ADHD needs Attention in our Society and Medical World

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Juni Banerjee, PhD, Neucrad Health Desk, August 15, 2021

ADHD stands for “Attention Deficit Hyperactivity Disorder”. It is a neurobehavioral disorder which is commonly found in the children as well as in adolescents and adults. ADHD severely affects all the spheres of its patient’s life viz. personal, social, academic and occupational.

The two major symptom domains of ADHD are Inattentiveness and Hyperactivity. Of note, the symptoms have to be persistent and visible at multiple settings before being called as ADHD symptoms. A patient with ADHD mainly finds it difficult to concentrate, organize things, making decisions, regulating their emotions and completing simple day-to-day tasks. Let’s learn about the Diagnostic features, risk factors and treatment strategies of ADHD through this article.

Diagnostic Features of ADHD

It is very crucial to properly characterize the Diagnostic features of ADHD before going to treatment strategies. Let’s learn more about the 2 major symptoms of ADHD i.e. inattentiveness and hyperactivity in the following section:

  1. Inattentiveness: ADHD patients with these symptoms demonstrate a) Failing to pay attention to details b) Not being able to follow instructions c) Poor listening skills d) Facing difficulty in organizing e) Failure in finishing tasks and activities f) forgetfulness g) Losing things related to daily life.
  2. Hyperactivity: ADHD patient with these symptoms display a) Excess Fidgeting b) Feelings of restlessness c) Being loud d) Excessive talking e) Getting Impatient to Wait for f) Intruding and Interrupting behaviour.

Interestingly, some ADHD patients show symptoms belonging to both Hyperactivity and Inattentiveness groups and hence, are categorized as having the combined type of ADHD. Unlike ADHD in case of children, adults with ADHD manifest other sides of the symptoms e.g. procrastination, restlessness, impulsiveness, mood fluctuations, low self-esteem, and angry-outbursts

Factors affecting ADHD onset and Progress

In order to find out the best diagnosis, treatment and prevention for ADHD, comprehending the underlying biological processes of this disorder is important. This needs detection of the risk factors that trigger the onset and progression of ADHD. The main risk factors for ADHD can be broadly classified as:

  1. Genetic factors- A person in blood relation to the ADHD patient viz. sibling has more chances for having ADHD. Some of the known responsible genes are a) Dopamine Receptor genes DRD4 and DRD5 b) Dopamine transporter gene DAT1.
  2. The Non-genetic or the Environmental risk factors like a) Low socioeconomic status b) child abuse or family disputes c) exposure to toxins/pesticides (e.g. polychlorinated biphenyls) d) illicit drugs by expecting mother e) Nutritional factors (e.g. Sugar, Zinc, Polyunsaturated fatty acids i.e. omega-3) plays a key role as risk factors for ADHD.

Treatment Strategies for ADHD

Differentiating ADHD from other clinical disorders like depression, anxiety, normal mood fluctuations etc is crucial before going to treatment. Evidence-based data highlight the importance of seeking professional/medical counsellor’s help about ADHD. The two main ways for combating ADHD can be classified into 2 groups:

  1. Pharmacological- Treatment strategies involve proper assessment via detection and identification of (i) the precise nature of the ADHD symptoms (ii) age of ADHD onset and course of its progress (iii) functional impairment due to ADHD (iv) any other co-existing medical problems and mental disorder.

Conducting physical, gene-related, neurological examinations (e.g. EEG and Neuroimaging), continuous performance tests (CPTs) and rating scales/questionnaires are some key steps in the pharmacological treatment strategy. Doctors often prescribe Amphetamines and Methylphenidates, the 2 first-line psychostimulants for ADHD treatment. These psychostimulants mainly help to increase the dopamine and nor-epinephrine activities to improve attention and functional aspects of the ADHD patient.

2. Non-pharmacological- It further consists of 3 types of treatment (i) Behavior management interventions involving parents, teachers, office-colleagues and peer-groups of the ADHD patient (ii) Cognitive Behavior training (CBT) (iii) Physiological treatments involving exercises, yoga, meditations etc. Getting enough sleep and practising time-management all comes under non-pharmacological treatment strategies only.

Importantly, in many cases combination of both, the above methods yield the best results. Henceforth, once again proper diagnosis is the utmost requirement in case of ADHD and other such mental disorders to bring out the best treatment strategies.

In conclusion, ADHD is a chronic condition whose negative impacts may stay for a lifetime unless taken care. Henceforth, it is important to determine the prevalence rate of ADHD (in children, adolescents and adults), performing correct diagnosis and treatment/therapies. Importantly, more research attention and social awareness related to ADHD can help in further prevention of ADHD.

References:

  1. Wilens TE, Spencer TJ. Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgrad Med. 2010;122(5):97-109. doi:10.3810/pgm.2010.09.2206
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Attention deficit hyperactivity disorder (ADHD): Overview. 2015 Sep 9 [Updated 2018 Sep 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK321129/
  3. Bélanger SA, Andrews D, Gray C, Korczak D. ADHD in children and youth: Part 1-Etiology, diagnosis, and comorbidity. Paediatr Child Health. 2018;23(7):447-453. doi:10.1093/pch/pxy109
  4. Geffen J, Forster K. Treatment of adult ADHD: a clinical perspective. Ther Adv Psychopharmacol. 2018;8(1):25-32. doi:10.1177/2045125317734977
  5. Rodríguez C, González-Castro P, Cueli M, Areces D, González-Pienda JA. Attention Deficit/Hyperactivity Disorder (ADHD) Diagnosis: An Activation-Executive Model. Front Psychol. 2016;7:1406. Published 2016 Sep 21. doi:10.3389/fpsyg.2016.01406

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