Attention Deficit Hyperactivity Disorder (ADHD), sometimes inaccurately referred to as ADD (There is no clinical term by this name) is a disorder usually first diagnosed in infancy, childhood or adolescence. In the United States, approximately 3 – 5% of children are diagnosed with this disorder currently, with the peak around ages 8-9 years of age., with approximately 50% of cases diagnosed before age 4. The ratio of males to females is 3 males for every 1 female diagnosed.
There are 4 recognized types of ADHD. They are: ADHD – predominantly inattentive type; ADHD – predominantly hyperactive-impulsive type; ADHD – combined type (inattention and hyperactivity-impulsivity); and ADHD – Not otherwise specified.
Some of the symptoms of ADHD – hyperactive-impulsive type include: over-activity, impulse inhibition, language disorders, rejection by peers, aggressiveness, and conduct disorders. These children are generally referred for their behaviors early in their schooling or by their parents, and the symptoms have a high chance of persistence. More males than females have this subtype of disorder. Thus, the younger the age a child is diagnosed, the greater the chance they will be diagnosed with ADHD – hyperactive-impulsive subtype.
Some of the symptoms of ADHD – inattentive type include: sluggishness, organization, subtle deficits, social withdrawl, anxiety and depression. These children are generally referred for learning disabilities later in school, and have a greater chance for adjustment. Males and females have a more equal chance of being afflicted by this subtype of the disorder. Those diagnosed in their teen years are more likely to be diagnosed with ADHD – inattentive subtype.
There is a high level of correlation between children with ADHD and other psychiatric illnesses. This included illnesses ranging from behavioral, mood, family, anxiety, cognitive, social to school functioning, with the greatest increase in those with the ADHD – combines subtype. 45% of those with ADHD ADHD exhibit symptoms of Oppositional Defiant Disorder, and 25% Conduct Disorder. Younger children are more at risk for social phobia, while adolescent children are at risk for depression.
The symptoms of ADHD change over time. As children enter adolescence, ADHD is persistent, although the diagnosis appears to change from ADHD – hyperactivity-impulsive or ADHD – combined to one of ADHD – inattentive. This is possibly due to the hormonal changes. At this point, only 70-80% still meet the full criteria for ADHD, lowering the percentage of teenagers with ADHD to 1-2%. Entering Adulthood, the estimates range from 30 to 70% of those diagnosed as a child still meeting the full criteria, though there is general agreement that those who do meet the criteria have a definite lessening of the hyperactivy-impulsivity of the disease.
Substance abuse is common among those with ADHD. 75% of males with ADHD who were not on medication are reported as having a substance abuse disorder, 25% of those on medication having a substance abuse disorder (18% of the general population has a substance abuse disorder for comparison), and adults with ADHD were 2 times as likely to develop a substance abuse disorder. They esimate that 33% of adults with ADHD abuse alcohol and 20% abuse other substances.
The primary treatment for ADHD is stimulant medications such as Ritalin or Adderal, sometimes combines with supportive psychotherapy, especially when other psychiatric disorders are present.
With appropriate psychotherapy, that focuses on controlling their environment to increase or decrease stimulation as needed, working on coping mechanisms, among other factors, approximately 50% of adults with ADHD can stop medications by some reports.