|Attention deficit hyperactivity disorder
||Attention deficit disorder, hyperkinetic disorder (ICD-10)
|Children with ADHD may find it more difficult to focus and to complete their schoolwork.
||Problems paying attention, excessive activity, difficulty controlling behavior
||Before age 6-12
||Based on symptoms after other possible causes ruled out
||Normally active young child, conduct disorder, oppositional defiant disorder, learning disorder, bipolar disorder
||Counseling, lifestyle changes, medications
||Stimulants, atomoxetine, guanfacine
||51.1 million (2015)
Attention deficit hyperactivity disorder (ADHD) is a mental disorder of the neurodevelopmental type. It is characterized by problems paying attention, excessive activity, or difficulty controlling behavior which is not appropriate for a person's age. The symptoms appear before a person is twelve years old, are present for more than six months, and cause problems in at least two settings (such as school, home, or recreational activities). In children, problems paying attention may result in poor school performance. Although it causes impairment, particularly in modern society, many children with ADHD have a good attention span for tasks they find interesting.
Despite being the most commonly studied and diagnosed mental disorder in children and adolescents, the exact cause is unknown in the majority of cases. It affects about 5-7% of children when diagnosed via the DSM-IV criteria and 1-2% when diagnosed via the ICD-10 criteria. As of 2015 it is estimated to affect about 51.1 million people. Rates are similar between countries and depend mostly on how it is diagnosed. ADHD is diagnosed approximately three times more often in boys than in girls, although the disorder is often overlooked in girls due to their symptoms differing from those of boys. About 30-50% of people diagnosed in childhood continue to have symptoms into adulthood and between 2-5% of adults have the condition. The condition can be difficult to tell apart from other disorders, as well as to distinguish from high levels of activity that are still within the normal-range.
ADHD management recommendations vary by country and usually involve some combination of counseling, lifestyle changes, and medications. The British guideline only recommends medications as a first-line treatment in children who have severe symptoms and for medication to be considered in those with moderate symptoms who either refuse or fail to improve with counseling, though for adults medications are a first-line treatment. Canadian and American guidelines recommend that medications and behavioral therapy be used together as a first-line therapy, except in preschool-aged children. Stimulant medication therapy is not recommended as a first-line therapy in preschool-aged children in either guideline. Treatment with stimulants is effective for up to 14 months; however, its long term effectiveness is unclear. Adolescents and adults tend to develop coping skills which make up for some or all of their impairments.
The medical literature has described symptoms similar to ADHD since the 19th century. ADHD, its diagnosis, and its treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents, and the media. Topics include ADHD's causes and the use of stimulant medications in its treatment. Most healthcare providers accept ADHD as a genuine disorder in children and adults, and the debate in the scientific community mainly centers on how it is diagnosed and treated. The condition was officially known as attention deficit disorder (ADD) from 1980 to 1987 while before this it was known as hyperkinetic reaction of childhood.
Signs and symptoms
Inattention, hyperactivity (restlessness in adults), disruptive behavior, and impulsivity are common in ADHD. Academic difficulties are frequent as are problems with relationships. The symptoms can be difficult to define as it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and significant levels requiring interventions begin.
According to the DSM-5, symptoms must be present for six months or more to a degree that is much greater than others of the same age and they must cause significant problems functioning in at least two settings (e.g., social, school/work, or home). The full criteria must have been met prior to age 12 in order to receive a diagnosis of ADHD.
ADHD is divided into three subtypes: predominantly inattentive (ADHD-PI or ADHD-I), predominantly hyperactive-impulsive (ADHD-PH or ADHD-HI), and combined type (ADHD-C).
A child with ADHD inattentive type has most or all of following symptoms, excluding situations where these symptoms are better explained by another psychiatric or medical condition:
- Be easily distracted, miss details, forget things, and frequently switch from one activity to another
- Have difficulty maintaining focus on one task
- Become bored with a task after only a few minutes, unless 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
- Seem to not be listening when spoken to
- Daydream, become easily confused, and move slowly
- Have difficulty processing information as quickly and accurately as others
- Struggle to follow instructions
- Have trouble understanding minute details
A child with ADHD hyperactive-impulsive type has most or all of the following symptoms, excluding situations where these symptoms are better explained by another psychiatric or medical condition:
- 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, doing homework, and story time
- Be constantly in motion
- Have difficulty doing quiet tasks or activities
- 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
- Often interrupt conversations or others' activities
Girls tend to have less hyperactivity, inattention, and impulsivity but more intellectual problems. Symptoms of hyperactivity tend to go away with age and turn into "inner restlessness" in teens and adults with ADHD.
People with ADHD of all ages are more likely to have problems with social skills, such as social interaction and forming and maintaining friendships. This is true for all subtypes. About half of children and adolescents with ADHD experience social rejection by their peers compared to 10-15% of non-ADHD children and adolescents. People with attention deficits are prone to having difficulty processing verbal and nonverbal language which can negatively affect social interaction. They also may drift off during conversations, miss social cues, and have trouble learning social skills.
Difficulties managing anger are more common in children with ADHD as are poor handwriting and delays in speech, language and motor development. Although it causes significant impairment, particularly in modern society, many children with ADHD have a good attention span for tasks they find interesting.
Overall, studies have shown that people with ADHD tend to have lower scores on intelligence quotient (IQ) tests. The significance of this is controversial due to the differences between people with ADHD and the difficulty determining the influence of symptoms, such as distractibility, on lower scores rather than intellectual capacity. In studies of ADHD, higher IQs may be over represented because many studies exclude individuals who have lower IQs despite those with ADHD scoring on average 9 points lower on standardized intelligence measures.
In children, ADHD occurs with other disorders about 2/3 of the time. Some commonly associated conditions include:
- Learning disabilities have been found to occur in about 20-30% of children with ADHD. Learning disabilities can include developmental speech and language disorders and academic skills disorders. ADHD, however, is not considered a learning disability, but it very frequently causes academic difficulties.
- Tourette syndrome has been found to occur more commonly in the ADHD population.
- Oppositional defiant disorder (ODD) and conduct disorder (CD), which occur with ADHD in about 50% and 20% of cases respectively. They are characterized by antisocial behaviors such as stubbornness, aggression, frequent temper tantrums, deceitfulness, lying, and stealing. About half of those with hyperactivity and ODD or CD develop antisocial personality disorder in adulthood. Brain imaging supports that conduct disorder and ADHD are separate conditions.
- Primary disorder of vigilance, which is characterized by poor attention and concentration, as well as difficulties staying awake. These children tend to fidget, yawn and stretch and appear to be hyperactive in order to remain alert and active.
- Sluggish cognitive tempo (SCT) is a cluster of symptoms that potentially comprises another attention disorder. It may occur in 30-50% of ADHD cases, regardless of the subtype.
- Mood disorders (especially bipolar disorder and major depressive disorder). Boys diagnosed with the combined ADHD subtype are more likely to have a mood disorder. Adults with ADHD sometimes also have bipolar disorder, which requires careful assessment to accurately diagnose and treat both conditions.
- Anxiety disorders have been found to occur more commonly in the ADHD population.
- Obsessive-compulsive disorder (OCD) can co-occur with ADHD and shares many of its characteristics.
- Substance use disorders. Adolescents and adults with ADHD are at increased risk of substance abuse. This is most commonly seen with alcohol or cannabis. The reason for this may be an altered reward pathway in the brains of ADHD individuals. This makes the evaluation and treatment of ADHD more difficult, with serious substance misuse problems usually treated first due to their greater risks.
- Restless legs syndrome has been found to be more common in those with ADHD and is often due to iron deficiency anaemia. However, restless legs can simply be a part of ADHD and requires careful assessment to differentiate between the two disorders.
- Sleep disorders and ADHD commonly co-exist. They can also occur as a side effect of medications used to treat ADHD. In children with ADHD, insomnia is the most common sleep disorder with behavioral therapy the preferred treatment. Problems with sleep initiation are common among individuals with ADHD but often they will be deep sleepers and have significant difficulty getting up in the morning.Melatonin is sometimes used in children who have sleep onset insomnia.
- People with ADHD have an increased risk of persistent bed wetting.
- A 2016 systematic review found a well established association between ADHD and obesity, asthma and sleep disorders, and tentative evidence for association with celiac disease and migraine, while another 2016 systematic review did not support a clear link between celiac disease and ADHD, and stated that routine screening for celiac disease in people with ADHD is discouraged.
Most ADHD cases are of unknown causes. It is believed to involve interactions between genetics, the environment, and social factors. Certain cases are related to previous infection of or trauma to the brain.
Twin studies indicate that the disorder is often inherited from one's parents with genetics determining about 75% of cases. Siblings of children with ADHD are three to four times more likely to develop the disorder than siblings of children without the disorder. Genetic factors are also believed to be involved in determining whether ADHD persists into adulthood.
Typically, a number of genes are involved, many of which directly affect dopamine neurotransmission. Those involved with dopamine include DAT, DRD4, DRD5, TAAR1, MAOA, COMT, and DBH. Other genes associated with ADHD include SERT, HTR1B, SNAP25, GRIN2A, ADRA2A, TPH2, and BDNF. A common variant of a gene called LPHN3 is estimated to be responsible for about 9% of cases and when this variant is present, people are particularly responsive to stimulant medication. The 7 repeat variant of dopamine receptor D4 (DRD4-7R) causes increased inhibitory effects induced by dopamine and is associated with ADHD. The DRD4 receptor is a G protein-coupled receptor that inhibits adenylyl cyclase. The DRD4-7R mutation results in a wide range of behavioral phenotypes, including ADHD symptoms reflecting split attention.
Evolution may have played a role in the high rates of ADHD, particularly hyperactive and impulsive traits in males. Some have hypothesized that some women may be more attracted to males who are risk takers, increasing the frequency of genes that predispose to hyperactivity and impulsivity in the gene pool. Others have claimed that these traits may be an adaptation that helped males face stressful or dangerous environments with, for example, increased impulsivity and exploratory behavior. In certain situations, ADHD traits may have been beneficial to society as a whole even while being harmful to the individual. The high rates and heterogeneity of ADHD may have increased reproductive fitness and benefited society by adding diversity to the gene pool despite being detrimental to the individual. In certain environments, some ADHD traits may have offered personal advantages to individuals, such as quicker response to predators or superior hunting skills.
People with Down syndrome are more likely to have ADHD.
In addition to genetics, some environmental factors might play a role in causing ADHD. Alcohol intake during pregnancy can cause fetal alcohol spectrum disorders which can include ADHD or symptoms like it. Children exposed to certain toxic substances, such as lead or polychlorinated biphenyls, may develop problems which resemble ADHD. Exposure to the organophosphate insecticides chlorpyrifos and dialkyl phosphate is associated with an increased risk; however, the evidence is not conclusive. Exposure to tobacco smoke during pregnancy can cause problems with central nervous system development and can increase the risk of ADHD.
Extreme premature birth, very low birth weight, and extreme neglect, abuse, or social deprivation also increase the risk as do certain infections during pregnancy, at birth, and in early childhood. These infections include, among others, various viruses (measles, varicella zoster encephalitis, rubella, enterovirus 71). At least 30% of children with a traumatic brain injury later develop ADHD and about 5% of cases are due to brain damage.
