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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Attention deficit hyperactivity disorder
Other Resources UpToDate PubMed

Attention deficit hyperactivity disorder

Contributors: Shea A. Nagle MPH, David Sullo MD, Abhijeet Waghray MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by a persistent pattern of inattention and/or hyperactivity or impulsivity in more than one social setting. Among the behaviors contributing to functional impairment are difficulty focusing (sitting still, listening, following directions), fidgeting, restlessness, persistent motion (running, climbing, jumping), persistent interrupting and talking, and other behaviors that interfere with social, occupational, or academic function. Children may have academic deficits and more reported behavior problems at school.

Typically, symptoms present before age 12. When diagnosed in adults, presenting symptoms include inattention, restlessness, and impulsivity but also involve emotional dysregulation (angry outbursts, low threshold of frustration) and executive dysfunction (trouble organizing and completing tasks, missing appointments or deadlines). Hoarding symptoms may be present in up to 25% of adults with ADHD.

The prevalence of ADHD is about 5% in pediatric and 2.5% in adult populations. In children, ADHD is twice as common in boys compared to girls; however, girls are more likely to present with predominantly inattentive symptoms. Smoking exposure during fetal development, low birth weight, and a first-degree relative with ADHD are associated with increased risk for developing ADHD.

Codes

ICD10CM:
F90.9 – Attention-deficit hyperactivity disorder, unspecified type

SNOMEDCT:
406506008 – Attention Deficit Hyperactivity Disorder

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Normal variation in learning and cognition
  • Autism spectrum disorder
  • Stereotypic movement disorder
  • Tourette syndrome
  • Childhood absence epilepsy
  • Specific learning disorder: reading, writing, math
  • Intellectual disability
  • Oppositional defiant disorder
  • Intermittent explosive disorder
  • Anxiety disorders (see Generalized anxiety disorder)
  • Depressive disorders
  • Bipolar disorders
  • Disruptive mood dysregulation disorder
  • Obsessive-compulsive disorder
  • Personality disorders, particularly cluster B
  • Psychotic disorder
  • Neurocognitive disorder: Dementia, early Alzheimer disease
  • Substance use disorder
  • Inattention or hyperactivity secondary to a medical disorder: Hyperthyroidism, Hypothyroidism, hearing loss, vision loss, Obstructive sleep apnea, etc
  • Medication-induced symptoms: bronchodilators, isoniazid, levothyroxine, etc

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:02/13/2020
Last Updated:02/23/2020
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Attention deficit hyperactivity disorder
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A medical illustration showing key findings of Attention deficit hyperactivity disorder : Restlessness, Forgetfulness
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