive treatment was controlled, and subjects received no medication or treatment other than that provided in the trial throughout the study.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.These variables it has been argued could account for the regional brain size differences rather than ADHD itself.^ These differences in brain activity and structure are mainly evident in the prefrontal cortex, the basal ganglia, and the cerebellum (Castellanos & Swanson, in press).
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Various diagnostic models may well define samples that differ in natural history, severity, comorbidity, ADHD subtype, and response to treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[105][106] .They believe many neuroimaging studies are oversimplified in both popular and scientific discourse and given undue weight despite deficiencies in experimental methodology.^ Many experts believe that the disorder is both over- and underdiagnosed.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

^ In one study, although children with probable ADHD were able to self-report many ADHD symptoms, they tended to believe they used their time wisely, in contrast to reports by their teacher.
  • Howstuffworks "Attention-deficit Hyperactivity Disorder In-Depth" 9 February 2010 12:45 UTC healthguide.howstuffworks.com [Source type: FILTERED WITH BAYES]

[105]

Diagnosis

.ADHD is diagnosed via a psychiatric assessment; to rule out other potential causes or comorbidities, physical examination, radiological imaging, and laboratory tests may be used.^ Based on the history and physical examination, further work-up may be indicated in areas such as genetic or chromosomal, neurological, or biomedical conditions.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ Patients undergoing further assessment for biomedical, emotional/psychiatric, family/psychosocial, speech/language, and academic/learning problems may be identified as having a related comorbidity to the primary ADHD condition.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

^ For those patients suspected of other conditions or comorbidities, continued assessment is necessary to confirm or exclude such conditions.
  • NGC - NGC Summary 9 February 2010 12:45 UTC www.guideline.gov [Source type: Academic]

[107]
.In North America, the DSM-IV criteria are often the basis for a diagnosis, while European countries usually use the ICD-10.^ The word often appears before each symptom of inattention, hyperactivity, and impulsivity in the DSM-IV-TR. In order to be considered a symptom of AD/HD, a behavior can't be "a once in a while" problem.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Medication treatment of ADHD should be limited to individuals meeting diagnostic criteria delineated in the DSM-IV text revision (American Psychiatric Association, 2000).
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Nine of the 22 studies diagnosed ADHD using DSM criteria.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[108] .If the DSM-IV criteria is used rather than the ICD-10 a diagnosis ADHD is 3–4 times more likely.^ Nine of the 22 studies diagnosed ADHD using DSM criteria.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Boys were 1.8 times more likely than girls to be treated.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[13] .Factors other than those within the DSM or ICD however have been found to effect the diagnosis in clinical practice.^ Hallucinations occurred more often in medicated children than has been reported in other studies (3/61), but on the whole, adverse effects were few and relatively mild.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Data on outcomes other than those identified a priori as being of interest were not reported in these tables.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Clinical practice guideline: Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

.A child's social and school environment as well as academic pressures at school are likely to be of influence.^ The information provided by the parents, classroom teacher and school counselor about the child's academic difficulties guides the pediatrician to form an initial diagnosis.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The data collected should reflect what the child actually does, what is happening in the environment when the behavior occurs, the consequences of the behavior, as well as the frequency.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ To be well done, it's necessary before starting the treatment to analyze precisely the disorder and how it interferes with the child's environment.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[109]
.Many of the symptoms of ADHD occur from time to time in everyone; in patients with ADHD, the frequency of these symptoms is greater and patients' lives are significantly impaired.^ Insomnia was the only adverse event to occur with significantly greater frequency in a modafinil group (200/100) than in the placebo group (14% vs. CONCLUSION: Modafinil significantly improved ADHD symptoms in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Impairment must occur in multiple settings to be classified as ADHD.[34] As with many other psychiatric and medical disorders, the formal diagnosis is made by a qualified professional in the field based on a set number of criteria.^ Further complicating diagnosis is that ADHD is associated with multiple functional impairments and comorbid psychiatric disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ METHODS: Review by 50 psychiatrists and 50 primary care practitioners (PCPs) of 537 and 317 medical records, respectively, of adults diagnosed as having ADHD. Information on other psychiatric disorders, time of onset of ADHD, source of referral, use of referrals for diagnosis, ADHD treatment, and use of drug holidays was recorded.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ While child and adolescent physicians are familiar with the treatment of attention-deficit/hyperac-tivity disorder (ADHD), many adult physicians have had little experience with the disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.In the USA these criteria are laid down by the American Psychiatric Association in their Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edition.^ The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) distinguishes among a primarily inattentive subtype, a hyperactive-impulsive subtype, and a combined subtype ( American Psychiatric Association, 1994 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Copyright 2000 American Psychiatric Association.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Diagnostic and statistical manual of mental disorders (4th ed., text revision).
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

Based on the DSM-IV criteria listed below, three types of ADHD are classified:
  1. ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months
  2. ADHD Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months
  3. ADHD, Predominantly Hyperactive-Impulsive Type: if criterion 1B is met but criterion 1A is not met for the past six months.
.The previously used term ADD expired with the most recent revision of the DSM. Consequently, ADHD is the current nomenclature used to describe the disorder as one distinct disorder which can manifest itself as being a primary deficit resulting in hyperactivity/impulsivity (ADHD, predominately hyperactive-impulsive type) or inattention (ADHD predominately inattentive type) or both (ADHD combined type).^ Atomoxetine for attention deficit/hyperactivity disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Combination of neuroleptic and stimulant treatment in attention deficit disorder with hyperactivity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) .
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

DSM-IV criteria

I. Either A or B:[110]
EITHER
(A.) Six or more of the following signs of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
  • Inattentive:
  1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
  2. Often has trouble keeping attention on tasks or play activities.
  3. Often does not seem to listen when spoken to directly.
  4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
  5. Often has trouble organizing activities.
  6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
  7. Often loses things needed for tasks and activities (such as toys, school assignments, pencils, books, or tools).
  8. Is often easily distracted.
  9. Often forgetful in daily activities.
OR
(B.) Six or more of the following signs of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
  • Hyperactivity:
  1. Often fidgets with hands or feet or squirms in seat.
  2. Often gets up from seat when remaining in seat is expected.
  3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
  4. Often has trouble playing or enjoying leisure activities quietly.
  5. Is often "on the go" or often acts as if "driven by a motor".
  6. Often talks excessively.
  • Impulsiveness:
  1. Often blurts out answers before questions have been finished. (See: NAQT)
  2. Often has trouble waiting one's turn.
  3. Often interrupts or intrudes on others (example: butts into conversations or games).
.II. Some signs that cause impairment were present before age 7 years.^ B Some hyperactive-impulsive or inattention symptoms that caused impairment were present before age 7 years.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ C Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In order to be labeled as such, signs and symptoms must start before age 7 and are primarily characterized by inattention, distractibility, and impulsiveness.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.III. Some impairment from the signs is present in two or more settings (such as at school/work and at home).^ C Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There must be clear evidence of significant difficulty in two or more settings (e.g., at home, in school, with peers, or at work) Symptoms of inattention, hyperactivity, or impulsivity must be present at least six months Some of these symptoms have to cause problems before age 7 The symptoms have to be developmentally inappropriate "Developmentally inappropriate" is an important point.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ It is critical to learn what these accommodations are and to work to see that they are put in place across different environments-school, home, community.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

.IV. There must be clear evidence of significant impairment in social, school, or work functioning.^ D. There must be clear evidence of clinically significant impairment in social, academic or occupational functioning.
  • The Child With ADHD: Using the AAP Clinical Practice Guideline - May 1, 2001 - American Family Physician 19 January 2010 8:47 UTC www.aafp.org [Source type: Academic]

^ There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
  • Mental Health: A Report of the Surgeon General - Chapter 3 11 October 2009 9:35 UTC www.surgeongeneral.gov [Source type: Academic]
  • ATTENTION DEFICIT HYPERACTIVITY DISORDER 19 January 2010 8:48 UTC www.utoronto.ca [Source type: FILTERED WITH BAYES]

^ But by middle school, there were clear signs.
  • Learning To Thrive With Attention Deficit Disorder : NPR 9 February 2010 12:45 UTC www.npr.org [Source type: General]

.V. The signs do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder.^ E The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Generally, the DSM-IV-TR requires clinicians to rule out AD/HD if they see Pervasive Developmental Disorder (PDD), schizophrenia, other psychotic disorders, or if the symptoms are better explained by another disorder.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Objective: This pilot study examined the effects of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms and autistic features in children with pervasive developmental disorders (PDD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The signs are not better accounted for by another mental disorder (such as Mood Disorder, Anxiety Disorder, Dissociative Identity Disorder, or a Personality Disorder).^ E The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Comorbid internalizing disorders such as anxiety or depressive disorders are also common (reviewed in Jensen, Martin, and Cantwell, 1997 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Emphasis was placed on ODD, CD, Tourette's syndrome, anxiety disorder, depressive disorder, learning disorder, and mental retardation.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

