TREATMENTS FOR ADHD

Treatments for ADHD

Treatments for ADHD

Introduction

Attention deficit hyperactivity disorder, also known as ADHD, is a relatively common behavioral disorder affecting 3 to 7 percent of the school-age population. It is a persistent pattern of inattention and/or hyperactivity-impulsivity that is not typically observed in individuals of a comparable age. Behavioral characteristics of the disorder are observable from the preschool years onward. Assessment requires a careful, multisource approach as ADHD must be differentiated from a wide range of other psychiatric, developmental, and medical conditions. The effects of ADHD are life encompassing and, without treatment, may lead to a wide range of severe impairments including poor academic outcome, work difficulty, social rejection, driving accidents, increased risk of smoking, alcohol and drug abuse, and poor self-esteem.

Classification of what constitutes ADHD has changed over the past 20 years based upon revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the criteria used to define the disorder. Currently, DSM-IV notes specific criteria for diagnosing subtypes of ADHD. The main symptoms consist of inattention, hyperactivity, and impulsivity, and have been present before the age of 7. The symptoms are present in two or more settings, lead to significant impairment, and cannot be better accounted for by another psychiatric disorder. Those diagnosed with ADHD are also more likely to have other developmental, social, and health problems. ADHD is commonly associated with oppositional defiant disorder, conduct disorder, depression, and anxiety. A significant number of children and adolescents will continue to have some symptoms of the disorder into adulthood.

Causes of ADHD

The actual cause of ADHD is not known but is believed to include multiple factors. Explanations can be simply divided into biological and environmental. Biological explanations include genetics and brain structure, while environmental includes parenting and diet. Studies have demonstrated that cases of ADHD tend to run in families and suggest that transmission may be partly mediated by genetics. Current studies are looking at specific dopamine genes as well as how brain structure relates to behavior. Evidence for environmental influences on ADHD have been noted in intervention studies demonstrating improvement in symptoms when parents have been taught alternative parenting skills (this does not imply that parents of children with ADHD are bad parents). Food additives, refined sugars, and fatty acid deficiencies have all been associated with ADHD symptoms; however, the clinical importance of dietary change as a means of treating ADHD symptoms remains uncertain.

Treatments for ADHD

There are three basic types of treatment for ADHD: medication, behavioral intervention, and combined or multimodal intervention. Medications such as Ritalin are considered by medical professionals to be the most effective treatment for the core symptoms of ADHD. The use of medication is controversial because of concerns about the abuse and misuse of these drugs and because little is known about their long-term effect (i.e., longer than 14 months) on development. Possible racial and ethnic differences in how these medications are processed by the body have not been conclusively demonstrated.

Behavioral or psychosocial interventions include parent education, social skills training, structured positive reinforcement ...