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Attention Deficit Hyperactivity Disorder

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Neurological and Psychiatric Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Attention deficit hyperactivity disorder (ADHD) is a highly prevalent, heterogeneous syndrome of cognitive and behavioral features including inattention, impulsivity, deficient behavioral inhibition, and hyperactivity. Prevalence is about 4%, with a moderate excess of a mainly inattentive subtype, and fewer mixed or mainly hyperactive/impulsive cases. Comorbid conditions include conduct, learning, and mood disorders. ADHD can be found at any age, but the diagnosis is more common in boys than girls or adults, and in the United States than in Europe. Risk is 35% to 40% among first-degree relatives, and more than twice greater in identical twins; heritability is high. Polymorphisms of the dopamine neuronal transporter gene (DAT1) and D4 receptor gene (DRD4) have been associated with ADHD. Diagnosis remains essentially clinical and there are no specific diagnostic tests. Prominent deficits occur in executive functions, including response inhibition, sustained attention, and working memory, all suggesting dysfunction of prefrontal cerebral cortex that is tentatively supported by some brain-imaging studies. A precise neuropathophysiology remains undefined. Laboratory animal models of ADHD include genetic (spontaneously hypertensive rat, DAT-knock-out mouse, coloboma mouse) and neurotoxin models (neonatal 6-hydroxydopamine-lesioned rodents). Most models emphasize hyperactivity rather than specific cognitive dysfunctions, and vary in their neuropharmacological congruence with the clinical therapeutics of ADHD. Empirically employed treatments with research support for cognitive as well as behavioral benefits include most stimulants, and antidepressants with noradrenergic actions; these treatments are best combined with comprehensive behavioral and educational interventions.

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Author information

Authors and Affiliations

  1. McLean Hospital, Department of Psychiatry, Harvard Medical School, Boston, MA

    Kehong Zhang MD, PhD

  2. Department of Psychiatry, University of Essen, Essen, Germany

    Eugen Davids MD

  3. Department of Psychotherapy, University of Essen, Essen, Germany

    Eugen Davids MD

  4. Mailman Research Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA

    Ross J. Baldessarini MD

Authors
  1. Kehong Zhang MD, PhD
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  2. Eugen Davids MD
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  3. Ross J. Baldessarini MD
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Editor information

Editors and Affiliations

  1. Department of Psychiatry and Neuroscience Program, Harvard Medical School, Boston, MA

    Frank I. Tarazi PhD, MSc

  2. Laboratory of Psychiatric Neuroscience, McLean Hospital, Belmont, MA

    Frank I. Tarazi PhD, MSc

  3. Department of Pharmacology and Neuroscience, Univesity of North Texas Health Science Center, Fort Worth, TX

    John A. Schetz PhD

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© 2005 Humana Press Inc., Totowa, NJ

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Zhang, K., Davids, E., Baldessarini, R.J. (2005). Attention Deficit Hyperactivity Disorder. In: Tarazi, F.I., Schetz, J.A. (eds) Neurological and Psychiatric Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-856-0:229

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  • DOI: https://doi.org/10.1385/1-59259-856-0:229

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-369-5

  • Online ISBN: 978-1-59259-856-4

  • eBook Packages: MedicineMedicine (R0)

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