ICD-10

In the tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) the signs of ADHD are given the name "Hyperkinetic disorders". When a conduct disorder (as defined by ICD-10[111]) is present, the condition is referred to as "Hyperkinetic conduct disorder". Otherwise the disorder is classified as "Disturbance of Activity and Attention", "Other Hyperkinetic Disorders" or "Hyperkinetic Disorders, Unspecified". The latter is sometimes referred to as, "Hyperkinetic Syndrome".[111]

Other diagnostic guidelines

The American Academy of Pediatrics Clinical Practice Guideline for children with ADHD emphasizes that a reliable diagnosis is dependent upon the fulfillment of three criteria:[112]
  • The use of explicit criteria for the diagnosis using the DSM-IV-TR.
  • The importance of obtaining information about the child’s signs in more than one setting.
  • The search for coexisting conditions that may make the diagnosis more difficult or complicate treatment planning.
.All three criteria are determined using the patient's history given by the parents, teachers and/or the patient.^ Inclusion and Exclusion Criteria (questions 21, 22): Inclusion and exclusion criteria are used to determine patient eligibility for study enlistment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There were no differences among the three groups when teacher ratings were used.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RESULTS: Outcomes among atomoxetine-treated patients were superior to those of the placebo treatment group as assessed by investigator, parent, and teacher ratings.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Adults often continue to be impaired by ADHD. Adults with ADHD are diagnosed under the same criteria, including the stipulation that their signs must have been present prior to the age of seven.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Studies evaluating therapies for ADHD in adults (> 18 years of age).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Remember, AD/HD symptoms must exist for at least six months and cause some difficulty before the age of seven.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

[110] .Adults face some of their greatest challenges in the areas of self-control and self-motivation, as well as executive functioning, usually having more signs of inattention and fewer of hyperactivity or impulsiveness than children do.^ Six or more of the symptoms of hyperactivity-impulsivity, but fewer than six of the symptoms of inattention have persisted for at least six months in a child's behavior.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ In addition to symptoms of inattention, impulsivity, and hyperactivity, you may also see these types of executive function problems: .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Attention-Deficit/Hyperactivity Disorder is a neurological disorder in children and adults with a persistent pattern of problems in the areas of inattention, hyperactivity and impulsivity.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

[113]

Comorbid conditions

.Common comorbid conditions include oppositional defiant disorder (ODD).^ Opposition defiant disorder: .
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ ADHD with comorbid oppositional defiant and/or conduct disorder is the most prevalent comorbidity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ ODD: oppositional defiant disorder .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.About 20% to 25% of children with ODD meet criteria for a learning disorder.^ PubMed ] O'Toole K, Abramowitz A, Morris R, Dulcan M. Effects of methylphenidate on attention and nonverbal learning in children with attention-deficit hyperactivity disorder.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Linden M, Habib T, Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Measurement before and after the trials showed that children with attention-deficit/hyperactivity disorder learn to regulate negative slow cortical potentials.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[114] .Learning disorders are more common when there are inattention signs.^ CONCLUSIONS. There is a clear correlation between ADHD and sleep disorders and they are very common in visits to the neuropaediatric department.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ See more articles cited in this paragraph A chart review study of the inattentive and combined types of ADHD. J Atten Disord.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Overview of ADHD in the General Population of Children ADHD, the most common neurobehavioral disorder of childhood, is characterized by developmentally inappropriate levels of hyperactivity, inattention, and impulsivity.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[115]
.Comorbid disorders or substance abuse can make the diagnosis and treatment of ADHD more difficult.^ ADHD in adolescents: Diagnosis and treatment .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Impact of ADHD and its treatment on substance abuse in adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Psychosocial therapy is useful in treating some comorbid conditions.^ Clinical guidelines for each of these agents, as well as their use in combination with stimulants in comorbid conditions, will be discussed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Combination Therapy of Clonidine and Stimulants or Antidepressants Combining clonidine and stimulants is a common clinical practice frequently used to treat ADHD with comorbid oppositional defiant, conduct disorder, tics, and insomnia.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[116] ADHD is not, in boys, associated with increased substance misuse unless there is comorbid conduct disorder; but "research needs to examine the extent to which ADHD in adulthood increases the risk of substance use disorders."[117]
.Depression may also coincide with ADHD, increasingly prevalent among girls and older children.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ According to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), the prevalence of ADHD in school-age children is 3 to 5 percent.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[39]
.Epilepsy is a commonly found comorbid disorder in ADHD diagnosed individuals.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The majority of adults with ADHD exhibit at least 1 comorbid psychiatric disorder, such as major depressive disorder, anxiety disorder, personality disorder, substance abuse disorder, or bipolar disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ ADHD conceived in this manner is by far the most commonly diagnosed psychological/behavioral disorder of childhood (e.g., Barkley, DuPaul, & McMurray, 1990 ; Szatmari, 1992 ; Weiss & Hechtman, 1979 ).
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

Some forms of epilepsy can also cause ADHD like behaviour which can be misdiagnosed as ADHD.[118][119]

Differential diagnoses

.To make the diagnosis of ADHD, a number of other possible medical and psychological conditions must be excluded.^ Studies including conditions other than ADHD were reported if separate subgroup analyses for patients with ADHD were provided.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Other Pharmacological Treatment of ADHD A medication shown to be effective for which FDA approval for ADHD is being sought is guanfacine (Tenex).
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ To estimate rates of parent-reported ADHD diagnosis and medication treatment for ADHD, CDC analyzed data from the 2003 National Survey of Children's Health (NSCH).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

Medical conditions
.Medical conditions that must be excluded include: hypothyroidism, anemia, lead poisoning, chronic illness, hearing or vision impairment, substance abuse, medication side effects, sleep impairment and child abuse, among others.^ In the short term, stimulant medication is effective in reducing the symptoms of ADHD and appears well tolerated with relatively minor side effects.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ General Side Effects of Stimulant Drugs The common side effects of stimulant medications include decreased appetite, insomnia, emotional lability, stomachaches, and headaches.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ PubMed ] Hinshaw SP, Buhrmester D, Heller T. Anger control in response to verbal provocation: Effects of stimulant medication for boys with ADHD. J Abnorm Child Psychol.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[120]
Sleep conditions
.As with other psychological and neurological issues, the relationship between ADHD and sleep is complex.^ CONCLUSIONS. There is a clear correlation between ADHD and sleep disorders and they are very common in visits to the neuropaediatric department.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ PubMed ] Halperin JM, Gittelman R, Katz S, Struve FA. Relationship between stimulant effect, electroencephalogram, and clinical neurological findings in hyperactive children.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.In addition to clinical observations, there is substantial empirical evidence from a neuroanatomic standpoint to suggest that there is considerable overlap in the central nervous system centers that regulate sleep and those that regulate attention/arousal.^ Central Nervous System Involvement Converging evidence from neuropsychology, neuroimaging, neuropharmacology, and genetics suggests involvement of the frontostriatal dopaminergic circuits in the brain.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Conclusion: The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder, particularly in the areas of behavioural and cognitive functions.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Central nervous system stimulants, specifically methylphenidate and amphetamine, remain first-line pharmacological treatments.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[121] .Primary sleep disorders play a role in the clinical presentation of symptoms of inattention and behavioral dysregulation.^ RESULTS: In each study, atomoxetine was statistically superior to placebo in reducing both inattentive and hyperactive and impulsive symptoms as assessed by primary and secondary measures.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ For a diagnosis of combined type , six or more symptoms of inattention, plus six or more symptoms of hyperactivity or impulsivity, must be present.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ The word often appears before each symptom of inattention, hyperactivity, and impulsivity in the DSM-IV-TR. In order to be considered a symptom of AD/HD, a behavior can't be "a once in a while" problem.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

There are multilevel and bidirectional relationships among sleep, neurobehavioral functioning and the clinical syndrome of ADHD.[122]
.Behavioral manifestations of sleepiness in children range from the classic ones (yawning, rubbing eyes), to externalizing behaviors (impulsivity, hyperactivity, aggressiveness), to mood lability and inattentiveness.^ With AD/HD, these are manifested to the world as inattention, hyperactivity, impulsivity, and related behaviors.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ PubMed ] Wender EH, Solanto MV. Effects of sugar on aggressive and inattentive behavior in children with attention deficit disorder with hyperactivity and normal children.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RESULTS: In each study, atomoxetine was statistically superior to placebo in reducing both inattentive and hyperactive and impulsive symptoms as assessed by primary and secondary measures.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[121][123][124] .Many sleep disorders are important causes of symptoms which may overlap with the cardinal symptoms of ADHD; children with ADHD should be regularly and systematically assessed for sleep problems.^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ CONCLUSIONS. There is a clear correlation between ADHD and sleep disorders and they are very common in visits to the neuropaediatric department.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[121][125]
From a clinical standpoint, mechanisms that account for the phenomenon of excessive daytime sleepiness include:
.
  • Chronic sleep deprivation, that is insufficient sleep for physiologic sleep needs,
  • Fragmented or disrupted sleep, caused by, for example, obstructive sleep apnea (OSA) or periodic limb movement disorder (PLMD),
  • Primary clinical disorders of excessive daytime sleepiness, such as narcolepsy and
  • Circadian rhythm disorders, such as delayed sleep phase syndrome (DSPS).^ Ballon JS, Feifel D. Department of Psychiatry, University of California, San Diego, CA, USA. BACKGROUND: Modafinil is a novel wake-promoting agent that has U.S. Food and Drug Administration approval for narcolepsy and shift work sleep disorder and as adjunctive treatment of obstructive sleep apnea/hypopnea syndrome.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Most studies did not clearly describe clinically important information such as the primary outcomes of interest, the presence of comorbid disorders, the characteristics of the patients' families, compliance with treatment, and baseline measurement of outcomes of interest.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Treating daytime sleepiness is complex, and determining the precise nature of the sleep disorder is vital.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    .A study in the Netherlands compared two groups of unmedicated 6-12-year-olds, all of them with "rigorously diagnosed ADHD". 87 of them had problems getting to sleep, 33 had no sleep problems.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    .The larger group had a significantly later dim light melatonin onset (DLMO) than did the children with no sleep problems.^ CONCLUSION:: Combined sleep hygiene and melatonin was a safe and effective treatment for initial insomnia in children with ADHD taking stimulant medication.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Interventions in the IAI group were delivered with significantly greater integrity; however, groups did not differ with respect to teacher ratings of treatment acceptability.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Although the number of dropouts in the methylphenidate group was higher than the theophylline group, there was no significant difference between the two protocols in terms of the dropouts.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    [126]

