Definition and Diagnosis
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning, with symptoms present before age 12 and across more than one setting.
Epidemiology
ADHD affects roughly 5-7% of children and an estimated 2.5-4% of adults worldwide, as symptoms in many cases persist beyond childhood in a modified form. It is diagnosed more often in boys during childhood, though rates in adult women are increasingly recognized.
Risk Factors
ADHD has a strong genetic component, with additional contributions from prenatal exposures (such as smoking or alcohol use during pregnancy), low birth weight, and early environmental adversity. It commonly co-occurs with learning disorders, anxiety, and mood disorders.
Symptoms and Subtypes
Inattentive symptoms include difficulty sustaining attention, disorganization, and forgetfulness, while hyperactive-impulsive symptoms include fidgeting, difficulty remaining seated, and interrupting others. Presentation can be predominantly inattentive, predominantly hyperactive-impulsive, or combined.
Diagnosis
Diagnosis requires a comprehensive evaluation, including developmental history, input from multiple settings (such as home and school or work), and rating scales, assessed against DSM-5-TR criteria. Co-occurring conditions are carefully considered since they can mimic or mask ADHD symptoms.
Treatment
Stimulant medications are the most well-studied pharmacological treatment, with non-stimulant options available for those who cannot tolerate them. Behavioral interventions, organizational skills training, and educational or workplace accommodations are important complementary approaches.
Prognosis
While core symptoms often persist into adulthood in some form, many individuals develop effective coping strategies and function well with appropriate treatment and support. Early identification and intervention are associated with better academic, occupational, and relational outcomes.
Reference
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).