Attention deficit hyperactivity disorder (ADHD) is a neurodevelopment disorder featuring the core features of difficulty maintaining attention, excessive energy and activity, and impulsivity. It is more than twice as common in males.
It is thought to result from a combination of factors:
- Genetic (there is significant heritability)
- Pregnancy-related factors (e.g., maternal smoking, premature birth and low birth weight)
- Environmental factors
The symptoms start in childhood and should be consistent across settings. When a person displays symptoms only at work or school but is calm and focused at home, this is suggestive of an environmental effect rather than an underlying diagnosis.
Features
All the features of ADHD can be part of a normal spectrum of behaviour. When many of these features are present, and they are adversely affecting the person, ADHD may be considered. Symptoms include:
- Short attention span
- Easily distracted
- Quickly moving from one activity to another
- Quickly losing interest in a task
- Inability to persist with and complete tasks
- Constantly moving or fidgeting
- Impulsive behaviour
- Disruptive behaviour
- Difficulty managing time
The Adult ADHD Self-Report Scale (ASRS) can be used as a screening test to support a referral.
Management
A specialist will make the diagnosis after a detailed assessment, including a history dating back to childhood.
Managing strategies for parents include:
- A positive approach
- Structured routines
- Clear boundaries
- Plenty of physical activity
- A healthy diet (certain foods may exacerbate the symptoms)
Self-management strategies for adults to help manage symptoms include organisation techniques, a healthy diet, exercise, and a sleep routine. Reasonable adjustments to the workplace may be helpful.
Medication is an option after conservative management has failed, or in severe cases. This should be coordinated by a specialist. The medication are central nervous system stimulants. Examples are:
- Methylphenidate
- Lisdexamfetamine
- Dexamfetamine
- Atomoxetine
Monitoring requirements whilst taking medications include heart rate, blood pressure, weight and mood changes.
Last updated June 2024
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