Symptom domains Inattention

HyperactivityImpulsivity

Psychiatric Co-morbiditiesConduct disorder

Oppositional Defiant DisorderAnxiety and Mood

Disorders

Lead to

Functional Impairments

SELF – low self esteem accidents substance abuse delinquency

SCHOOL- academic difficulties underachievement HOME- Family stress Parenting difficulties

SOCIAL- Poor peer relation ships

Zuddas, ADHD in Europe, 2004

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CLINICAL PICTURE Course of the Disorder – Psychosocial Impairments

Age 6 10 14-16

ADHDonly

Disruptivebehavior

ODDLD

Low self esteem, poor social skills , challenging behavior

Substanceabuse

School Extension

Mood disorder

Conductdisorder

Complex LD

UNMANAGED ADHDleads to COMPLICATIONS

Adapted from American Psychiatric Association m DSM IV TR 2000

ADHD : Treatment Goals

Decrease disruptive/setting –inappropriate behaviors

Improve relationship with parents, siblings, teachers or peers

Improve academic performance Improve self esteem Improve organizational skills and overall

executive functioning

American Academy of Child and Adolescent Psychiatry, 2004

ADHD: Treatment Options

Educational Accomodations Classroom placement, special education, tutoring,

private schools Behavior Therapy

Parent training, social skills training, behavior modification, daily report card

Medications Stimulants, nonstimulants, tricyclic

antidepressants

FDA-Approved Pharmacotherapy

Methylphenidate Ritalin ®

Concerta ®

Ritalin LA ®

Methylin ®

Focalin ®

Metadate CD Amphetamine Mixed

Salts Adderall ®

Aderall XR ®

Stimulant Medications

Not available in drugstores

Prognosis of ADHD

Symptoms of ADHD persist throughout childhood

70% continue to have the disorder in adolescence, with 10-60% to adulthood

More likely to persist in those with aggression or conduct problems

Untreated adults have increased incidence of aggressive behavior, antisocial and conduct disorder, divorce, alcohol and drug abuse

Life Expectancy

Adults with ADHD may achieve lower socioeconomic status and have more marital problems than do the general population

They have the same life expectancy

Developmental Disabilities

Birth---Infancy-----Early Childhood----School Age ---Adolescence

Down Syndrome

Cerebral palsy

Autistic Spectrum Disorders

ADHD

Learning Disabilities