ADHD Flashcards
What is ADHD?
Attention deficit and hyperactivity disorder, neurodevelopmental condition
characterized by symptoms of inattention, hyperactivity, and impulsivity.
Direct negative impact on academic, social or occupational functioning
Outside expected for age and intellect
What neurotransmitters are altered levels in the pathophysiology of ADHD?
Dopamine and noradrenaline
Reduced neurotransmission - secretion, binding to receptors or inc reuptake
These neurotransmitters are crucial for attention and impulse control.
Which brain regions are involved in ADHD?
- Prefrontal cortex
- Basal ganglia - short circuit
- Corpus callosum
- Cerebellum
*Limbic system
May be structural or communication between these areas
Changes in these areas affect cognitive functions and behavior.
What are the classifications of ADHD?
- Predominantly inattentive
- Predominantly hyperactive-impulsive
- Combined
Based on predminant symptoms over the last 6 months
What is the heritability percentage for ADHD?
70-80%
This indicates a strong genetic component in the disorder.
What are some environmental risk factors for ADHD?
- Prenatal tobacco, alcohol, or drug exposure
- Premature birth and low birth weight
- Early childhood exposure to toxins
In terms of epidemiology, how much more common is ADHD in boys compared to girls?
3:1
What percentage of UK adults are estimated to have ADHD?
4%
This statistic reflects the adult prevalence of the disorder.
What socioeconomic factors are associated with ADHD?
- Poverty
- Lower family income
- Social class
- family environment encourages behaviour
At what age do symptoms of ADHD typically appear?
Between age 3 and 7 years
Diagnosis often occurs after age 7
.
What are the classic signs of hyperactivity in ADHD?
- Constant motion
- Fidgeting
- Excessive talking or moving
What is a common symptom of impulsive behavior in ADHD?
Interrupting conversations
Risk taking behaviour
Social difficulties
Classroom disruption
What symptoms characterize inattentiveness in ADHD?
- Lack of attention during tasks
- Not listening when spoken to directly
- Losing items
- Trouble organizing activities
- Avoiding tasks requiring mental effort (homework and school work)
How does ADHD change during adolescence?
Hyperactivity decreases; attention and impulse worsen - leading to risk taking behaviour
.
What challenges do adults with ADHD typically face?
- Time management
- Goal setting
- Employment
- Relationships
These challenges can significantly impact daily life.
For how long must ADHD symptoms be present to consider a diagnosis?
At least 6 months in two different environments
What does a comprehensive assessment for ADHD include?
- Developmental history
- School performance
- Behavior in different settings
- Exclusion of differentials
A thorough evaluation is essential for accurate diagnosis.
What is a non-pharmacological treatment for ADHD in children under 6 years?
Parent-training programmes
School based intervention - education or behavioural.
What is the first-line medication for ADHD?
Methylphenidate (Ritalin)
What are common side effects of Methylphenidate?
- Aggression
- Alopecia
- Anxiety
- Appetite depression
- Arrhythmias
- Arthralgia
Monitoring for side effects is important during treatment.
What are the second-line medications for ADHD?
- Dexamfetamine
- Atomoxetine
These may be used if first-line medications are ineffective.
What is the first-line medication for adults with ADHD?
- Lisdexamfetamine
- Atomoxetine
These medications can help manage symptoms in adults.
What co-morbidities are commonly associated with ADHD?
- Learning disabilities
- Anxiety
- Forensic history
- Depression
- Substance abuse
How does methylphenidate work to treat ADHD?
- CNS stimulant medication
- Inhibition of reuptake of dopamine and norepinephrine
- increase dopamine and norephineprhine in synpatic cleft – inc activity at synapse ->
- prefrontal cortex (attention and executive function)
What biological factors can be risk factors for ADHD?
Epilepsy
Acquired brain injury
Lead exposure
Iron deficiency
Child health conditions (head injuries)
What is the typical process in the diagnosis of ADHD?
Must be over 5yrs
Intial 10w watch and wait
ADHD focused parent training or educational programme
NDA following DSM-5 scale
Neurodevelopmental panel for clinical formulation and diagnosis.
What are the common side effects of ADHD medication?
Headaches
Increase in HR and BP
Irritability
Trouble sleeping
Loss of appetite
Nausea
Dizziness
Suicidal thoughts (atomoxetine)
Liver damage (atomoxetine)
What therapy may be used to treat ADHD?
Psychotherapy
Behavioural therapy - management stratergies for behaviour
Social skills training - role plays scenarios to help learn skills
CBT - talking therapies help patients manage problems by changing approach
Diet - healthy and balanced, may suggest omega3/6
