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In two places (including the lead) a questionably precise figure, 2.58%, is given for prevalence of adult ADHD (childhood onset), based on the estimate of a recent meta-analysis. This looks like a good source, but there are caveats: particularly the pooling of studies using different diagnostic criteria, and also variation between individual studies which the authors noted "could not be fully ruled out by a priori selected variables". If the childhood prevalence estimates are so broad (according to different diagnostic criteria) I find it hard to imagine there isn't the same level of uncertainty around adult ADHD & different diagnostic criteria. I'd be inclined to use a more explicit attributed statement, such as "a 2021 meta-analysis estimated a prevalence of 2.58%", or perhaps in the lead "an estimated prevalence of around 2.6%" or "around "2.5%" (in line with other sources). Additionally, the 2014 literature review also cited in the lead sentence provides a different figure, a range of 2.5-5%. Should we instead include a range, or does the meta-analysis unambiguously supersede this? Any thoughts welcome, & pinging @ Xurizuri as I see they did some work on this in July. Jr8825 • Talk 17:38, 24 August 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 9 December 2022. Further details are available on the course page. Student editor(s): Smummert1 ( article contribs).
— Assignment last updated by Brennam29 ( talk) 15:21, 21 September 2022 (UTC)
The work of Dr Barkley and other experts seems to indicate that ADHD may in fact be two separate conditions that result from different mechanisms.
One of them has historically been called ADHD-PH (predominantly hyperactive).
The other has historically been called ADHD-PI (predominantly inattentive), as well as SCT (Sluggish Cognitive Tempo) and, in Dr Barkley's work, CDD (Concentration Deficit Disorder).
The hypothesis goes that stimulants are only effective on the first disorder and not the second because they are caused by different mechanisms.
I think such interesting ideas (being also supported by some experts) would serve the reader's awareness of current research. EditorPerson53 ( talk) 17:58, 24 September 2022 (UTC)
Currently this article says, "Malnourishment can result in symptoms that look similar to those of ADHD, which has the potential to be misdiagnosed as "ADHD" without proper clinical assessment and screening for disordered eating and nutritional adequacy. Individuals with co-morbid ADHD and disordered eating should be referred to a Registered Dietitian who specializes in using a Health at Every Size and Intuitive Eating approach, combined with neurodivergent-affirming, eating-disorder-informed care, for proper treatment." This is the source link, a pay-to-view webinar: https://edrdpro.com/tag/adhd/
Health at every size/Intuitive eating are pretty controversial and it seems inappropriate for the article to recommend them as a treatment for eating disorders, or to recommend treatments for eating disorders at all, really, especially making it seem as if this is the medical consensus on the topic. 2001:9E8:238:2900:D1E0:1127:ADDC:86AD ( talk) 12:48, 18 October 2022 (UTC)
The paragraph "Despite a popular myth, it does not appear to be related to any particular style of parenting or discipline" and the cited source [15] contain a suggestive nature and are poorly worded in my eyes. A single MD's opinion piece quoting polls does not suffice as a valid argumentative ground to call it a myth, especially if it's says at the beginning that causes are not known for sure. Suggesting a rewording like "A connection to a particular style of parenting or discipline appears to be debatable." 91.6.16.168 ( talk) 21:48, 27 September 2022 (UTC)
The result of the move request was: not moved. per discussion consensus. WP:MEDTITLE, WP:ACROTITLE were more convincing to participants, based upon the "official" and "recognized medical name" criteria, and that ACROTITLE may not apply given how commonly know the official name is. ACROTITLE is most commonly employed for acronym titles which are confusing to those searching for the article, given that they are seldom spelled out. This is not the case for ADHD, as multiple participants pointed out. Participants were not as convinced by WP:NCACRO as a reason to move the title, given its common usage in a spelled-out form.( closed by non-admin page mover) — Shibbolethink ( ♔ ♕) 03:08, 31 October 2022 (UTC)
Attention deficit hyperactivity disorder → ADHD – Per WP:UCRN. "ADHD" is incidentally already a redirect to this page. In this article it is referred to as "ADHD" approx. 7 times more than "attention deficit hyperactivity disorder". Regarding WP:MEDTITLE, this is the recognised medical name (as an abbreviation). 12u ( talk) 17:42, 14 October 2022 (UTC) — Relisting. — Ceso femmuin mbolgaig mbung, mello hi! ( 投稿) 19:43, 23 October 2022 (UTC)
Wondering if this should be removed or at least altered. It doesn't seem like the sources provided for the point that 10-20% of patients with ADHD report paradoxical reactions to stimulants and anesthetics are adequate to back up such a bold claim.