Management

.Methods of treatment often involve some combination of behavior modification, life-style changes, counseling, and medication.^ Change evaluation methods to suit the child's learning styles and strengths.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Results revealed significant effects of both interventions with the mean effect size of medication being more than twice as great as that of the behavior modification.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Parent training in effective child behavior management methods, classroom behavior modification methods and academic interventions, and special educational placement appear to have the greatest promise of efficacy.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.A 2005 study found that medical management and behavioral treatment is the most effective ADHD management strategy, followed by medication alone, and then behavioral treatment.^ Overall, the most frequent treatment was stimulant medication alone (42.0%).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Psychostimulants are the compounds that have been most extensively studied for the treatment of ADHD in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Evans SW, Vallano G, Pelham W. Treatment of parenting behavior with a psychostimulant: A case study of an adult with attention-deficit hyperactivity disorder.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[127] .While medication has been shown to improve behavior when taken over the short term, they have not been shown to alter long term outcomes.^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Although stimulant medications are an effective first-line treatment for ADHD , concern persists regarding the possible side effects and long-term health outcomes associated with stimulant consumption.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ In conclusion, memory capacities seem normal in AD/HD. Methylphenidate does not have an effect on the memory capacities, but may improve the strategies in which the short-term memory can be effectively transferred to the long-term memory.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[128]

Behavioral interventions

A 2009 review concluded that the evidence is strong for the effectiveness of behavioral treatments in ADHD.[129]
.Psychological therapies used to treat ADHD include psychoeducational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), family therapy, school-based interventions, social skills training and parent management training.^ Some families need to use formal behavior management systems.
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Behavior intervention d: Use good communication skills .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ CBT: cognitive behavioral therapy .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[24]
.Parent training and education have been found to have short term benefits.^ The MTA confirmed the findings of previous studies demonstrating short-term benefits do continue during longer term treatment ( MTA Cooperative Group, 1999 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In summary, the results of studies comparing stimulants with placebo indicate that stimulants offer benefit at least in the short term.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[130] .Family therapy has shown to be of little use in the treatment of ADHD,[131] though it may be worth noting that parents of children with ADHD are more likely to divorce than parents of children without ADHD, particularly when their children are younger than eight years old.^ Treatment Setting (more than one (more...
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Krause, Dresel, Krause, la Fougere, and Ackenheil (2003) report that individuals with ADHD are far more likely to smoke than are individuals with ADD: “It was striking how many of the 20- to 40-year-old patients in our group, who had shown symptoms of hyperactivity and impulsivity in childhood, were smokers: nine smoked and only three were non-smokers … The opposite was shown in the patients with only inattentive symptoms throughout their whole life: only two smoked, seven were non-smokers” (pp.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Various diagnostic models may well define samples that differ in natural history, severity, comorbidity, ADHD subtype, and response to treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[132]
Several ADHD specific support groups exist as informational sources and to help families cope with challenges associated with dealing with ADHD.
.A 2009 study found that children with ADHD move around a lot because it helps them stay alert enough to complete challenging tasks.^ RESULTS: 223 children completed the study.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The researcher advises that when they are doing homework, one should let them fidget, stand or chew gum since it may help them cope.^ A buddy system to check the completion of each agenda and the inclusion in backpacks of materials required to complete homework can help to ensure students take home what they need.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Family therapy without medication may help to develop structure in the family, help to manage children's behaviour, and may help families cope with distress from the presence of the disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ As students with AD/HD grow older, they may need help with issues of peer acceptance and walking the fine line between independence and belonging.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

Unless their behavior is destructive, severely limiting their activity could be counterproductive.[38]

Medications

Ritalin (methylphenidate) 10 mg
Adderall XR 25 mg
.Management with medication has been shown to be the most cost-effective, followed by behavioral treatment and combined treatment in a 14 month follow-up study.^ This study examined long-term (14 months with a 24-month followup) effectiveness of medication for treatment of ADHD vs. In a parallel-groups design, 576 children (age 7 to 9 years) with ADHD were thoroughly assessed and randomized to 4 conditions: (1) medication alone, (2) psychosocial treatment alone, (3) the combination of both, or (4) community comparison ( Richters, Arnold, Jensen et al., 1995 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Evans SW, Vallano G, Pelham W. Treatment of parenting behavior with a psychostimulant: A case study of an adult with attention-deficit hyperactivity disorder.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[127] .However, a longer follow-up study of 3 years found that stimulant medication offered no benefits over behavioral therapy in children.^ However, the studies lack information on the reasons that so many children discontinue medication and provide little evidence for improvement in academic performance with stimulants, even though MPH treatment does appear to produce consistent behavior improvement.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Although both stimulant medication and behavioral therapy have been shown to improve symptoms in children with ADHD, 148 the National Institute of Mental Health–funded multisite trial comparing pharmacological and an intensive behavioral treatment for ADHD found that parent and teacher ratings of ADHD symptoms improved significantly more for children on stimulant medication than with an intensive behavioral treatment (MTA Cooperative Group, 1999).
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ However, while no firm conclusions can be drawn, there are indications that the instructional approach may have contributed to a reduction of impulsive and restless behaviors in the classroom.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[133] .Stimulant medication or non-stimulant medication may be prescribed.^ It has been hypothesized that individuals with ADHD who are not taking stimulant medication may try to self-medicate by smoking.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Stimulant medications are often prescribed in the treatment of AD/HD. Many people question why stimulants would be used for students who already appear to be over stimulated.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Other medications or combinations of medications may be prescribed for students with AD/HD. .
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

.A 2007 drug class review found that there are no good studies of comparative effectiveness between various drugs for ADHD and that there is a lack of quality evidence on their effects on overall academic performance and social behaviors.^ There was evidence of relapse between 3 and 6 months.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Dose effects on classroom academic and social behavior.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ However, the studies lack information on the reasons that so many children discontinue medication and provide little evidence for improvement in academic performance with stimulants, even though MPH treatment does appear to produce consistent behavior improvement.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[134] .ADHD medications are not recommended for preschool children as their long term effects in such young people are unknown.^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ PubMed ] Barkley RA, Koplowitz S, Anderson T, McMurray MB. Sense of time in children with ADHD: Effects of duration, distraction, and stimulant medication.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[24][135] There is very little data on the long-term adverse effects or benefits of stimulants for ADHD.[136]

