Attention Deficit Hyperactivity Disorder (ADHD)

What are the symptoms of each subtype of ADHD?

The symptoms of ADHD are detailed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which lists nine symptoms that suggest ADHD: primarily inattention and nine that suggest ADHD: primarily hyperactivity/impulsivity. A child can be diagnosed with ADHD only if he or she has at least six of the nine symptoms from one of the lists below, and if the symptoms have been noted for at least six months in two or more settings, for example, at home and at school. Additionally, the symptoms must interfere with the child's functioning or development, and at least some of the symptoms must have been evident before age 12. Older adolescents and adults may need to consistently demonstrate only five of these symptoms in multiple settings.
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The symptoms of ADHD with inattentive presentation are characterized by: 

• Often does not pay close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
• Often has difficulty maintaining attention on tasks or play activities (e.g., has difficulty staying focused during lectures, conversations, or long readings).
• Often appears not to listen when spoken to directly (e.g., mind appears to be elsewhere, even in the absence of an obvious distraction).
• Often does not follow instructions and complete schoolwork, household chores, or workplace duties (e.g., starts tasks but quickly loses focus and is easily distracted).
• Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks, difficulty keeping materials and belongings in order, messy and disorganized work, poor time management, failure to meet deadlines).
• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., school or homework assignments; for older adolescents and adults, preparing reports, completing forms, reviewing long documents).
• Often loses things necessary for tasks or activities (e.g., school supplies, pencils, books, tools, wallets, keys, papers, glasses, cell phones).
• Often easily distracted by extraneous stimuli (for older teens and adults, may include unrelated thoughts).
• Often forgets about daily activities (e.g., doing homework, running errands; for older teens and adults, returning calls, paying bills, keeping appointments)
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The symptomatology of ADHD with a hyperactive/impulsive presentation is characterized by: 

• Often fidgets or taps with hands or feet or squirms in seat.
• Often leaves seat in situations where he or she is expected to remain seated (e.g., leaves his or her place in the classroom, office, or other workplace, or in other situations that require remaining in place) .
• Often runs or climbs in situations where it is not appropriate. (Note: in teenagers or adults, it may be limited to feeling restless.)
• Often unable to play or participate in leisure activities quietly.
• Is often “on the move,” acting as if “driven by a motor” (e.g., cannot sit still or feels uncomfortable for a long time, such as in restaurants, meetings; others may perceive him or her as restless or difficult to keep) up).
• Often talks in excess.
• Often blurts out a response before a question has been completed (e.g., completes people's sentences; cannot wait their turn in conversation).
• Often has difficulty waiting his turn (e.g., while waiting in line).
• Often interrupts or intrudes on others (e.g., intrudes on conversations, games, or activities; may begin to use other people's things without asking or receiving permission; in adolescents and adults, may intrude or take charge of what others do)
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Prevalence

ADHD is one of the most common neurodevelopmental disorders in childhood, affecting 5% of school-age children. It is a disorder of cross-cultural validity and is universal in all cultures. Regarding gender, ADHD has a higher incidence in males than in females, with a ratio of 3:1 in the pediatric population.

According to the Centers for Disease Control and Prevention, 1 in 10 children between the ages of 5 and 17 are diagnosed with ADHD, 7 making ADHD one of the most common childhood neurodevelopmental disorders in the US.

ADHD symptoms are often identified at school, as many children with ADHD find the symptoms interfere with their academic performance..

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The etiology of ADHD is multicausal. The factors that are involved include genetics, environmental conditions and neurobiological impairment.

Risk factor's

Risk factors for attention deficit/hyperactivity disorder may include:

• Blood relatives, such as parents or siblings, with attention deficit/hyperactivity disorder or another mental health disorder.
• Exposure to environmental toxins, such as lead,in patients with genetic vulnerability.
• Drug use, alcohol consumption or smoking by the mother during pregnancy.
• Premature birth.

Although sugar consumption is popularly suspected of causing hyperactivity, there is no reliable evidence to confirm this. Many problems in childhood can lead to difficulty maintaining attention, but that is not the same as having attention deficit/hyperactivity disorder.

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Complications

ADHD can make life difficult for children. Children with ADHD have these characteristics:

• They often struggle in the classroom, which can lead to academic failure and judgment from other children and adults.
• They tend to have more accidents andthey may not weigh the risks.
• They tend to have low self-esteem.
• They are more likely to have problems interacting with and being accepted by peers and adults.
• They are more likely to engage in risky behavior (increased alcohol and drug consumption, as well as criminal behavior).
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Coexisting conditions

ADHD does not cause other psychological or developmental problems. However, children with ADHD are more likely than others to have conditions such as:

• Oppositional defiant disorder, generally defined as a pattern of negative, defiant, and hostile behavior toward authority figures.
• conduct disorder, marked by antisocial behavior, such as stealing, fighting, destroying property, and harming people or animals.
• Disruptive mood dysregulation disorder, characterized by irritability and problems tolerating frustration.
• Learning difficulties, including problems with reading, writing, comprehension and communicationand calculation.
• Substance abuse disorders, including drugs, alcohol and smoking.
• Anxiety disorders, which can cause overwhelming worry and nervousness, and include obsessive-compulsive disorder (OCD).
• Mood disorders, including depression and bipolar disorder, which includes depression and manic behavior.
• autism spectrum disorder, a condition related to brain development that affects how a person perceives and socializes with others.
• Nervous tic or Tourette's syndrome, disorders that involve repetitive movements or unwanted sounds (tics) that cannot be easily controlled.