Attention deficit hyperactivity disorder (ADHD) was originally believed to be primarily a pediatric condition. However, the available data suggest that between 30 and 70 percent of children with ADHD continue to manifest symptoms in adulthood. It is estimated that between 1 and 7 percent of the adult population experiences ADHD symptoms.
Patho-physiologic basis of ADHD centers on an imbalance in catecholamine metabolism in the cerebral cortex. Basically an imbalance of the neuro-hormones.
ADHD is both inattention andhyperactivity/impulsivity. These criteria best describe a pediatric presentations; symptoms are more subtle in adults. Poor concentration, distractibility, elevated motor activity, and impulsivity should be pervasive features disrupting at least two domains of daily life (eg, school, family, peer relationships). Poor self-regulation, inability to prevent immediate responding, and difficulty with both focused attention and goal-directed thought and action.Hyperactivity is less overt in adults. The "on the go" drive seen in children is replaced with restlessness, difficulty relaxing, and feeling chronically "on edge." Deficits in sustained attention and concentration may become more apparent in late adolescence and early adulthood as responsibilities increase. Appointments, social commitments, and school and work deadlines are frequently forgotten. Completed work is frequently misplaced amid clutter
A subset of adults with ADHD have difficulties with executive functioning (sustained attention, working memory, verbal fluency, and speed of motor and mental processing), identified by psychometric testing; this subset had greater functional impairment in one study, resulting in lower academic, occupational, and socioeconomic achievement
Differential diagnosis for ADHD includes depression, bipolar disorder, generalized anxiety, substance abuse, and learning disability; some of these may be co morbiddiagnoses. Medical conditions with symptoms overlapping ADHD include hyperthyroidism, seizure disorder, lead toxicity, and adverse effects from medications or head injury.
Its absolutely important for the diagnosis to be established properly initially not only for proper treatment, the lack of which would be detrimental to one’s functional life, but also because lack of proper diagnosis can cause exacerbation of another condition that may have been masked by ADHD.