Melchior Adam Weikard was born on April 27, 1742, near Fulda Germany. He was a physician and a philosopher. Weikard wrote the earliest reference to the behavioral disorder attention deficit hyperactivity disorder (ADHD). He was progressive for his time, believing that illnesses have physical causes and that they are not a result of moral wrongs or the spiritual influences. Weikard died near his birthplace on July 25, 1803. [1]
Weikard grew up around Fulda and, at the age of six, developed a spinal deformity. [2] In secondary school, at the Frobenius-Gymnasium in Hammelburg, Weikard studied in the modern-day equivalent of the STEM program. [1] Weikard then went on to study physics, philosophy, and medicine at the University of Würzburg. [3] [1] He did not have kind things to say about his education. Weikard was nearsighted, physically deformed, and missed two years of school which made his experience arduous. Weikard claimed to have teachers who taught out of date material in secondary school and at university claimed to have bad teaching from the professors. It was also said that because he studied at Würzburg his ability was doubted since it was a smaller less prestigious school. Later in his life, Weikard argued for getting rid of small Catholic universities, like the one he studied at, which did not have the funding for good teachers. He instead recommended sending talented boys farther away to better schools in bigger cities that had the proper resources. [4] From his own retelling, one gets the sense that he should not have been trusted with performing medicine. He makes the impression he should not have been successful, but he was. It makes one wonder whether his education wasn't as poor as he remembered.
Despite his reported lack of proficient teachers, he succeeded in his career. In 1763, Weikard became a physician in Fulda [3] and in 1764, he worked at the government-run resort spa in the office of Bruckenau until 1776. [1] In 1770, Weikard became the physician to Prince-Bishop Heinrich von Bibra. [2] [1] During this time, he also earned the rank of Professor of Medicine at the University of Fulda. [1] [3]
Weikard was quite the rebel in his adult life. Germany was Catholic at the time though Weikard didn't take any of the church's teachings to heart. Weikard believed in a God, but he criticized the idea that demons and witches caused ills and evil. Instead he believed in physical causes of illnesses. [1] He also criticized philosophers’ attempts to reconcile materialism with Christianity. He challenged the assumption of a soul [5] and, in a last act of defiance, refused sacraments on his deathbed. [1] One of the consequences of him not believing in a soul or immaterial influence was he argued that all cognitive functioning depends on the physical state of the brain. He not only acknowledged physical factors, but also climate and education as factors affecting cognitive capabilities. [5] At the time the belief that the presence of a good or evil star during conception or birth would determine personality was common. Since he believed the brain controlled a person he did not believe in or condone astrology. [1] Weikard also valued evidence and objectivity more than what was usual of his time and he was not afraid of confrontation with medical and theological adversaries. [1]
In 1790, the third edition of Der Philosophische Arzt [The Philosophical Doctor] by Melchior Adam Weikard was published. The first edition was published in 1775 and there was a second edition as well. The first and second editions of the textbook were published anonymously. Although, back then and now, many believe that Weikard wrote them. [1] Anonymously writing the book may have been a good idea since the book was not well received. Weikard's reputation sank and it was recorded that his friends were fearful of the public backlash to being seen with him.
The church condemned the book for criticizing its remedies. Journal articles of the time were particularly harsh towards the book. Though the backlash was sharp, it did not seem to matter all that much because the book had enough success to have at least one more edition published. Through all the public outrage, Weikard's patron, Prince Heinrich von Bibra remained supportive. Many were not happy with this outcome, so the prince issued a decree prohibiting the textbook. Though he did not punish Weikard directly and even went on to financially support his retirement. [1]
He continued to have success in his career as well. Weikard was the Physician-in-ordinary at the Russian court for Catharine II in 1784. [6] While there, he was appointed to State Council and served in the position until he left of his own accord in 1789. In 1791 he became the personal physician of Prince-Bishop Karl Theodor von Dalberg of Mainz but stopped shortly after in 1792. [1] Weikard then went to Mannheim to practice medicine, and two years later moved to Heilbronn. After that, he became the Imperial Chief Physician to Tsar Paul in Russia. [1] [7] He then retired to his home and became a Privy Councilor, Director of the Medical Institutes. [7]
In Weikard's book, [8] he describes a “lack of attention” disorder commonly known as attention deficit hyperactivity disorder or ADHD. He provides many details that closely match the disorder we currently know, and many of Weikard's observations hold up to modern scrutiny. [1] [3] Weikard characterizes the disorder as distractible by anything even a person's own imagination, taking more effort to complete tasks, flighty, careless, work has many errors, and generally disorganized. He hints at impulsivity though he does not explicitly say it. This matches the DSM-V's diagnostic criteria of inattention and hints at the hyperactivity and impulsivity criteria.