They are a letter to the editor of a journal stating that the authors observed reports of this in their outpatient ADHD clinic and then a piece published by two of the authors of the aforementioned letter that mentions paradoxical reactions existing as a side note at the end without any additional citations. These are the only mentions of this reaction I can find at all in the academic literature. If anyone else with more journal access can find something more substantial we should add it but if not, it seems like this section should either be altered to reflect the fact that in reality there's very little clinical evidence for this or just removed entirely. LanaDelEditor ( talk) 21:08, 5 December 2022 (UTC)
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Could you change DSM-4 to DSM-5 and ICD-10 to ICD-11 under Dignosis? Thank you! ÄËÖÜÏŁ ( talk) 15:00, 23 January 2023 (UTC)
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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder (Childhood) characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate. Icsabc ( talk) 00:17, 8 February 2023 (UTC)
The figures on the comorbidities of Conduct Disorder and Oppositional Defiance Disorder with ADHD appears to be largely inflated.
"Oppositional defiant disorder (ODD) occurs in about 25% of children with an inattentive presentation and 50% of those with a combined presentation."
"Conduct disorder (CD) occurs in about 25% of adolescents with ADHD."
Both have referenced the DSM-5-TR however I've had a read through and was unable to find these numbers anywhere. Also couldn't find any evidence to suggest that the inverse may be true - ie that ADHD occurs in 25% of children/adolescents with ODD/CD. Aaalliex ( talk) 10:25, 8 April 2023 (UTC)
Could someone add this under Management -> Medication -> Non-stimulants:
Low-dose cannabinoids have shown moderate to large positive effects on core ADHD symptoms in the absence of adverse effects; this implicates the cannabinoid system as a potential new target for drug development. https://pubmed.ncbi.nlm.nih.gov/28576350/ Douweziel ( talk) 00:47, 4 April 2023 (UTC)
The article gives various prevalence figures that may be confusing and potentially not consistent with each other. We should reconcile and consolidate prevalence information:
It affects about 5–7% of children when diagnosed via the DSM-IV criteria, and 1–2% when diagnosed via the ICD-10 criteria. [in lede]
About 30–50% of people diagnosed in childhood continue to have ADHD in adulthood, with 2.58% of adults estimated to have ADHD which began in childhood. [in lede]
Frequency 0.8-1.5% (2019, using DSM-IV-TR and ICD-10) [in infobox, using term "frequency"]
ADHD is estimated to affect about 6–7% of people aged 18 and under when diagnosed via the DSM-IV criteria. When diagnosed via the ICD-10 criteria, rates in this age group are estimated around 1–2%. [Epidemiology subsection]
This question does not seem to have been comprehensively discussed before, although there were partial previous discussions potentially relevant: 2022-09 2013-08 AncientWalrus ( talk) 10:02, 23 May 2023 (UTC)
Many studies and a highly substantiated meta-analysis (citated in article) determined that atomoxetine (ATX) is equally as effective as methylphenidate (MTH) in terms of degree of improvement in alleviating symptoms.
Said research and those studies cited by the meta-analysis used school/academic performance as core factors in substantiating effect and improvement of symptoms; especially to compare the efficacy between MTH & ATX.
The very fact that this is the case supports benefits in academic performance and this conclusion is not implied. Therefore the singular, outdated study from 2014 suggesting otherwise is scientifically unsupportable compared to the mountains of evidence showing otherwise and should be redacted, in my view.
I also wouldn't consider this a synthesised conclusion as I am utilising the available information specified in the studies, especially those reviewed by the meta-analysis in achieving their results even if this exact topic was not the main objective of the research. Димитрий Улянов Иванов ( talk) 14:38, 20 September 2023 (UTC)
Revising 'subtypes' to presentations
Basis for edit: DSM-5 (the diagnostic and statistical manual of mental disorders version 5), our diagnostic manual, does not have “subtypes" and they were replaced with presentations in the new, 5th edition. Subtypes were used in DSM-4. It was once thought there were three types of ADHD but DSM now recognises that these are not valid subtypes but presentations of the disorder that change over time.