Stimulant medication

.Stimulants are the most commonly prescribed medications for ADHD. The most common stimulant medications are the chain subsitituted amphetamine methylphenidate (Ritalin, Metadate, Concerta), dextroamphetamine (Dexedrine), mixed amphetamine salts (Adderall),[137][138] dextromethamphetamine (Desoxyn)[139] and lisdexamfetamine (Vyvanse).^ Adderall, a mixture of amphetamine salts, and Dexedrine (dexamphetamine) are also widely used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Benefits and side effects for methylphenidate and mixed amphetamine salts (Adderall) were examined.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Cardiac Effects of Specific Drugs Methylphenidates (Concerta, Focalin, Metadate, Methylin, Ritalin) Methylphenidate has statistically significant but clinically insignificant hemodynamic effects given in therapeutic doses.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[140]
.Stimulants used to treat ADHD raise the extracellular concentrations of the neurotransmitters dopamine and norepinephrine which causes an increase in neurotransmission.^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ METHOD:: Twenty-seven stimulant-treated children (6-14 years of age) with ADHD and initial insomnia (> 60 minutes) received sleep hygiene intervention.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The therapeutic benefits are due to noradrenergic effects at the locus coeruleus and the prefrontal cortex and dopaminergic effects at the nucleus accumbens.^ Effects of methylphenidate on the membrane potential and current in neurons of the rat locus coeruleus.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Garris PA, Wightman RM. Different kinetics govern dopaminergic transmission in the amygdala, prefrontal cortex, and striatum: An in vivo voltametric study.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ See more articles cited in this paragraph Different kinetics govern dopaminergic transmission in the amygdala, prefrontal cortex, and striatum: an in vivo voltammetric study.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[141]
.A meta analysis of clinical trials found that about 70% of children improve after being treated with stimulants in the short term but found that this conclusion may be biased due to the high number of low quality clinical trials in the literature.^ Selegiline in comparison with methylphenidate in attention deficit hyperactivity disorder children and adolescents in a double-blind, randomized clinical trial.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Stimulant medication improves recognition memory in children diagnosed with attention-deficit/hyperactivity disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.There have been no randomized placebo controlled clinical trials investigating the long term effectiveness of methylphenidate (Ritalin) beyond 4 weeks.^ RCT: randomized controlled trial .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ A randomized placebo-controlled double-blind cross-over trial.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ A randomized, double-blind, placebo-controlled trial.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Thus the long term effectiveness of methylphenidate has not been scientifically demonstrated.^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ In conclusion, memory capacities seem normal in AD/HD. Methylphenidate does not have an effect on the memory capacities, but may improve the strategies in which the short-term memory can be effectively transferred to the long-term memory.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ One of the new psychostimulants is Concerta, a very long acting methylphenidate preparation, that has been shown to be very effective.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Serious concerns of publication bias regarding the use of methylphenidate for ADHD has also been noted.^ CONCLUSION: In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ DATA SYNTHESIS: Stimulants are currently first-line therapy for ADHD. However, their use raises several concerns including the potential for abuse and adverse effects.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ OBJECTIVE: To review published algorithms for guiding the use of methylphenidate (MPH) in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[142]
.Higher rates of schizophrenia and bipolar disorder as well as increased severity of these disorders occur in individuals with a past history of stimulant use for ADHD in childhood.^ Various diagnostic models may well define samples that differ in natural history, severity, comorbidity, ADHD subtype, and response to treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[143]
.Both children with and without ADHD abuse stimulants, with ADHD individuals being at the highest risk of abusing or diverting their stimulant prescriptions.^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Ten children without ADHD were evaluated at similar intervals.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Between 16 and 29 percent of students who are prescribed stimulants report diverting their prescriptions.^ Stimulant medications are often prescribed in the treatment of AD/HD. Many people question why stimulants would be used for students who already appear to be over stimulated.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ At 5 years, adherents (n = 16) showed greater improvement in teacher-reported symptoms than nonadherents on stimulants (n = 15) and those off medication (n = 14) (p =.04).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Between 5 and 9 percent of grade/primary and high school children and between 5 and 35 percent of college students have used nonprescribed stimulants.^ Clinical use of stimulant drugs in children.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Studies of use found that stimulant medications are extensively prescribed in the US by both psychiatrists and primary care physicians.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Firestone, Crowe, Goodman et al., 1986 (stimulant vs. In this study, the use of parent training (PT) in the treatment of ADHD was evaluated in 73 children between 5 and 9 years of age.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

Most often their motivation is to concentrate, improve alertness, "get high," or to experiment.[144]
.One study found that children with ADHD actually need to move more to maintain the required level of alertness while performing tasks that challenge their working memory.^ What limits children's working memory span?
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Performing math problems mentally and remembering multi-step directions are examples of tasks that require working memory, which involves remembering and manipulating information for a short time.^ Working memory (WM) capacity is the ability to retain and manipulate information during a short period of time.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The working memory deficit in many children with ADD is accompanied by markedly slowed reaction times, a characteristic that covaries with poorer working memory in general.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ A separate category of studies comparing the short-term effect ( <3 months) of stimulants with placebos was not included in the scope of work for this Task Order.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.These findings may also explain why stimulant medications improve the behavior of most children with ADHD. Those medications improve the physiological arousal of children with ADHD, increasing their alertness.^ MPH may reduce behavioral disturbance in children with ADHD while it is taken.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ We would agree with the conclusion of a recent special article in Pediatrics that states that "there does not seem to be compelling findings of a medication-specific risk necessitating changes in our stimulant treatment of children and adolescents with ADHD." 150 Although those authors suggest that the "use of existing guidelines on the use of stimulants (and psychotropic agents) may identify children, adolescents and adults who are vulnerable to sudden death," we offer the following recommendations as a refinement of these previous guidelines to aid in the identification of children who are potentially at an increased risk from any type of increased stimulation.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ CONCLUSIONS: Poor parental supervision might serve as a mechanism to explain why children with behavior disorders, and those with oppositional behavior patterns in particular, have increased risk of unintentional injury.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[38] .Previous studies have shown that stimulant medications temporarily improve working memory abilities.^ Stimulant medication improves recognition memory in children diagnosed with attention-deficit/hyperactivity disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Studies of use found that stimulant medications are extensively prescribed in the US by both psychiatrists and primary care physicians.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ PubMed ] D'Esposito M, Postle BR, Rypma B. Prefrontal cortical contributions to working memory: Evidence from event-related fMRI studies.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Although "under medical supervision, stimulant medications are considered safe",[112][145] the use of stimulant medications for the treatment of ADHD has generated controversy because of undesirable side effects, uncertain long term effects[10][136][146][147][148] and social and ethical issues regarding their use and dispensation.^ Although stimulant medications are an effective first-line treatment for ADHD , concern persists regarding the possible side effects and long-term health outcomes associated with stimulant consumption.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ In the long term, much of the benefit of stimulant medication disappears after medication is ceased.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Newer medical treatment options of long-acting stimulants and non-stimulants (e.g.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The FDA has added black-box warnings to some ADHD medications,[149][150] while the American Heart Association and the American Academy of Pediatrics feel that it is prudent to carefully assess children for heart conditions before treating them with stimulant medications.^ Children are often treated with medication, usually stimulant medication such as methylphenidate.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The FDA advisory panel recommended with an 8-to-7 vote that a "black box" warning about possible cardiovascular risks associated with stimulant medications used to treat ADHD be added to the drug labeling.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ The FDA stated that "the number of cases of sudden deaths reported for Adderall is only slightly greater, per million prescriptions, than the number reported for methylphenidate products, which are also commonly used to treat pediatric patients with ADHD." 39b Despite the lack of data to support limiting the use of the stimulant medications in children with heart disease, in August 2005, the FDA added a warning to the Adderall labeling, titled "Sudden Death and Preexisting Structural Cardiac Abnormalities," which states, "Sudden death has been reported in association with amphetamine treatment at usual doses in children with structural cardiac abnormalities.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[151]

Antipsychotic medication

.On the contrary to stimulant medication, atypical antipsychotic drug use is rising among ADHD children.^ Fourteen of the children with ADHD used medication daily.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Clinical use of stimulant drugs in children.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Antipsychotics work by blocking dopamine whereas stimulants trigger its release, putting further stigma on the pharmacological treatment of ADHD. As a second-line approach to treatment in children who do not respond to stimulant medications, this class of drugs has not been well-studied or proven to work safely in children with the disorder.^ A replication study of diagnosis and drug treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Psychostimulants are the compounds that have been most extensively studied for the treatment of ADHD in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Weight gain, diabetes, lactation, gynecomastia, drooling, dysphoria, fatigue, sexual dysfunction, heart rhythm problems and the possibility of tardive dyskinesia, an irreversible movement disorder, are among the adverse events associated with antipsychotic drugs.^ The disorder is commonly associated with volatile moods, antisocial behavior, and drug and alcohol misuse.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Bupropion XL was safe and well tolerated, with no serious or unexpected adverse events and a low rate of drug-related study discontinuation (5%).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Future studies are necessary to assess the true risk of SCD in association with stimulant drugs in children and adolescents with and without heart disease.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

[152][153]

Other non-stimulant medications

.Atomoxetine (Strattera) was the only non-stimulant drug approved for the treatment of ADHD. Other medications which may be prescribed off-label include alpha-2A adrenergic receptor blockers such as guanfacine and clonidine, certain antidepressants such as tricyclic antidepressants, SNRIs or MAOIs.^ Newer medical treatment options of long-acting stimulants and non-stimulants (e.g.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Nonstimulant options are available for the treatment of ADHD and include atomoxetine, alpha-adrenergic agents, and antidepressants.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[154][155][156][157]
.Another non-stimulant drug that has been used to treat ADHD is the analeptic drug modafinil.^ Clinical use of stimulant drugs in children.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.There have been double-blind randomised controlled trials that have demonstrated the efficacy and tolerability of modafinil,[158][159] however there are risks of serious side effects such as skin reactions and modafinil is not recommended for use in children.^ DATA SYNTHESIS: There have been 33 double-blind, placebo-controlled trials of modafinil.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ A randomized placebo-controlled double-blind cross-over trial.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ A randomized, double-blind, placebo-controlled trial.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[160]

Experimental and alternative treatments

.Dietary supplements and specialized diets are sometimes used by people with ADHD with the intent to mitigate some or all of the symptoms.^ ADHD symptoms were assessed using parent- and investigator-rated scales.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ CONCLUSION: In adolescents, once-daily OROS methylphenidate significantly reduced ADHD symptoms and was well tolerated using dosages up to 72 mg/d.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Mean reductions in symptom ratings (measured using the ADHD-Rating Scale-IV school version questionnaire) ranged from 15.0 to 19.7 (7.3 to 10.1 for placebo).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

