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Attention deficit disorder : ウィキペディア英語版
Attention deficit hyperactivity disorder



Attention deficit hyperactivity disorder (ADHD, similar to hyperkinetic disorder in the ICD-10) is a neurodevelopmental psychiatric disorder in which there are significant problems with executive functions (e.g., attentional control and inhibitory control) that cause attention deficits, hyperactivity, or impulsiveness which is not appropriate for a person's age. These symptoms must begin by age six to twelve and persist for more than six months for a diagnosis to be made. In school-aged individuals inattention symptoms often result in poor school performance. Although it causes impairment, particularly in modern society, many children have a good attention span for tasks they find interesting.〔

Despite being the most commonly studied and diagnosed psychiatric disorder in children and adolescents, the cause in the majority of cases is unknown. The World Health Organization estimates that it affected about 39 million people as of 2013. It affects about 6–7% of children when diagnosed via the DSM-IV criteria and 1–2% when diagnosed via the ICD-10 criteria. Rates are similar between countries and depend mostly on how it is diagnosed. ADHD is diagnosed approximately three times more in boys than in girls. About 30–50% of people diagnosed in childhood continue to have symptoms into adulthood and between 2–5% of adults have the condition.〔〔 The condition can be difficult to tell apart from other disorders as well as that of high normal activity.〔

ADHD management recommendations vary by country and usually involves some combination of counseling, lifestyle changes, and medications. The British guideline only recommends medications as a first-line treatment in children who have severe symptoms and for them to be considered in those with moderate symptoms who either refuse or fail to improve with counseling. Canadian and American guidelines recommend that medications and behavioral therapy be used together as a first-line therapy, except in preschool-aged children.〔 Stimulant therapy is not recommended as a first-line therapy in preschool-aged children in either guideline.〔〔 Treatment with stimulants is effective for up to 14 months; however, its long term effectiveness is unclear.〔 Adolescents and adults tend to develop coping skills which make up for some or all of their impairments.〔

ADHD, its diagnosis, and its treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents, and the media. Topics include ADHD's causes and the use of stimulant medications in its treatment. Most healthcare providers accept ADHD as a genuine disorder, and the debate in the scientific community mainly centers on how it is diagnosed and treated. Before 1987 the condition was known as attention deficit disorder (ADD).
==Signs and symptoms==
Inattention, hyperactivity (restlessness in adults), disruptive behavior, and impulsivity are common in ADHD. Academic difficulties are frequent as are problems with relationships.〔 The symptoms can be difficult to define as it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and significant levels requiring interventions begin.
To be diagnosed per DSM-5, symptoms must be observed in multiple settings for six months or more and to a degree that is much greater than others of the same age. They must also cause problems in the person's social, academic, or work life.〔
Based on the presenting symptom ADHD can be divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined type.〔
An individual with inattention may have some or all of the following symptoms:
* Be easily distracted, miss details, forget things, and frequently switch from one activity to another
* Have difficulty maintaining focus on one task
* Become bored with a task after only a few minutes, unless doing something enjoyable
* Have difficulty focusing attention on organizing and completing a task or learning something new
* Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
* Not seem to listen when spoken to
* Daydream, become easily confused, and move slowly
* Have difficulty processing information as quickly and accurately as others
* Struggle to follow instructions
An individual with hyperactivity may have some or all of the following symptoms:〔
* Fidget and squirm in their seats
* Talk nonstop
* Dash around, touching or playing with anything and everything in sight
* Have trouble sitting still during dinner, school, doing homework, and story time
* Be constantly in motion
* Have difficulty doing quiet tasks or activities
These hyperactivity symptoms tend to go away with age and turn into "inner restlessness" in teens and adults with ADHD.〔
An individual with impulsivity may have some or all of the following symptoms:〔
* Be very impatient
* Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
* Have difficulty waiting for things they want or waiting their turns in games
* Often interrupt conversations or others' activities
People with ADHD more often have difficulties with social skills, such as social interaction and forming and maintaining friendships. This is true for all subtypes. About half of children and adolescents with ADHD experience social rejection by their peers compared to 10–15% of non-ADHD children and adolescents. People with ADHD have attention deficits which cause difficulty processing verbal and nonverbal language which can negatively affect social interaction. They also may drift off during conversations, and miss social cues.
Difficulties managing anger are more common in children with ADHD〔(【引用サイトリンク】title=ADHD Anger Management Directory )〕 as are poor handwriting and delays in speech, language and motor development.〔 Although it causes significant impairment, particularly in modern society, many children with ADHD have a good attention span for tasks they find interesting.〔

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
ウィキペディアで「Attention deficit hyperactivity disorder」の詳細全文を読む



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