Adding additional symptoms:
Basis for edit: emotional dysregulation, disinhibition and impaired working memory are all underlying and recognised symptoms of ADHD most of which, if not all, are mentioned further down in the article. You can also see the International Consensus Statement on ADHD for references.
Alphabetically ordering CDS above CD
Basis for edit: alphabetically, cognitive disengagement syndrome comes before conduct disorder as the g is a predecessor to n in the standard English alphabet (A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V, W, X, Y Z)
Revising hyperfocus:
Basis for edit: it is erroneous to state that people with ADHD simply cannot sustain attention on tasks they are not interested in completing; they are often interested in completing the task, but their executive self-regulatory deficits prevent them from doing so. Usually, the delay between the action and its consequence or reward is what disables the person with ADHD. This is known as time-blindness.
Using "sustained attention" over "focus":
Basis for edit: there are 6 different types of attention in humans: focused attention, sustained attention, span of apprehension, arousal, alertness, and divided attention. Psychologists Alan Mirsky and David Posner have written reviews about them that you can find using Google Scholar. ADHD only implicates sustained attention, the self-regulatory executive functioning kind, and not focused attention hence the correction there. The other attention disorder, cognitive disengagement syndrome, affects oriented or focused attention.
(colloquially, focus/focused attention can also refer to a more broader perspective however it's still better and more accurate to use sustained attention in the context of ADHD)
If you are in disagreement with only a one or select amount of these edits, please critique here, and do not contain or reverse every single one! Thankyou.
Димитрий Улянов Иванов (
talk) 16:26, 20 October 2023 (UTC)
Further, though, the "main article" of that section, History of attention deficit hyperactivity disorder says (emphasis mine):In 1987, this was changed to ADHD in the DSM-III-R, and in 1994 the DSM-IV in split the diagnosis into three subtypes: ADHD inattentive type, ADHD hyperactive-impulsive type, and ADHD combined type. These terms were kept in the DSM-5 in 2013 and in the DSM-5-TR in 2022. […] ADHD was split into the current three sub-types because of a field trial completed by Lahey and colleagues.
These should all be edited for consistency and I think "presentation" is the more accurate up-to-date term to use in the main article body. Kimen8 ( talk) 16:47, 20 October 2023 (UTC)Under the DSM-5, there are three ADHD presentations, including one which lacks the hyperactivity component.
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The diamine oxidase (DAO) enzyme, which metabolizes histamine extracellularly, may play a key role in the pathophysiology of ADHD. A decreased DAO activity may lead to an accumulation of histamine, which could contribute to ADHD symptoms.
reference Blasco-Fontecilla H. Is Histamine and Not Acetylcholine the Missing Link between ADHD and Allergies? Speer Allergic Tension Fatigue Syndrome Re-Visited. J Clin Med. 2023 Aug 17;12(16):5350. doi: 10.3390/jcm12165350. PMID: 37629392; PMCID: PMC10455974. Jofeenstra ( talk) 00:57, 24 October 2023 (UTC)
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. PianoDan ( talk) 21:18, 24 October 2023 (UTC)
ADD SECTIONS OR CREATE A SOMARY, because the article is very long. (Sorry for the english) BlueDevil455054 ( talk) 02:20, 27 January 2023 (UTC)
Suggest revising "ADHD is diagnosed approximately twice as often in boys as in girls..." to "ADHD is diagnosed approximately twice as often in boys than in girls..."
This is a minor change. For what it's worth, I had to read the sentence a few times to understand the meaning. 2603:6000:DC01:AC86:4D7B:52CE:5C39:7452 ( talk) 19:19, 1 December 2023 (UTC)
I heard (from my psychiatrist, actually) that ADHD is just a nomenclature and even that being the name of the disorder, people may or may not develop hyperactivity. I'm a bit busy at the moment and away from my Computer. But I'll try to find any reliable source on that as soon as I can. — Nanami73 talk 17:17, 20 December 2023 (UTC)
In this on 22 October 2023, Димитрий Улянов Иванов changed the lead sentence of the article from:
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
to
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
The edit summary states: "Revised the initial description to be more accurate concerning the disorder and its symptoms. As noted in the paragraph below (with citations), ADHD symptoms arise from executive dysfunction (the underlying deficit in ADHD is EF) and emotional dysregulation is often considered a core symptom."
