M.

Faisal Idrus
Apparent in some children in the preschool and
early school years
Estimated that between 3 and 5 percent of
children have ADHD,
first described by Dr. Heinrich Hoffman in 1845
1902 that Sir George F. Still described a group of
impulsive children with significant behavioral
problems, recognized as having ADHD
ADHD often continues into adulthood
There is considerable evidence to suggest that ADHD is not a
recent phenomenon
493 BC, the great physician-scientist Hippocrates described a condition
that seems to be compatible with what we now know as ADHD.
Hippocrates attributed this condition to an "overbalance of fire over
water.
1845. ADHD was alluded to by Dr. Heinrich Hoffmann, a German
physician in Der Struwwelpeter was a description of a little boy who could
be interpreted as having attention deficit hyperactivity disorder.
1902 The English pediatrician George Still, described a condition which
some have claimed is analogous to ADHD. Analysis of Still's descriptions
by Palmer and Finger indicated that the qualities Still described are not
"considered primary symptoms of ADHD".
[62]




The 19181919 influenza pandemic left many survivors with encephalitis,
affecting their neurological functions. Some of these exhibited
immediate behavioral problems which correspond to ADD. This caused
many to believe that the condition was the result of injury rather than
genetics.
1937 Dr. Bradley in Providence RI reported that a group of children with
behavioral problems improved after being treated with stimulant
medication.
1957 The stimulant methylphenidate (Ritalin) became available. It
remains one of the most widely prescribed medications for ADHD in its
various forms (Ritalin, Focalin, Concerta, Metadate, and Methylin).
1960 Stella Chess described "Hyperactive Child Syndrome", introducing
the concept of hyperactivity not being caused by brain damage.
By 1966, following observations that the condition existed without any
objectively observed pathological disorder or injury, researchers changed
the terminology from Minimal Brain Damage to Minimal Brain
Dysfunction.
[65]

1973 Dr Ben F. Feingold, Chief of Allergy at Kaiser Permanente Medical
Center in San Francisco, claimed that hyperactivity was increasing in
proportion to the level of food additives.
1975 Pemoline (Cylert) is approved by the FDA for use in the treatment
of ADHD. While an effective agent for managing the symptoms, the
development of liver failure in at least 14 cases over the next 27 years
would result in the manufacturer withdrawing this medication from the
market.
1980 The name Attention Deficit Disorder (ADD) was first introduced in
DSM-III, the 1980 edition.


1987 The DSM-IIIR was released changing the diagnosis to "Undifferentiated
Attention Deficit Disorder."
1994 DSM-IV described three groupings within ADHD, which can be simplified as:
mainly inattentive; mainly hyperactive-impulsive; and both in combination.
1996 ADHD accounted for at least 40% of child psychiatry references.
1999 New delivery systems for medications are invented that eliminate the need for
multiple doses across the day or taking medication at school. These new systems
include pellets of medication coated with various time-release substances to permit
medications to dissolve hourly across an 812 hour period (Medadate CD, Adderall XR,
Focalin XR) and an osmotic pump that extrudes a liquid methylphenidate sludge
across an 812 hour period after ingestion (Concerta).
1999 The largest study of treatment for ADHD in history is published in the American
Journal of Psychiatry. Known as the Multimodal Treatment Study of ADHD (MTA
Study), it involved more than 570 ADHD children at 6 sites in the United States and
Canada randomly assigned to 4 treatment groups. Results generally showed that
medication alone was more effective than psychosocial treatments alone, but that
their combination was beneficial for some subsets of ADHD children beyond the
improvement achieved only by medication. More than 40 studies have subsequently
been published from this massive dataset.


1999 The largest study of treatment for ADHD in history is published in
the American Journal of Psychiatry. Known as the Multimodal Treatment
Study of ADHD (MTA Study), it involved more than 570 ADHD children at
6 sites in the United States and Canada randomly assigned to 4
treatment groups. Results generally showed that medication alone was
more effective than psychosocial treatments alone.
2001 The International Consensus Statement on ADHD is published and
signed by more than 80 of the world's leading experts on ADHD to
counteract periodic media misrepresentation that ADHD is a real
disorder and that medications are justified as a treatment for the
disorder
2003 Atomoxetine, the first new medication for ADHD in 25 years,
receives FDA approval for use in children, teens, and adults with ADHD.
In 2005, another 100 European experts on ADHD added their signatures
to this historic document certifying the validity of ADHD as a valid
mental disorder.



Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)
states that ADHD is a developmental disorder that presents during
childhood, with at least some symptoms causing impairment
before the age of seven. It is characterized by developmentally
inappropriate levels of inattention and/or hyperactive-impulsive
behavior, with significant impairment occurring in at least two
settings
International Statistical Classification of Diseases and Related
Health Problems (ICD-10) the symptoms of ADHD are given the
name "Hyperkinetic disorders". When a conduct disorder (as
defined by ICD-10, F91) is present, the condition is referred to as
"Hyperkinetic conduct disorder". Otherwise the disorder is
classified as "Disturbance of Activity and Attention", "Other
Hyperkinetic Disorders" or "Hyperkinetic Disorders, Unspecified".
Attention-deficit syndrome (ADS): Equivalent
to ADHD, but used to avoid the connotations of
"disorder".
[

Minimal cerebral dysfunction (MCD):
Equivalent to ADHD, but largely obsolete in the
United States, though still commonly used
internationally.
Deficits in Attention, Motor control and
Perception (DAMP): A name for ADHD in
combination with dyspraxia that is recognized
only in Denmark and Sweden.
ADHD has been found to exist in every country
and culture studied to date.
The prevalence among children is estimated to
be in the range of 5% to 8% in children, and 4%
to 8% in adults. 10% of males, and (only) 4% of
females have been diagnosed.
This apparent sex difference may reflect either a
difference in susceptibility.
Females with ADHD are less likely to be
diagnosed than males.
The exact cause of ADHD remains unknown, but
there is no shortage of speculation concerning
its etiology, most of which centers around the
brain.
Hereditary dopamine deficiency
Diet

Research suggests that ADHD arises from a
combination of various genes, many of which have
something to do with dopamine transporters.

Suspect genes include the 10-repeat allele of the
DAT1 gene,

the 7-repeat allele of the DRD4 gene, and
the dopamine beta hydroxylase gene (DBH TaqI).

Additionally, SPECT scans found people with ADHD to
have reduced blood circulation, and a significantly
higher concentration of dopamine transporters in the
striatum which is in charge of planning ahead.
It has long been suggested that ADHD could be the result of a nutritional
problem.
Recent studies have begun to find metabolic differences in these
children, indicating that an inability to handle certain elements of one's
diet might contribute to the development of ADHD, or at least ADHD-
like symptoms. For example,
In 1990 the English chemist, Neil Ward,

showed that children with ADHD
lose zinc when exposed to a food dye.
Some studies suggest that a lack of fatty acids, specifically omega-3 fatty
acids can trigger the development of ADHD.
Support for this theory comes from findings that children who are
breastfed for six or more months seem to be less likely to have ADHD
than their bottlefed counterparts and until very recently, infant formula
did not contain any omega-3 fatty acids at all.

Time and further investigation will perhaps tell whether this correlation is
reliable or merely a coincidence.

Biohazards including alcohol, tobacco smoke, and
lead poisoning.
Allergies (including those to artificial additives)
complications during pregnancy and birth--including
premature birth.
women who smoke while pregnant are more likely to
have children with ADHD. Since nicotine is known to
cause hypoxia (lack of oxygen) in utero,
Head injuries can cause a damage done to the
patient's frontal lobes. Because symptoms were
attributable to brain damage, the earliest designation
for ADHD was "Minimal Brain Damage".


Failing to pay close attention to details or making careless
mistakes when doing schoolwork or other activities
Trouble keeping attention focused during play or tasks
Appearing not to listen when spoken to
Failing to follow instructions or finish tasks
Avoiding tasks that require a high amount of mental effort and
organization, such as school projects
Frequently losing items required to facilitate tasks or activities,
such as school supplies
Excessive distractibility
Forgetfulness
Procrastination, inability to begin an activity
Difficulties with household activities (cleaning, paying bills, etc.)
Fidgeting with hands or feet or squirming in seat
Leaving seat often, even when inappropriate
Running or climbing at inappropriate times
Difficulty in quiet play
Frequently feeling restless
Excessive speech
Answering a question before the speaker has finished
Failing to await one's turn
Interrupting the activities of others at inappropriate
times
Impulsive spending, leading to financial difficulties

A positive diagnosis is made if the patient has
experienced six of the above symptoms for at
least three months.
Symptoms must appear consistently in varied
environments (e.g., not only at home or only
at school) and interfere with function.
Children who grow up with ADHD often
continue to have symptoms as they grow into
adulthood

Learning Disabilities.
Tourette Syndrome.
Oppositional Defiant Disorder
Conduct Disorder.
Anxiety and Depression
Bipolar Disorder
Mainstream Treatment
Stimulant
Nonstimulant
Alternative treatment
Nutrition

Stimulant, stimulating the areas of the brain responsible
for focus, attention, and impulse control. paradoxical effect.
Methylphenidate (Ritalin and Concerta),
Amphetamines (Adderall) and
dextroamphetamines (Dexedrine). ,
Cylert.
Nonstimulant
Bupropion (Wellbutrin)
Atomoxetine (Strattera).

Nutrition
Feingold diet, Removing salicylates, artificial colors and
flavors, and certain synthetic preservatives from
children's diets.
vitamin B
6
.
zinc
multivitamins omega-3
caffeine , theobromine
ginkgo biloba