For example, Omega-3 supplementation (seal, fish or krill oil) may reduce ADHD symptoms for a subgroup of children and adolescents with ADHD "characterized by inattention and associated neurodevelopmental disorders."[161] Although vitamin or mineral supplements (micronutrients) may help children diagnosed with particular deficiencies, there is no evidence that they are helpful for all children with ADHD. Furthermore, megadoses of vitamins, which can be toxic, must be avoided.[162] In the United States, no dietary supplement has been approved for the treatment for ADHD by the FDA.[163] There is however a pilot study done which shows that phosphatidyl serine (PS) can help against ADHD.[164]
.EEG biofeedback is a treatment strategy used for children, adolescents and adults with ADHD.[165] The human brain emits electrical energy which is measured with electrodes on the brain.^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ It also included a description of the search strategy used to identify literature on the assessment and treatment of children, adolescents, and adults with ADHD. The report did not present the issues of interest as questions but was structured following clear sections by topics of interest.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Biofeedback alerts the patient when beta waves are present.^ ECG abnormalities are present in 90% of LQTS patients and include prolongation of the corrected QT interval (QTc) with abnormal T-wave morphology.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

.This theory believes that those with ADHD can train themselves to decrease ADHD symptoms.^ Adult ADHD often presents differently from childhood ADHD. Because adult ADHD can be comorbid with other disorders and has symptoms similar to those of other disorders, it is important to understand differential diagnoses.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ In this monograph, Craig L. Donnelly, MD, reviews the history of ADHD and discusses the pathophysiologic progression of childhood symptoms into those commonly exhibited by adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Methylphenidate (MPH) and atomoxetine are the two drugs being currently prescribed and their efficacy in decreasing the symptoms of ADHD is well documented.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.There is a distinct split in the scientific community about the effectiveness of the treatment.^ Conclusion: The trial suggests scientific evidence of the effectiveness of homeopathy in the treatment of attention deficit hyperactivity disorder, particularly in the areas of behavioural and cognitive functions.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ There is substantial scientific evidence that several methylphenidate- and amphetamine-based preparations have acute efficacy in the treatment of this condition in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The treatment manuals developed to support clinical trials can assist the dissemination of effective treatments to community practitioners.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.A number of studies indicate the scientific evidence has been increasing in recent years for the effectiveness of EEG biofeedback for the treatment of ADHD. According to a 2007 review, with effectiveness of the treatment was demonstrated to be equivalent to that of stimulant medication.^ Stimulant treatment over five years: adherence, effectiveness, and adverse effects.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Therefore, research has been directed towards determining if the treatment of ADHD with stimulant medications can be safe and effective for the individual with active SUD and concomitant ADHD. An initial trial of methylphenidate in a population of adults with active cocaine dependence and ADHD indicates that this is the case.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.The review noted, improvements are seen at the behavioral and neuropsychological level with the symptoms of inattention, hyperactivity and impulsivity showing significant decreases after treatment.^ Six or more of the symptoms of hyperactivity-impulsivity, but fewer than six of the symptoms of inattention have persisted for at least six months in a child's behavior.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Asherson P. MRC Social Genetic Developmental Psychiatry Centre, Institute of Psychiatry, Kings College London, London, SE5 8AF, UK. p.asherson@iop.kcl.ac.uk Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder that frequently persists into adulthood, with significant levels of inattentive, hyperactive and impulsive behavior.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Six or more of the symptoms of inattention and six or more of the symptoms of hyperactivity-impulsivity have persisted for at least six months in a child's behavior.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

.There are no known side effects from EEG biofeedback therapy.^ PubMed ] Linden M, Habib T, Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Linden M, Habib T, Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Although this may be true, no attempts have been made to evaluate the tradeoff explicitly (i.e., examine the differential utility) between behavioral changes and side effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.There are methodological limitations and weaknesses in study designs however.^ However, we regarded these study designs as too vulnerable to bias and of limited value for direct head-to-head comparisons between psychosocial therapies and interventions.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There were no studies designed to determine the proportion of adults with ADHD who will use and benefit from other interventions.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ These studies, however, will require complex designs, substantial amounts of resources, and efficient collaboration among research groups.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.In a 2005 review, Loo and Barkley stated that problems including lack of blinding such as placebo control and randomisation are significant limitations to the studies into EEG biofeedback and make definitive conclusions impossible to make.^ A pilot placebo-controlled study.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ A randomized placebo-controlled double-blind cross-over trial.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Are limitations of the review process stated?
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[166] .As a result more robust clinical studies have been strongly recommended.^ Drug vs. Despite the limitations in the individual studies, the results indicate consistently that stimulants are more effective than nonpharmacological interventions when compared head-to-head.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Dykman RA, McGrew J, Ackerman PT. A double-blind clinical study of pemoline in MBD children: Comments on the psychological test results.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Information on the presence of comorbid disorders is important in order to judge the generalizability of the results of a study to a particular clinical setting.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[167] .A German review in 2004 found that EEG biofeedback, also sometimes referred to as neurofeedback, is more effective than previously thought in treating attention deficiency, impulsivity and hyperactivity; short-term effects match those of stimulant treatment and a persistent normalization of EEG parameters is found which is not found after treatment with stimulants.^ Longer term effects of stimulant treatments for Attention-Deficit/Hyperactivity Disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Attention styles of hyperactive and normal girls.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Combination of neuroleptic and stimulant treatment in attention deficit disorder with hyperactivity.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[168] .There are no known side effects from biofeedback therapy although research into biofeedback has been limited and further research has been recommended.^ No significant side effects or worsening of manic symptoms was observed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although the overall percentage of subjects having any side effect on both methylphenidate and placebo was rather high, side effects on methylphenidate over and above those on placebo were few and mild.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although this may be true, no attempts have been made to evaluate the tradeoff explicitly (i.e., examine the differential utility) between behavioral changes and side effects.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[168] An American review the following year also emphasized the benefits of this method.[169] Similar findings were reported in a study by another German team in 2004.[170]
.Aerobic fitness may improve cognitive functioning and neural organization related to executive control during pre-adolescent development, though more studies are needed in this area.^ Executive function is taxed when conscious, top-down control is needed.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Faster processing and improved executive function performance may covary because they both reflect more efficient neural processing and improved signal/noise ratios, either because of systemwide improvements in the nervous system or because a better functioning prefrontal cortex improves signal/noise ratios for diverse neural regions, permitting faster and more efficient cognitive processing.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Diamond A. Normal development of prefrontal cortex from birth to young adulthood: Cognitive functions, anatomy, and biochemistry.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[171] .One study suggests that athletic performance in boys with ADHD may increase peer acceptance when accompanied by fewer negative behaviors.^ The studies available provide little evidence for improvement in academic performance with stimulants, even though MPH treatment appears to produce consistent behavior improvement.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Brown, Wynne, and Medenis, 1985 : In this study, CBT alone resulted in minimal improvement in attention and no improvement in behavior or academic performance.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[172]
.Art is thought by some to be an effective therapy for some of the symptoms of ADHD. Other sources, including some psychologists who have written on the subject, feel that cutting down on time spent on television, video games, or violent media can help some children.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ No studies were designed to determine the proportion of adults with ADHD who will use, and benefit from, other interventions, particularly nonpharmacological.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Objective: This pilot study examined the effects of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms and autistic features in children with pervasive developmental disorders (PDD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.One study indicated a correlation between excessive TV time as a child with higher rates of ADHD symptoms.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ CONCLUSIONS. There is a clear correlation between ADHD and sleep disorders and they are very common in visits to the neuropaediatric department.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[173] .Other therapies that have been effective for some have been ADHD coaching, positive changes in diet, such as low sugar, low additives, and no caffeine.^ Paroxetine had no effect on ADHD. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) scores were low to start, and no treatment differences were evident at endpoint.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Stimulant medications remain the most effective ADHD therapies and provide robust improvement in ADHD symptoms in both youth and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Other forms of treatment, such as clonidine or fenfluramine, have also proved to be effective to a certain extent in patients with MR, especially in the clinical setting.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

Children who spend time outdoors in natural settings, such as parks, seem to display fewer symptoms of ADHD, which has been dubbed "Green Therapy".[174]

