By Dr Ananya Mandal, MD
ADHD is short for Attention Deficit Hyperactivity disorder. It is covers a wide range of behavioral symptoms which may include hyperactivity, lack of attention or concentration and tendency towards impulsive behavior.
ADHD commonly also includes other problems like sleep disturbances, learning problems etc. However, contrary to the popular myth, having ADHD does not necessarily mean low or poor intelligence. (1)
How is ADHD diagnosed?
Diagnosis of ADHD is usually made in children. Since many of the symptoms of ADHD are present to a mild degree in many children, diagnosis using set criteria is important.
Most patients are diagnosed between ages three and seven. ADHD may also manifest in adulthood. Due to the lack of age-appropriate criteria and symptomatology, diagnosis in adults may be more difficult. (1)
Types of ADHD
There are classically three different types of ADHD. This classification is based on the strongest symptom showed by the child. (2)
- Predominantly Inattentive – This includes major symptoms like lack of attention, purposefulness to complete a given task, follow instructions and conversation and pay attention to smaller details. Distraction is common in these persons.
- Predominantly Hyperactive – Persons with this type of ADHD often fidget and talk more than necessary. They find it difficult to sit still for work, meals or school. In toddlers this may manifest as constant running, jumping and physical movements. This condition also manifests as impulsivity. The person may speak out of turn or grab things from others. This impulsivity also makes the individuals prone to accidents and injuries.
- Combination of both types – These persons show a mixture of symptoms of both types.
Other symptoms of ADHD
Children with ADHD are also prone to have other mental health related conditions and illnesses. Various learning disabilities are the most common, such as difficulty with spelling, reading, writing or math.
Some children may show Oppositional Defiant Disorder which is characterized by stubborn nature or rebelliousness.
Some children may also have conduct disorders that cause them to do wilful harm to persons or properties. These children run a risk of getting arrested for illegal activities.
Children with ADHD may also develop Anxiety disorders and Depression. Some may also be diagnosed with concomitant Bipolar Disorder, insomnia, bed-wetting, substance abuse or Tourette syndrome.
Tourette syndrome is characterized by repeated actions like tics, blinks, facial grimaces etc. These mental health problems need to be diagnosed and addressed while treating patients with ADHD. (3)
How many people does ADHD affect?
In The United Kingdom, ADHD affects approximately 3-9% of all school-going children and young people. (1)
According to the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) 3-7% of school aged children in the United States have ADHD. However studies have shown higher percentages in communities. (4)
ADHD affects 2% of the adult population worldwide. ADHD is more common among males. (1)
Impact of ADHD
The impact of ADHD on the child is enormous. Children with ADHD have 3 times higher problems with their peers than those who do not have ADHD.
Parents of these children are 10 times more likely to report that the condition interferes with forming friendships in their children. A study shows that children with ADHD are more likely to suffer non-fatal injuries. In addition those with ADHD are also more likely to suffer major injuries, emergency department, hospital in or outpatient admissions.
When older these children are further at a higher risk of drink driving, automobile accidents and violations of traffic rules. (4)
Apart from this, ADHD also implies a heavy economic burden on the country. The cost includes not only those for ambulatory care visits but also other health care costs, costs of admissions, medications, therapy and cost of work loss for patient as well as family members and parents.
Those with ADHD have increased chances of having at least one day off for sickness per month compared to healthy workers. Studies estimate that ADHD is the reason for 143.8 million lost days of productivity annually. (4,3)
Are there any cures for ADHD?
At present there are no definitive cures for ADHD. Around two thirds of the children with ADHD continue to have symptoms of the conditions at the age of 25.
Symptoms may, however, be controlled and learning difficulties may be overcome using medication, behavioral, psychological and social therapy. (1)
Edited by April Cashin-Garbutt, BA Hons (Cantab)
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