ADD & ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a common developmental and behavioural disorder.

ADD/ADHD is defined by elevated levels of inattentive and/or hyperactive and impulsive behaviours that emerge prior to age seven and that cause functional impairment in multiple settings. These include home, school, work and social environments. It continues into adulthood but through maturity adults can better deal with the condition.

For children, ADD/ADHD is characterised by poor concentration, distractibility, hyperactivity, and impulsiveness, at levels which are inappropriate to the child's age. Both adults and children with ADHD are easily distracted by sights and sounds in their environment. They cannot concentrate for long periods of time and can be restless and impulsive. There is a tendency to daydream and be slow to complete tasks or even to get started.

Attention Deficit Disorder (ADD) is commonly defined as ADHD without hyperactivity present.

Attention Deficit Hyperactivity Disorder (ADHD) is the current description for the most prevalent psychiatric disorder of childhood. Symptoms typically worsen in situations requiring sustained attention.

Preschool and early school age children with ADHD are more prone to overactivity within the gross motor area with fidgeting, excessive movement particularly identified in the classroom setting, excitability, and poor self control or self monitoring. Adolescents tend to exhibit less hyperactivity and more inattentiveness and impulsivity.

Early diagnosis allows for early intervention which can have a significant positive effect on both the child and community. Without appropriate treatment, these problems may lead to, or be associated with, other emotional and social problems such as social failure, lying, cheating, stealing, fighting, delinquency, substance abuse and rejection by parents, siblings, teachers and peers.

The Facts and Figures

• ADD/ADHD occurs in 4-6% of children, 3-4% of adults and is independent of IQ level and socioeconomic status
• 33% of people who exhibit ADD/ADHD do not complete school
• Students with ADD/ADHD are more likely to be the victims of bullying. In the playground they are more likely to be targetted by other students
• Students with ADD/ADHD who remain undiagnosed and untreated are in the highest risk category for attempted suicide as well as being the most likely to get into trouble with the police
• The National Survey of Mental Health and Wellbeing (Australia) has shown that 14% of people with ADD/ADHD also suffer from Depression
• Perth has the highest incidence per capita for the prescription of psychostimulants in the treatment of ADD/ADHD.

Conditions associated with ADD/ADHD

Addictions
ADHD is associated with an increased risk of addiction to Nicotine (KENNETH P. TERCYAK), as well as addiction to marijuana. Marijuana seems to be the drug of choice in ADHD. Marijuana is being used as a means of self-medication by those suffering from ADHD without them being aware of it.

Antisocial Activities
30% of ADHD sufferers are involved in anti- social behaviour.

Delinquency
25% of jail inmates meet ADHD criteria. Considering the much lower incidence of ADHD in the general population it can be inferred that untreated ADHD can lead to a greater chance of imprisonment.

Academic Under-Performance
33% of people who exhibit ADHD do not complete school.

Schizophrenia
ADHD patients have a 9 times greater risk of developing Schizophrenia later in life.

Additional Psychiatric or Learning Disorders
In 50%-70% of people who exhibit ADHD, the situation is further complicated by one or more additional psychiatric or learning disorders, including poor working memory, depression, suicide, work absenteeism etc.

Comorbid Disorders
The National Survey of Mental Health and Wellbeing (Aust) has shown the most common disorders associated with ADHD are:
- Conduct Disorder 16%
- Depression 14%

Genetics

ADHD has been shown to be a highly inheritable disorder (Levy et al 2002).
Advances in molecular genetics point to dopaminergic, noradrenergic and seratonergic dysfunction system involvements. It is expected that in five to ten years, treatment will be tailored more closely to the specific neurotransmitter systems.

Prevalance

Males seem to suffer in greater numbers than females, perhaps because the detection rate is higher for males, as they tend to be more disruptive.