ADHD



Developmental-Behavioral Pediatrics, 2008

Josh Mandelberg

ADHD

• Intro

o Behavioral syndrome of cluster of suggestive behaviors, not simple diagnosis

o Young children – interfere with relationships (parents, peers, teachers), discipline problems

o Adolescent and Adult – impair job/academic achievement, relationships, associated with legal difficulties, MVA’s, smoking, substance abuse

o Current theory - Thought to represent d/o of “executive function” (Russell Barkley) – problems with behavioral inhibition or self-regulation (non-verbal working memory, speech internalization, affect, emotion, motivation, arousal), problems with delayed behavior / long term-consequences

• Epi

o Most common neurodevelopmental d/o of childhood (anxiety is more common child psych problem but ADHD treated more)

o Recognized initially 1902, more prevalent after Flu Pandemic

o Best estimate probably 4-8% prevalence in children and adolescents, 4% in adults (criteria for inclusion vary and make prevalence estimates vary), more common in lower SES, 2:1 Male:Female (older studies undercapture female internalizing behaviors), similar rates in other countries

o Combined type (50-75%), inattentive (20-30%, more overlooked), hyperactive/impulsive ( ................
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