“Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder characterised by the core symptoms of hyperactivity, impulsivity and inattention, which are judged excessive for the patient's age or level of overall development”. NICE 2019.
Attention Deficit Hyperactivity Disorder (ADHD) is categorised into three subtypes3: predominantly inattentive presentation, predominantly hyperactive-impulsive presentation, combined presentation.
Inattention - manifests as difficulty sustaining attention on tasks or activities, frequently making careless mistakes, and struggling to follow through on instructions. Individuals with ADHD may seem forgetful or easily distracted and have trouble organising tasks and activities. This is a consistent pattern that interferes with daily functioning.
Hyperactivity - refers to excessive and often inappropriate levels of physical activity. While it's commonly associated with children bouncing off the walls, hyperactivity in ADHD can manifest differently across the lifespan. In adults, it may present as inner restlessness, an inability to relax, or constantly feeling "on the go." In children, hyperactivity may involve excessive fidgeting, running or climbing excessively, and difficulty engaging in quiet activities.
Impulsivity - characterised by acting without forethought or consideration of consequences. Individuals with ADHD may blurt out answers before questions are completed, interrupt others' conversations or activities, and have difficulty waiting their turn. Impulsivity can lead to impulsive decision-making, risk-taking behaviors, and interpersonal conflicts.All these symptoms persist over time and significantly impact various aspects of life, including academic or occupational performance, relationships, and self-esteem.
It often coexists with other mental health conditions, such as anxiety, depression, obsessive-compulsive disorder, bipolar disorder, alcohol and drug misuse, autism, eating disorders and learning disabilities. It can be complicated by alcohol.
Early assessment, and diagnosis are crucial steps to improve the quality of life for individuals with ADHD and reduce the inequalities that they face. Prompt recognition of ADHD enables timely interventions and support, which can significantly enhance outcomes and address barriers that impede achievement.
Contrary to popular opinion, ADHD is under diagnosed and under-treated4,5. It can cause significant functional impairment and a range of adverse outcomes such as failure in relationships, academia or employment, low self-esteem, increased accidents and a raised mortality rate, increased mental health conditions and suicidality, unplanned pregnancies, criminality and social isolation.
Treatment for ADHD typically involves a multimodal approach, incorporating pharmacotherapy, psychoeducation, behavioural interventions, and support services. Stimulant medications are commonly prescribed and have been shown to effectively reduce symptoms of inattention, hyperactivity, and impulsivity in many people with ADHD. However, medication is not a one-size-fits-all solution; careful monitoring and adjustments are necessary to optimise effectiveness and minimise side effects.
Non-pharmacological interventions, such as cognitive-behavioural therapy (CBT) and organisational skills training, can also be beneficial in addressing specific challenges associated with ADHD, such as improving time management, organisation and impulse control.
NICE Guidelines - ADHD: Diagnosis and Management
For Screening and Assessment Tools please visit the resources section of this website