Some studies suggest that in a small number of children, artificial food dyes or preservatives may be associated with an increased prevalence of ADHD or ADHD-like symptoms but the evidence is weak and may only apply to children with food sensitivities. The United Kingdom and the European Union have put in place regulatory measures based on these concerns. In a minority of children, intolerances or allergies to certain foods may worsen ADHD symptoms.
Research does not support popular beliefs that ADHD is caused by eating too much refined sugar, watching too much television, parenting, poverty or family chaos; however, they might worsen ADHD symptoms in certain people.
The diagnosis of ADHD may reflect a dysfunctional family or a poor educational system rather than problems with the individual themself. Some cases may be explained by increasing academic expectations, with a diagnosis being a method for parents in some countries to get extra financial and educational support for their child. The youngest children in a class have been found to be more likely to be diagnosed as having ADHD possibly due to their being developmentally behind their older classmates. Behaviors typical of ADHD occur more commonly in children who have experienced violence and emotional abuse.
The social construct theory of ADHD suggests that because the boundaries between "normal" and "abnormal" behavior are socially constructed, (i.e. jointly created and validated by all members of society, and in particular by physicians, parents, teachers, and others) it then follows that subjective valuations and judgements determine which diagnostic criteria are used and, thus, the number of people affected. This could lead to the situation where the DSM-IV arrives at levels of ADHD three to four times higher than those obtained with the ICD-10.Thomas Szasz, a supporter of this theory, has argued that ADHD was "...invented and then given a name."
Current models of ADHD suggest that it is associated with functional impairments in some of the brain's neurotransmitter systems, particularly those involving dopamine and norepinephrine. The dopamine and norepinephrine pathways that originate in the ventral tegmental area and locus coeruleus project to diverse regions of the brain and govern a variety of cognitive processes. The dopamine pathways and norepinephrine pathways which project to the prefrontal cortex and striatum are directly responsible for modulating executive function (cognitive control of behavior), motivation, reward perception, and motor function; these pathways are known to play a central role in the pathophysiology of ADHD. Larger models of ADHD with additional pathways have been proposed.
In children with ADHD, there is a general reduction of volume in certain brain structures, with a proportionally greater decrease in the volume in the left-sided prefrontal cortex. The posterior parietal cortex also shows thinning in ADHD individuals compared to controls. Other brain structures in the prefrontal-striatal-cerebellar and prefrontal-striatal-thalamic circuits have also been found to differ between people with and without ADHD.
Previously it was thought that the elevated number of dopamine transporters in people with ADHD was part of the pathophysiology but it appears that the elevated numbers are due to adaptation to exposure to stimulants. Current models involve the mesocorticolimbic dopamine pathway and the locus coeruleus-noradrenergic system. ADHD psychostimulants possess treatment efficacy because they increase neurotransmitter activity in these systems. There may additionally be abnormalities in serotoninergic, glutamatergic, or cholinergic pathways.
Executive function and motivation
The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory). Executive functions are a set of cognitive processes that are required to successfully select and monitor behaviors that facilitate the attainment of one's chosen goals. The executive function impairments that occur in ADHD individuals result in problems with staying organized, time keeping, excessive procrastination, maintaining concentration, paying attention, ignoring distractions, regulating emotions, and remembering details. People with ADHD appear to have unimpaired long-term memory, and deficits in long-term recall appear to be attributed to impairments in working memory. The criteria for an executive function deficit are met in 30-50% of children and adolescents with ADHD. One study found that 80% of individuals with ADHD were impaired in at least one executive function task, compared to 50% for individuals without ADHD. Due to the rates of brain maturation and the increasing demands for executive control as a person gets older, ADHD impairments may not fully manifest themselves until adolescence or even early adulthood.
ADHD has also been associated with motivational deficits in children. Children with ADHD find it difficult to focus on long-term over short-term rewards, and exhibit impulsive behavior for short-term rewards.
ADHD is diagnosed by an assessment of a person's childhood behavioral and mental development, including ruling out the effects of drugs, medications and other medical or psychiatric problems as explanations for the symptoms. It often takes into account feedback from parents and teachers with most diagnoses begun after a teacher raises concerns. It may be viewed as the extreme end of one or more continuous human traits found in all people. Whether someone responds to medications does not confirm or rule out the diagnosis. As imaging studies of the brain do not give consistent results between individuals, they are only used for research purposes and not diagnosis.
In North America, DSM-5 criteria are used for diagnosis, while European countries usually use the ICD-10. With the DSM-IV criteria a diagnosis of ADHD is more likely than with the ICD-10 criteria. It is classified as neurodevelopmental psychiatric disorder. Additionally, it is classified as a disruptive behavior disorder along with oppositional defiant disorder, conduct disorder, and antisocial personality disorder. A diagnosis does not imply a neurological disorder.
Associated conditions that should be screened for include anxiety, depression, oppositional defiant disorder, conduct disorder, and learning and language disorders. Other conditions that should be considered are other neurodevelopmental disorders, tics, and sleep apnea.
Diagnosis of ADHD using quantitative electroencephalography (QEEG) is an ongoing area of investigation, although the value of QEEG in ADHD is currently unclear. In the United States, the Food and Drug Administration has approved the use of QEEG to evaluate the morbidity of ADHD.
Self-rating scales, such as the ADHD rating scale and the Vanderbilt ADHD diagnostic rating scale are used in the screening and evaluation of ADHD.
Diagnostic and Statistical Manual
As with many other psychiatric disorders, formal diagnosis should be made by a qualified professional based on a set number of criteria. In the United States, these criteria are defined by the American Psychiatric Association in the DSM. Based on the DSM criteria, there are three sub-types of ADHD:
- ADHD predominantly inattentive type (ADHD-PI) presents with symptoms including being easily distracted, forgetful, daydreaming, disorganization, poor concentration, and difficulty completing tasks.
- ADHD, predominantly hyperactive-impulsive type presents with excessive fidgetiness and restlessness, hyperactivity, difficulty waiting and remaining seated, immature behavior; destructive behaviors may also be present.
- ADHD, combined type is a combination of the first two subtypes.
This subdivision is based on presence of at least six out of nine long-term (lasting at least six months) symptoms of inattention, hyperactivity-impulsivity, or both. To be considered, the symptoms must have appeared by the age of six to twelve and occur in more than one environment (e.g. at home and at school or work). The symptoms must be not appropriate for a child of that age and there must be evidence that it is causing social, school or work related problems.
International Classification of Diseases
In the ICD-10 by the World Health Organization, the symptoms of "hyperkinetic disorder" are analogous to ADHD in the DSM-5. When a conduct disorder (as defined by ICD-10) 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.
In the preliminary draft for ICD-11 (planned for 2018), ADHD is classified under 6A42 (Attention deficit hyperactivity disorder) and everything seems to be fully identical now to DSM-5.
Adults with ADHD are diagnosed under the same criteria, including that their signs must have been present by the age of six to twelve. Questioning parents or guardians as to how the person behaved and developed as a child may form part of the assessment; a family history of ADHD also adds weight to a diagnosis. While the core symptoms of ADHD are similar in children and adults they often present differently in adults than in children, for example excessive physical activity seen in children may present as feelings of restlessness and constant mental activity in adults.
It is estimated that between 2-5% of adults have ADHD. Around 25-50% of children with ADHD continue to experience ADHD symptoms into adulthood, while the rest experiences fewer or no symptoms. Currently, most adults remain untreated. Many adults with ADHD without diagnosis and treatment have a disorganized life and some use non-prescribed drugs or alcohol as a coping mechanism. Other problems may include relationship and job difficulties, and an increased risk of criminal activities. Associated mental health problems include: depression, anxiety disorder, and learning disabilities.
Some ADHD symptoms in adults differ from those seen in children. While children with ADHD may climb and run about excessively, adults may experience an inability to relax, or they talk excessively in social situations. Adults with ADHD may start relationships impulsively, display sensation-seeking behavior, and be short-tempered. Addictive behavior such as substance abuse and gambling are common. The DSM-V criteria do specifically deal with adults, unlike those in DSM-IV, which were criticized for not being appropriate for adults; those who presented differently may lead to the claim that they outgrew the diagnosis.
Symptoms of ADHD such as low mood and poor self-image, mood swings, and irritability can be confused with dysthymia, cyclothymia or bipolar disorder as well as with borderline personality disorder. Some symptoms that are due to anxiety disorders, antisocial personality disorder, developmental disabilities or mental retardation or the effects of substance abuse such as intoxication and withdrawal can overlap with some ADHD. These disorders can also sometimes occur along with ADHD. Medical conditions which can cause ADHD type symptoms include: hyperthyroidism, seizure disorder, lead toxicity, hearing deficits, hepatic disease, sleep apnea, drug interactions, untreated celiac disease, and head injury.
Primary sleep disorders may affect attention and behavior and the symptoms of ADHD may affect sleep. It is thus recommended that children with ADHD be regularly assessed for sleep problems. Sleepiness in children may result in symptoms ranging from the classic ones of yawning and rubbing the eyes, to hyperactivity and inattentiveness.Obstructive sleep apnea can also cause ADHD type symptoms.
Reviews of ADHD biomarkers have noted that platelet monoamine oxidase expression, urinary norepinephrine, urinary MHPG, and urinary phenethylamine levels consistently differ between ADHD individuals and healthy control. These measurements could potentially serve as diagnostic biomarkers for ADHD, but more research is needed to establish their diagnostic utility. Urinary and blood plasma phenethylamine concentrations are lower in ADHD individuals relative to controls and the two most commonly prescribed drugs for ADHD, amphetamine and methylphenidate, increase phenethylamine biosynthesis in treatment-responsive individuals with ADHD. Lower urinary phenethylamine concentrations are also associated with symptoms of inattentiveness in ADHD individuals.Electro encephalogram (EEG)) is not accurate enough to make the diagnosis.
The management of ADHD typically involves counseling or medications either alone or in combination. While treatment may improve long-term outcomes, it does not get rid of negative outcomes entirely. Medications used include stimulants, atomoxetine, alpha-2 adrenergic receptor agonists, and sometimes antidepressants. In those who have trouble focusing on long-term rewards, a large amount of positive reinforcement improves task performance. ADHD stimulants also improve persistence and task performance in children with ADHD.
There is good evidence for the use of behavioral therapies in ADHD and they are the recommended first line treatment in those who have mild symptoms or are preschool-aged. Psychological therapies used include: psychoeducational input, behavior therapy, cognitive behavioral therapy (CBT), interpersonal psychotherapy, family therapy, school-based interventions, social skills training, behavioral peer intervention, organization training,parent management training, and neurofeedback. Behavior modification and neurofeedback have the best support.
Parent training and education have been found to have short-term benefits. There is little high quality research on the effectiveness of family therapy for ADHD, but the evidence that exists shows that it is similar to community care and better than a placebo. Several ADHD specific support groups exist as informational sources and may help families cope with ADHD.
Training in social skills, behavioral modification and medication may have some limited beneficial effects. The most important factor in reducing later psychological problems, such as major depression, criminality, school failure, and substance use disorders is formation of friendships with people who are not involved in delinquent activities.
