Mental Health and Illness - Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a relatively new name for a psychiatric disorder that usually begins or becomes apparent in preschool- and elementary school-aged children. Children with ADHD cannot sit still, have difficulty controlling their impulsive actions, and are unable to focus on projects long enough to complete them. Although teachers originally dubbed ADHD a "learning problem," the disorder affects more than just schoolwork. Children with ADHD have trouble socializing, are often unable to make friends, and suffer from low self-esteem. Left untreated, ADHD can leave children unable to cope academically or socially and the disorder could progress to depression.

The NIMH estimates that 3 to 5 percent of children—about two million—suffer from ADHD. Boys are affected two to three times more frequently than girls. ADHD is frequently comorbid (coexists) with other mental health problems such as substance abuse, anxiety disorders, depression, or antisocial behavior.

In the absence of clear criteria for ADHD or guidelines by which to diagnose it, researchers fear that the disorder may be underdiagnosed or overdiagnosed. Until imaging studies revealed differences in the brains of children with and without ADHD and scientists found a link between inability to pay attention and diminished utilization of glucose in parts of the brain, some researchers questioned whether the disorder really existed. They speculated that maybe the affected children simply were high-spirited, undisciplined, or misbehaving.

Further controversy about ADHD has focused on its treatment. Prescription stimulants—such as methylphenidate (Ritalin), dextromethamphetamine (Dexedrine), and amphetamine (Adderall)—have proved to be safe and effective for short-term treatment of ADHD. Despite the results of a study of 600 children reported by the NIMH in December 1999 confirming the safety of this treatment, some researchers still question the wisdom of treatment with potentially addicting, powerful stimulants. NIMH research has indicated that there are two effective treatment methods for elementary-school children with ADHD—a closely monitored medication regimen and a combination of medication and behavioral interventions. Behavioral interventions include psychotherapy, cognitive/behavioral therapy, social skills training, support groups, and parent and educator skills training.

ATTENTION DEFICIT HYPERACTIVITY DISORDER IN ADULTS.

For many years, it was thought that ADHD generally subsided before or during early adulthood. Beginning in the late 1970s, however, studies began to show that significant numbers of adults suffer from ADHD. By 2000, a study in Child and Adolescent Psychiatric Clinics of North America estimated that anywhere from 30 to 70 percent of children with ADHD continue to exhibit symptoms as adults. For an adult to be diagnosed with ADHD, he or she must have symptoms of the disorder that first manifested during their childhood and have persisted into adulthood. Treatment for ADHD in adults is similar to treatment for the disorder in children.