Prognosis

.Children diagnosed with ADHD have significant difficulties in adolescence, regardless of treatment.^ Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[175] .In the United States, 37% of those with ADHD do not get a high school diploma even though many of them will receive special education services.^ Individuals with ADHD also tend to consume a disproportionate share of resources and attention from educators, the health care system, social service agencies, and the legal system.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Estimating the number of children who have had ADHD diagnosed and are currently taking medication for the disorder is an important step toward understanding the overall burden of ADHD in the United States.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Doggett AM. School of Education, Colorado State University, USA. doggett@lamar.colostate.edu The purpose of this article is to discuss alternative treatments other than drug therapy for Attention-Deficit/Hyperactive Disorder (ADHD) in educational settings.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[25] .A 1995 briefing citing a 1994 book review says the combined outcomes of the expulsion and dropout rates indicate that almost half of all ADHD students never finish high school.^ See more articles cited in this paragraph A chart review study of the inattentive and combined types of ADHD. J Atten Disord.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The Young Mania Rating Scale (for manic symptoms) and the Clinical Global Impression of improvement (for ADHD symptoms) were the primary outcome measures.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although the rate of ADHD falls with age, at least half of children with the disorder will have impairing symptoms in adulthood.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[176] .Also in the US, less than 5% of individuals with ADHD get a college degree[177] compared to 28% of the general population.^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Adult ADHD seems to be a reality, but much less frequent than in youths.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Drug vs. Despite the limitations in the individual studies, the results indicate consistently that stimulants are more effective than nonpharmacological interventions when compared head-to-head.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[178] .Those with ADHD as children are at increased risk of a number of adverse life outcomes once they become teenagers.^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ They administered a spatial-span task and found a striking difference between children with ADHD broadly defined and controls.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

These include a greater risk of auto crashes, injury and higher medical expenses, earlier sexual activity, and teen pregnancy.[179] .Russell Barkley states that adult ADHD impairments affect "education, occupation, social relationships, sexual activities, dating and marriage, parenting and offspring psychological morbidity, crime and drug abuse, health and related lifestyles, financial management, or driving.^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Children with ADHD can have academic impairments, social dysfunction, and poor self-esteem.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Their parents completed an anonymous questionnaire covering their perceptions relating to diagnosis, treatment and overall management.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.ADHD can be found to produce diverse and serious impairments".[180] The proportion of children meeting the diagnostic criteria for ADHD drops by about 50% over three years after the diagnosis.^ Children with ADHD can have academic impairments, social dysfunction, and poor self-esteem.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ They administered a spatial-span task and found a striking difference between children with ADHD broadly defined and controls.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This report describes the results of that analysis, which indicated that, in 2003, approximately 4.4 million children aged 4-17 years were reported to have a history of ADHD diagnosis; of these, 2.5 million (56%) were reported to be taking medication for the disorder.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.This occurs regardless of the treatments used and also occurs in untreated children with ADHD.[120][133][147] ADHD persists into adulthood in about 30-50% of cases.^ A large percentage of children diagnosed with ADHD have symptoms that persist into adolescence and adulthood.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Atomoxetine shows no abuse potential and is not a controlled substance in the US. In November of 2002 the FDA approved atomoxetine for use in the US for the treatment of ADHD in children, adolescents and adults.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[7] Those affected are likely to develop coping mechanisms as they mature, thus compensating for their previous ADHD.[9]

Epidemiology

Percent of United States youth 4-17 years of age ever diagnosed with ADHD as of 2003.[181]
.ADHD's global prevalence is estimated at 3-5% in people under the age of 19. There is, however, both geographical and local variability among studies.^ Prevalence estimates of ADHD vary according to the methods of ascertainment, diagnostic criteria, informants, and population sampled.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Method: Twelve children (aged 6-14 years) with PDD accompanied by ADHD symptoms entered a 10-week open-label study with atomoxetine (1.19 +/- 0.41 mg/kg/day).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ However, given the present debate around the existence of ADHD, the variation in estimates of prevalence, and the frequency with which comorbid disorders are identified, it is not surprising to find wide variation and controversy around its treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Geographically, children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East,[182] well published studies have found rates of ADHD as low as 2% and as high as 14% among school aged children.^ All but six studies were published in North America.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[27] .The rates of diagnosis and treatment of ADHD are also much higher on the East Coast of the USA than on the West Coast.^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Adult ADHD seems to be a reality, but much less frequent than in youths.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Paroxetine had no effect on ADHD. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) scores were low to start, and no treatment differences were evident at endpoint.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[183] .The frequency of the diagnosis differs between male children (10%) and female children (4%) in the United States.^ HCM has a prevalence of 1 in 500 in the United States, with an incidence of sudden death in children of 2% to 8% per year.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ They administered a spatial-span task and found a striking difference between children with ADHD broadly defined and controls.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Consistently, the disorder is diagnosed more frequently in males than in females ( American Academy of Child and Adolescent Psychiatry, 1997a ; American Psychiatric Association, 1994 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[184] .This difference between genders may reflect either a difference in susceptibility or that females with ADHD are less likely to be diagnosed than males.^ Various diagnostic models may well define samples that differ in natural history, severity, comorbidity, ADHD subtype, and response to treatment.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Adult ADHD seems to be a reality, but much less frequent than in youths.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ They administered a spatial-span task and found a striking difference between children with ADHD broadly defined and controls.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[185]
.Rates of ADHD diagnosis and treatment have increased in both the UK and the USA since the 1970s.^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.In the UK an estimated 0.5 per 1,000 children had ADHD in the 1970s, while 3 per 1,000 received ADHD medications in the late 1990s.^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ PubMed ] Barkley RA, Koplowitz S, Anderson T, McMurray MB. Sense of time in children with ADHD: Effects of duration, distraction, and stimulant medication.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.In the USA in the 1970s 12 per 1,000 children had the diagnosis, while in the late 1990s 34 per 1,000 had the diagnosis and the numbers continue to increase.^ The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The sample consisted of 89 children 6 to 12 years of age whose diagnosis of ADHD was based on the Conners Teacher Rating Scale.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[24]
.Adults are likely not to be diagnosed or treated for ADHD. This may result in a substantial underestimation of prevalence in most populations.^ Most adult sufferers of ADHD have not been properly diagnosed or treated.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Prevalence estimates of ADHD vary according to the methods of ascertainment, diagnostic criteria, informants, and population sampled.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Awareness about Hyperactivity and ADHD or its signs and symptoms has been rudimentary until early 1990 across Europe.^ Objective: This pilot study examined the effects of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms and autistic features in children with pervasive developmental disorders (PDD).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Physicians should work with patients to provide feedback about their symptoms, to educate them about ADHD, and to set treatment goals.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.In the UK in 2003 a prevalence of 3.6% is reported in male children and less than 1% is reported in female children.^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ Consistently, the disorder is diagnosed more frequently in males than in females ( American Academy of Child and Adolescent Psychiatry, 1997a ; American Psychiatric Association, 1994 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Hallucinations occurred more often in medicated children than has been reported in other studies (3/61), but on the whole, adverse effects were few and relatively mild.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[186]
.As of 2009, eight percent of all Major League Baseball players have been diagnosed with ADHD, making the disease epidemic among this population.^ The children included in this study had diagnoses of ADHD with depressive symptoms, ADHD and major depressive disorder, or major depressive disorder with prominent attentional symptoms.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ ADHD in Children With Heart Disease ADHD may be more prevalent in children with heart disease than in the general pediatric population.
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

^ The points I make in this paper include the following: many individuals currently diagnosed with the inattentive subtype of ADHD appear to be misdiagnosed.
  • Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity) 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

The increase coincided with the League's 2006 ban on stimulants (q.v. Major League Baseball drug policy).[187]

History

Hyperactivity has long been part of the human condition. .Sir Alexander Crichton describes "mental restlessness" in his book An Inquiry Into the Nature and Origin of Mental Derangement written in 1798.[188][189] The terminology used to describe the symptoms of ADHD has gone through many changes over history including: "minimal brain damage", "minimal brain dysfunction" (or disorder),[190] "learning/behavioral disabilities" and "hyperactivity". In the DSM-II (1968) it was the "Hyperkinetic Reaction of Childhood". In the DSM-III "ADD (Attention-Deficit Disorder) with or without hyperactivity" was introduced.^ Advocating for students with learning disabilities and attention deficit hyperactivity disorder in public schools.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ PubMed ] Lie N. Follow-ups of children with attention deficit hyperactivity disorder (ADHD).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ [Drug therapy in attention deficit disorders with hyperactivity in children] (Ger).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.In 1987 this was changed to ADHD in the DSM-III-R and subsequent editions.^ DSM-IIIR and -IV criteria were used almost as often (28 studies) as DSM-I and -III (30 studies) for the diagnosis of ADHD. .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The study included 40 patients diagnosed with ADHD using DSM-III criteria between 5 and 13 years of age and of average intellectual functioning.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[191] The use of stimulants to treat ADHD was first described in 1937.[192]

