A report on Attention deficit hyperactivity disorder

People with ADHD may struggle more than others to focus on tasks such as schoolwork, but can maintain an unusually intense level of attention for tasks they find rewarding or interesting
The left prefrontal cortex, shown here in blue, is often affected in ADHD.
Percent of people 4–17 ever diagnosed in the US as of 2011
Timeline of ADHD diagnostic criteria, prevalence, and treatment

Neurodevelopmental disorder characterized by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate.

- Attention deficit hyperactivity disorder
People with ADHD may struggle more than others to focus on tasks such as schoolwork, but can maintain an unusually intense level of attention for tasks they find rewarding or interesting

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Overall

Skeletal formula of dopamine

Dopamine

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Neuromodulatory molecule that plays several important roles in cells.

Neuromodulatory molecule that plays several important roles in cells.

Skeletal formula of dopamine
Dopamine processing in a synapse. After release dopamine can either be taken up again by the presynaptic terminal, or broken down by enzymes.
TH: tyrosine hydroxylase
DOPA: L-DOPA
DAT: dopamine transporter
DDC: DOPA decarboxylase
VMAT: vesicular monoamine transporter 2
MAO: Monoamine oxidase
COMT: Catechol-O-methyl transferase
HVA: Homovanillic acid
Major dopamine pathways. As part of the reward pathway, dopamine is manufactured in nerve cell bodies located within the ventral tegmental area (VTA) and is released in the nucleus accumbens and the prefrontal cortex. The motor functions of dopamine are linked to a separate pathway, with cell bodies in the substantia nigra that manufacture and release dopamine into the dorsal striatum.
Main circuits of the basal ganglia. The dopaminergic pathway from the substantia nigra pars compacta to the striatum is shown in light blue.
Illustration of dopaminergic reward structures
Dopamine HCl preparation, single dose vial for intravenous administration
Cocaine increases dopamine levels by blocking dopamine transporters (DAT), which transport dopamine back into a synaptic terminal after it has been emitted.
Methamphetamine hydrochloride also known as crystal meth
Dopamine can be found in the peel and fruit pulp of bananas.

Restless legs syndrome and attention deficit hyperactivity disorder (ADHD) are associated with decreased dopamine activity.

Bipolar disorder is characterized by episodes of depression and mania.

Bipolar disorder

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Mood disorder characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each.

Mood disorder characterized by periods of depression and periods of abnormally-elevated happiness that last from days to weeks each.

Bipolar disorder is characterized by episodes of depression and mania.
Bipolar mood shifts
An 1892 color lithograph depicting a woman diagnosed with hilarious mania
An 1858 lithograph captioned 'Melancholy passing into mania'
'Melancholy' by William Bagg, after a photograph by Hugh Welch Diamond
Brain imaging studies have revealed differences in the volume of various brain regions between patients with bipolar disorder and healthy control subjects.
Since Emil Kraepelin's distinction between bipolar disorder and schizophrenia in the 19th century, researchers have defined a spectrum of different types of bipolar disorder.
Simplified graphical comparison of bipolar I, bipolar II and cyclothymia
Lithium is the only medication approved by the FDA for treating mania in children.
Lithium is often used to treat bipolar disorder and has the best evidence for reducing suicide.
German psychiatrist Emil Kraepelin first distinguished between manic–depressive illness and "dementia praecox" (now known as schizophrenia) in the late 19th century.
Singer Rosemary Clooney's public revelation of bipolar disorder made her an early celebrity spokesperson for mental illness.

Other conditions that have overlapping symptoms with bipolar disorder include attention deficit hyperactivity disorder, personality disorders, schizophrenia, and substance use disorder as well as many other medical conditions.

Repetitively stacking or lining up objects is associated with autism spectrum disorder.

Autism spectrum

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Range of neurodevelopmental conditions generally characterized by difficulties in social interactions and communication, repetitive behaviors, intense interests, and unusual responses to sensory stimuli.

Range of neurodevelopmental conditions generally characterized by difficulties in social interactions and communication, repetitive behaviors, intense interests, and unusual responses to sensory stimuli.

