ADHD

Question 1

ADHD def.

Answer 1

ADHD : is a chronic condition characterized by persistent inattention, hyperactivity, and impulsivity inconsistent with the patient’s developmental stage.

Question 2

M:F

Answer 2

Males:females with 2:1 ratio

Question 3

Diagnosis , DSM-5 criteria

Answer 3

Two symptom domains: -inattentiveness and hyperactivity/impulsivity.

Symptoms >6 months and present in two or more settings (e.g., home, school, work) .

Symptoms not due to another mental disorder.

At least six inattentive symptoms and/or At least six hyperactivity/impulsivity symptoms .
Symptoms interfere with or reduce quality of social/academic/occupational functioning .
Onset prior to age 12, but can be diagnosed retrospectively in adulthood
Females present more often with inattentive symptoms.

Question 4

Inattentive Symptoms

Answer 4

Fails to give close attention to details or makes careless mistakes.
Has difficulty sustaining attention.
Does not appear to listen.
Struggles to follow through on instructions.
Has difficulty with organization.
Avoids or dislikes tasks requiring a lot of thinking.
Loses things.
Is easily distracted.
Is forgetful in daily activities.

Question 5

Hyperactivity Symptoms

Answer 5

Fidgets with hands or feet or squirms in chair.
Has difficulty remaining seated.
Runs about or climbs excessively in childhood; extreme restlessness in adults.
Difficulty engaging in activities quietly.
Acts as if driven by a motor; may be an internal sensation in adults.
Talks excessively.
Blurts out answers before questions have been completed.
Difficulty waiting or taking turns.
Interrupts or intrudes upon others.

Question 6

The etiology :-

Answer 6

The etiology of ADHD is multifactorial and may include:
Genetic factors:
↑ rate in first-degree relatives of affected individuals

Environmental factors: 
Low birth weight 
smoking during pregnancy
childhood abuse/neglect
neurotoxin/alcohol exposure

Question 7

prognosis :-

Answer 7

Stable through adolescence.

Many continue to have symptoms as adults.
(inattentive > hyperactive)

High incidence of comorbid oppositional defiant disorder, conduct disorder (CD), and specific learning disorder.

Question 8

Treatment

Answer 8

Multimodal treatment plan :-

Pharmacological treatments :-
stimulants, norepinephrine reuptake inhibitor
Non-pharmacological treatments :-
social skills training , Educational interventions

Medications are the most effective treatment for decreasing core symptoms, but should be used in conjunction with educational and behavioral interventions.

Question 9

Pharmacological Treatments:

Answer 9

First-line:
Stimulants : methylphenidate compounds, dextroamphetamine, and mixed amphetamine salts

Second-line choice:
atomoxetine, a norepinephrine reuptake inhibitor

Alpha-2 agonists (e.g., clonidine, guanfacine) can be used instead of or as adjunctive therapy to stimulants .