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Attention deficit disorders. With/Without hyperactivity Dr. Kersi Chavda. Fact:. This is one of the most common diagnosed and treated paediatric mental health problems, and is increasingly being diagnosed in adults as well

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Attention deficit disorders

Attention deficit disorders

With/Without hyperactivity

Dr. Kersi Chavda


Attention deficit disorders
Fact:

  • This is one of the most common diagnosed and treated paediatric mental health problems, and is increasingly being diagnosed in adults as well

  • There is a persistent pattern of inattention and/or hyperactive/impulsive behaviours that are developmentally inappropriate, chronic and interfere with normal function.


Attention deficit disorders
Also

  • Some features should have been present before seven years of age

  • The ADHD features should have affected at least two domains of function>>>academic/functional/social/

    occupational

  • They should have persisted for at least six months


Etiology
Etiology

Genetic: Heritability in ADHD is amongst the highest of psychiatric disorders

Neurological: Functional imaging suggests abnormality of the prefrontal cortex

Cathecholamine hypothesis: attributes ADHD to dysregulation of dopamine or norepinephrine in the CNS or PNS


Co morbidity
Co-morbidity:

  • SLD(60%)

  • CD and ODD (40%)

  • Depression(15 to 32%)

  • Anxiety Disorder(25%)

  • High incidence of substance abuse


Clinical features
Clinical Features

Inattention:

might include poor attention to details, tendency to make careless mistakes , easy distractibility , difficulty in sustaining attention, poor listening, poor task completion disorganization, avoidance of tasks requiring sustained attention, tendency to lose things necessary for tasks, forgetfulness


Hyperactivity impulsive
Hyperactivity/Impulsive

Symptoms might include

Fidgetiness, inability to stay seated, running or climbing inappropriately, noisiness in play, seeming “on the go” or as if driven by a motor, excessive talkativeness, prematurely blurting out answers, inability to take turns, interrupting others


Subtypes
Subtypes

  • Predominantly Inattentive : with at least six inattentive symptoms

  • Predominantly Hyperactive/Impulsive :with at least six hyperactive/impulsive symptoms

  • Combined : with at least six symptoms from both categories


Outcome
Outcome

Hyperactive and impulsive symptoms may remit with maturity

Inattentive symptoms often persist


Adults with adhd
Adults with ADHD

  • Substantial impairments in multiple domains

  • Higher arrest rates, more marital problems, involved in more car accidents, academic and occupational underachievement

  • Substance abuse is very common