Repetitively stacking or lining up objects is associated with autism spectrum disorder.
A young autistic boy who has arranged his toys in a row
Hundreds of different genes are implicated in susceptibility to developing autism, most of which alter the brain structure in a similar way
Process for screening and diagnosing ASD; M-CHAT is Modified Checklist for Autism in Toddlers; (+) is positive test result; (-) is negative test result
An autistic three-year-old points to fish in an aquarium, as part of an experiment on the effect of intensive shared-attention training on language development.
Reports of autism cases per 1,000 children rose considerably in the US from 1996 to 2007. It is unknown how much growth came from changes in rates of autism.
Portrait of Victor of Aveyron, a feral child caught in 1798 who displayed possible symptoms of autism
Leo Kanner introduced the label early infantile autism in 1943.
Donna Williams, one of several memoirists who have introduced the general public to a more nuanced, emic portrayal of life on the spectrum

It is unclear why autism commonly co-occurs with ADHD, intellectual disabilities, epilepsy and a range of other conditions.

A drawing of someone with insomnia from the 14th century

Insomnia

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Sleep disorder in which people have trouble sleeping.

Sleep disorder in which people have trouble sleeping.

A drawing of someone with insomnia from the 14th century
Potential complications of insomnia.
Normison (temazepam) is a benzodiazepine commonly prescribed for insomnia and other sleep disorders.
Disability-adjusted life year for insomnia per 100,000 inhabitants in 2004.
no data
less than 25
25–30.25
30.25–36
36–41.5
41.5–47
47–52.5
52.5–58
58–63.5
63.5–69
69–74.5
74.5–80
more than 80

Mental, neurobehavioral, or neurodevelopmental disorders such as bipolar disorder, clinical depression, generalized anxiety disorder, post traumatic stress disorder, schizophrenia, obsessive compulsive disorder, autism, dementia, ADHD, Asperger syndrome, and FASD

DSM-5

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2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA).

2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA).

Attention deficit hyperactivity disorder (ADHD).

Georges Gilles de la Tourette (1857–1904),
namesake of Tourette syndrome

Tourette syndrome

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Common neurodevelopmental disorder that begins in childhood or adolescence.

Common neurodevelopmental disorder that begins in childhood or adolescence.

Georges Gilles de la Tourette (1857–1904),
namesake of Tourette syndrome
André Malraux (center) was a French Minister of Culture, author and adventurer who may have had Tourette syndrome.
The basal ganglia and thalamus are implicated in Tourette syndrome.
Clonidine is one of the medications typically tried first when medication is needed for Tourette's. It is available as a pill or a transdermal (skin) patch.
Tim Howard, described in 2019 by a staff writer for the Los Angeles Times as the "greatest goalkeeper in U.S. soccer history", attributes his success in the sport to his Tourette's.
Jean-Martin Charcot was a French neurologist and professor who named Tourette syndrome for his intern, Georges Gilles de la Tourette. In A Clinical Lesson at the Salpêtrière (1887), André Brouillet portrays a medical lecture by Charcot (the central standing figure) and shows de la Tourette in the audience (seated in the first row, wearing an apron).
Samuel Johnson c. undefined 1772. Johnson is likely to have had Tourette syndrome.

Other conditions, such as attention deficit hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD), are more likely to be present among those who are referred to specialty clinics than they are among the broader population of persons with Tourette's. These co-occurring conditions often cause more impairment to the individual than the tics; hence it is important to correctly distinguish co-occurring conditions and treat them.

Amphetamine

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Amphetamine (contracted from a lpha- m ethyl ph en et hyl amine ) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity.

Ritalin: 20 mg sustained-release (SR) tablets

Stimulant

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Overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects.

Overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects.

Ritalin: 20 mg sustained-release (SR) tablets
A chart comparing the chemical structures of different amphetamine derivatives
Roasted coffee beans, a common source of caffeine.
Tablets containing MDMA
Lines of illicit cocaine, used as a recreational stimulant
Catha edulis

Stimulants in therapeutic doses, such as those given to patients with ADHD, increases ability to focus, vigor, sociability, libido and may elevate mood.

Orbitofrontal cortex, part of the prefrontal cortex that shapes decision-making

Impulsivity

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Tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences.

Tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences.

Orbitofrontal cortex, part of the prefrontal cortex that shapes decision-making

Impulsivity is both a facet of personality and a major component of various disorders, including FASD, ADHD, substance use disorders, bipolar disorder, antisocial personality disorder, and borderline personality disorder.

A child with Down syndrome

Neurodevelopmental disorder

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Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect emotion, learning ability, self-control, and memory.

Neurodevelopmental disorders are a group of disorders that affect the development of the nervous system, leading to abnormal brain function which may affect emotion, learning ability, self-control, and memory.

A child with Down syndrome
CT scan showing epidural hematoma, a type of traumatic brain injury (upper left)

1) Attention deficit hyperactivity disorder (ADHD)