1. A TTENTION DEFICIT DISORDERS With/Without hyperactivity Dr. Kersi Chavda

2. F ACT : This is one of the most common diagnosed and treated paediatric mental health problems, and is increasingly being diagnosed in adults as well There is a persistent pattern of inattention and/or hyperactive/impulsive behaviours that are developmentally inappropriate, chronic and interfere with normal function.

3. A LSO Some features should have been present before seven years of age The ADHD features should have affected at least two domains of function>>>academic/functional/social/ occupational They should have persisted for at least six months

4. E TIOLOGY Genetic: Heritability in ADHD is amongst the highest of psychiatric disorders Neurological: Functional imaging suggests abnormality of the prefrontal cortex Cathecholamine hypothesis: attributes ADHD to dysregulation of dopamine or norepinephrine in the CNS or PNS

5. C O - MORBIDITY : SLD(60%) CD and ODD (40%) Depression(15 to 32%) Anxiety Disorder(25%) High incidence of substance abuse

6. C LINICAL F EATURES Inattention: might include poor attention to details, tendency to make careless mistakes, easy distractibility, difficulty in sustaining attention, poor listening, poor task completion disorganization, avoidance of tasks requiring sustained attention, tendency to lose things necessary for tasks, forgetfulness

7. H YPERACTIVITY /I MPULSIVE Symptoms might include Fidgetiness, inability to stay seated, running or climbing inappropriately, noisiness in play, seeming “on the go” or as if driven by a motor, excessive talkativeness, prematurely blurting out answers, inability to take turns, interrupting others

8. S UBTYPES Predominantly Inattentive : with at least six inattentive symptoms Predominantly Hyperactive/Impulsive :with at least six hyperactive/impulsive symptoms Combined : with at least six symptoms from both categories

9. O UTCOME Hyperactive and impulsive symptoms may remit with maturity Inattentive symptoms often persist

10. A DULTS WITH ADHD Substantial impairments in multiple domains Higher arrest rates, more marital problems, involved in more car accidents, academic and occupational underachievement Substance abuse is very common

11. Thank you