What You Need to Know About ADHD

A recent report released by the Centers for Disease Prevention and Control (CDC) shows that nearly one in ten of all U.S. children are diagnosed with attention deficit hyperactivity disorder (ADHD). This number, which represents a 22 per cent increase in the past five years, is attributed to increased awareness and better screening. However, not all experts agree, especially when most European countries cite a 5 per cent incidence of ADHD in children. The CDC study was also based on reports given by parents without clear documentation of how the diagnosis was made. In addition, wide variations exist in reported rates of ADHD in different parts of the country, suggesting that different diagnostic criteria are being used. The highest incidence of ADHD is reported in Alabama and the lowest incidence in Colorado.

ADHD is characterized by symptoms of hyperactivity, inattention or impulsivity, symptoms everyone has from time to time. However, in ADHD the symptoms interfere with normal behavior and are present in more than one social setting such as home and school. The majority of children with ADHD have a combined form of ADHD in which children show symptoms of hyperactivity with either inattention or impulsivity. Even with adequate treatment, about one-third of all children with ADHD continue to have disruptive symptoms that persist into adulthood.

Gender Differences

While boys with hyperactivity may become boisterous and show more aggressive and impulsive symptoms, girls with ADHD often have difficulty controlling their emotions in relationships. Girls are also more likely to take offence easily and instigate confrontations by making impulsive remarks. However, the difference isn’t in symptoms so much as in the varied expression of behavior in the daily life of boys and girls and in men and women. In general, girls with ADHD have a tendency to lose a sense of internal locus of control (feeling they’re in control of their actions; in external locus of control others are controlling their actions) sooner than boys do. Girls with ADHD also tend to lose their internal locus of control sooner than girls without ADHD. In women with ADHD, symptoms may be expressed as low self-regard.

Conditions Confused With ADHD

Conditions that cause symptoms similar to those of ADHD include endocrine disorders, particularly thyroid hormone resistance and adrenal disorders; hearing and vision disorders; borderline personality disorder; brain injuries; fetal alcohol syndrome and fetal alcohol effects; nutrient disorders, such as gluten sensitivity and zinc deficiency; seizures disorders; generalized anxiety disorder and depression; infectious causes; and Tourette’s syndrome.

Causes of ADHD

ADHD is thought to be caused by a combination of genetic and environmental factors. Contributing factors include endocrine disruptors, particularly organochlorine pesticides and polychlorinated biphenyls (PCBs); structural and biochemical brain changes; food additives and dyes; central auditory processing disorders; allergies; and exposure to toxins.

Comorbidities

Several different co-morbid disorders frequently exist with ADHD. These include conduct disorder, oppositional defiant disorder, depression, and bipolar disorder. When comorbidities exist, it’s important that both disorders are treated.

Treatment Issues

As early as 1936, psychostimulant drugs such as amphetamine were found to reduce symptoms in children with behavioral disorders. However, fears of amphetamine abuse prevented researchers from pursuing the use of this therapy until the 1950s when methylphenidate (Ritalin) came into use. Today, psychiatrists universally agree that psychostimulant medications are the treatment of choice for most individuals with ADHD. Behavioral therapies are also effective and are often used together with drug therapies. A number of non-stimulant drugs such as Intuniv are also effective although they take longer to show effects. Are fears of stimulant use leading to drug abuse justified? Apparently, they’re not. Reports from the National Institute of Drug Abuse show that children with ADHD who use stimulant medications are less likely to abuse drugs in later life than children with ADHD who aren’t treated.

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