Weikard attributes the problem to “the fibers too soft or too agile and can also cause the fact that they lack the necessary strength for the constant attention.” He blamed upbringing for the lack of ability of the “fibers”. This incorrect idea of upbringing causing the disorder persisted well into the 1970s and some still believe that it is the cause today. [1] Weikard also gives cures for this disorder. He recommends distractions to be removed, though he goes a step farther in saying being left alone in a dark room will help. This is not an ethical practice and is not recommended. He also recommends “rubbing, cold baths, steel powder, cinchona, mineral waters, horseback riding, and gymnastic exercises” along with making sure the individual learns a topic thoroughly and in a way that is interesting to them before they move on to other topics. The majority of these cures are rubbish but removing distractions and exercising are currently used to temporarily lessen symptoms and increase productivity. [1]
Weikard also makes the correct observation that this disorder was more prevalent in children than adults. He noted that women are less attentive than men which is incorrect and was colored by the ideas of the day. [3]
After Weikard, the Scottish physician Sir Alexander Crichton wrote about ADHD in 1798. [1] [3] Crichton was the first person to publish a textbook only on mental diseases and he went on to write a second book on the topic. Crichton's disease of attention is also extremely consistent with today's definition. [3] For a long time, it was recorded that Crichton had the earliest reference to ADHD. This could be attributed to the lack of translations of Weikard's work into English or simply modern scholars did not look closely at his work. Then in 2012 Barkley and Peters wrote their article about Weikard and his diagnosis. They had heard a story of a medical book that referenced a condition similar to ADHD that was written before Crichton's. They found an original copy of Weikard's book and translated it. You may note that Weikard's and Crichton's disorders are similar and only 23 years apart in publication. Barkley and Peters suggest that Crichton might have met and known Weikard since Crichton studied in cities where Weikard lived and taught. Though Crichton gives no reference to Weikard in his own texts. [1] We now, of course, give credit to Weikard on writing the earliest reference to ADHD.
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.
Atomoxetine, sold under the brand name Strattera, is a selective norepinephrine reuptake inhibitor medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, cognitive disengagement syndrome. It may be used alone or along with psychostimulants. It enhances the executive functions of self-motivation, sustained attention, inhibition, working memory, reaction time and emotional self-regulation. Use of atomoxetine is only recommended for those who are at least six years old. It is taken orally. The effectiveness of atomoxetine is comparable to the commonly prescribed stimulant medication methylphenidate.
Fasoracetam is a research chemical of the racetam family. It is a putative nootropic that failed to show sufficient efficacy in clinical trials for vascular dementia. It is currently being studied for its potential use for attention deficit hyperactivity disorder.
Hyperfocus is an intense form of mental concentration or visualization that focuses consciousness on a subject, topic, or task. In some individuals, various subjects or topics may also include daydreams, concepts, fiction, the imagination, and other objects of the mind. Hyperfocus on a certain subject can cause side-tracking away from assigned or important tasks.
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.
The hunter versus farmer hypothesis is a proposed explanation for the nature of attention-deficit hyperactivity disorder (ADHD). It was first suggested by radio host Thom Hartmann in his book Attention Deficit Disorder: A Different Perception.
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. To scientists in the field, it has reached the threshold of evidence and recognition as a distinct syndrome.
Russell Alan BarkleyFAPA is a retired American clinical neuropsychologist who was a clinical professor of psychiatry at the VCU Medical Center until 2022 and president of Division 12 of the American Psychological Association (APA) and of the International Society for Research in Child and Adolescent Psychopathology (ISRCAP). Involved in research since 1973 and a licensed psychologist since 1977, he is an expert on attention-deficit hyperactivity disorder (ADHD) and has devoted much of his scientific career to studying ADHD and related fields like childhood defiance. He proposed the renaming of sluggish cognitive tempo (SCT) to concentration deficit disorder (CDD) and later cognitive disengagement syndrome (CDS).
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.
Edward McKey Hallowell is an American psychiatrist, speaker, New York Times best-selling author and podcast host. He specializes in ADHD and is the founder of the Hallowell ADHD Centers. Hallowell is the author of 20 books, including the Distraction series, co-authored with Dr. John Ratey.
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 a systematic literature review and meta analysis conducted in 2024, only FDA-approved medications and psychosocial interventions have been shown to improve core ADHD symptoms compared to control groups.
Alternative therapies for developmental and learning disabilities include a range of practices used in the treatment of dyslexia, ADHD, autism spectrum disorders, Down syndrome and other developmental and learning disabilities. Treatments include changes in diet, dietary supplements, biofeedback, chelation therapy, homeopathy, massage and yoga. These therapies generally rely on theories that have little scientific basis, lacking well-controlled, large, randomized trials to demonstrate safety and efficacy; small trials that have reported beneficial effects can be generally explained by the ordinary waxing and waning of the underlying conditions.
Sir Alexander Crichton was a Scottish physician and author.
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 that significantly impair academic, social and work performance. 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.
The Pediatric Attention Disorders Diagnostic Screener (PADDS), created by Dr. Thomas K. Pedigo and Kenneth L. Pedigo, is a suite of computer administered neuropsychological tests of attention and executive functioning. The PADDS is used in the diagnosis of attention deficit hyperactivity disorder (ADHD) in children between the ages of 6 and 12 years. The PADDS software program represents a multi-dimensional, evidence-based approach to ADHD assessment, consisting of the Computer Administered Diagnostic Interview (CADI), the Swanson, Nolan, and Pelham—IV (SNAP-IV) Parent and Teacher rating scales, and the three computer-administered objective measures of the Target Tests of Executive Functioning (TTEF). It calculates a diagnostic likelihood ratio, where each data source is allowed to contribute to (or detract from) the prediction of the diagnosis, as well as normalized relative standard scores, t-scores, z-scores, and percentile ranks for comparison to the non-clinical reference group.
Hyperactivity has long been part of the human condition, although hyperactive behaviour has not always been seen as problematic.
Der Philosophische Arzt is a medical publication published in the late 18th century by Melchior Adam Weikard, a prominent German physician and philosopher to the Russian Empress, Catherine II.
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.
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.
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