Attention Deficit Hyperactivity Disorder : an overview

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobehavioural disorder found more commonly, but not exclusively, in school-age children. The hallmarks of the condition are inattention and hyperactivity/ impulsivity, which often go together. Although the term ADHD was coined relatively recently, ADHD has in fact been described as early as 1902. This review article will go through the most important historical aspects of the condition, and will also give an account of what is known about the aetiology of ADHD. The diagnostic criteria issued by the American Psychiatric Association in DSM-5, have been last updated in May 2013. This article will highlight the differences between DSM-5 and the previous version, DSM-IV-TR, and will also touch upon the latest developments in electroencephalographybased investigations and imaging studies for ADHD. Although the condition cannot be cured, symptoms can be managed using various modalities such as behaviour intervention strategies and medication, such that the individual affected by ADHD can have the least possible disruption to social and academic functioning.peer-reviewe

Attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder is a common neurobehavioural disorder that compromises the core symptoms of developmentally inappropriate levels of inattention, impulsivity and hyperactivity. Many patients are still not diagnosed, or do not receive appropriate sustained treatment, in spite of a general greater awareness of the disorder. With such a high prevalence, the clinician needs to be well-informed about the presentation, treatment and challenges associated with this complex disorder.Keywords: attention-deficit/hyperactivity disorder, ADHD, methylphenidate, atomoxetin

Facilitating maximum benefit for students with attention deficit hyperactivity disorder in distance education

Traditional distance education environments are not conducive to learners with Attention Deficit Hyperactivity Disorder. The purpose of this literature review is to address how learners with Attention Deficit Hyperactivity Disorder (ADHD) can better succeed in distance education learning environments. The review defines distance education, and Attention Deficit Hyperactivity Disorder, and briefly explains some of the details of each. It then reviews strategies for helping students with Attention Deficit Hyperactivity Disorder. Considerations for Attention Deficit Hyperactivity Disorder in distance education are addressed. It discusses media, interaction, engagement of learners, feedback, motivation, and support systems as possible ways to help learners with ADHD succeed. Sources reviewed were books and articles by subject experts in distance education and Attention Deficit Hyperactivity Disorder. This review supports the idea that distance education can not only be an acceptable medium for education with students with ADHD, but that it may even be more beneficial than the traditional classroom when implemented properly to meet the learner\u27s needs

Attention Deficit Hyperactivity Disorder

Attention deficit hyperactivity disorder (ADHD) is a mental disorder of the neurodevelopmental type. The disorder represents one of the common causes of referral for behavioral problems in children to medical and mental health doctors all around the world. The diagnosis can be done by DSM-V criteria. According to DSM-V, there are three main subtypes of ADHD: ADHD-inattentive type, ADHD-hyperactive-impulsive type, and ADHD-combined type. The etiology of ADHD is not definitively known. A genetic imbalance of catecholamine metabolism in the cerebral cortex appears to play a primary role. Various environmental factors may play a secondary role. Cognitive impairments in a variety of domains have been found in ADHD as well as impairment in overall intellectual function. A meta-analysis of children and adolescents with ADHD showed impairments in several aspects of executive functioning. The most important part of any intervention plan for a child with ADHD is the physical, behavioral and neuromotor/neuropsychological examination. Medication should be started with one of the stimulants. Both d-amphetamine and methylphenidate have been shown to be effective for improvement of hyperactivity, concentration problems, learning disorders, and other comorbidities

Cannabis Use in Adults Who Screen Positive for Attention Deficit/Hyperactivity Disorder: CANreduce 2.0 Randomized Controlled Trial Subgroup Analysis.

BACKGROUND Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy. OBJECTIVE We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not. METHODS We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety. RESULTS Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, P<.001; without: mean 8.53, SD 9.4, P<.001) and severity of cannabis use (SDS: with: mean 3.57, SD 3.65, P<.001; without: mean 2.47, SD 3.39, P<.001; CUDIT: with: mean 6.38, SD 5.96, P<.001; without: mean 5.33, SD 6.05, P<.001), as well as anxiety (with: mean 4.31, SD 4.71, P<.001; without: mean 1.84, SD 4.22, P<.001) and depression (with: mean 10.25, SD 10.54; without: mean 4.39, SD 10.22, P<.001). Those who screened positive for attention deficit/hyperactivity disorder also reported significantly decreased attention deficit/hyperactivity disorder scores (mean 4.65, SD 4.44, P<.001). There were no significant differences in change in use (P=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=-0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=-0.09; P=.43). The same was true for the rate of adverse effects (P=.33). CONCLUSIONS Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program's advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185