Regular physical exercise, particularly aerobic exercise, is an effective add-on treatment for ADHD in children and adults, particularly when combined with stimulant medication, although the best intensity and type of aerobic exercise for improving symptoms are not currently known. In particular, the long-term effects of regular aerobic exercise in ADHD individuals include better behavior and motor abilities, improved executive functions (including attention, inhibitory control, and planning, among other cognitive domains), faster information processing speed, and better memory. Parent-teacher ratings of behavioral and socio-emotional outcomes in response to regular aerobic exercise include: better overall function, reduced ADHD symptoms, better self-esteem, reduced levels of anxiety and depression, fewer somatic complaints, better academic and classroom behavior, and improved social behavior. Exercising while on stimulant medication augments the effect of stimulant medication on executive function. It is believed that these short-term effects of exercise are mediated by an increased abundance of synaptic dopamine and norepinephrine in the brain.
Stimulant medications are the pharmaceutical treatment of choice. They have at least some effect on symptoms in the short term in about 80% of people.Methylphenidate appears to improve symptoms as reported by teachers and parents. Stimulants may also reduce the risk of injuries in children with ADHD.
There are a number of non-stimulant medications, such as atomoxetine, bupropion, guanfacine, and clonidine that may be used as alternatives, or added to stimulant therapy. There are no good studies comparing the various medications; however, they appear more or less equal with respect to side effects. Stimulants appear to improve academic performance while atomoxetine does not. Atomoxetine, due to its lack of addiction liability, may be preferred in those who are at risk of recreational or compulsive stimulant use. There is little evidence on the effects of medication on social behaviors. As of June 2015 , the long-term effects of ADHD medication have yet to be fully determined.Magnetic resonance imaging studies suggest that long-term treatment with amphetamine or methylphenidate decreases abnormalities in brain structure and function found in subjects with ADHD.
Guidelines on when to use medications vary by country, with the United Kingdom's National Institute for Health and Care Excellence recommending use for children only in severe cases, though for adults medication is a first-line treatment, while most United States guidelines recommend medications in most age groups. Medications are not recommended for preschool children. Underdosing of stimulants may occur and result in a lack of response or later loss of effectiveness. This is particularly common in adolescents and adults as approved dosing is based on school-aged children, causing some practitioners to use weight based or benefit based off-label dosing instead.
While stimulants and atomoxetine are usually safe, there are side-effects and contraindications to their use. A large overdose on ADHD stimulants is commonly associated with symptoms such as stimulant psychosis and mania; although very rare, at therapeutic doses these events appear to occur in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Administration of an antipsychotic medication has been found to effectively resolve the symptoms of acute amphetamine psychosis. Regular monitoring has been recommended in those on long-term treatment. Stimulant therapy should be stopped periodically to assess continuing need for medication, decrease possible growth delay, and reduce tolerance. Long-term misuse of stimulant medications at doses above the therapeutic range for ADHD treatment is associated with addiction and dependence. Untreated ADHD, however, is also associated with elevated risk of substance use disorders and conduct disorders. The use of stimulants appears to either reduce this risk or have no effect on it. The safety of these medications in pregnancy is unclear.
Dietary modifications may be of benefit to a small proportion of children with ADHD. A 2013 meta-analysis found less than a third of children with ADHD see some improvement in symptoms with free fatty acid supplementation or decreased eating of artificial food coloring. These benefits may be limited to children with food sensitivities or those who are simultaneously being treated with ADHD medications. This review also found that evidence does not support removing other foods from the diet to treat ADHD. A 2014 review found that an elimination diet results in a small overall benefit. A 2016 review stated that the use of a gluten-free diet as standard ADHD treatment is discouraged. Iron, magnesium and iodine may also have an effect on ADHD symptoms. There is a small amount of evidence that lower tissue zinc levels may be associated with ADHD. In the absence of a demonstrated zinc deficiency (which is rare outside of developing countries), zinc supplementation is not recommended as treatment for ADHD. However, zinc supplementation may reduce the minimum effective dose of amphetamine when it is used with amphetamine for the treatment of ADHD. There is evidence of a modest benefit of omega 3 fatty acid supplementation, but it is not recommended in place of traditional medication.
An 8-year follow up of children diagnosed with ADHD (combined type) found that they often have difficulties in adolescence, regardless of treatment or lack thereof. In the USA, fewer than 5% of individuals with ADHD get a college degree, compared to 28% of the general population aged 25 years and older. The proportion of children meeting criteria for ADHD drops by about half in the three years following the diagnosis and this occurs regardless of treatments used. ADHD persists into adulthood in about 30-50% of cases. Those affected are likely to develop coping mechanisms as they mature, thus compensating to some extent for their previous symptoms.
ADHD is estimated to affect about 6-7% of people aged 18 and under when diagnosed via the DSM-IV criteria. When diagnosed via the ICD-10 criteria rates in this age group are estimated at 1-2%. Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East; this is believed to be due to differing methods of diagnosis rather than a difference in underlying frequency. If the same diagnostic methods are used, the rates are more or less the same between countries. It is diagnosed approximately three times more often in boys than in girls. This difference between sexes may reflect either a difference in susceptibility or that females with ADHD are less likely to be diagnosed than males.
Rates of diagnosis and treatment have increased in both the United Kingdom and the United States since the 1970s. This is believed to be primarily due to changes in how the condition is diagnosed and how readily people are willing to treat it with medications rather than a true change in how common the condition is. It is believed that changes to the diagnostic criteria in 2013 with the release of the DSM-5 will increase the percentage of people diagnosed with ADHD, especially among adults.
Timeline of ADHD diagnostic criteria, prevalence, and treatment
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. ADHD was first clearly described by George Still in 1902.
The terminology used to describe the condition has changed over time and has included: in the DSM-I (1952) "minimal brain dysfunction," in the DSM-II (1968) "hyperkinetic reaction of childhood," and in the DSM-III (1980) "attention-deficit disorder (ADD) with or without hyperactivity." In 1987 this was changed to ADHD in the DSM-III-R and the DSM-IV in 1994 split the diagnosis into three subtypes, ADHD inattentive type, ADHD hyperactive-impulsive type and ADHD combined type. These terms were kept in the DSM-5 in 2013. Other terms have included "minimal brain damage" used in the 1930s.
The use of stimulants to treat ADHD was first described in 1937. In 1934, Benzedrine became the first amphetamine medication approved for use in the United States. Methylphenidate was introduced in the 1950s, and enantiopure dextroamphetamine in the 1970s.
Society and culture
ADHD, its diagnosis, and its treatment have been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, states that the current treatments and methods of diagnosis are based on the dominant view of the academic literature. In 2014, Keith Conners, one of the early advocates for recognition of the disorder, spoke out against overdiagnosis in a New York Times article. In contrast, a 2014 peer-reviewed medical literature review indicated that ADHD is underdiagnosed in adults.
With widely differing rates of diagnosis across countries, states within countries, races, and ethnicities, some suspect factors other than the presence of the symptoms of ADHD are playing a role in diagnosis. Some sociologists consider ADHD to be an example of the medicalization of deviant behavior, that is, the turning of the previously issue of school performance into a medical one. Most healthcare providers accept ADHD as a genuine disorder, at least in the small number of people with severe symptoms. Among healthcare providers the debate mainly centers on diagnosis and treatment in the much greater number of people with mild symptoms.
- ^ a b c d e f g "Attention Deficit Hyperactivity Disorder". National Institute of Mental Health. March 2016. Archived from the original on 23 July 2016. Retrieved 2016.
- ^ a b c d e f g h i j k l m n o American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 59-65. ISBN 978-0-89042-555-8.
- ^ a b c d e f g h "Symptoms and Diagnosis". Attention-Deficit / Hyperactivity Disorder (ADHD). Division of Human Development, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. 29 September 2014. Archived from the original on 7 November 2014. Retrieved 2014.
- ^ a b c d e f NIMH (2013). "Attention Deficit Hyperactivity Disorder (Easy-to-Read)". National Institute of Mental Health. Archived from the original on 14 April 2016. Retrieved 2016.
- ^ Ferri, Fred F. (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed. ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter A. ISBN 0323076998.
- ^ Coghill, DR; Banaschewski, T; Soutullo, C; Cottingham, MG; Zuddas, A (20 April 2017). "Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder.". European child & adolescent psychiatry. PMID 28429134. doi:10.1007/s00787-017-0986-y.
- ^ Jain, R; Katic, A (18 August 2016). "Current and Investigational Medication Delivery Systems for Treating Attention-Deficit/Hyperactivity Disorder.". The primary care companion for CNS disorders. 18 (4). PMID 27828696. doi:10.4088/PCC.16r01979.
- ^ a b GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.". Lancet. 388 (10053): 1545-1602. PMC 5055577 . PMID 27733282. doi:10.1016/S0140-6736(16)31678-6.
- ^ Sroubek, A; Kelly, M; Li, X (February 2013). "Inattentiveness in attention-deficit/hyperactivity disorder". Neuroscience Bulletin. 29 (1): 103-10. PMC 4440572 . PMID 23299717. doi:10.1007/s12264-012-1295-6.
- ^ a b Caroline, SC, ed. (2010). Encyclopedia of Cross-Cultural School Psychology. Springer Science & Business Media. p. 133. ISBN 9780387717982. Archived from the original on 6 May 2016.
- ^ a b c Dulcan, Mina K.; Lake, MaryBeth (2011). "Axis I Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence: Attention-Deficit and Disruptive Behavior Disorders". Concise Guide to Child and Adolescent Psychiatry (4th illustrated ed.). American Psychiatric Publishing. p. 34. ISBN 978-1-58562-416-4 - via Google Books.
- ^ a b c Walitza, S; Drechsler, R; Ball, J (August 2012). "Das schulkind mit ADHS" [The school child with ADHD]. Ther Umsch (in German). 69 (8): 467-73. PMID 22851461. doi:10.1024/0040-5930/a000316.
- ^ a b Willcutt, EG (July 2012). "The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review". Neurotherapeutics. 9 (3): 490-9. PMC 3441936 . PMID 22976615. doi:10.1007/s13311-012-0135-8.
- ^ a b c Cowen, Philip; Harrison, Paul; Burns, Tom (2012). "Drugs and other physicial treatments". Shorter Oxford Textbook of Psychiatry (6th ed.). Oxford University Press. p. 546. ISBN 978-0-19-960561-3 - via Google Books.
- ^ a b Faraone, SV (2011). "Ch. 25: Epidemiology of Attention Deficit Hyperactivity Disorder". In Tsuang, MT; Tohen, M; Jones, P. Textbook of Psychiatric Epidemiology (3rd ed.). John Wiley & Sons. p. 450. ISBN 9780470977408. Archived from the original on 6 May 2016.
- ^ Crawford, Nicole (February 2003). "ADHD: a women's issue". Monitor on Psychology. American Psychological Association. 34 (2): 28. Archived from the original on 9 April 2017.
- ^ a b Emond, V; Joyal, C; Poissant, H (April 2009). "Neuroanatomie structurelle et fonctionnelle du trouble déficitaire d'attention avec ou sans hyperactivité (TDAH)" [Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)]. Encephale (in French). 35 (2): 107-14. PMID 19393378. doi:10.1016/j.encep.2008.01.005.
- ^ a b c d Singh, I (December 2008). "Beyond polemics: Science and ethics of ADHD". Nature Reviews Neuroscience. 9 (12): 957-64. PMID 19020513. doi:10.1038/nrn2514.