While the user is correct that this article does note that the article does state that "ADHD symptoms arise from executive dysfunction", this is not necessarily accurate about ADHD, nor are the statements claiming it well supported. (I do not object to the "emotional dysregulation" aspect being added.)
For example, let's examine that statement in the second paragraph of the article: "ADHD symptoms arise from executive dysfunction..." To support this, three references are given; however, only two actually discuss "executive dysfunction" in ADHD. (The Malenka does not mention “executive dysfunction" in regards to ADHD and would be an WP:OR interpretation). The first is a 2008 article with the single author, Thomas Brown, in which the author acknowledges that his opinion that ADHD is "cognitive disorder, a developmental impairment of executive functions (EFs)" is a departure from the belief of "many clinicians". This article fails WP:MEDRS and also likely fails WP:FRINGE and/or WP:DUE, as the author notes his opinion is in conflict with “many clinicians” and is also in conflict with the WP:MEDRS compliant article below. The second is a single-author manuscript by Diamond from 2012–13, which only mentions ADHD twice, and the references to it appear to be “provided in passing” per WP:CONTEXTMATTERS. In any case, it is also not a WP:MEDRS complaint source.
Other areas of the article also seem to have similar statements: The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." To support this, a single reference is given with the supporting quote, "Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention." The source merely notes that "early results" show that those with ADHD, as a group, may have thinning in areas that impact "working memory and attention." It does not say "symptoms of ADHD arise from a deficiency in certain executive functions". Attempts to say otherwise would be, at best, WP:OR.
The objection I have to the phrase "executive dysfunction" being used in the way it is used in article is that it implies that executive dysfunction is not only required for a diagnosis of ADHD, but is also the cause of ADHD. I do not feel this is accurate, nor is supported by the weight of the evidence, nor do the DSM nor the ICD mention "executive dysfunction" in regards to ADHD. While executive dysfunction is certainly more common in those with ADHD, it is far from required for a diagnosis, much less the cause of the disorder. A
WP:MEDRS complaint source states: "Specifically, estimates for the proportion of pediatric ADHD cases who exhibit any form of executive dysfunction range from 21% to 60% across studies employing a wide range of tasks and impairment criteria (Biederman et al., 2004; Coghill et al., 2014; Fair, Bathula, Nikolas, & Nigg, 2012; Geurts, van der Oord, & Crone, 2006; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke, Bitsalou, & Thompson, 2010)." (Kofler MJ, Irwin LN, Soto EF, Groves NB, Harmon SL, Sarver DE (February 2019).
"Executive Functioning Heterogeneity in Pediatric ADHD". Journal of Abnormal Child Psychology. 47 (2): 273–286.
doi:
10.1007/s10802-018-0438-2.
PMC
6204311.
PMID
29705926.) My point is more explicitly stated in a WP:RS (but admittedly not a WP:MEDRS due to age): "Indeed, executive dysfunction is not required for the diagnosis of ADHD, which is defined at the behavioral, rather than neuropsychological, level." (Cortese S, Comencini E, Vincenzi B, Speranza M, Angriman M (November 2013).
"Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?". BMC Psychiatry. 13: 286.
doi:
10.1186/1471-244X-13-286.
PMC
4226281.
