Attention deficit hyperactivity disorder (ADHD/ADD) - causes, symptoms & pathology

Summary

The script clarifies misconceptions about ADD and ADHD, explaining that they are synonymous, with ADHD encompassing inattention, hyperactivity, and impulsiveness. It details the three subtypes of ADHD as outlined in the DSM-5 and the criteria for diagnosis. The complex etiology involving genetic and environmental factors is discussed, highlighting the role of neurotransmitters like dopamine and norepinephrine. The script also covers treatment approaches, including behavioral psychotherapy and medication, emphasizing the controlled release of dopamine by ADHD medications to improve focus and attention.

Takeaways

• 🔄 ADD and ADHD are actually synonymous terms, with ADD being an outdated term used before 1987.
• 🔍 ADHD encompasses symptoms of inattention, hyperactivity, and impulsiveness, not just an inability to focus.
• 📚 According to the DSM-5, the most recent update in 2013, ADHD is divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined type.
• 🚫 A diagnosis of ADHD requires the presence of at least six out of nine symptoms for at least six months for either subtype.
• 👶 ADHD is considered a neurodevelopmental disorder with symptoms typically emerging between the ages of 6 and 12.
• 🧬 The cause of ADHD is complex and likely involves a combination of genetic and environmental factors.
• 👨‍👧‍👦 A genetic component is suggested by higher likelihood of ADHD in siblings, especially identical twins, though it is not deterministic.
• 🧬 The severity of ADHD symptoms may be influenced by multiple genes affecting neurotransmitter production or regulation.
• 💊 Neurotransmitters like dopamine and norepinephrine are thought to play a role in ADHD, with lower levels potentially contributing to symptoms.
• 💼 Treatment for ADHD can include behavioral psychotherapy, medication, or a combination of both, tailored to the individual's symptoms.
• 👶👩 For children, behavioral therapy often involves structured routines and rewards, with parental and teacher involvement being crucial.
• 💊 Stimulant medications are often the first-line treatment for ADHD, working by increasing neurotransmitter levels to reduce symptoms.

Q & A

What is the relationship between ADD and ADHD?

ADD and ADHD are actually synonymous, meaning they refer to the same condition. ADD was an outdated term used before 1987, which evolved into ADHD to better encompass the range of symptoms experienced by individuals with the disorder.

How are ADHD symptoms categorized according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)?

The DSM-5 categorizes ADHD into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and a combined subtype that includes symptoms of both.

What are some examples of symptoms for the inattentive subtype of ADHD?

Symptoms of the inattentive subtype may include making careless mistakes, not listening, or being easily distracted.

What are some examples of symptoms for the hyperactive-impulsive subtype of ADHD?

Symptoms of the hyperactive-impulsive subtype may include fidgeting, squirming, or frequently getting up from a chair.

How many symptoms are required for a diagnosis of ADHD, and for how long must these symptoms be present?

A diagnosis of ADHD requires that an individual has at least six of the nine symptoms for either subtype, and these symptoms must be present for at least six months.

At what age range do symptoms of ADHD typically start, and what is the consideration regarding the behavior's appropriateness for age?

Symptoms of ADHD typically start between the ages of 6 and 12, and the behavior must not be age-appropriate for a diagnosis to be made.

What factors are believed to contribute to the development of ADHD?

ADHD is thought to be influenced by a combination of environmental and genetic factors. Genetic factors are suggested by higher rates of ADHD in siblings, especially identical twins, but environmental factors also play a role.

How might genetic factors influence the severity of ADHD symptoms?

Genetic factors likely influence the production or regulation of the brain's neurotransmitters, which are involved in attention and behavior. It is not one single gene but multiple genes that may determine the severity of symptoms.

Which neurotransmitters are implicated in ADHD, and how might their levels affect the symptoms?

Dopamine and norepinephrine are neurotransmitters implicated in ADHD. Lower levels of these neurotransmitters may contribute to the symptoms of ADHD, as they are involved in reward, risk-taking, impulsivity, attention, and arousal.

What are the common treatment approaches for ADHD, and how do they differ between children and adults?

Treatment for ADHD may involve behavioral psychotherapy, medication, or both. Behavioral psychotherapy often targets children, focusing on time management and organizational skills, while for adults, it may focus on reducing distractions and improving organization. Medication, when prescribed, typically involves stimulants that increase neurotransmitter levels to reduce symptoms.

How do ADHD medications differ from illicit stimulants like methamphetamine in terms of their effect on neurotransmitter release?

ADHD medications cause a slow and controlled release of dopamine, which helps improve focus and attention, whereas illicit stimulants like methamphetamine cause a rapid and large release of dopamine, leading to euphoria and addiction.