ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with or reduces quality of functioning in daily life. Onset typically occurs in childhood and symptoms may persist into adolescence and adulthood. The condition is diagnosed based on established diagnostic criteria and careful clinical evaluation.

ADHD is categorized into three presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Inattention refers to difficulties sustaining focus, following through on tasks, and organizing activities. Hyperactivity-impulsivity includes excessive movement, difficulty with self-control, and acting without considering consequences. Symptoms must be present before a specified age and occur in more than one setting, causing impairment. Severity ranges from mild to severe.

Etiology involves a combination of genetic and environmental factors leading to neurodevelopmental differences, particularly in brain regions involved in attention and executive function. Heritability is high, and differences in prefrontal cortex activity and related neural circuits are commonly observed. ADHD frequently co-occurs with learning disorders, anxiety, depressive disorders, and autism spectrum disorder.

Diagnosis requires comprehensive assessment by a clinician, including developmental history, standardized rating scales, and information from multiple informants, with rules out other conditions that can mimic ADHD symptoms.

Treatment typically uses a multimodal approach: educational and behavioral interventions, parent training, and accommodations in school or work. Pharmacotherapy, especially stimulant medications such as methylphenidate or amphetamines, is often first-line and can improve core symptoms. Non-stimulant medications are alternatives. Ongoing monitoring of benefits and side effects is important. With appropriate treatment and supports, many individuals achieve better functioning and quality of life.