Society and culture

The media have reported on many issues related to ADHD. In 2001 PBS's Frontline aired a one-hour program about the effects of the diagnosis and treatment of ADHD in minors, entitled "Medicating Kids."[193] The program included a selection of interviews with representatives of various points of view. .In one segment, entitled Backlash, retired neurologist Fred Baughman and Peter Breggin whom PBS described as "outspoken critics who insist [ADHD is] a fraud perpetrated by the psychiatric and pharmaceutical industries on families anxious to understand their children's behavior"[194] were interviewed on the legitimacy of the disorder.^ The children had been referred to a psychiatric clinic for disruptive behavior problems and met criteria for ADHD based on parent and teacher interviews.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Johnson CR, Handen BL, Lubetsky MJ, Sacco KA. Efficacy of methylphenidate and behavioral intervention on classroom behavior in children with ADHD and mental retardation.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ PubMed ] Linden M, Habib T, Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Russell Barkley and Xavier Castellanos, then head of ADHD research at the National Institute of Mental Health (NIMH), defended the viability of the disorder.^ The NIH has also funded a long-term, collaborative Multimodal Treatment Study of Children with ADHD (the MTA Collaborative Group study) to address issues emphasized by the Institute of Medicine study Research on Children and Adolescents with Mental, Behavioral, and Developmental Disorders , the National Institute of Mental Health (NIMH) National Plan for Research on Child and Adolescent Mental Disorders , the Healthy People 2000 , and Healthy Children 2000 .
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ The National Institutes of Health (NIH) held a consensus planning conference on ADHD in November 1998.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ To estimate rates of parent-reported ADHD diagnosis and medication treatment for ADHD, CDC analyzed data from the 2003 National Survey of Children's Health (NSCH).
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

In the interview with Castellanos, he stated that little is scientifically understood.[195] Lawrence Diller was interviewed on the business of ADHD along with a representative from Shire Plc.[citation needed]
A number of notable individuals have given controversial opinions on ADHD. Scientologist Tom Cruise's interview with Matt Lauer was widely watched by the public. .In this interview he spoke about postpartum depression and also referred to Ritalin and Adderall as being "street drugs" rather than as ADHD medication.^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Although these are often described as "symptoms" they are really "signs" of ADHD, as they are observed phenomena rather than subjective experiences of the patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[196] .In England Baroness Susan Greenfield, a leading neuroscientist, spoke out publicly about the need for a wide-ranging inquiry in the House of Lords into the dramatic increase in the diagnosis of ADHD in the UK and possible causes[197] following a 2007 BBC Panorama programme which highlighted US research (The Multimodal Treatment Study of Children with ADHD by the University of Buffalo showing treatment results of 600) suggesting drugs are no better than other forms of therapy for ADHD in the long term.^ The results emphasize the need for a focus upon occupation in assessment and treatment of children with ADHD. ----- CNS Drugs.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Psychostimulants are the compounds that have been most extensively studied for the treatment of ADHD in children.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ ADHD and drug therapy: is it still a valid treatment?
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[198]

Controversies

.ADHD and its diagnosis and treatment have been considered controversial since the 1970s.^ ADHD in adolescents: Diagnosis and treatment .
  • LD OnLine :: Attention Deficit/Hyperactivity Disorder 9 February 2010 12:45 UTC www.ldonline.org [Source type: FILTERED WITH BAYES]

^ Successful treatment of attention deficit hyperactivity disorder (ADHD) begins with an accurate diagnosis and understanding of a child's weaknesses and strengths.

^ The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[16][18][199] .The controversies have involved clinicians, teachers, policymakers, parents and the media.^ ADHD has been surrounded by great controversy involving clinicians, teachers, policymakers, parents, and the media.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ For student with severe difficulties, daily or weekly progress reports to parents can assist teachers to involve parents in ongoing support.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ The effect of Adderall was significant for clinician and parent ratings but not for teacher ratings and was significant for both fixed-dose and best-dose designs.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

.Opinions regarding ADHD range from not believing it exists at all to believing there are genetic and physiological bases for the condition as well as disagreement about the use of stimulant medications in treatment.^ The range of opinion regarding the validity of ADHD extends from those who do not believe it exists and regard it as a myth, to those who believe that there is genetic and physiological evidence supporting its existence.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There is also variation and controversy around the treatment of ADHD, which often includes stimulant medication.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ There are many alternative treatments for ADHD, most of them heavily disputed or relegated to adjunct status with medication treatment.
  • Attention-deficit hyperactivity disorder - Psychology Wiki 9 February 2010 12:45 UTC psychology.wikia.com [Source type: Academic]
  • Attention-deficit hyperactivity disorder - Psychology Wiki 25 September 2009 4:14 UTC psychology.wikia.com [Source type: Academic]

[17][18][19] .Most healthcare providers accept that ADHD is a genuine disorder with debate in the scientific community centering mainly around how it is diagnosed and treated.^ How is ADHD diagnosed?

^ Many adults with ADHD have not been diagnosed and treated.

^ How is ADHD identified and diagnosed?
  • Attention Deficit Hyperactivity Disorder 19 January 2010 8:48 UTC www.omh.state.ny.us [Source type: FILTERED WITH BAYES]

[20][21][22]
.Others have included that it may stem from a misunderstanding of the diagnostic criteria and how they are utilized by clinicians,[15]:p.3 teachers, policymakers, parents and the media.^ ADHD has been surrounded by great controversy involving clinicians, teachers, policymakers, parents, and the media.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Non-RCT studies were included if they met all of the other inclusion criteria and if they evaluated adverse effects associated with treatment for more than 12 weeks and included more than 10 patients.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ This may include other teachers, including those who have previously worked with the student, the Consulting Teacher (or special education supervisor if needed), and/or the Resource Teacher, the School Counselor, and/or the Principal or other administrator.
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

[17] .Debates center around: whether ADHD is a disability or whether it is merely a neurological description, the cause of the disorder, the changing of the diagnostic criteria, and the rapid increase in diagnosis of ADHD and the use of stimulants to treat the disorder.^ Attention-Deficit Hyperactivity Disorder (AD/HD) is a neurological disorder requiring a clinical diagnosis based on criteria outlined in The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV).
  • Teaching Students with Attention-Deficit/Hyperactivity Disorder 19 January 2010 8:48 UTC www.slc.sevier.org [Source type: FILTERED WITH BAYES]

^ Food and Drug Administration-approved medications for ADHD include the stimulants and nonstimulants, although tricyclic antidepressants and bupropion are also commonly used.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ The diagnosis and treatment of attention-deficit hyperactivity disorder continues to raise controversy, and, there is also an increase in treatment options.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[200] Some do not believe it exists at all.[17] .Long term possible side effects of stimulants and their usefulness are largely unknown because of a lack of long term studies.^ The MTA study confirms that large-scale, long-term collaboration among researchers is possible.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Studies evaluating the effect of long-term therapies (> 12 weeks).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[201] Some research raises questions about the long term effectiveness and side effects of medications used to treat ADHD.[202]
.In 1998, the US National Institutes of Health (NIH) released a consensus statement on the diagnosis and treatment of ADHD. The statement, while recognizing that stimulant treatment is controversial, supports the validity of the ADHD diagnosis and the efficacy of stimulant treatment.^ The National Institutes of Health (NIH) held a consensus planning conference on ADHD in November 1998.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ NIH Consensus Statement Online, 1998 ).
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Thus, in 1998, the National Institutes of Health consensus panel on the diagnosis and treatment of ADHD concluded that the costs associated with ADHD were large, stating that individuals with ADHD "consume a disproportionate share of resources and attention from the health care system, criminal justice system, schools, and other social service agencies."
  • Cardiovascular Monitoring of Children and Adolescents With Heart Disease Receiving Medications for Attention Deficit/Hyperactivity Disorder: A Scientific Statement From the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing -- Vetter et al. 117 (18): 2407 -- Circulation 11 October 2009 9:35 UTC circ.ahajournals.org [Source type: Academic]

.It found controversy only in the lack of sufficient data on long-term use of medications, and in the need for more research in many areas.^ Few long-term followup studies of the effectiveness of treatment for ADHD have been conducted even in the area of medication trials.
  • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Data that do exist suggest that long-term treatment with psychostimulants in appropriately diagnosed patients may be associated with salutary effects as well as relatively modest risks.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

^ Studies of use found that stimulant medications are extensively prescribed in the US by both psychiatrists and primary care physicians.
  • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

[203]
The British Psychological Society said in a 1997 report that physicians and psychiatrists should not follow the American example of applying medical labels to such a wide variety of attention-related disorders: "The idea that children who don’t attend or who don’t sit still in school have a mental disorder is not entertained by most British clinicians."[204][205] However, several years later, in 2009, the British Psychological Society, in collaboration with the Royal College of Psychiatrists, released a set of guidelines for the diagnosis and treatment of ADHD.[206]

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Bibliography

  • Dr Jennifer Erkulwater; Dr Rick Mayes; Dr Catherine Bagwell (2009). .Medicating Children: ADHD and Pediatric Mental Health.^ Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ PubMed ] Barkley RA, Koplowitz S, Anderson T, McMurray MB. Sense of time in children with ADHD: Effects of duration, distraction, and stimulant medication.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ RECENT FINDINGS: Recent evidence suggests that the overall rate of medication treatment for ADHD has been increasing, with over 2 million children being treated with stimulants in 1997.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    Cambridge: Harvard University Press. pp. 5. ISBN 0-674-03163-6.
     

