Attention-deficit hyperactivity disorder history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2], Haleigh Williams, B.S.
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Overview
The most common symptoms of ADHD include chronic and long-lasting hyperactivity, impulsivity, and inattention.[1]
History
Obtaining a thorough history is useful for the diagnosis of ADHD. It is particularly important to collect a family history with regard to psychiatric disorders, as ADHD has such a strong genetic component. It is also vital to understand how long the patient has been experiencing symptoms of ADHD, as the DSM-V stipulates that symptoms must have been present for at least 6 months in order for a diagnosis of ADHD to be made. Similarly, an adult cannot be diagnosed with ADHD unless his/her symptoms were present prior to the age of 12 years.[2]
Common symptoms
The primary symptoms of ADHD are inattention, hyperactivity, and impulsivity. While healthy people may exhibit these characteristics on occasion, they appear more frequently and in a more severe form in people with ADHD, and they often interfere with the patient’s academic or professional performance.[1]
Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension. Inattention may manifest itself as:
- Overlooking details or making careless mistakes;
- Struggling to pay attention during lectures, conversations, or lengthy readings;
- Appearing not to be listening while being spoken to directly;
- Quickly losing focus and being easily distracted from the tasks at hand;
- Avoiding or disliking tasks that require sustained mental effort; and/or
- Being forgetful or easily distracted in daily activities, such as chores or errands.[1]
Hyperactivity means a person seems to move about constantly, especially in situations in which it is not appropriate, and excessively fidgets, taps, or talks. Impulsivity means a person behaves without thinking, including actions that may have high potential for harm. Impulsivity also encompasses a desire for immediate rewards and/or an inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without first considering the potential long-term consequences.[1] Hyperactivity/impulsivity may manifest as:
- Excessive fidgeting or squirming;
- Leaving their seats in situations where staying seated is expected, such as in the classroom or the office;
- Being unable to play or engage in hobbies quietly;
- Being constantly in motion or “on the go;”
- Talking nonstop; and/or
- Interrupting others during conversations or activities.[1]
ADHD symptoms can appear as early as between the ages of 3 and 6 and continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, which can lead to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.[1]
ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and may be replaced by feelings of restlessness or fidgeting, though inattention and impulsivity often remain. Many adolescents with ADHD also struggle with relationships and antisocial behavior.[1]