Hyperkinetic disorder

Last updated
Hyperkinetic disorder
Specialty Psychiatry   OOjs UI icon edit-ltr-progressive.svg
Symptoms Inattention,
Hyperactivity,
Impulsivity

Hyperkinetic disorder was a psychiatric neuro-developmental 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]

Contents

Symptoms

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 dis-social 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]

Diagnosis

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]

Epidemiology

The rate in school age children was thought to be about 1.5%, compared with an estimated 5.3% for ADHD. [1]

Treatment

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]

See also

Related Research Articles

<span class="mw-page-title-main">Attention deficit hyperactivity disorder</span> Neurodevelopmental disorder

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate.

<span class="mw-page-title-main">Social skills</span> Competence facilitating interaction and communication with others

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) in adults. It is a neurodevelopmental disorder, meaning symptoms must present in childhood except when ADHD occurs after traumatic brain injury. Specifically, for ADHD, multiple symptoms must have been present before age 12 years, according to DSM-5 diagnostic criteria. This cutoff age of 12 is a change from the previous requirement of symptom onset prior to age 7 in the DSM-IV 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 significantly affect individuals' daily functioning in multiple domains.

Cognitive disengagement syndrome (CDS) is an attention syndrome characterised by prominent dreaminess, mental fogginess, hypoactivity, sluggishness, slow reaction time, staring frequently, inconsistent alertness, and a slow working speed.

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. Unlike conduct disorder (CD), those with ODD do not show patterns of aggression towards people or 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 and thus it was not distinguished from hyperactive ADHD in the Diagnostic and Statistical Manual (DSM-III-R).

<span class="mw-page-title-main">Attention deficit hyperactivity disorder controversies</span>

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.

Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a rare mental disorder in children and adolescents, and is controversial, mainly because adult bipolar medication can cause serious harm in childhood, so misdiagnosis is problematic. PBD is hypothesized to be like bipolar disorder (BD) in adults, thus is proposed as an explanation for periods of extreme shifts in mood called mood episodes. These shifts alternate between periods of depressed or irritable moods and periods of abnormally elevated moods called manic or hypomanic episodes. Mixed mood episodes can occur when a child or adolescent with PBD experiences depressive and manic symptoms simultaneously. Mood episodes of children and adolescents with PBD deviate from general shifts in mood experienced by children and adolescents because mood episodes last for long periods of time and cause severe disruptions to an individual's life. There are three known forms of PBD: Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS). Just as in adults, bipolar I is also the most severe form of PBD in children and adolescents, and can impair sleep, general function, and lead to hospitalization. Bipolar NOS is the mildest form of PBD in children and adolescents. The average age of onset of PBD remains unclear, but reported ages of onset range from 5 years of age to 19 years of age. PBD is typically more severe and has a poorer prognosis than bipolar disorder with onset in late-adolescence or adulthood.

Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD.

Dual diagnosis is the condition of having a mental illness and a comorbid substance use disorder. There is considerable debate surrounding the appropriateness of using a single category for a heterogeneous group of individuals with complex needs and a varied range of problems. The concept can be used broadly, for example depression and alcohol use disorder, or it can be restricted to specify severe mental illness and substance use disorder, or a person who has a milder mental illness and a drug dependency, such as panic disorder or generalized anxiety disorder and is dependent on opioids. Diagnosing a primary psychiatric illness in people who use substances is challenging as substance use disorder itself often induces psychiatric symptoms, thus making it necessary to differentiate between substance induced and pre-existing mental illness.

Joseph Biederman was Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at the Massachusetts General Hospital, professor of psychiatry at Harvard Medical School. Biederman was Board Certified in General and Child Psychiatry.

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.

The Adult ADHD Self-Report Scale (ASRS) Symptom Checklist is a self-reported questionnaire used to assist in the diagnosis of adult ADHD. ADHD is a neurological disorder that can present itself in adolescence and adulthood. Adults with ADHD may experience difficulties in relation to cognitive, academic, occupational, social and economic situations.

<span class="mw-page-title-main">Disruptive mood dysregulation disorder</span> Medical condition

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 those of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety disorders, and childhood bipolar 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. When diagnosed via the ICD-10 criteria, hyperkinetic disorder gives rates between 1 and 2 percent in this age group.

<span class="mw-page-title-main">Metadoxine</span> Medication used for alcohol intoxication

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.

References

  1. 1 2 3 4 5 Banaschewski, Tobias; Rohde, Louis (2009). "Phenomenology". In Banaschewski, Tobias; Coghill, David; Danckaerts, Marina (eds.). Attention Deficit Hyperactivity Disorder and Hyperkinetic Disorder. Oxford, UK: OUP. pp. 3–18. ISBN   9780191576010.
  2. ICD-11 Implementation version. who.int
  3. "International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010". World Health Organisation. 2010. Retrieved 2014-01-17.
  4. Professor Michael Fitzgerald; Dr. Mark Bellgrove; Michael Gill (30 April 2007). Handbook of Attention Deficit Hyperactivity Disorder. John Wiley & Sons. p. 270. ISBN   978-0-470-03215-2.
  5. Santosh, Paramala J; Henry, Amy; Varley, Christopher K (24 January 2008). "ADHD and hyperkinetic disorder". In Peter Tyrer; Kenneth R. Silk (eds.). Cambridge Textbook of Effective Treatments in Psychiatry. Cambridge University Press. p. 782. ISBN   978-1-139-46757-5.
  6. Banaschewski T, Coghill D, Santosh P, et al. (March 2008). "[Long-acting medications for the treatment of hyperkinetic disorders - a systematic review and European treatment guideline. Part 1: overview and recommendations]". Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (in German). 36 (2): 81–94, quiz 94–5. doi:10.1024/1422-4917.36.2.81. PMID   18622938.
  7. "A Comprehensive Literature Review on Guanfacine as a Potential Treatment for ADHD". 2023-05-01. Retrieved 2023-11-27.
  8. Coghill, David; Danckaerts, Marina (2009). "Organizing and Delivering Treatment". In Banaschewski, Tobias; Coghill, David; Danckaerts, Marina (eds.). Attention Deficit Hyperactivity Disorder and Hyperkinetic Disorder. Oxford, UK: OUP. pp. 91–106. ISBN   9780191576010.