ADHD
Hyperkinetic Disorders: ICD-10 Classification
F90.0: Disturbance of activity and attention
F90.1: Hyperkinetic conduct disorder
F90.8: Other hyperkinetic disorders
F90.9: Hyperkinetic disorder, unspecified
General Symptoms:
Clear abnormal levels of inattention, hyperactivity, and impulsivity.
Symptoms must be cross-situational and persistent.
Symptoms are not due to other disorders (e.g., autism, mood disorders).
Inattention Symptoms (G1 criterion - 6 Symptoms for 6 months):
Careless mistakes and inattention to detail.
Difficulty maintaining attention during activities.
Often appears not to listen.
Problems following through on tasks and organization.
Avoidance of tasks requiring prolonged effort.
Frequent loss of necessary items.
Easily distracted by external stimuli.
Forgetfulness in daily activities.
Attention Overview: Summary on the role of attention in ADHD related to childhood and adolescence.
Hyperactivity Symptoms (G2 criterion - 3 Symptoms for 6 months):
Fidgeting or inability to stay seated.
Excessive running or climbing in inappropriate situations.
Difficulty engaging in quiet play.
Persistent excessive motor activity that is not influenced by context.
Impulsivity Symptoms (G3 criterion - 1 Symptom for 6 months):
Blurting out answers prematurely.
Difficulty waiting for turn in situations.
Frequent interruptions or disturbances to others.
Excessive talking inappropriate to the context.
Further Criteria:
Symptoms must start before age 7.
Must affect multiple settings (home, school, etc.).
Symptoms must cause significant distress or impairment in functioning.
Exclusion of pervasive developmental disorders or major mood/anxiety episodes.
Prevalence:
ICD criteria are considered stricter due to the requirement of all three symptom clusters for diagnosis.
Symptoms in Infancy and Toddlerhood:
High psychophysiological activity level with negative temperamental traits.
Potential developmental deficits and behavioral issues.
Causes and Maintenance: Overview of ADHD causes and maintenance factors.
Epidemiology - Prevalence Data:
Rates range between 3.6% and 6.7% for children, and 2.2% to 2.6% for adolescents in European studies.
Worldwide prevalence average is 5.3%.
ADHD in Adulthood:
40-60% of children with ADHD retain symptoms into adulthood.
Common comorbid disorders include mood and anxiety disorders, affecting social functioning.
Parents of Children with ADHD:
Discuss implications for parenting and possible psychotherapy for parents.
Comorbidity Data:
High prevalence (up to 80%) of comorbid disorders among children with ADHD.
Negative impacts on academic performance and social interactions.
Comorbidity Frequencies:
Conduct Disorder: 50%
Affective Disorders: 30-40%
Anxiety Disorders: 10-40%
Learning Disorders: Up to 30%.
Aetiology and ADHD Overview:
Overview of contributing factors, including genetics, CNS impacts, and environmental conditions.
Genetic Factors:
High heritability of ADHD (60 - 90%).
Involvement of multiple genes with potential environmental interaction effects.
CNS Damage:
Risk factors include CNS infections, low birth weight, seasonal viral illnesses during pregnancy, and exposure to substances.
Allergic Reactions and Food Sensitivity:
Limited evidence supporting food additives' impact on ADHD, with some elimination diets showing effects.
Psychosocial Factors:
Higher incidence in lower socio-economic families, single parent homes, and negative parent-child relationships.
Diagnostics Study Overview:
Study on child psychiatric case vignettes to assess ADHD diagnosis criteria fulfillment.
Diagnostics Study Results:
Awareness of gender biases in ADHD diagnosis.
Assessment:
Overview of assessment practices in diagnosing ADHD.
Differential Diagnosis:
Disorders with symptom overlap include social behavior disorder, anxiety, depression, OCD, and autism.
Diagnostics Fundamentals:
Symptoms must manifest in various settings and must be recorded before age 7.
Diagnostic Clinical Observations:
Strategies for assessing ADHD symptoms under various stress conditions.
Page 31
DISYPS-III for Preschool Age:
Assessment criteria focused on attention span and behavioral issues.
Page 32
ICD-10 and DSM-IV Symptom Criteria:
Detailed ICD-10 criteria for assessing ADHD symptoms and behavior patterns.
Page 33
Intervention Strategies: Overview of ADHD interventions and their development.
Page 34
Psychotherapy - Psychoeducation:
Introduces characters as a narrative for illustrating ADHD experiences.
Page 35
THOP Therapy Programme for Children:
Treatment framework targeting behavioral issues in children aged 3-12.
Page 36
THOP Contents:
Program development focused on defining behavioral problems and planning treatments.
Page 37
THOP Continued:
Emphasis on interaction dynamics, including modeling and reinforcement strategies.
Page 38
Pharmacotherapy Overview:
Description of stimulant medications, their effectiveness, and demographic responder rates.
Page 39
Side Effects of Stimulants:
Common side effects, including growth reduction and cardiovascular risks.
Page 40
Evaluation of Psychotherapy:
Effectiveness comparison between environment-centered interventions and pharmacotherapy approaches.
Summary of Key Points:
ADHD is defined by impulsivity, hyperactivity, and inattention.
Neurobiology is a key causal factor, with social factors influencing severity.
Importance of comprehensive diagnostics across multiple settings.
Both psychotherapy and medication are vital for effective treatment.