Adhd

ADHD (Attention Deficit Hyperactivity Disorder)

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Attention Deficit Hyperactivity Disorder (ADHD) is a behavioural syndrome that can affect children, young people and adults. ADHD can cause impulsivity, hyperactivity and inattention. People with ADHD may often have other conditions alongside it. An ADHD diagnosis can only be made by a medical professional. For someone to have an ADHD diagnosis, the person must show significant impairment. There seems to be a genetic component in ADHD. Guidelines for the treatment of ADHD recommend the use of certain ‘stimulant’ medication for children, young people and adults. It is also recommended that someone with ADHD is referred to a type of talking therapy called Cognitive Behaviour Therapy.

This factsheet covers: 1. 2. 3. 4. 5. 6. 7. What is ADHD? What are the symptoms of ADHD? What are the different types of ADHD? How is ADHD diagnosed? What causes ADHD? How is ADHD treated? Useful contacts

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1. What is ADHD? Attention Deficit Hyperactivity Disorder (ADHD) is a behavioural syndrome that can affect children, young people and adults. The condition has symptoms of impulsivity, hyperactivity and inattention. ADHD is thought to affect 3-9% of school aged children and young people in the UK and about 2% of adults worldwide.1 ADHD develops in childhood and is most commonly noticed at the age of 5. Research suggests that 80% of children diagnosed with ADHD continue to experience symptoms during adolescence and 67% continue to have symptoms into adulthood.2 Top 2. What are the symptoms of ADHD? The symptoms of ADHD are Inattention People with inattention problems may not be able to concentrate for long periods, or complete tasks. They may be disorganised and lose things often. They may also be easily distracted, and find it difficult to listen to people who are talking. Hyperactivity People who are hyperactive may fidget and find it difficult to sit still. They may seem very restless (which children may show by running around a lot of the time). They may talk constantly and be noisy, finding it difficult to take part in quiet activities. Impulsivity People with impulsivity problems may interrupt other people, and find it hard to wait their turn. They may also speak without thinking through the consequences (e.g. make inappropriate comments). Symptoms of ADHD are present throughout the general population and can very in severity. However, only people who have a significant psychological, educational, occupational (work-related) or social impairment meet the diagnostic criteria for an ADHD diagnosis. Also, symptoms of ADHD can overlap with symptoms of other disorders. There a number of conditions that can commonly exist alongside ADHD. In children, these can include anxiety, learning or mood disorders. In adults, these can include personality disorders, bipolar disorder, substance misuse and obsessive-compulsive disorder.3 Generally, ADHD is a condition that persists. Most young people with an ADHD diagnosis will go on to have significant problems in adulthood. This may include continuing ADHD, or emotional or social difficulties, unemployment or substance misuse. Top

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3. What are the different types of ADHD? The symptoms of ADHD (impulsivity, hyperactivity and inattention) are not seen to the same degree in all people with this condition. People with ADHD may show     predominantly hyperactive and impulsive symptoms predominately inattentive symptoms a combination of all three. ADHD not otherwise specified (if the previous three categories do not fit) Top

4. How is ADHD diagnosed? Only health care professionals can diagnose ADHD. However, it is possible that a child psychologist or psychiatrist, paediatrician, social worker, educational psychologist or GP will be involved in this process. The healthcare professional carrying out the diagnosis must rule out any other condition that might be causing the unusual behaviour or moods, such as learning disability, hearing impairment, autism or depression. There is not one specific test for the diagnosis of ADHD, but is it likely that the individual’s mental processes will be tested and their behaviour rated and compared with the diagnostic manual DSM-IV. ADHD can be diagnosed as mild, moderate or severe. Mild and moderate forms may sometimes respond well to treatment without medication, but this will vary between individuals. Top 5. What causes ADHD?4 ADHD has multiple causes. It is not caused by bad parenting. The evidence suggests that the causes are genetic and neurobiological (physical make up of the brain). Whilst some environmental factors will influence the way in which the disorder develops, they should not be thought of as causing ADHD. Genetic causes ADHD appears to have a significant genetic component. For example, if one child in a family has ADHD, the chance of another brother or sister also having it is 30-40%. There is also a 45% chance that at least one of the parents will also have ADHD. If a child with ADHD has an identical twin, the chance of the twin also having the condition is around 90%. 3

Physiological causes Research has also suggested that in a small percentage of cases, ADHD can be due to injury to specific regions of the brain during its development. For example, use of alcohol, tobacco or street drugs during pregnancy, premature delivery with associated minor brain bleeding or accidental head injury after birth could cause ADHD-like symptoms. Environmental causes ADHD is not associated with purely social factors such as poor parenting, family stress, divorce, excessive TV viewing or video game playing, or diet, although some of these factors make a pre-existing condition worse. Top

6. How is ADHD treated? Most experts agree that the most effective way to treat ADHD is with a variety of different approaches. Behavioural therapies NICE guidelines recommend that children or young people with moderate ADHD could be referred to group cognitive behaviour therapy (CBT) or social skills training. CBT is a psychological therapy that focuses on the ‘here and now’ and can help someone to change how he or she thinks ("cognitive") and what he or she does ("behavior)". For more information on CBT and other talking therapies, please see our ‘Talking treatments (psychological therapies)’ factsheet. A copy can be obtained by contacting the Rethink Advice & Information Service (contact details in Further Information section) or a copy can be downloaded for free from www.rethink.org/factsheets. The NICE guidelines recommend that a course of CBT should be offered to adults with ADHD if this is preferred to trying medication, or if medication is not effective in controlling the ADHD symptoms. Parent training / education Nice guidelines also recommend that if a child or young person is affected by ADHD, his or her parents should be offered a referral to a group parent training or education programme. Medication Medication should be offered to children and young people with severe ADHD. If medication is given to either children, young people or adults for ADHD, this should always be part of a comprehensive treatment plan, including psychological and behavioural help.

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Generally, methylphenidate should be considered first of all. Other medications recommended to treat ADHD are atomoxetine and dexamfetamine. These kinds of medications are stimulant medications. They affect certain chemicals in the brain, and can make someone more alert and attentive. Antipsychotic medication should not be used to treat ADHD. Top The Attention Deficit Disorder Information and Support Service (ADDISS) provides a wide range of resources, information and support for everyone affected by ADHD. ADDISS PO Box 340 Edgware Middlesex HA8 9HL Tel - 020 8952 2800 Email - [e-mail] Web - www.addiss.co.uk Fax - 020 8952 2909

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National Institute of Health and Clinical Excellence. Attention Deficit Hyperactivity Disorder: Diagnosis and management of ADHD in children, young people and adults. Clinical Guidance 72, http://www.nice.org.uk. 2008. 2 Green C and Chee K. Understanding ADHD – A Parent’s Guide to Attention Deficit Hyperactivity Disorder in Children. Vermillion Publishing 1997. 3 National Institute of Health and Clinical Excellence. Attention Deficit Hyperactivity Disorder: Diagnosis and management of ADHD in children, young people and adults. Clinical Guidance 72, http://www.nice.org.uk. 2008. 4 ADDISS ADDISS Common Questions www.addiss.co.uk/adhd.htm [As accessed March 2011]

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RET0252 © Rethink Mental Illness 2011 Last updated March 2011 Next update March 2013

Last updated 01/10/2010

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