Further reading

.
  • Barkley, Russell A. Take Charge of ADHD: The Complete Authoritative Guide for Parents (2005) New York: Guilford Publications.
  • Conrad, Peter Identifying Hyperactive Children (Ashgate, 2006).
  • Crawford, Teresa I'm Not Stupid!^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Barkley RA, Cunningham CE. The effects of methylphenidate on the mother-child interactions of hyperactive children.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ This preliminary study compared the daily living skills of children with and without attention-deficit-hyperactivity disorder (ADHD), and the influence of a social skills training group on these skills.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    I'm ADHD!
  • Faraone, Stephen V. (2005). .The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder.^ [Drug therapy in attention deficit disorders with hyperactivity in children] (Ger).
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Clinical assessment and treatment of attention deficit hyperactivity disorder in adults.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Clonidine for treatment of attention-deficit/hyperactivity disorder.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    .Eur Child Adolesc Psychiatry 14, 1-10.
  • Faraone, Stephen, V.Straight Talk about Your Child's Mental Health: What to Do When Something Seems Wrong (2003) New York:Guilford Press
  • Green, Christopher, Kit Chee, Understanding ADD; Doubleday 1994; ISBN 0-86824-587-9
  • Hanna, Mohab.^ Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test the efficacy of reboxetine in ADHD. ----- J Am Acad Child Adolesc Psychiatry.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ PubMed ] Gunning WB, Ferdinand RF, De Vrijer JC, Minderaa RB. The application of clonidine in child and adolescent psychiatry.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Heinrich H, Gevensleben H, Freisleder FJ, Moll GH, Rothenberger A. Department of Child and Adolescent Psychiatry, University of Gottingen, Gottingen, Germany.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    .(2006) Making the Connection: A Parent's Guide to Medication in ADHD, Washington D.C.: Ladner-Drysdale.
  • Hartmann, Thom (2003).^ To estimate rates of parent-reported ADHD diagnosis and medication treatment for ADHD, CDC analyzed data from the 2003 National Survey of Children's Health (NSCH).
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ A guide to the treatment of adults with ADHD. Weiss MD, Weiss JR. University of British Columbia Medical Center, Division of Child Psychiatry, British Columbia's Children's Hospital, Vancouver.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Most had parents and/or children with ADHD. Medication dose was individually titrated and administered for 6 to 15 weeks.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    The Edison gene: ADHD and the gift of the hunter child. Rochester, Vt: Park Street Press. ISBN 0-89281-128-5. 
  • Matlen, Terry. .(2005) "Survival Tips for Women with AD/HD". ISBN 1-886941-59-9
  • Mellor, Nigel ADHD or Attention Seeking?^ OBJECTIVES: To investigate whether docosahexaenoic acid (DHA) supplementation was able to ameliorate attention-deficit/hyperactivity disorder(AD/HD) symptoms in AD/HD children.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    .Ways of Distinguishing Two Common Childhood Problems (2008)
  • Millichap, J. Gordon, MD, FRCP Attention Deficit Hyperactivity Disorder Handbook: A Physician’s Guide to ADHD. New York: Springer, 2010 ISBN: 978-1441913968
  • Ninivaggi, F.J. "Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: Rethinking Diagnosis and Treatment Implications for Complicated Cases", Connecticut Medicine.^ Attention-deficit hyperactivity disorder.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Arnold LE, Clark DL, Sachs LA, Jakim S, Smithies C. Vestibular and visual rotational stimulation as treatment for attention deficit and hyperactivity.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ PubMed ] Hunt RD, Arnsten AFT, Asbell MD. An open trial of guanfacine in the treatment of attention-deficit hyperactivity disorder.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    September 1999; Vol. 63, No. 9, 515-521. PMID 10531701
  • Southall, Angela (2007). .The Other Side of ADHD:Attention Deficit Hyperactivity Disorder Exposed and Explained.^ Selegiline in comparison with methylphenidate in attention deficit hyperactivity disorder children and adolescents in a double-blind, randomized clinical trial.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Additional research should focus on the control of unspecific effects, medication, and subtypes to confirm the assumption that slow cortical potential feedback is a viable treatment option for attention-deficit/hyperactivity disorder.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Miller A, Lee SK, Raina P, Klassen A, Zupancic J, Olsen L. A review of therapies for attention-deficit/hyperactivity disorder.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    Radcliffe Publishing Ltd. ISBN 1846190681. http://books.google.ca/books?id=AKXhThWgvyYC&pg=PA41&lpg=PA41&dq=barkley+drug+company+funding&source=bl&ots=X-Twuf7Jvx&sig=FE3J6Ov1puhnrxC3c-464VbbVaE&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPP1,M1. Retrieved 2009-05-02.
     
Adult ADHD
  • Kelly, Kate, Peggy Ramundo. (1993) You Mean I'm Not Lazy, Stupid or Crazy?! .A Self-Help Book for Adults with Attention deficit Disorder.^ Selegiline in comparison with methylphenidate in attention deficit hyperactivity disorder children and adolescents in a double-blind, randomized clinical trial.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ^ Miller A, Lee SK, Raina P, Klassen A, Zupancic J, Olsen L. A review of therapies for attention-deficit/hyperactivity disorder.
    • Treatment of Attention-Deficit/Hyperactivity Disorder: Evidence Report/Technology Assessment Number 11 -- AHRQ Evidence Reports -- NCBI Bookshelf 9 February 2010 12:45 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ OBJECTIVE: To test the hypothesis that transdermal nicotine would be efficacious for the treatment of children and adolescents with attention deficit hyperactivity disorder (ADHD).
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ISBN 0-684-81531-1
  • Ratey, Nancy. .(2008) The Disorganized Mind: Coaching Your ADHD Brain to Take Control of Your Time, Tasks, and Talents.^ Atomoxetine is a valuable new treatment option for adults with ADHD and is particularly useful in patients who are at risk for substance abuse or who do not wish to take a controlled substance.
    • Attention Deficit Hyperactivity Disorder: Free Medical and Health Information on ADHD Treatment and Research 19 January 2010 8:48 UTC www.lifestages.com [Source type: Academic]

    ISBN 0312355335
  • Sarkis, Stephanie. (2006) 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals. ISBN 1572244348
  • Weiss, Lynn. (2005) Attention Deficit Disorder in Adults, 4th Edition: A Different Way of Thinking ISBN 1589792378

External links

.

Simple English

Attention-deficit hyperactivity disorder (ADHD) is a kind of brain disorder. It affects how people think and behave. People with ADHD usually have problems with focus and priority. An easy (though not completely correct) way to imagine what ADHD is like is to think of a shiny light or a constant noise in a room. Imagine that you want to be able to turn your attention away to focus on other things, like getting the mess cleaned up, or doing your homework, but that shiny light or that buzzing sound is constantly distracting you. This is similar to why people with ADHD have trouble focusing. They want to focus, but they are constantly being distracted by that shiny thought in their head. On the contrary, when that shiny thought is not barred from being their top priority, a person with ADHD will sometimes hyperfocus, nearly completely shutting out the rest of the world and focusing intensely.

They may also be hyperactive. Because ADHD affects how people's nerves develop, it is called a neurological developmental disorder.[1][2][3] Researchers believe that about 3-5% of the people around the world are affected by ADHD. It is also believed that the disorder is often genetically inherited.

A review of 102 studies estimated that throughout the entire world, the prevalence of ADHD in people under the age of 19 is 5.29%. Not all of the 102 studies had similar findings, though, and they used different groups of people, conditions, and measurement tools. There are more people diagnosed with ADHD in North America than there are in Africa and the Middle East.[4] In the United States, about 7% of children between 3 and 17 years old are diagnosed with ADHD. About 10% of all boys in the United States are diagnosed with ADHD, but only 4% of girls are said to have ADHD.[5] This could be because boys are more likely to get ADHD, or because girls who have ADHD are less likely to be diagnosed.[6][7]

ADHD is most often diagnosed in children, but it is common for adults to be diagnosed as well. About 60% of children diagnosed with ADHD still have the condition when they become adults.[8] Treatment is usually with a combination of medications, behavior training, lifestyle changes, and counseling. Many people who continue to have ADHD as adults learn how to make up for their difficulties.

References

  1. LONI: Laboratory of Neuro Imaging
  2. NINDS Attention Deficit-Hyperactivity Disorder Information Page. National Institute of Neurological Disorders and Stroke (NINDS/NIH) February 9, 2007. Retrieved on 2007-08-13.
  3. Dr. Russell A. Barkley Official Site, Authority ADHD, Attention Deficit Hyperactivity Disorder
  4. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2007). [Expression error: Unexpected < operator "The worldwide prevalence of ADHD: a systematic review and metaregression analysis"]. Am J Psychiatry 164 (6): 942–48. doi:10.1176/appi.ajp.164.6.942. PMID 17541055. 
  5. "National Health Interview survey, 2002"PDF (3.71 MB). Centers for Disease Control (March, 2004). Retrieved on December 11, 2006.
  6. Staller J, Faraone SV. (2006) "Attention-deficit hyperactivity disorder in girls: epidemiology and management." CNS Drugs. 2006;20(2):107–23. PMID 16478287
  7. Biederman J, Faraone SV. (2004) "The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorder in youth and relatives." Psychiatr Clin North Am. Jun;27(2):225–32. PMID 15063995
  8. Attention-Deficit / Hyperactivity Disorder: ADHD in Adults. WebMd.com. Retrieved on December 11, 2006.

Citable sentences

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