Hyperkinetic disorder | |
---|---|
Specialty | Psychiatry |
Symptoms | Inattention, hyperactivity, impulsivity |
Hyperkinetic disorder was a neuropsychiatric condition that was thought to emerge in early childhood. Its features included an enduring pattern of severe, developmentally-inappropriate symptoms of inattention, hyperactivity, and impulsivity across different settings (e.g., home and school) that significantly impair academic, social, and work performance. [1] It was classified in the World Health Organization's ICD-10 and was roughly similar to the "combined presentation" of attention deficit hyperactivity disorder in the American Psychiatric Association's DSM-5. However, in the ICD-11 the entry for hyperkinetic disorder no longer exists and is replaced by attention-deficit/hyperactivity disorder. [2]
Hyperkinetic people displayed disorganized, poorly controlled, and excessive activity; they lacked perseverance in tasks involving thought and attention and tended to move from one activity to the next without completing any. They were frequently accident-prone, reckless, and impulsive and might thoughtlessly (rather than defiantly) break rules. Cognitive impairment and delayed language and motor development were more common in this group than in the general population, and they might have experienced low self-esteem and engaged in antisocial behavior as a consequence of the disorder.
While hyperkinetic children were commonly incautious and unreserved with adults, they might have been isolated and unpopular with other children. [3]
Though the American Psychiatric Association's criteria for Attention Deficit Hyperactivity Disorder (ADHD), and the World Health Organization's criteria for hyperkinetic disorder each list a very similar set of 18 symptoms, the differing rules governing diagnosis meant that hyperkinetic disorder featured greater impairment and more impulse-control difficulties than typical ADHD, and it most resembled a severe case of ADHD combined type. [1]
Unlike ADHD, a diagnosis of hyperkinetic disorder required that the clinician directly observed the symptoms (rather than relying only on parent and teacher reports), that onset must have been by age 6 not 7; [4] and that at least six inattention, three hyperactivity and one impulsivity symptom be present in two or more settings. While ADHD may exist comorbid with (in the presence of) mania or a depressive or anxiety disorder, the presence of one of these rules out a diagnosis of hyperkinetic disorder. [1] Most cases of hyperkinetic disorder appear to have met the broader criteria of ADHD. [5]
Hyperkinetic disorder was also sometimes comorbid with conduct disorder, in which case the diagnosis was hyperkinetic conduct disorder. [1]
The rate in school age children was thought to be about 1.5%, compared with an estimated 5.3% for ADHD. [1]
Once the patient and family had been educated about the nature, management and treatment of the disorder and a decision has been made to treat, the European ADHD Guidelines group [6] [7] recommended medication rather than behavioral training as the first treatment approach; and the UK's National Institute for Health and Clinical Excellence recommended medication as first line treatment for those with hyperkinesis/severe ADHD, and the provision of group parent-training in all cases of ADHD. [8]
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally-inappropriate.
Methylphenidate, sold under the brand names Ritalin and Concerta among others, is a central nervous system (CNS) stimulant used medically to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, narcolepsy. It is a first-line treatment for ADHD ; it may be taken by mouth or applied to the skin, and different formulations have varying durations of effect. For ADHD, the effectiveness of methylphenidate is comparable to atomoxetine but modestly lower than amphetamines, alleviating the executive functioning deficits of sustained attention, inhibition, working memory, reaction time and emotional self-regulation.
Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10. These disorders comprise developmental language disorder, learning disorders, developmental coordination disorders, and autism spectrum disorders (ASD). In broader definitions, attention deficit hyperactivity disorder (ADHD) is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.
A social skill is any competence facilitating interaction and communication with others where social rules and relations are created, communicated, and changed in verbal and nonverbal ways. The process of learning these skills is called socialization. Lack of such skills can cause social awkwardness.
Adult Attention Deficit Hyperactivity Disorder is the persistence of attention deficit hyperactivity disorder (ADHD) into adulthood. It is a neurodevelopmental disorder, meaning impairing symptoms must have been present in childhood, except for when ADHD occurs after traumatic brain injury. Specifically, multiple symptoms must be present before the age of 12, according to DSM-5 diagnostic criteria. The cutoff age of 12 is a change from the previous requirement of symptom onset, which was before the age of 7 in the DSM-IV. This was done to add flexibility in the diagnosis of adults. ADHD was previously thought to be a childhood disorder that improved with age, but recent research has disproved this. Approximately two-thirds of childhood cases of ADHD continue into adulthood, with varying degrees of symptom severity that change over time and continue to affect individuals with symptoms ranging from minor inconveniences to impairments in daily functioning.
