ADHD

Question 1

What is ADHD?

Answer 1

A neurodevelopmental disorder characterized by difficulties in attention and impulse control

Question 2

What are the three criteria for diagnosing ADHD?

Answer 2

• Significantly less attention and impulse control than typically developing children
• Causes impairment in academic or social functioning
• Not accounted for by other medical or psychiatric conditions
  Symptoms were seen before 12 y

Question 3

What proportion of children with ADHD has comorbid oppositional defiant disorder (ODD) or conduct disorder (CD)?

Answer 3

25%–33%

ODD and CD are behavioral disorders often seen alongside ADHD.

Question 4

What percentage of children diagnosed with ADHD also meet criteria for major depressive disorder (MDD)?

Answer 4

11%

Treatment of depression rarely leads to remission of ADHD symptoms.

Question 5

What is the prevalence of emotional dysregulation in children with ADHD?

Answer 5

24%–50%

Emotional dysregulation can complicate the management of ADHD.

Question 6

What is the relationship between ADHD and autism spectrum disorder (ASD)?

Answer 6

Children with ASD have a higher-than-expected prevalence of ADHD (40% to 50%) and children with ADHD show elevated rates of mild autistic symptoms.

Question 7

What prenatal factor is associated with an increased risk of ADHD?

Answer 7

Prenatal exposure to smoking

This association persists even when controlling for parental psychiatric history and socioeconomic status.

Question 8

What are the risks associated with very low birth weight and prematurity concerning ADHD?

Answer 8

Increased risk for ADHD; the more extreme the low birth weight, the greater the risk.

Question 9

What types of exposure have been correlated with subsequent ADHD?

Answer 9

• Neurotoxin exposure (e.g., lead)
• Infections (e.g., encephalitis)
• Alcohol exposure in utero

Question 10

What did the ENIGMA study find regarding gray matter volume in ADHD?

Answer 10

Significant differences between ADHD and control subjects in the gray matter volume of subcortical structures.

Question 11

What effect does long-term stimulant use have on cortical development in ADHD?

Answer 11

It appears to be associated with some degree of normalization of cortical development.

Question 12

What percentage of children still met criteria for ADHD eight years later in the MTA study?

Answer 12

One-third of the initial sample of 7- to 9-year-old children.

Question 13

What social risks are adolescents with ADHD more likely to develop compared to their peers?

Answer 13

• Antisocial traits
• Illegal substance use
• Incarceration

Question 14

What is the estimated prevalence of ADHD in children and adults?

Answer 14

7%–10% of children and 4% of adults.

Question 15

What brain networks are implicated in ADHD?

Answer 15

• Frontoparietal
• Dorsal and ventral attention
• Salience
• Default mode

Question 16

What are some serious adult sequelae associated with ADHD?

Answer 16

• Antisocial behavior
• Academic underachievement
• Teenage pregnancy
• Substance abuse
• Poor employment records

Question 17

What are common comorbid disorders associated with ADHD?

Answer 17

• Anxiety (~33%)
• Depression (~11%)
• Oppositional defiant and conduct disorders (up to 50%)
• Learning disorders (~20%)
• Mood dysregulation (4%–16%)

Question 18

What is the initial treatment approach for ADHD?

Answer 18

Often pharmacological, including stimulants, atomoxetine, and α agonists.

Question 19

When should psychosocial interventions be added in ADHD treatment?

Answer 19

When comorbid disorders are present or when pharmacological intervention does not result in full remission of symptoms.