- ^ a b c d e f g h i j k l m n o Kooij, SJ; Bejerot, S; Blackwell, A; Caci, H; et al. (2010). "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD". BMC Psychiatry. 10: 67. PMC 2942810 . PMID 20815868. doi:10.1186/1471-244X-10-67.
- ^ a b Bálint, S; Czobor, P; Mészáros, A; Simon, V; et al. (2008). "Neuropszichológiai károsodásokat feln?tt figyelemhiányos hiperaktivitás zavar(ADHD): A szakirodalmi áttekintés" [Neuropsychological impairments in adult attention deficit hyperactivity disorder: A literature review]. Psychiatria Hungarica (in Hungarian). 23 (5): 324-335. PMID 19129549.
- ^ a b Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP (2014). "Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature". Prim Care Companion CNS Disord. 16 (3). PMC 4195639 . PMID 25317367. doi:10.4088/PCC.13r01600.
Reports indicate that ADHD affects 2.5%-5% of adults in the general population,5-8 compared with 5%-7% of children.9,10 ... However, fewer than 20% of adults with ADHD are currently diagnosed and/or treated by psychiatrists.7,15,16
- ^ a b National Collaborating Centre for Mental Health (2009). "Pharmacological Treatment". Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines. 72. Leicester: British Psychological Society. pp. 303-307. ISBN 978-1-85433-471-8. Archived from the original on 13 January 2016 - via NCBI Bookshelf.
- ^ a b "Canadian ADHD Practice Guidelines" (PDF). Canadian ADHD Alliance. Retrieved 2011.
- ^ a b "Attention-Deficit / Hyperactivity Disorder (ADHD): Recommendations". Centers for Disease Control and Prevention. 24 June 2015. Archived from the original on 7 July 2015. Retrieved 2015.
- ^ a b c d e f National Collaborating Centre for Mental Health (2009). Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines. 72. Leicester: British Psychological Society. ISBN 978-1-85433-471-8. Archived from the original on 13 January 2016 - via NCBI Bookshelf.
- ^ Huang, YS; Tsai, MH (July 2011). "Long-term outcomes with medications for attention-deficit hyperactivity disorder: Current status of knowledge". CNS Drugs. 25 (7): 539-554. PMID 21699268. doi:10.2165/11589380-000000000-00000.
- ^ Arnold, LE; Hodgkins, P; Caci, H; Kahle, J; et al. (February 2015). "Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: A systematic review". PLoS ONE. 10 (2): e0116407. PMC 4340791 . PMID 25714373. doi:10.1371/journal.pone.0116407.
- ^ a b Parker J, Wales G, Chalhoub N, Harpin V (September 2013). "The long-term outcomes of interventions for the management of attention-deficit hyperactivity disorder in children and adolescents: a systematic review of randomized controlled trials". Psychol. Res. Behav. Manag. 6: 87-99. PMC 3785407 . PMID 24082796. doi:10.2147/PRBM.S49114.
Results suggest there is moderate-to-high-level evidence that combined pharmacological and behavioral interventions, and pharmacological interventions alone can be effective in managing the core ADHD symptoms and academic performance at 14 months. However, the effect size may decrease beyond this period. ... Only one paper examining outcomes beyond 36 months met the review criteria. ... There is high level evidence suggesting that pharmacological treatment can have a major beneficial effect on the core symptoms of ADHD (hyperactivity, inattention, and impulsivity) in approximately 80% of cases compared with placebo controls, in the short term.22
- ^ a b c d e Gentile JP, Atiq R, Gillig PM (August 2006). "Adult ADHD: Diagnosis, Differential Diagnosis, and Medication Management". Psychiatry (Edgmont). 3 (8): 25-30. PMC 2957278 . PMID 20963192.
- ^ Lange, KW; Reichl, S; Lange, KM; Tucha, L; et al. (December 2010). "The history of attention deficit hyperactivity disorder". ADHD Attention Deficit and Hyperactivity Disorders. 2 (4): 241-55. PMC 3000907 . PMID 21258430. doi:10.1007/s12402-010-0045-8.
- ^ a b c Parrillo VN (2008). Encyclopedia of Social Problems. SAGE. p. 63. ISBN 9781412941655. Retrieved 2009.
- ^ a b c Mayes R, Bagwell C, Erkulwater J (2008). "ADHD and the rise in stimulant use among children". Harv Rev Psychiatry. 16 (3): 151-166. PMID 18569037. doi:10.1080/10673220802167782.
- ^ Sim MG, Hulse G, Khong E (August 2004). "When the child with ADHD grows up" (PDF). Aust Fam Physician. 33 (8): 615-618. PMID 15373378. Archived (PDF) from the original on 24 September 2015. Retrieved 2014.
- ^ a b Silver LB (2004). Attention-deficit/hyperactivity disorder (3rd ed.). American Psychiatric Publishing. pp. 4-7. ISBN 978-1-58562-131-6.
- ^ a b Schonwald A, Lechner E (April 2006). "Attention deficit/hyperactivity disorder: complexities and controversies". Curr. Opin. Pediatr. 18 (2): 189-195. PMID 16601502. doi:10.1097/01.mop.0000193302.70882.70.
- ^ Weiss, Lawrence G. (2005). WISC-IV clinical use and interpretation scientist-practitioner perspectives (1st ed.). Amsterdam: Elsevier Academic Press. p. 237. ISBN 978-0-12-564931-5. Archived from the original on 8 September 2017.
- ^ "ADHD: The Diagnostic Criteria". PBS. Frontline. Archived from the original on 20 April 2016. Retrieved 2016.
- ^ a b Dobie C (2012). "Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents". Institute for Clinical Systems Improvement: 79. Archived from the original on 1 March 2013.
- ^ a b CDC (6 January 2016), Facts About ADHD, Centers for Disease Control and Prevention, archived from the original on 22 March 2016, retrieved 2016
- ^ a b Ramsay JR (2007). Cognitive behavioral therapy for adult ADHD. Routledge. pp. 4, 25-26. ISBN 978-0-415-95501-0.
- ^ a b National Institute of Mental Health (2008). "Attention Deficit Hyperactivity Disorder (ADHD)". National Institutes of Health. Archived from the original on 19 January 2013.
- ^ Gershon, J (January 2002). "A meta-analytic review of gender differences in ADHD.". Journal of attention disorders. 5 (3): 143-54. PMID 11911007. doi:10.1177/108705470200500302.
- ^ Coleman WL (August 2008). "Social competence and friendship formation in adolescents with attention-deficit/hyperactivity disorder". Adolesc Med State Art Rev. 19 (2): 278-99, x. PMID 18822833.
- ^ "ADHD Anger Management Directory". Webmd.com. Archived from the original on 5 November 2013. Retrieved 2014.
- ^ Racine MB, Majnemer A, Shevell M, Snider L (April 2008). "Handwriting performance in children with attention deficit hyperactivity disorder (ADHD)". J. Child Neurol. 23 (4): 399-406. PMID 18401033. doi:10.1177/0883073807309244.
- ^ a b c "F90 Hyperkinetic disorders", International Statistical Classification of Diseases and Related Health Problems 10th Revision, World Health Organisation, 2010, archived from the original on 2 November 2014, retrieved 2014
- ^ Bellani M, Moretti A, Perlini C, Brambilla P (December 2011). "Language disturbances in ADHD". Epidemiol Psychiatr Sci. 20 (4): 311-315. PMID 22201208. doi:10.1017/S2045796011000527.
- ^ a b Frazier, TW; Demaree, HA; Youngstrom, EA (July 2004). "Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder.". Neuropsychology. 18 (3): 543-55. PMID 15291732. doi:10.1037/0894-4126.96.36.1993.
- ^ Mackenzie, GB; Wonders, E (2016). "Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder.". Frontiers in psychology. 7: 794. PMC 4886698 . PMID 27303350. doi:10.3389/fpsyg.2016.00794.
- ^ a b Bailey, Eileen. "ADHD and Learning Disabilities: How can you help your child cope with ADHD and subsequent Learning Difficulties? There is a way.". Remedy Health Media, LLC. Archived from the original on 3 December 2013. Retrieved 2013.
- ^ McBurnett, K; Pfiffner, LJ (November 2009). "Treatment of aggressive ADHD in children and adolescents: Conceptualization and treatment of comorbid behavior disorders". Postgrad Med. 121 (6): 158-165. PMID 19940426. doi:10.3810/pgm.2009.11.2084.
- ^ a b Krull, KR (5 December 2007). "Evaluation and diagnosis of attention deficit hyperactivity disorder in children". Uptodate. Wolters Kluwer Health. Archived from the original on 5 June 2009. Retrieved 2008. (Subscription required (help)).
- ^ Hofvander B, Ossowski D, Lundström S, Anckarsäter H (2009). "Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition". Int J Law Psychiatry. 32 (4): 224-234. PMID 19428109. doi:10.1016/j.ijlp.2009.04.004.
- ^ Rubia K (June 2011). ""Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review". Biol. Psychiatry. 69 (12): e69-87. PMID 21094938. doi:10.1016/j.biopsych.2010.09.023.
- ^ Weinberg, Warren A.; Brumback, Roger A. "Primary disorder of vigilance: A novel explanation of inattentiveness, daydreaming, boredom, restlessness, and sleepiness". The Journal of Pediatrics. 116 (5): 720-725. doi:10.1016/s0022-3476(05)82654-x.
- ^ Barkley, R. A. (2014). "Sluggish Cognitive Tempo (Concentration Deficit Disorder?): Current Status, Future Directions, and a Plea to Change the Name" (PDF). Journal of Abnormal Child Psychology. 42: 117-125. PMID 24234590. doi:10.1007/s10802-013-9824-y. Archived (PDF) from the original on 9 August 2017.
- ^ a b c Wilens TE, Spencer TJ (September 2010). "Understanding attention-deficit/hyperactivity disorder from childhood to adulthood". Postgrad Med. 122 (5): 97-109. PMC 3724232 . PMID 20861593. doi:10.3810/pgm.2010.09.2206.
- ^ Baud P, Perroud N, Aubry JM (June 2011). "[Bipolar disorder and attention deficit/hyperactivity disorder in adults: differential diagnosis or comorbidity]". Rev Med Suisse (in French). 7 (297): 1219-1222. PMID 21717696.
- ^ a b c National Collaborating Centre for Mental Health (2009). "Attention Deficit Hyperactivity Disorder". Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines. 72. Leicester: British Psychological Society. pp. 18-26, 38. ISBN 978-1-85433-471-8. Archived from the original on 13 January 2016 - via NCBI Bookshelf.
- ^ Wilens TE, Morrison NR (July 2011). "The intersection of attention-deficit/hyperactivity disorder and substance abuse". Curr Opin Psychiatry. 24 (4): 280-285. PMC 3435098 . PMID 21483267. doi:10.1097/YCO.0b013e328345c956.
- ^ Merino-Andreu M (March 2011). "Trastorno por déficit de atención/hiperactividad y síndrome de piernas inquietas en niños" [Attention deficit hyperactivity disorder and restless legs syndrome in children]. Rev Neurol (in Spanish). 52 Suppl 1: S85-95. PMID 21365608.
- ^ Picchietti MA, Picchietti DL (August 2010). "Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment". Sleep Med. 11 (7): 643-651. PMID 20620105. doi:10.1016/j.sleep.2009.11.014.