Cannabis Use in Adults Who Screen Positive for Attention Deficit/Hyperactivity Disorder: CANreduce 2.0 Randomized Controlled Trial Subgroup Analysis

Background: Prevalence rates for lifetime cannabis use and cannabis use disorder are much higher in people with attention deficit/hyperactivity disorder than in those without. CANreduce 2.0 is an intervention that is generally effective at reducing cannabis use in cannabis misusers. This self-guided web-based intervention (6-week duration) consists of modules grounded in motivational interviewing and cognitive behavioral therapy. Objective: We aimed to evaluate whether the CANreduce 2.0 intervention affects cannabis use patterns and symptom severity in adults who screen positive for attention deficit/hyperactivity disorder more than in those who do not. Methods: We performed a secondary analysis of data from a previous study with the inclusion criterion of cannabis use at least once weekly over the last 30 days. Adults with and without attention deficit/hyperactivity disorder (based on the Adult Attention deficit/hyperactivity disorder Self-Report screener) who were enrolled to the active intervention arms of CANreduce 2.0 were compared regarding the number of days cannabis was used in the preceding 30 days, the cannabis use disorder identification test score (CUDIT) and the severity of dependence scale score (SDS) at baseline and the 3-month follow-up. Secondary outcomes were Generalized Anxiety Disorder score, Center for Epidemiological Studies Depression scale score, retention, intervention adherence, and safety. Results: Both adults with (n=94) and without (n=273) positive attention-deficit/hyperactivity disorder screening reported significantly reduced frequency (reduction in consumption days: with: mean 11.53, SD 9.28, P<.001; without: mean 8.53, SD 9.4, P<.001) and severity of cannabis use (SDS: with: mean 3.57, SD 3.65, P<.001; without: mean 2.47, SD 3.39, P<.001; CUDIT: with: mean 6.38, SD 5.96, P<.001; without: mean 5.33, SD 6.05, P<.001), as well as anxiety (with: mean 4.31, SD 4.71, P<.001; without: mean 1.84, SD 4.22, P<.001) and depression (with: mean 10.25, SD 10.54; without: mean 4.39, SD 10.22, P<.001). Those who screened positive for attention deficit/hyperactivity disorder also reported significantly decreased attention deficit/hyperactivity disorder scores (mean 4.65, SD 4.44, P<.001). There were no significant differences in change in use (P=.08), dependence (P=.95), use disorder (P=.85), attention deficit/hyperactivity disorder status (P=.84), depression (P=.84), or anxiety (P=.26) between baseline and final follow-up, dependent on positive attention-deficit/hyperactivity disorder screening. Attention deficit/hyperactivity disorder symptom severity at baseline was not associated with reduced cannabis use frequency or severity but was linked to greater reductions in depression (Spearman ρ=.33) and anxiety (Spearman ρ=.28). Individuals with positive attention deficit/hyperactivity disorder screening were significantly less likely to fill out the consumption diary (P=.02), but the association between continuous attention deficit/hyperactivity disorder symptom severity and retention (Spearman ρ=-0.10, P=.13) was nonsignificant. There also was no significant intergroup difference in the number of completed modules (with: mean 2.10, SD 2.33; without: mean 2.36, SD 2.36, P=.34), and there was no association with attention deficit/hyperactivity disorder symptom severity (Spearman ρ=-0.09; P=.43). The same was true for the rate of adverse effects (P=.33). Conclusions: Cannabis users screening positive for attention deficit/hyperactivity disorder may benefit from CANreduce 2.0 to decrease the frequency and severity of cannabis dependence and attenuate symptoms of depression and attention deficit/hyperactivity disorder-related symptoms. This web-based program's advantages include its accessibility for remote users and a personalized counselling option that may contribute to increased adherence and motivation to change among program users. Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN) 11086185; http://www.isrctn.com/ISRCTN11086185. Keywords: ADHD; CANreduce; anxiety; attention deficit/hyperactivity disorder; cannabis; cannabis use disorder; depression; digital health; mental health; online health; online tool; web-based self-help tool