Attention deficit hyperactivity disorder

1,414,511views

test

00:00 / 00:00

Attention deficit hyperactivity disorder

Psychiatry

Psychiatry

Mood disorders: Clinical
Anxiety disorders: Clinical
Schizophrenia spectrum disorders: Clinical
Dissociative disorders: Clinical
Eating disorders: Clinical
Obsessive compulsive disorders: Clinical
Trauma- and stressor-related disorders: Clinical
Disruptive, impulse-control and conduct disorders: Clinical
Personality disorders: Clinical
Sleep disorders: Clinical
Somatic symptom disorders: Clinical
Sexual dysfunctions: Clinical
Paraphilic disorders: Clinical
Dementia and delirium: Clinical
Toxidromes: Clinical
Medication overdoses and toxicities: Pathology review
Environmental and chemical toxicities: Pathology review
Substance misuse and addiction: Clinical
Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review
Psychiatric emergencies: Pathology review
Schizophrenia spectrum disorders: Pathology review
Drug misuse, intoxication and withdrawal: Stimulants: Pathology review
Drug misuse, intoxication and withdrawal: Alcohol: Pathology review
Selective serotonin reuptake inhibitors
Serotonin and norepinephrine reuptake inhibitors
Tricyclic antidepressants
Monoamine oxidase inhibitors
Atypical antidepressants
Typical antipsychotics
Atypical antipsychotics
Lithium
Nonbenzodiazepine anticonvulsants
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Psychomotor stimulants
Opioid agonists, mixed agonist-antagonists and partial agonists
Opioid antagonists
ADHD: Information for patients and families (The Primary School)
Attention deficit hyperactivity disorder
Autism spectrum disorder
Neurodevelopmental disorders: Clinical
Major depressive disorder
Suicide
Bipolar and related disorders
Major depressive disorder with seasonal pattern
Premenstrual dysphoric disorder
Generalized anxiety disorder
Social anxiety disorder
Panic disorder
Agoraphobia
Phobias
Obsessive-compulsive disorder
Body focused repetitive disorders
Body dysmorphic disorder
Post-traumatic stress disorder
Physical and sexual abuse
Schizoaffective disorder
Schizophreniform disorder
Delusional disorder
Schizophrenia
Delirium
Amnesia
Dissociative disorders
Anorexia nervosa
Bulimia nervosa
Cluster A personality disorders
Cluster B personality disorders
Cluster C personality disorders
Somatic symptom disorder
Factitious disorder
Tobacco dependence
Opioid dependence
Cannabis dependence
Cocaine dependence
Alcohol use disorder
Bruxism
Nocturnal enuresis
Insomnia
Night terrors
Narcolepsy (NORD)
Erectile dysfunction
Male hypoactive sexual desire disorder
Orgasmic dysfunction
Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Disruptive, impulse control, and conduct disorders
Learning disability
Fetal alcohol syndrome
Tourette syndrome
Rett syndrome
Shaken baby syndrome
Enuresis
Encopresis
Serotonin syndrome
Neuroleptic malignant syndrome
Mood disorders: Pathology review
Amnesia, dissociative disorders and delirium: Pathology review
Personality disorders: Pathology review
Eating disorders: Pathology review
Psychological sleep disorders: Pathology review
Malingering, factitious disorders and somatoform disorders: Pathology review
Trauma- and stress-related disorders: Pathology review
Developmental and learning disorders: Pathology review
Childhood and early-onset psychological disorders: Pathology review
Vascular dementia
Frontotemporal dementia
Dementia: Pathology review
Alzheimer disease

Assessments

Flashcards

0 / 10 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

6 pages

Flashcards

Attention deficit hyperactivity disorder

0 of 10 complete

Questions

USMLE® Step 1 style questions USMLE

0 of 2 complete

An 11-year-old boy is brought to the pediatrician by his parents for evaluation of behavior problems. The patient has been frequently interrupting his parents when they are speaking with others. He often forgets to complete tasks assigned to him, such as cleaning up toys or taking out the trash and is easily distracted. His parents state that when they speak to him, he often does not seem to listen. The patient has been performing poorly in school, and his parents are scheduled to meet with the teacher next week. Past medical history is notable for a tonsillectomy at age 9. Height and weight are consistently tracking at the 50th percentile. Physical examination is unremarkable. Which of the following would be most useful in identifying the patient’s underlying condition?  

External References

First Aid

2024

2023

2022

2021

Attention deficit disorder (ADD)

amphetamines for p. 241

Attention-deficit hyperactivity disorder (ADHD) p. 574

drug therapy for p. 590

smoking and p. 632

sympatholytic drugs for p. 242

Tourette syndrome p. 574

treatment p. 724

Transcript

Watch video only

Content Reviewers

What most people know—or think they know—about attention deficit disorder, or ADD, is that it’s used to describe somebody who can’t stay focused…and when they REALLY can’t focus, they have attention deficit hyperactivity disorder, or ADHD. This continuum from one to the next isn’t quite how it works, though.

ADD and ADHD are actually synonymous, as in, they’re the same. ADD is an outdated term used prior to 1987, after which it evolved into ADHD to encompass more of the symptoms that people with ADHD often experience, which in addition to being inattentive, includes both hyperactivity and impulsiveness. So somebody might be diagnosed with ADHD because they have symptoms related to not being able to pay attention, but they also might be diagnosed with ADHD if they have symptoms relating to being overly active and impulsive. They might also have ADHD if they have symptoms of both.

According to the diagnostic and statistical manual for mental disorders, the Fifth Edition, text revision, the most recent update being in 2022, ADHD is split into these 3 subtypes: inattentive, hyperactive-impulsive, or both.

Inattentive and hyperactive-impulsive each have a set of 9 symptoms. For example, someone with the inattentive subtype might make careless mistakes, or not listen, or be easily distracted; and someone with the hyperactivity and impulsive subtype might fidget, or squirm around, or get up from their chair often.

Now, you might be thinking that everyone fidgets now and then, right? Well a diagnosis is given when someone has 6 of the 9 symptoms for either subtype for at least 6 months occurring in more than one setting. Most commonly though, children have symptoms of both subtypes and therefore have the combined subtype.

Since ADHD is considered a neurodevelopmental disorder, the symptoms also have to have started between age 6 and 12, and the behavior can’t be appropriate for their age or developmental level.

Alright, but what causes someone to be hyperactive, or impulsive, or inattentive? Well, as you might guess, it’s pretty complicated...and we don’t really know, probably a lot of different factors, and ultimately they all fall into some combination of environmental and genetic factors.

One interesting clue to a genetic component of ADHD is looking at families—for example, a child with a sibling that’s been diagnosed with ADHD is more likely to develop it themselves. Furthermore, if those siblings are identical twins, meaning they have the same DNA, their chances of developing ADHD is considerably higher. Having identical DNA doesn’t mean that the twin is definitely going to develop ADHD, though, which again, suggests that both genetic factors and environmental factors play a part.

As to a specific gene, it’s probably not one single gene that leads to ADHD, but rather multiple genes that determine how severe their symptoms are. These genes likely influence the production or regulation of the brain’s neurotransmitters, which are signaling molecules in the brain that are released by one neuron, and received by receptors of another neuron. This movement from a neurotransmitter from neuron A to neuron B is basically a message being relayed—it’s like the neurons are talking.