- ^ Karroum E, Konofal E, Arnulf I (2008). "Restless-legs syndrome". Rev. Neurol. (Paris) (in French). 164 (8-9): 701-721. PMID 18656214. doi:10.1016/j.neurol.2008.06.006.
- ^ Corkum P, Davidson F, Macpherson M (June 2011). "A framework for the assessment and treatment of sleep problems in children with attention-deficit/hyperactivity disorder". Pediatr. Clin. North Am. 58 (3): 667-683. PMID 21600348. doi:10.1016/j.pcl.2011.03.004.
- ^ Tsai MH, Huang YS (May 2010). "Attention-deficit/hyperactivity disorder and sleep disorders in children". Med. Clin. North Am. 94 (3): 615-632. PMID 20451036. doi:10.1016/j.mcna.2010.03.008.
- ^ a b c d e f Brown TE (October 2008). "ADD/ADHD and Impaired Executive Function in Clinical Practice". Curr Psychiatry Rep. 10 (5): 407-411. PMID 18803914. doi:10.1007/s11920-008-0065-7.
- ^ Bendz LM, Scates AC (January 2010). "Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder". Annals of Pharmacotherapy. 44 (1): 185-191. PMID 20028959. doi:10.1345/aph.1M365.
- ^ Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR (January 2009). "Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among United States children: results from a nationally representative study". J Am Acad Child Adolesc Psychiatry. 48 (1): 35-41. PMC 2794242 . PMID 19096296. doi:10.1097/CHI.0b013e318190045c.
- ^ Instanes JT, Klungsøyr K, Halmøy A, Fasmer OB, Haavik J (2016). "Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review.". J Atten Disord (Systematic Review). PMID 27664125. doi:10.1177/1087054716669589. Archived from the original on 7 February 2017.
- ^ a b c Ertürk, E; Wouters, S; Imeraj, L; Lampo, A (29 January 2016). "Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature.". Journal of Attention Disorders (Review). PMID 26825336. doi:10.1177/1087054715611493.
Up till now, there is no conclusive evidence for a relationship between ADHD and CD. Therefore, it is not advised to perform routine screening of CD when assessing ADHD (and vice versa) or to implement GFD as a standard treatment in ADHD. Nevertheless, the possibility of untreated CD predisposing to ADHD-like behavior should be kept in mind. ... It is possible that in untreated patients with CD, neurologic symptoms such as chronic fatigue, inattention, pain, and headache could predispose patients to ADHD-like behavior (mainly symptoms of inattentive type), which may be alleviated after GFD treatment. (CD: celiac disease; GFD: gluten-free diet)
- ^ a b c Millichap, J. Gordon (2010). "Chapter 2: Causative Factors". Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD (2nd ed.). New York, NY: Springer Science. p. 26. ISBN 978-1-4419-1396-8. LCCN 2009938108. doi:10.1007/978-104419-1397-5.
- ^ a b Thapar A, Cooper M, Eyre O, Langley K (January 2013). "What have we learnt about the causes of ADHD?". J Child Psychol Psychiatry. 54 (1): 3-16. PMC 3572580 . PMID 22963644. doi:10.1111/j.1469-7610.2012.02611.x.
- ^ Neale, BM; Medland, SE; Ripke, S; et al. (September 2010). "Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder". J Am Acad Child Adolesc Psychiatry. 49 (9): 884-897. PMC 2928252 . PMID 20732625. doi:10.1016/j.jaac.2010.06.008.
- ^ Burt SA (July 2009). "Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences". Psychol Bull. 135 (4): 608-637. PMID 19586164. doi:10.1037/a0015702.
- ^ Nolen-Hoeksema S (2013). Abnormal Psychology (Sixth ed.). p. 267. ISBN 978-0-07-803538-8.
- ^ Franke B, Faraone SV, Asherson P, Buitelaar J, Bau CH, Ramos-Quiroga JA, Mick E, Grevet EH, Johansson S, Haavik J, Lesch KP, Cormand B, Reif A (October 2012). "The genetics of attention deficit/hyperactivity disorder in adults, a review". Mol. Psychiatry. 17 (10): 960-987. PMC 3449233 . PMID 22105624. doi:10.1038/mp.2011.138.
- ^ a b Gizer IR, Ficks C, Waldman ID (July 2009). "Candidate gene studies of ADHD: a meta-analytic review". Hum. Genet. 126 (1): 51-90. PMID 19506906. doi:10.1007/s00439-009-0694-x.
- ^ a b c Kebir O, Tabbane K, Sengupta S, Joober R (March 2009). "Candidate genes and neuropsychological phenotypes in children with ADHD: review of association studies". J Psychiatry Neurosci. 34 (2): 88-101. PMC 2647566 . PMID 19270759.
- ^ a b Berry, MD (January 2007). "The potential of trace amines and their receptors for treating neurological and psychiatric diseases". Reviews on Recent Clinical Trials. 2 (1): 3-19. PMID 18473983. doi:10.2174/157488707779318107. Archived from the original on 1 February 2017.
Although there is little direct evidence, changes in trace amines, in particular PE, have been identified as a possible factor for the onset of attention deficit/hyperactivity disorder (ADHD). ... Further, amphetamines, which have clinical utility in ADHD, are good ligands at trace amine receptors. Of possible relevance in this aspect is modafanil, which has shown beneficial effects in ADHD patients and has been reported to enhance the activity of PE at TAAR1. Conversely, methylphenidate, ...showed poor efficacy at the TAAR1 receptor. In this respect it is worth noting that the enhancement of functioning at TAAR1 seen with modafanil was not a result of a direct interaction with TAAR1.
- ^ Sotnikova TD, Caron MG, Gainetdinov RR (August 2009). "Trace amine-associated receptors as emerging therapeutic targets". Mol. Pharmacol. 76 (2): 229-235. PMC 2713119 . PMID 19389919. doi:10.1124/mol.109.055970.
- ^ Arcos-Burgos M, Muenke M (November 2010). "Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD". Atten Defic Hyperact Disord. 2 (3): 139-147. PMC 3280610 . PMID 21432600. doi:10.1007/s12402-010-0030-2.
- ^ Nikolaidis A, Gray JR (June 2010). "ADHD and the DRD4 exon III 7-repeat polymorphism: an international meta-analysis". Social Cognitive and Affective Neuroscience. 5 (2-3): 188-193. PMC 2894686 . PMID 20019071. doi:10.1093/scan/nsp049.
- ^ a b c Glover V (April 2011). "Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective". J Child Psychol Psychiatry. 52 (4): 356-67. PMID 21250994. doi:10.1111/j.1469-7610.2011.02371.x.
- ^ a b c Williams J, Taylor E (June 2006). "The evolution of hyperactivity, impulsivity and cognitive diversity". J R Soc Interface. 3 (8): 399-413. PMC 1578754 . PMID 16849269. doi:10.1098/rsif.2005.0102.
- ^ a b Cardo E, Nevot A, Redondo M, et al. (March 2010). "Trastorno por déficit de atención/hiperactividad: ¿un patrón evolutivo?" [Attention deficit disorder and hyperactivity: a pattern of evolution?]. Rev Neurol (in Spanish). 50 Suppl 3: S143-7. PMID 20200842.
- ^ Adriani, Walter; Zoratto, Francesca; Laviola, Giovanni (13 January 2012). "Brain Processes in Discounting: Consequences of Adolescent Methylphenidate Exposure". In Stanford, Clare; Tannock, Rosemary. Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. Current Topics in Behavioral Neurosciences. Volume 9. New York: Springer. pp. 132-134. ISBN 978-3-642-24611-1.
- ^ Ekstein, Sivan; Glick, Benjamin; Weill, Michal; Kay, Barrie; Berger, Itai (1 October 2011). "Down Syndrome and Attention-Deficit/Hyperactivity Disorder (ADHD)". Journal of Child Neurology. 26 (10): 1290-1295. ISSN 0883-0738. PMID 21628698. doi:10.1177/0883073811405201. Archived from the original on 20 November 2015.
- ^ CDC (16 March 2016), Attention-Deficit / Hyperactivity Disorder (ADHD), Centers for Disease Control and Prevention, archived from the original on 14 April 2016, retrieved 2016
- ^ Burger PH, Goecke TW, Fasching PA, Moll G, Heinrich H, Beckmann MW, Kornhuber J (September 2011). "[How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child]". Fortschr Neurol Psychiatr (Review) (in German). 79 (9): 500-506. PMID 21739408. doi:10.1055/s-0031-1273360.
- ^ Eubig PA, Aguiar A, Schantz SL (December 2010). "Lead and PCBs as risk factors for attention deficit/hyperactivity disorder". Environ. Health Perspect. (Review. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, Non-P.H.S.). 118 (12): 1654-1667. PMC 3002184 . PMID 20829149. doi:10.1289/ehp.0901852.
- ^ de Cock M, Maas YG, van de Bor M (August 2012). "Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review". Acta Paediatr. (Review. Research Support, Non-U.S. Gov't). 101 (8): 811-818. PMID 22458970. doi:10.1111/j.1651-2227.2012.02693.x.
- ^ Abbott LC, Winzer-Serhan UH (April 2012). "Smoking during pregnancy: lessons learned from epidemiological studies and experimental studies using animal models". Crit. Rev. Toxicol. (Review). 42 (4): 279-303. PMID 22394313. doi:10.3109/10408444.2012.658506.
- ^ Thapar, A.; Cooper, M.; Jefferies, R.; Stergiakouli, E. (March 2012). "What causes attention deficit hyperactivity disorder?". Arch Dis Child (Review. Research Support, Non-U.S. Gov't). 97 (3): 260-5. PMID 21903599. doi:10.1136/archdischild-2011-300482.
- ^ Millichap JG (February 2008). "Etiologic classification of attention-deficit/hyperactivity disorder". Pediatrics (Review). 121 (2): e358-65. PMID 18245408. doi:10.1542/peds.2007-1332.
- ^ Eme, R (April 2012). "ADHD: an integration with pediatric traumatic brain injury". Expert Rev Neurother (Review). 12 (4): 475-83. PMID 22449218. doi:10.1586/ern.12.15.
- ^ a b c d e f Mayes R, Bagwell C, Erkulwater JL (2009). Medicating Children: ADHD and Pediatric Mental Health (illustrated ed.). Harvard University Press. pp. 4-24. ISBN 978-0-674-03163-0.
- ^ a b Millichap, JG; Yee, MM (February 2012). "The diet factor in attention-deficit/hyperactivity disorder". Pediatrics. 129 (2): 330-7. PMID 22232312. doi:10.1542/peds.2011-2199. Archived from the original on 11 September 2015.
- ^ a b c d Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J (March 2013). "Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments". Am J Psychiatry. 170 (3): 275-289. PMID 23360949. doi:10.1176/appi.ajp.2012.12070991.
Free fatty acid supplementation and artificial food color exclusions appear to have beneficial effects on ADHD symptoms, although the effect of the former are small and those of the latter may be limited to ADHD patients with food sensitivities...
- ^ Tomaska LD, Brooke-Taylor S (2014). "Food Additives - General". In Motarjemi Y, Moy GG, Todd EC. Encyclopedia of Food Safety. 3 (1st ed.). Amsterdam: Elsevier/Academic Press. pp. 449-54. ISBN 978-0-12-378613-5. OCLC 865335120.
