Attention-deficit hyperactivity disorder

David Feifel, MD, PHD, contributor

VOL 100 / NO 3 / SEPTEMBER 1996 / POSTGRADUATE MEDICINE

At one time, attention-deficit hyperactivity disorder (ADHD) was thought to "burn itself out" by adolescence. Now, experts have found that it can persist into adulthood.

How is ADHD diagnosed?
No laboratory test can identify ADHD. The best method is a careful interview with a physician, who looks for a persistent pattern of specific behaviors. Behaviors may be at their worst in a certain setting, such as school, but they must be noticeable in more than one setting, day in and day out, to be ADHD. Certain questionnaires and performance tests can be useful in diagnosis. Disorders that can cause symptoms similar to ADHD (learning disorders, depression, drug use, thyroid abnormalities, fatigue syndromes) must be ruled out.

The problem must have been present in childhood for adults to have ADHD, so parents and childhood report cards may need to be consulted. Many adults and some children do not have hyperactivity but do have other symptoms of ADHD. Most squirmy, high-energy children are just being normal kids. But if a person has several of the following traits, ADHD should be considered:

• Often misses details and makes careless mistakes in work
• Cannot organize chores or follow the steps of a procedure
• Jumps from one unfinished activity to another
• Often does not seem to listen
• Often misplaces and forgets things
• Is easily distracted by other people or activities
• Always seems to be tapping, jiggling, or moving in some way
• Cannot tolerate sitting still for long periods
• Often interrupts, intrudes, finishes the sentences of others, or blurts out answers ahead of time
• Is extremely frustrated by having to wait
• Jumps into situations without thinking

What is the treatment for ADHD?
Patients can be taught to cope with some of their problems, for example, by making lists and establishing a routine to get organized. They may be able to choose activities that involve independence and variation and avoid those that bring out their impatience and impulsiveness. Medications that regulate areas of the brain affecting attention and impulse control are often helpful when taken as prescribed.

This information is not a substitute for medical treatment.

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