PMID
24200119.{{
cite journal}}
: CS1 maint: unflagged free DOI (
link))
In summary, I feel the above statements should be modified to remove "executive dysfunction" as a cause of and/or requirement of ADHD. At the absolute minimum, if WP:RS and WP:MEDRS are found to give the viewpoint WP:DUE, WP:CONFLICTING states both viewpoints should be acknowledged. Wikipedialuva ( talk) 10:15, 9 January 2024 (UTC)
Here I examine the nature of and evidence for a frequently cited benefit of ADHD claimed in this article – that being “hyper-focusing (HF).". Despite its widespread belief, this relationship has not been explored much in the scientific literature, with less than 8 studies being identified. The results are conflicting, depending on whether the study used people who just had elevated symptoms of ADHD, and not the disorder, compared to studies of clinically diagnosed individuals who had the full disorder (symptoms and impairments). In general, there does seem to be a significant relationship between ADHD and HF when ADHD is measured as rated symptoms. But in clinically diagnosed people the results are conflicting, with one study finding the relationship and another not ( Groen et al., 2020; Ozel-Kizil et al., 2016). And while HF is often presented as a benefit or gift of ADHD, some studies show that it also has a very negative side, being related to risk for internet addiction ( Ishii et al., 2023) and certain types of offending behaviour ( Worthington & Wheeler, 2023). From my understanding the roots of hyperfocus are in the EF/poor self-regulation that underlies ADHD. People vary in the degree to which their behaviour is controlled by distant rewards (e.g., if I study a lot, I'll get a good job a few years from now) vs. immediate rewards (e.g., when playing a video game, the environment is providing a great deal of continuous and immediate rewards for engagement; placing little demands on EF) ( Jackson & Mackillop, 2016; Marx et al., 2021). For many people with ADHD, immediate rewards are very potent and can lead to such perseverative responding ( Patros et al., 2016), even to the point of an inability to disengage from such environments likely linked to the same deficits in the disorder (i.e., in inhibition and working memory). So, the claim that ADHD is definitely linked to hyper-focusing and that it is a positive trait is not definitively established at this time. More research is clearly needed but such claims of HF as being widespread among those with ADHD, and entirely a benefit, cannot be taken on face value as an established fact. Assertions in this article regarding HF should therefore be amended. Димитрий Улянов Иванов ( talk) 00:34, 16 January 2024 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 25 | Archive 26 | Archive 27 | Archive 28 |
In two places (including the lead) a questionably precise figure, 2.58%, is given for prevalence of adult ADHD (childhood onset), based on the estimate of a recent meta-analysis. This looks like a good source, but there are caveats: particularly the pooling of studies using different diagnostic criteria, and also variation between individual studies which the authors noted "could not be fully ruled out by a priori selected variables". If the childhood prevalence estimates are so broad (according to different diagnostic criteria) I find it hard to imagine there isn't the same level of uncertainty around adult ADHD & different diagnostic criteria. I'd be inclined to use a more explicit attributed statement, such as "a 2021 meta-analysis estimated a prevalence of 2.58%", or perhaps in the lead "an estimated prevalence of around 2.6%" or "around "2.5%" (in line with other sources). Additionally, the 2014 literature review also cited in the lead sentence provides a different figure, a range of 2.5-5%. Should we instead include a range, or does the meta-analysis unambiguously supersede this? Any thoughts welcome, & pinging @ Xurizuri as I see they did some work on this in July. Jr8825 • Talk 17:38, 24 August 2022 (UTC)
This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 9 December 2022. Further details are available on the course page. Student editor(s): Smummert1 ( article contribs).
— Assignment last updated by Brennam29 ( talk) 15:21, 21 September 2022 (UTC)
The work of Dr Barkley and other experts seems to indicate that ADHD may in fact be two separate conditions that result from different mechanisms.
One of them has historically been called ADHD-PH (predominantly hyperactive).
The other has historically been called ADHD-PI (predominantly inattentive), as well as SCT (Sluggish Cognitive Tempo) and, in Dr Barkley's work, CDD (Concentration Deficit Disorder).
The hypothesis goes that stimulants are only effective on the first disorder and not the second because they are caused by different mechanisms.