- ^ FDA (March 2011), Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children (PDF), U.S. Food and Drug Administration, archived (PDF) from the original on 6 November 2015
- ^ a b Nigg JT, Holton K (October 2014). "Restriction and elimination diets in ADHD treatment". Child Adolesc Psychiatr Clin N Am (Review). 23 (4): 937-53. PMC 4322780 . PMID 25220094. doi:10.1016/j.chc.2014.05.010.
an elimination diet produces a small aggregate effect but may have greater benefit among some children. Very few studies enable proper evaluation of the likelihood of response in children with ADHD who are not already preselected based on prior diet response.
- ^ "Mental health of children and adolescents" (PDF). 15 January 2005. Archived from the original (PDF) on 24 October 2009. Retrieved 2011.
- ^ a b Elder TE (September 2010). "The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates". J Health Econ. 29 (5): 641-656. PMC 2933294 . PMID 20638739. doi:10.1016/j.jhealeco.2010.06.003.
- ^ Parritz, R (2013). Disorders of Childhood: Development and Psychopathology. Cengage Learning. p. 151. ISBN 978-1-285-09606-3.
- ^ Parens E, Johnston J (2009). "Facts, values, and Attention-Deficit Hyperactivity Disorder (ADHD): an update on the controversies". Child Adolesc Psychiatry Ment Health. 3 (1): 1. PMC 2637252 . PMID 19152690. doi:10.1186/1753-2000-3-1.
- ^ Szasz, Thomas (2001). "Psychiatric Medicine: Disorder". Pharmacracy: medicine and politics in America. Westport, CT: Praeger. p. 101. ISBN 0-275-97196-1 - via Google Books.
Mental diseases are invented and then given a name, for example attention deficit hyperactivity disorder (ADHD).
- ^ a b c d e Chandler DJ, Waterhouse BD, Gao WJ (May 2014). "New perspectives on catecholaminergic regulation of executive circuits: evidence for independent modulation of prefrontal functions by midbrain dopaminergic and noradrenergic neurons". Front. Neural Circuits. 8: 53. PMC 4033238 . PMID 24904299. doi:10.3389/fncir.2014.00053.
- ^ a b c d e f g h i j k Malenka RC, Nestler EJ, Hyman SE (2009). "Chapters 10 and 13". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 266, 315, 318-323. ISBN 978-0-07-148127-4.
Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention.
- ^ a b c d e f g h Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin". In Sydor A, Brown RY. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 148, 154-157. ISBN 978-0-07-148127-4.
DA has multiple actions in the prefrontal cortex. It promotes the "cognitive control" of behavior: the selection and successful monitoring of behavior to facilitate attainment of chosen goals. Aspects of cognitive control in which DA plays a role include working memory, the ability to hold information "on line" in order to guide actions, suppression of prepotent behaviors that compete with goal-directed actions, and control of attention and thus the ability to overcome distractions. Cognitive control is impaired in several disorders, including attention deficit hyperactivity disorder. ... Noradrenergic projections from the LC thus interact with dopaminergic projections from the VTA to regulate cognitive control. ... it has not been shown that 5HT makes a therapeutic contribution to treatment of ADHD.
NOTE: DA: dopamine, LC: locus coeruleus, VTA: ventral tegmental area, 5HT: serotonin (5-hydroxytryptamine)
- ^ a b c Castellanos FX, Proal E (January 2012). "Large-scale brain systems in ADHD: beyond the prefrontal-striatal model". Trends Cogn. Sci. (Regul. Ed.). 16 (1): 17-26. PMC 3272832 . PMID 22169776. doi:10.1016/j.tics.2011.11.007.
Recent conceptualizations of ADHD have taken seriously the distributed nature of neuronal processing [10,11,35,36]. Most of the candidate networks have focused on prefrontal-striatal-cerebellar circuits, although other posterior regions are also being proposed .
- ^ a b c Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX (October 2012). "Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies". Am J Psychiatry. 169 (10): 1038-1055. PMC 3879048 . PMID 22983386. doi:10.1176/appi.ajp.2012.11101521.
- ^ Krain AL, Castellanos FX (August 2006). "Brain development and ADHD". Clin Psychol Rev. 26 (4): 433-444. PMID 16480802. doi:10.1016/j.cpr.2006.01.005.
- ^ Fusar-Poli P, Rubia K, Rossi G, Sartori G, Balottin U (March 2012). "Striatal dopamine transporter alterations in ADHD: pathophysiology or adaptation to psychostimulants? A meta-analysis". Am J Psychiatry. 169 (3): 264-72. PMID 22294258. doi:10.1176/appi.ajp.2011.11060940.
- ^ a b c Bidwell LC, McClernon FJ, Kollins SH (August 2011). "Cognitive enhancers for the treatment of ADHD". Pharmacol. Biochem. Behav. 99 (2): 262-274. PMC 3353150 . PMID 21596055. doi:10.1016/j.pbb.2011.05.002.
- ^ Cortese S (September 2012). "The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know". Eur. J. Paediatr. Neurol. 16 (5): 422-433. PMID 22306277. doi:10.1016/j.ejpn.2012.01.009.
- ^ Lesch KP, Merker S, Reif A, Novak M (June 2013). "Dances with black widow spiders: dysregulation of glutamate signalling enters centre stage in ADHD". Eur Neuropsychopharmacol. 23 (6): 479-491. PMID 22939004. doi:10.1016/j.euroneuro.2012.07.013.
- ^ a b Diamond A (2013). "Executive functions". Annu. Rev. Psychol. 64: 135-168. PMC 4084861 . PMID 23020641. doi:10.1146/annurev-psych-113011-143750.
EFs and prefrontal cortex are the first to suffer, and suffer disproportionately, if something is not right in your life. They suffer first, and most, if you are stressed (Arnsten 1998, Liston et al. 2009, Oaten & Cheng 2005), sad (Hirt et al. 2008, von Hecker & Meiser 2005), lonely (Baumeister et al. 2002, Cacioppo & Patrick 2008, Campbell et al. 2006, Tun et al. 2012), sleep deprived (Barnes et al. 2012, Huang et al. 2007), or not physically fit (Best 2010, Chaddock et al. 2011, Hillman et al. 2008). Any of these can cause you to appear to have a disorder of EFs, such as ADHD, when you do not.
- ^ Skodzik T, Holling H, Pedersen A (November 2013). "Long-Term Memory Performance in Adult ADHD: A Meta-Analysis". J. Atten. Disord. PMID 24232170. doi:10.1177/1087054713510561.
- ^ Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH (August 2010). "Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ?". J Child Psychol Psychiatry. 51 (8): 895-904. PMID 20406332. doi:10.1111/j.1469-7610.2010.02248.x.
- ^ Nigg JT, Willcutt EG, Doyle AE, Sonuga-Barke EJ (June 2005). "Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes?". Biol. Psychiatry. 57 (11): 1224-1230. PMID 15949992. doi:10.1016/j.biopsych.2004.08.025.
- ^ a b c d Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A (2013). "Are motivation deficits underestimated in patients with ADHD? A review of the literature". Postgrad Med. 125 (4): 47-52. PMID 23933893. doi:10.3810/pgm.2013.07.2677.
Behavioral studies show altered processing of reinforcement and incentives in children with ADHD. These children respond more impulsively to rewards and choose small, immediate rewards over larger, delayed incentives. Interestingly, a high intensity of reinforcement is effective in improving task performance in children with ADHD. Pharmacotherapy may also improve task persistence in these children. ... Previous studies suggest that a clinical approach using interventions to improve motivational processes in patients with ADHD may improve outcomes as children with ADHD transition into adolescence and adulthood.
- ^ a b National Collaborating Centre for Mental Health (2009). "Diagnosis". Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines. 72. Leicester: British Psychological Society. pp. 116-7, 119. ISBN 978-1-85433-471-8. Archived from the original on 13 January 2016 - via NCBI Bookshelf.
- ^ "MerckMedicus Modules: ADHD -Pathophysiology". August 2002. Archived from the original on 1 May 2010.
- ^ Wiener JM, Dulcan MK (2004). Textbook Of Child and Adolescent Psychiatry (illustrated ed.). American Psychiatric Publishing. ISBN 978-1-58562-057-9. Archived from the original on 6 May 2016. Retrieved 2014.
- ^ Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, Ganiats TG, Kaplanek B, Meyer B, Perrin J, Pierce K, Reiff M, Stein MT, Visser S (November 2011). "ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents". Pediatrics. 128 (5): 1007-1022. PMC 4500647 . PMID 22003063. doi:10.1542/peds.2011-2654.
- ^ Sand T, Breivik N, Herigstad A (February 2013). "[Assessment of ADHD with EEG]". Tidsskr. Nor. Laegeforen. (in Norwegian). 133 (3): 312-316. PMID 23381169. doi:10.4045/tidsskr.12.0224.
- ^ Millichap JG, Millichap JJ, Stack CV (July 2011). "Utility of the electroencephalogram in attention deficit hyperactivity disorder". Clin EEG Neurosci. 42 (3): 180-184. PMID 21870470. doi:10.1177/155005941104200307.
- ^ "FDA permits marketing of first brain wave test to help assess children and teens for ADHD". United States Food and Drug Administration. 15 July 2013. Archived from the original on 25 September 2013.
- ^ Smith, B.H.; Barkley, R.A.; Shapiro, C.J. (2007). "Attention-Deficit/Hyperactivity Disorder". In Mash, Eric J.; Barkley, Russell A. Assessment of Childhood Disorders (4th ed.). New York, NY: Guilford Press. pp. 53-131. ISBN 978-1-59385-493-5.
- ^ a b Steinau S (2013). "Diagnostic Criteria in Attention Deficit Hyperactivity Disorder - Changes in DSM 5". Front Psychiatry. 4: 49. PMC 3667245 . PMID 23755024. doi:10.3389/fpsyt.2013.00049.
- ^ Berger I (September 2011). "Diagnosis of attention deficit hyperactivity disorder: much ado about something" (PDF). Isr. Med. Assoc. J. 13 (9): 571-574. PMID 21991721.
- ^ ICD-11 Beta Draft. Archived 2 February 2017 at the Wayback Machine. who.int
- ^ Culpepper L, Mattingly G (2010). "Challenges in identifying and managing attention-deficit/hyperactivity disorder in adults in the primary care setting: a review of the literature". Prim Care Companion J Clin Psychiatry. 12 (6): PCC.10r00951. PMC 3067998 . PMID 21494335. doi:10.4088/PCC.10r00951pur.
- ^ Consumer Reports; Drug Effectiveness Review Project (March 2012). "Evaluating Prescription Drugs Used to Treat: Attention Deficit Hyperactivity Disorder (ADHD) Comparing Effectiveness, Safety, and Price" (PDF). Best Buy Drugs. Consumer Reports: 2. Archived (PDF) from the original on 15 November 2012. Retrieved 2013.
- ^ Owens JA (October 2008). "Sleep disorders and attention-deficit/hyperactivity disorder". Curr Psychiatry Rep. 10 (5): 439-444. PMID 18803919. doi:10.1007/s11920-008-0070-x.
- ^ Walters AS, Silvestri R, Zucconi M, Chandrashekariah R, Konofal E (December 2008). "Review of the possible relationship and hypothetical links between attention deficit hyperactivity disorder (ADHD) and the simple sleep related movement disorders, parasomnias, hypersomnias, and circadian rhythm disorders". J Clin Sleep Med. 4 (6): 591-600. PMC 2603539 . PMID 19110891.
