Article Text

ATTENTION DEFICIT HYPERACTIVITY DISORDER: A CHALLENGE FOR GENERAL PAEDIATRICIANS
  1. M Katz1,2,3
  1. 1Maccabi Health Services, Israel
  2. 2Ben Gurion University, Beer Sheva, Israel
  3. 3Maimonides University, Argentina

Abstract

Attention deficit hyperactivity disorder (ADHD) is the most common behavioural problem in paediatrics. It represents almost 10% of the paediatric population and goes into adulthood in 50% of cases.

The Diagnostic and Statistial Manual of Mental Disorders, version IV recognises three types: hyperactive impulsive, inattentive and a combined type. Girls are underrecognised and probably are in a proportion of 1 : 2 to boys.

ADHD is a chronic condition, but 20% of children with ADHD will have a full diagnosis criteria. ADHD is a hereditable genetic condition; it runs in families. The genes are associated, affecting metabolism and having an effect on receptors and transporters in pre and postsynaptic parts of the neuron.

ADHD is heavily comorbid. Approximately 50% of ADHD patients have another mental behavioural problem, such as depression, conduct disorders, anxiety oppositional defiant disorder. 30% have language disabilities.

Children and adolescents treated have a threefold decreased risk of substance abuse while in adolescence or adulthood.

ADHD is a paediatric biological condition and has to be biologically medicated. Stimulants found to improve ADHD working on oppositionalism, aggressiveness, improving academic and social outcomes. Conductive behavioural treatments are not enough in the treatment of this condition.

ADHD is a very serious neurobehavioural problem that has to be identified and followed up by paediatricians. Paediatricians may work closely with the paediatric psychiatrist in order to cope with the wide spectrum of comorbidity.

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