What is Adult Attention Deficit Hyperactivity Disorder?
Attention Deficit-Hyperactivity Disorder (ADHD), once thought to occur
only in children, is now recognized as continuing into adulthood in
many people. It is now understood to be a chronic condition with symptoms
experienced over a lifetime, and it is estimated to affect as many as
4% of adults worldwide.
ADHD is characterized by difficulty initiating or completing tasks,
sustaining attention, and controlling impulsive actions. Patients
may have difficulties with organization and time management. As a
result of these difficulties, the disorder can negatively affect the
educational, social, and occupational lives of those who suffer from
its symptoms.
Three types of ADHD are diagnosed:
- Combined inattentive and hyperactive-impulsive (this is the most
common type, found in about 80% percent of patients).
- Predominantly inattentive (about 15%).
- Predominantly hyperactive-impulsive (about 5%)
The terminology can be confusing. Attention Deficit Disorder (ADD)
is an older term for what is now called Attention-Deficit/Hyperactivity
Disorder (ADHD). There is no longer any actual disorder “officially” called
ADD, but some people still use ADD (or Adult ADD) to refer to the
type ADHD that is predominantly inattentive, and use ADHD
(or Adult ADHD) for the type of ADHD that is predominantly hyperactive or impulsive.
However, these all refer to the same disorder.
No physical findings are diagnostic of ADHD. Computerized or manual
performance tests of attention and impulsivity can not definitively
rule in or out a diagnosis of ADHD. Diagnosis is made by taking a
careful psychiatric history from the patient, using as much collateral
information as is available, such as job evaluations, old report cards
and, if possible, the input of partners and family members. Laboratory,
EEG or neuroimaging studies rarely provide any additional diagnostic
benefit.
Although the exact mechanism is unknown, a number of associated neurochemical
abnormalities have been observed, and considerable evidence suggests
that the disorder has a strong genetic component and a biological
underpinning; the pathophysiology includes dysfunction in both norepinephrine
and dopamine activity. Pharmacotherapy (medication treatment) remains
the best established and most effective treatment for most patients.
For some patients, psychosocial interventions, such as exercise, psychotherapy
or coaching may provide additional important benefits. |