- ^ a b Lal C, Strange C, Bachman D (June 2012). "Neurocognitive impairment in obstructive sleep apnea". Chest. 141 (6): 1601-1610. PMID 22670023. doi:10.1378/chest.11-2214.
- ^ a b Irsfeld, M; Spadafore, M; Prüß, BM (September 2013). "?-phenylethylamine, a small molecule with a large impact". Webmedcentral. 4 (9). PMC 3904499 . PMID 24482732.
While diagnosis of ADHD is usually done by analysis of the symptoms (American Psychiatric Association, 2000), PEA was recently described as a biomarker for ADHD
- ^ a b c d Scassellati C, Bonvicini C, Faraone SV, Gennarelli M (October 2012). "Biomarkers and attention-deficit/hyperactivity disorder: a systematic review and meta-analyses". J. Am. Acad. Child Adolesc. Psychiatry. 51 (10): 1003-1019.e20. PMID 23021477. doi:10.1016/j.jaac.2012.08.015.
- ^ Al Rahbi, HA; Al-Sabri, RM; Chitme, HR (April 2014). "Interventions by pharmacists in out-patient pharmaceutical care.". Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society. 22 (2): 101-6. PMC 3950532 . PMID 24648820. doi:10.1016/j.jsps.2013.04.001.
- ^ Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, Arnold LE (4 September 2012). "A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment". BMC Med. 10: 99. PMC 3520745 . PMID 22947230. doi:10.1186/1741-7015-10-99.
- ^ Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC (March 2009). "A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder". Clin Psychol Rev. 29 (2): 129-140. PMID 19131150. doi:10.1016/j.cpr.2008.11.001.
- ^ Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V (March 2009). "Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist". Psychiatr. Clin. North Am. 32 (1): 39-56. PMID 19248915. doi:10.1016/j.psc.2008.10.001.
- ^ Evans, SW; Owens, JS; Bunford, N (2014). "Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder.". Journal of Clinical Child and Adolescent Psychology. 43 (4): 527-51. PMC 4025987 . PMID 24245813. doi:10.1080/15374416.2013.850700.
- ^ Arns M, de Ridder S, Strehl U, Breteler M, Coenen A (July 2009). "Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis". Clin EEG Neurosci. 40 (3): 180-189. PMID 19715181. doi:10.1177/155005940904000311.
- ^ Hodgson, K; Hutchinson, AD; Denson, L (May 2014). "Nonpharmacological treatments for ADHD: a meta-analytic review.". Journal of Attention Disorders. 18 (4): 275-82. PMID 22647288. doi:10.1177/1087054712444732.
- ^ Pliszka S (July 2007). "Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder". J Am Acad Child Adolesc Psychiatry. 46 (7): 894-921. PMID 17581453. doi:10.1097/chi.0b013e318054e724.
- ^ Antshel, KM (January 2015). "Psychosocial interventions in attention-deficit/hyperactivity disorder: update.". Child and adolescent psychiatric clinics of North America. 24 (1): 79-97. PMID 25455577. doi:10.1016/j.chc.2014.08.002.
- ^ Bjornstad G, Montgomery P (2005). Bjornstad GJ, ed. "Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents". Cochrane Database Syst Rev (2): CD005042. PMID 15846741. doi:10.1002/14651858.CD005042.pub2.
- ^ Turkington, Carol; Harris, Joseph (2009). "attention deficit hyperactivity disorder (ADHD)". The Encyclopedia of the Brain and Brain Disorders. Infobase Publishing. p. 47. ISBN 978-1-4381-2703-3 - via Google Books.
- ^ Mikami AY (June 2010). "The importance of friendship for youth with attention-deficit/hyperactivity disorder". Clin Child Fam Psychol Rev. 13 (2): 181-98. PMC 2921569 . PMID 20490677. doi:10.1007/s10567-010-0067-y.
- ^ a b c d e Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O (July 2016). "Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review". J. Neural. Transm. (Vienna). PMID 27400928. doi:10.1007/s00702-016-1593-7.
Beneficial chronic effects of cardio exercise were found on various functions as well, including executive functions, attention and behavior.
- ^ a b Kamp CF, Sperlich B, Holmberg HC (July 2014). "Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters". Acta Paediatr. 103 (7): 709-714. PMID 24612421. doi:10.1111/apa.12628. Archived from the original on 21 March 2015. Retrieved 2015.
We may conclude that all different types of exercise ... attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration and frequency of exercise is most effective
- ^ a b Rommel AS, Halperin JM, Mill J, Asherson P, Kuntsi J (September 2013). "Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise". J. Am. Acad. Child Adolesc. Psychiatry. 52 (9): 900-910. PMC 4257065 . PMID 23972692. doi:10.1016/j.jaac.2013.05.018.
The findings from these studies provide some support for the notion that exercise has the potential to act as a protective factor for ADHD.
- ^ a b c Wigal SB (2009). "Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults". CNS Drugs. 23 Suppl 1: 21-31. PMID 19621975. doi:10.2165/00023210-200923000-00004.
- ^ Castells X, Ramos-Quiroga JA, Bosch R, Nogueira M, Casas M (2011). Castells X, ed. "Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults". Cochrane Database Syst. Rev. (6): CD007813. PMID 21678370. doi:10.1002/14651858.CD007813.pub2.
- ^ Storebø, OJ; Ramstad, E; Krogh, HB; Nilausen, TD; Skoog, M; Holmskov, M; Rosendal, S; Groth, C; Magnusson, FL; Moreira-Maia, CR; Gillies, D; Buch Rasmussen, K; Gauci, D; Zwi, M; Kirubakaran, R; Forsbøl, B; Simonsen, E; Gluud, C (25 November 2015). "Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD).". The Cochrane database of systematic reviews. 11: CD009885. PMID 26599576. doi:10.1002/14651858.CD009885.pub2.
- ^ Dalsgaard, Søren; Leckman, James F.; Mortensen, Preben Bo; Nielsen, Helena Skyt; Simonsen, Marianne (1 August 2015). "Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study". The Lancet. Psychiatry. 2 (8): 702-709. ISSN 2215-0374. PMID 26249301. doi:10.1016/S2215-0366(15)00271-0.
- ^ Childress, A. C.; Sallee, F. R. (2012). "Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder". Drugs of Today (Barcelona, Spain: 1998). 48 (3): 207-217. ISSN 1699-3993. PMID 22462040. doi:10.1358/dot.2012.48.3.1750904.
- ^ a b McDonagh MS, Peterson K, Thakurta S, Low A (December 2011). "Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder". United States Library of Medicine. PMID 22420008. Archived from the original on 31 August 2016.
- ^ Prasad V, Brogan E, Mulvaney C, Grainge M, Stanton W, Sayal K (April 2013). "How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis". Eur Child Adolesc Psychiatry. 22 (4): 203-216. PMID 23179416. doi:10.1007/s00787-012-0346-x.
- ^ a b Kiely B, Adesman A (June 2015). "What we do not know about ADHD... yet". Curr. Opin. Pediatr. 27 (3): 395-404. PMID 25888152. doi:10.1097/MOP.0000000000000229.
In addition, a consensus has not been reached on the optimal diagnostic criteria for ADHD. Moreover, the benefits and long-term effects of medical and complementary therapies for this disorder continue to be debated. These gaps in knowledge hinder the ability of clinicians to effectively recognize and treat ADHD.
- ^ Hazell P (July 2011). "The challenges to demonstrating long-term effects of psychostimulant treatment for attention-deficit/hyperactivity disorder". Current Opinion in Psychiatry. 24 (4): 286-290. PMID 21519262. doi:10.1097/YCO.0b013e32834742db.
- ^ Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K (February 2013). "Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects". JAMA Psychiatry. 70 (2): 185-198. PMID 23247506. doi:10.1001/jamapsychiatry.2013.277.
- ^ Spencer TJ, Brown A, Seidman LJ, Valera EM, Makris N, Lomedico A, Faraone SV, Biederman J (September 2013). "Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies". J. Clin. Psychiatry. 74 (9): 902-917. PMC 3801446 . PMID 24107764. doi:10.4088/JCP.12r08287.
- ^ Frodl T, Skokauskas N (February 2012). "Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects.". Acta psychiatrica Scand. 125 (2): 114-126. PMID 22118249. doi:10.1111/j.1600-0447.2011.01786.x.
Basal ganglia regions like the right globus pallidus, the right putamen, and the nucleus caudatus are structurally affected in children with ADHD. These changes and alterations in limbic regions like ACC and amygdala are more pronounced in non-treated populations and seem to diminish over time from child to adulthood. Treatment seems to have positive effects on brain structure.
- ^ Greenhill LL, Posner K, Vaughan BS, Kratochvil CJ (April 2008). "Attention deficit hyperactivity disorder in preschool children". Child and Adolescent Psychiatric Clinics of North America. 17 (2): 347-366, ix. PMID 18295150. doi:10.1016/j.chc.2007.11.004.
- ^ Stevens, Jonathan R.; Wilens, Timothy E.; Stern, Theodore A. (2013). "Using Stimulants for Attention-Deficit/Hyperactivity Disorder: Clinical Approaches and Challenges". The Primary Care Companion for CNS Disorders. 15 (2). ISSN 2155-7772. PMC 3733520 . PMID 23930227. doi:10.4088/PCC.12f01472.
- ^ Young, Joel L. (2010). "Individualizing Treatment for Adult ADHD: An Evidence-Based Guideline". Medscape. Archived from the original on 8 May 2015. Retrieved 2016.
- ^ Biederman, Joseph (2003). "New-Generation Long-Acting Stimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder". Medscape. Archived from the original on 7 December 2003. Retrieved 2016.
As most treatment guidelines and prescribing information for stimulant medications relate to experience in school-aged children, prescribed doses for older patients are lacking. Emerging evidence for both methylphenidate and Adderall indicate that when weight-corrected daily doses, equipotent with those used in the treatment of younger patients, are used to treat adults with ADHD, these patients show a very robust clinical response consistent with that observed in pediatric studies. These data suggest that older patients may require a more aggressive approach in terms of dosing, based on the same target dosage ranges that have already been established - for methylphenidate, 1-1.5-2 mg/kg/day, and for D,L-amphetamine, 0.5-0.75-1 mg/kg/day....
In particular, adolescents and adults are vulnerable to underdosing, and are thus at potential risk of failing to receive adequate dosage levels. As with all therapeutic agents, the efficacy and safety of stimulant medications should always guide prescribing behavior: careful dosage titration of the selected stimulant product should help to ensure that each patient with ADHD receives an adequate dose, so that the clinical benefits of therapy can be fully attained.
- ^ Kessler, S. (1996). "Drug therapy in attention-deficit hyperactivity disorder". Southern Medical Journal. 89 (1): 33-38. ISSN 0038-4348. PMID 8545689. doi:10.1097/00007611-199601000-00005.
- ^ a b c Shoptaw SJ, Kao U, Ling W (January 2009). Shoptaw SJ, Ali R, ed. "Treatment for amphetamine psychosis". Cochrane Database Syst. Rev. (1): CD003026. PMID 19160215. doi:10.1002/14651858.CD003026.pub3.
A minority of individuals who use amphetamines develop full-blown psychosis requiring care at emergency departments or psychiatric hospitals. In such cases, symptoms of amphetamine psychosis commonly include paranoid and persecutory delusions as well as auditory and visual hallucinations in the presence of extreme agitation. More common (about 18%) is for frequent amphetamine users to report psychotic symptoms that are sub-clinical and that do not require high-intensity intervention ...