Cognitive disengagement syndrome (CDS) is a syndrome characterized by developmentally-inappropriate, impairing and persistent levels of decoupled attentional processing from the ongoing external context and resultant hypoactivity. Symptoms often manifest in difficulties with staring, mind blanking, withdrawal, mental confusion and maladaptive mind wandering alongside delayed, sedentary or slow motor movements. To scientists in the field, it has reached the threshold of evidence and recognition as a distinct syndrome.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness." This behavior is usually targeted toward peers, parents, teachers, and other authority figures, including law enforcement officials. Unlike conduct disorder (CD), those with ODD do not generally show patterns of aggression towards random people, violence against animals, destruction of property, theft, or deceit. One-half of children with ODD also fulfill the diagnostic criteria for ADHD.
Attention deficit hyperactivity disorder predominantly inattentive, is one of the three presentations of attention deficit hyperactivity disorder (ADHD). In 1987–1994, there were no subtypes or presentations and thus it was not distinguished from hyperactive ADHD in the Diagnostic and Statistical Manual (DSM-III-R). In DSM-5, subtypes were discarded and reclassified as presentations of the same disorder that change over time.
Despite the scientifically well-established nature of attention deficit hyperactivity disorder (ADHD), its diagnosis, and its treatment, each of these has been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, stated that the current treatments and methods of diagnosis are based on the dominant view of the academic literature.
Tourette syndrome is an inherited neurodevelopmental disorder that begins in childhood or adolescence, characterized by the presence of motor and phonic tics. The management of Tourette syndrome has the goal of managing symptoms to achieve optimum functioning, rather than eliminating symptoms; not all persons with Tourette's require treatment, and there is no cure or universally effective medication. Explanation and reassurance alone are often sufficient treatment; education is an important part of any treatment plan.
Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD. Approaches that have been evaluated in the management of ADHD symptoms include FDA-approved pharmacologic treatment and other pharmaceutical agents, psychological or behavioral approaches, combined pharmacological and behavioral approaches, cognitive training, neurofeedback, neurostimulation, physical exercise, nutrition and supplements, integrative medicine, parent support, and school interventions. Based on two 2024 systematic reviews of the literature, FDA-approved medications and to a lesser extent psychosocial interventions have been shown to improve core ADHD symptoms compared to control groups.
Joseph Biederman was an American academic psychiatrist. He was Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital and a professor of psychiatry at Harvard Medical School.
Mental disorders diagnosed in childhood can be neurodevelopmental, emotional, or behavioral disorders. These disorders negatively impact the mental and social wellbeing of a child, and children with these disorders require support from their families and schools. Childhood mental disorders often persist into adulthood. These disorders are usually first diagnosed in infancy, childhood, or adolescence, as laid out in the DSM-5 and in the ICD-11.
Hyperactivity has long been part of the human condition, although hyperactive behaviour has not always been seen as problematic.
Disruptive mood dysregulation disorder (DMDD) is a mental disorder in children and adolescents characterized by a persistently irritable or angry mood and frequent temper outbursts that are disproportionate to the situation and significantly more severe than the typical reaction of same-aged peers. DMDD was added to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a type of depressive disorder diagnosis for youths. The symptoms of DMDD resemble many other disorders, thus a differential includes attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety disorders, and childhood bipolar disorder, intermittent explosive disorder (IED), major depressive disorder (MDD), and conduct disorder.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty focusing attention, hyperactivity, and impulsive behavior. Treatments generally involve behavioral therapy and/or medications. ADHD is estimated to affect about 6 to 7 percent of people aged 18 and under when diagnosed via the DSM-IV criteria. However, these estimates may be inaccurate as females tend to have fewer symptoms, as identified in the DSM-IV, and thus tend to be under-diagnosed due to these sex differences in predicting ADHD. When diagnosed via the ICD-10 criteria, hyperkinetic disorder gives rates between 1 and 2 percent in this age group.
Metadoxine, also known as pyridoxine-pyrrolidone carboxylate, is a drug used to treat chronic and acute alcohol intoxication. Metadoxine accelerates alcohol clearance from the blood.
The Vanderbilt ADHD Diagnostic Rating Scale (VADRS) is a psychological assessment tool for attention deficit hyperactivity disorder (ADHD) symptoms and their effects on behavior and academic performance in children ages 6–12. This measure was developed by Mark L Wolraich at the Oklahoma Health Sciences Center and includes items related to oppositional defiant disorder, conduct disorder, anxiety, and depression, disorders often comorbid with ADHD.
The ADHD Rating Scale (ADHD-RS) is a parent-report or teacher-report inventory created by George J. DuPaul, Thomas J. Power, Arthur D. Anastopoulos, and Robert Reid consisting of 18–90 questions regarding a child's behavior over the past 6 months. The ADHD Rating Scale is used to aid in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children ranging from ages 5–17.
Externalizing disorders are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize their maladaptive emotions and cognitions, such feelings and thoughts are externalized in behavior in individuals with externalizing disorders. Externalizing disorders are often specifically referred to as disruptive behavior disorders or conduct problems which occur in childhood. Externalizing disorders, however, are also manifested in adulthood. For example, alcohol- and substance-related disorders and antisocial personality disorder are adult externalizing disorders. Externalizing psychopathology is associated with antisocial behavior, which is different from and often confused for asociality.