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ADHD (ADD) Description by M. L. Glaser, MD A.D.H.D.(ADHD) stands for attention deficit hyperactivity disorder. In the 1960's and early 1970's, ADHD was called A.D.D. This stood for Attention Deficit Disorder with or without hyperactivity. The name officially changed in the late 1970's to ADHD. ADHD has two subtypes. One is combined inattention plus hyperactivity and the other is inattention only without hyperactivity. They are both called ADHD. While there may be societal factors that contribute to the large number of children diagnosed with ADHD, the fact of the matter is the number of children (and teenagers) with ADHD has remained consistent over the last several decades. However, the number of children treated for ADHD with medication has increased. This is probably due to greater awareness of the severe lifelong problems ADHD causes and of the benefits of medication treatment. The main difficulties a person with ADHD has centers around three areas or domains. A person must have significant problems in at least one domain to qualify for ADHD. The first domain is inattention. This means the person can not stay focussed during tasks that require sustained attention. The ability to watch TV or play video games for long periods does not matter towards the diagnosis. Inattention in ADHD refers to tasks that are more monotonous, like school work, reading, household chores. The second domain is hyperactivity. This means unable to sit still, fidget, move about constantly. A child in school may be out of his seat a lot, or talking to their neighbor in class. Younger children will have a motor that won't shut off. The third domain is impulsivity. This means acting first without forethought. A child may dart out into traffic, an adult may make poor choices with great risk taking without enough planning. The above symptoms must cause significant problems in the person's life to meat criteria for the diagnosis. Also, symptoms must be present since childhood. Sometimes, symptoms don't show up till a person is older like in 6th grade when school work requires much greater attention spans. People with ADHD have very little patience. They can get angry very easily. Also, doing tasks that require sustained attention, like cleaning their room, is a much bigger deal to an ADHD person. Therefore they can be oppositional and defiant of authority. Children who have untreated ADHD are at much greater risk to have serious life problems as they grow older. Persons with untreated ADHD are more likely to have troubles with all the things an irresponsible person would have trouble with. They are more likely to drop out of school, use illegal drugs, get divorced, get into car accidents, get sexually transmitted diseases, and the list goes on. Those who are treated are close to having the same risk for the above as people without ADHD. What are the other illnesses a person with inattention and hyperactivity must be screened for? Since ADHD must be present since early childhood, adult onset ADHD is likely due to another reason. Depression and anxiety can cause inattention. Poor sleep can cause inattention and hyperactivity. Bipolar disorder and schizophrenia can have early symptoms that resemble ADHD especially in children. Is there a test for ADHD? There is no test for ADHD. ADHD is diagnosed only on the basis of symptoms described to the psychiatrist by the patient and other observers of the patient. Computer tests called TOVA or psychological testing can provide useful information but they can not make the diagnosis. Psychological testing can rule out learning disorders or mental retardation. The great news is that ADHD is a treatable condition. In my practice, I get great satisfaction seeing an ADHD patient go from suspensions and failing grades to honor role. Mitchell L. Glaser, MD. Chicago Il |
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