About 5-15% of the users who develop an amphetamine psychosis fail to recover completely (Hofmann 1983) ...
Findings from one trial indicate use of antipsychotic medications effectively resolves symptoms of acute amphetamine psychosis.
- ^ "Adderall XR Prescribing Information" (PDF). United States Food and Drug Administration. Shire US Inc. December 2013. Archived (PDF) from the original on 30 December 2013. Retrieved 2013.
Treatment-emergent psychotic or manic symptoms, e.g., hallucinations, delusional thinking, or mania in children and adolescents without prior history of psychotic illness or mania can be caused by stimulants at usual doses. ... In a pooled analysis of multiple short-term, placebo controlled studies, such symptoms occurred in about 0.1% (4 patients with events out of 3482 exposed to methylphenidate or amphetamine for several weeks at usual doses) of stimulant-treated patients compared to 0 in placebo-treated patients.
- ^ Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R (February 2009). "Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children". Pediatrics. 123 (2): 611-616. PMID 19171629. doi:10.1542/peds.2008-0185.
- ^ Kraemer M, Uekermann J, Wiltfang J, Kis B (July 2010). "Methylphenidate-induced psychosis in adult attention-deficit/hyperactivity disorder: report of 3 new cases and review of the literature". Clin Neuropharmacol. 33 (4): 204-6. PMID 20571380. doi:10.1097/WNF.0b013e3181e29174.
- ^ van de Loo-Neus GH, Rommelse N, Buitelaar JK (August 2011). "To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended?". Eur Neuropsychopharmacol. 21 (8): 584-599. PMID 21530185. doi:10.1016/j.euroneuro.2011.03.008.
- ^ Ibrahim, Kinda; Donyai, Parastou (2015). "Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades" (PDF). Journal of Attention Disorders. 19 (7): 551-568. ISSN 1557-1246. PMID 25253684. doi:10.1177/1087054714548035. Archived (PDF) from the original on 30 June 2016.
- ^ a b c Malenka, RC; Nestler, EJ; Hyman, SE (2009). Sydor, A; Brown, RY, eds. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 323, 368. ISBN 978-0-07-148127-4.
supervised use of stimulants at therapeutic doses may decrease risk of experimentation with drugs to self-medicate symptoms. Second, untreated ADHD may lead to school failure, peer rejection, and subsequent association with deviant peer groups that encourage drug misuse. ... amphetamines and methylphenidate are used in low doses to treat attention deficit hyperactivity disorder and in higher doses to treat narcolepsy (Chapter 12). Despite their clinical uses, these drugs are strongly reinforcing, and their long-term use at high doses is linked with potential addiction
- ^ Oregon Health & Science University (2009). "Black box warnings of ADHD drugs approved by the US Food and Drug Administration". Portland, Oregon: United States National Library of Medicine. Archived from the original on 8 September 2017. Retrieved 2014.
- ^ Ashton H, Gallagher P, Moore B (September 2006). "The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder". J. Psychopharmacol. (Oxford). 20 (5): 602-610. PMID 16478756. doi:10.1177/0269881106061710. Archived from the original on 15 August 2009.
- ^ Nigg JT, Lewis K, Edinger T, Falk M (January 2012). "Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives". J Am Acad Child Adolesc Psychiatry. 51 (1): 86-97. PMID 22176942. doi:10.1016/j.jaac.2011.10.015.
- ^ Konikowska K, Regulska-Ilow B, Róza?ska D (2012). "The influence of components of diet on the symptoms of ADHD in children". Rocz Panstw Zakl Hig. 63 (2): 127-134. PMID 22928358.
- ^ Arnold LE, DiSilvestro RA (2005). "Zinc in attention-deficit/hyperactivity disorder". Journal of child and adolescent psychopharmacology. 15 (4): 619-27. PMID 16190793. doi:10.1089/cap.2005.15.619.
- ^ Bloch, MH; Mulqueen, J (October 2014). "Nutritional supplements for the treatment of ADHD.". Child and adolescent psychiatric clinics of North America. 23 (4): 883-97. PMC 4170184 . PMID 25220092. doi:10.1016/j.chc.2014.05.002.
- ^ Krause J (April 2008). "SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder". Expert Rev. Neurother. 8 (4): 611-625. PMID 18416663. doi:10.1586/14737188.8.131.521.
Zinc binds at ... extracellular sites of the DAT , serving as a DAT inhibitor. In this context, controlled double-blind studies in children are of interest, which showed positive effects of zinc [supplementation] on symptoms of ADHD [105,106]. It should be stated that at this time [supplementation] with zinc is not integrated in any ADHD treatment algorithm.
- ^ Bloch MH, Qawasmi A (October 2011). "Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis". J Am Acad Child Adolesc Psychiatry. 50 (10): 991-1000. PMC 3625948 . PMID 21961774. doi:10.1016/j.jaac.2011.06.008.
- ^ Königs A, Kiliaan AJ (July 2016). "Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment". Neuropsychiatr. Dis. Treat. 12: 1869-1882. PMC 4968854 . PMID 27555775. doi:10.2147/NDT.S68652.
- ^ Molina BS, Hinshaw SP, Swanson JM, et al. (May 2009). "The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study". Journal of the American Academy of Child and Adolescent Psychiatry. 48 (5): 484-500. PMC 3063150 . PMID 19318991. doi:10.1097/CHI.0b013e31819c23d0.
- ^ Cimera, Robert E. (2002). Making ADHD a gift : teaching Superman how to fly. Lanham, Md.: Scarecrow Press. p. 116. ISBN 978-0-8108-4318-9. Archived from the original on 6 May 2016. Retrieved 2014.
- ^ Bergman, Mike (28 March 2005). "College Degree Nearly Doubles Annual Earnings, Census Bureau Reports". U.S. Census Bureau. Archived from the original on 23 September 2008. Retrieved 2008.
- ^ Jensen PS, Arnold LE, Swanson JM (August 2007). "3-year follow-up of the NIMH MTA study". Journal of the American Academy of Child and Adolescent Psychiatry. 46 (8): 989-1002. PMID 17667478. doi:10.1097/CHI.0b013e3180686d48.
- ^ "What is the evidence for using CNS stimulants to treat ADHD in children?". Therapeutics Initiative. University of British Columbia. March 2008. Archived from the original on 6 September 2010.
- ^ Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (June 2007). "The worldwide prevalence of ADHD: a systematic review and metaregression analysis". The American Journal of Psychiatry. 164 (6): 942-8. PMID 17541055. doi:10.1176/appi.ajp.164.6.942 .
- ^ Staller J, Faraone SV (2006). "Attention-deficit hyperactivity disorder in girls: epidemiology and management". CNS Drugs. 20 (2): 107-23. PMID 16478287. doi:10.2165/00023210-200620020-00003. (Subscription required (help)).
- ^ a b c d e "ADHD Throughout the Years" (PDF). Center For Disease Control and Prevention. Archived (PDF) from the original on 7 August 2013. Retrieved 2013.
- ^ Dalsgaard, Søren (February 2013). "Attention-deficit/hyperactivity disorder (ADHD)". European Child & Adolescent Psychiatry. 22 Suppl 1: S43-8. PMID 23202886. doi:10.1007/s00787-012-0360-z. (Subscription required (help)).
- ^ Palmer ED, Finger S (May 2001). "An early description of ADHD (inattentive subtype): Dr Alexander Crichton and 'Mental restlessness' (1798)". Child and Adolescent Mental Health. 6 (2): 66-73. doi:10.1111/1475-3588.00324. (Subscription required (help)).
- ^ Crichton, Alexander (1976) . An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. United Kingdom: AMS Press. p. 271. ISBN 0-404-08212-2. Retrieved 2014 - via Google Books.
- ^ Millichap, J. Gordon (2010). "Definition and History of ADHD". Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD (2nd ed.). Springer Science. pp. 2-3. ISBN 978-1-4419-1396-8. LCCN 2009938108. doi:10.1007/978-104419-1397-5_1 - via Google Books.
- ^ Weiss, Margaret; Hechtman, Lily Trokenberg; Weiss, Gabrielle (2001). "ADHD in Adulthood: An Introduction". ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment. Taylor & Francis. p. 34. ISBN 978-0-8018-6822-1 - via Google Books.
- ^ Patrick KS, Straughn AB, Perkins JS, González MA (January 2009). "Evolution of stimulants to treat ADHD: transdermal methylphenidate". Human Psychopharmacology. 24 (1): 1-17. PMC 2629554 . PMID 19051222. doi:10.1002/hup.992.
- ^ Rasmussen, Nicolas (July 2006). "Making the first anti-depressant: amphetamine in American medicine, 1929-1950". Journal of the History of Medicine and Allied Sciences. 61 (3): 288-323. PMID 16492800. doi:10.1093/jhmas/jrj039. (Subscription required (help)).
- ^ Foreman DM (February 2006). "Attention deficit hyperactivity disorder: legal and ethical aspects". Archives of Disease in Childhood. 91 (2): 192-194. PMC 2082674 . PMID 16428370. doi:10.1136/adc.2004.064576.
- ^ Faraone, Stephen V. (February 2005). "The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder". European Child & Adolescent Psychiatry. 14 (1): 1-10. PMID 15756510. doi:10.1007/s00787-005-0429-z. (Subscription required (help)).
- ^ Boseley, Sarah (30 September 2010). "Hyperactive children may suffer from genetic disorder, says study". The Guardian. Archived from the original on 8 July 2017.
- ^ a b Cormier, Eileen (October 2008). "Attention deficit/hyperactivity disorder: a review and . Journal of Pediatric Nursing. 23 (5): 345-57. PMID 18804015. doi:10.1016/j.pedn.2008.01.003.
- ^ a b Schwarz, Alan (14 December 2013). "The Selling of Attention Deficit Disorder". The New York Times (14 December 2013). Archived from the original on 1 March 2015. Retrieved 2015.
- ^ Merten, EC; Cwik, JC; Margraf, J; Schneider, S (2017). "Overdiagnosis of mental disorders in children and adolescents (in developed countries).". Child and adolescent psychiatry and mental health. 11: 5. PMC 5240230 . PMID 28105068.
- ^ Taylor, E (April 2017). "Attention deficit hyperactivity disorder: overdiagnosed or diagnoses missed?". Archives of disease in childhood. 102 (4): 376-379. PMID 27821518. doi:10.1136/archdischild-2016-310487.
- Attention deficit hyperactivity disorder at DMOZ
- National Institute of Mental Health on ADHD
- New Zealand MOH Guidelines for the Assessment and Treatment of Attention-Deficit/Hyperactivity Disorder
- AACAP Practice Parameters for the Assessment and Treatment of attention deficit hyperactivity disorder
- Faraone, Stephen V.; Asherson, Philip; Banaschewski, Tobias; Biederman, Joseph; Buitelaar, Jan K.; Ramos-Quiroga, Josep Antoni; Rohde, Luis Augusto; Sonuga-Barke, Edmund J. S.; Tannock, Rosemary; Franke, Barbara (6 August 2015). "Attention-deficit/hyperactivity disorder". Nature Reviews Disease Primers: 15020. doi:10.1038/nrdp.2015.20.