I think such interesting ideas (being also supported by some experts) would serve the reader's awareness of current research. EditorPerson53 ( talk) 17:58, 24 September 2022 (UTC)
Currently this article says, "Malnourishment can result in symptoms that look similar to those of ADHD, which has the potential to be misdiagnosed as "ADHD" without proper clinical assessment and screening for disordered eating and nutritional adequacy. Individuals with co-morbid ADHD and disordered eating should be referred to a Registered Dietitian who specializes in using a Health at Every Size and Intuitive Eating approach, combined with neurodivergent-affirming, eating-disorder-informed care, for proper treatment." This is the source link, a pay-to-view webinar: https://edrdpro.com/tag/adhd/
Health at every size/Intuitive eating are pretty controversial and it seems inappropriate for the article to recommend them as a treatment for eating disorders, or to recommend treatments for eating disorders at all, really, especially making it seem as if this is the medical consensus on the topic. 2001:9E8:238:2900:D1E0:1127:ADDC:86AD ( talk) 12:48, 18 October 2022 (UTC)
The paragraph "Despite a popular myth, it does not appear to be related to any particular style of parenting or discipline" and the cited source [15] contain a suggestive nature and are poorly worded in my eyes. A single MD's opinion piece quoting polls does not suffice as a valid argumentative ground to call it a myth, especially if it's says at the beginning that causes are not known for sure. Suggesting a rewording like "A connection to a particular style of parenting or discipline appears to be debatable." 91.6.16.168 ( talk) 21:48, 27 September 2022 (UTC)
The result of the move request was: not moved. per discussion consensus. WP:MEDTITLE, WP:ACROTITLE were more convincing to participants, based upon the "official" and "recognized medical name" criteria, and that ACROTITLE may not apply given how commonly know the official name is. ACROTITLE is most commonly employed for acronym titles which are confusing to those searching for the article, given that they are seldom spelled out. This is not the case for ADHD, as multiple participants pointed out. Participants were not as convinced by WP:NCACRO as a reason to move the title, given its common usage in a spelled-out form.( closed by non-admin page mover) — Shibbolethink ( ♔ ♕) 03:08, 31 October 2022 (UTC)
Attention deficit hyperactivity disorder → ADHD – Per WP:UCRN. "ADHD" is incidentally already a redirect to this page. In this article it is referred to as "ADHD" approx. 7 times more than "attention deficit hyperactivity disorder". Regarding WP:MEDTITLE, this is the recognised medical name (as an abbreviation). 12u ( talk) 17:42, 14 October 2022 (UTC) — Relisting. — Ceso femmuin mbolgaig mbung, mello hi! ( 投稿) 19:43, 23 October 2022 (UTC)
Wondering if this should be removed or at least altered. It doesn't seem like the sources provided for the point that 10-20% of patients with ADHD report paradoxical reactions to stimulants and anesthetics are adequate to back up such a bold claim.
They are a letter to the editor of a journal stating that the authors observed reports of this in their outpatient ADHD clinic and then a piece published by two of the authors of the aforementioned letter that mentions paradoxical reactions existing as a side note at the end without any additional citations. These are the only mentions of this reaction I can find at all in the academic literature. If anyone else with more journal access can find something more substantial we should add it but if not, it seems like this section should either be altered to reflect the fact that in reality there's very little clinical evidence for this or just removed entirely. LanaDelEditor ( talk) 21:08, 5 December 2022 (UTC)
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Could you change DSM-4 to DSM-5 and ICD-10 to ICD-11 under Dignosis? Thank you! ÄËÖÜÏŁ ( talk) 15:00, 23 January 2023 (UTC)
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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder (Childhood) characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate. Icsabc ( talk) 00:17, 8 February 2023 (UTC)
The figures on the comorbidities of Conduct Disorder and Oppositional Defiance Disorder with ADHD appears to be largely inflated.
"Oppositional defiant disorder (ODD) occurs in about 25% of children with an inattentive presentation and 50% of those with a combined presentation."
"Conduct disorder (CD) occurs in about 25% of adolescents with ADHD."
Both have referenced the DSM-5-TR however I've had a read through and was unable to find these numbers anywhere. Also couldn't find any evidence to suggest that the inverse may be true - ie that ADHD occurs in 25% of children/adolescents with ODD/CD. Aaalliex ( talk) 10:25, 8 April 2023 (UTC)
Could someone add this under Management -> Medication -> Non-stimulants:
Low-dose cannabinoids have shown moderate to large positive effects on core ADHD symptoms in the absence of adverse effects; this implicates the cannabinoid system as a potential new target for drug development. https://pubmed.ncbi.nlm.nih.gov/28576350/ Douweziel ( talk) 00:47, 4 April 2023 (UTC)
The article gives various prevalence figures that may be confusing and potentially not consistent with each other. We should reconcile and consolidate prevalence information:
It affects about 5–7% of children when diagnosed via the DSM-IV criteria, and 1–2% when diagnosed via the ICD-10 criteria. [in lede]
About 30–50% of people diagnosed in childhood continue to have ADHD in adulthood, with 2.58% of adults estimated to have ADHD which began in childhood. [in lede]
Frequency 0.8-1.5% (2019, using DSM-IV-TR and ICD-10) [in infobox, using term "frequency"]
ADHD is estimated to affect about 6–7% of people aged 18 and under when diagnosed via the DSM-IV criteria. When diagnosed via the ICD-10 criteria, rates in this age group are estimated around 1–2%. [Epidemiology subsection]
This question does not seem to have been comprehensively discussed before, although there were partial previous discussions potentially relevant: 2022-09 2013-08 AncientWalrus ( talk) 10:02, 23 May 2023 (UTC)
Many studies and a highly substantiated meta-analysis (citated in article) determined that atomoxetine (ATX) is equally as effective as methylphenidate (MTH) in terms of degree of improvement in alleviating symptoms.
Said research and those studies cited by the meta-analysis used school/academic performance as core factors in substantiating effect and improvement of symptoms; especially to compare the efficacy between MTH & ATX.
The very fact that this is the case supports benefits in academic performance and this conclusion is not implied. Therefore the singular, outdated study from 2014 suggesting otherwise is scientifically unsupportable compared to the mountains of evidence showing otherwise and should be redacted, in my view.
I also wouldn't consider this a synthesised conclusion as I am utilising the available information specified in the studies, especially those reviewed by the meta-analysis in achieving their results even if this exact topic was not the main objective of the research. Димитрий Улянов Иванов ( talk) 14:38, 20 September 2023 (UTC)
Revising 'subtypes' to presentations
Basis for edit: DSM-5 (the diagnostic and statistical manual of mental disorders version 5), our diagnostic manual, does not have “subtypes" and they were replaced with presentations in the new, 5th edition. Subtypes were used in DSM-4. It was once thought there were three types of ADHD but DSM now recognises that these are not valid subtypes but presentations of the disorder that change over time.
Adding additional symptoms:
Basis for edit: emotional dysregulation, disinhibition and impaired working memory are all underlying and recognised symptoms of ADHD most of which, if not all, are mentioned further down in the article. You can also see the International Consensus Statement on ADHD for references.
Alphabetically ordering CDS above CD
Basis for edit: alphabetically, cognitive disengagement syndrome comes before conduct disorder as the g is a predecessor to n in the standard English alphabet (A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P, Q, R, S, T, U, V, W, X, Y Z)
Revising hyperfocus:
Basis for edit: it is erroneous to state that people with ADHD simply cannot sustain attention on tasks they are not interested in completing; they are often interested in completing the task, but their executive self-regulatory deficits prevent them from doing so. Usually, the delay between the action and its consequence or reward is what disables the person with ADHD. This is known as time-blindness.
Using "sustained attention" over "focus":
Basis for edit: there are 6 different types of attention in humans: focused attention, sustained attention, span of apprehension, arousal, alertness, and divided attention. Psychologists Alan Mirsky and David Posner have written reviews about them that you can find using Google Scholar. ADHD only implicates sustained attention, the self-regulatory executive functioning kind, and not focused attention hence the correction there. The other attention disorder, cognitive disengagement syndrome, affects oriented or focused attention.
(colloquially, focus/focused attention can also refer to a more broader perspective however it's still better and more accurate to use sustained attention in the context of ADHD)
If you are in disagreement with only a one or select amount of these edits, please critique here, and do not contain or reverse every single one! Thankyou.
Димитрий Улянов Иванов (
talk) 16:26, 20 October 2023 (UTC)
Further, though, the "main article" of that section, History of attention deficit hyperactivity disorder says (emphasis mine):In 1987, this was changed to ADHD in the DSM-III-R, and in 1994 the DSM-IV in split the diagnosis into three subtypes: ADHD inattentive type, ADHD hyperactive-impulsive type, and ADHD combined type. These terms were kept in the DSM-5 in 2013 and in the DSM-5-TR in 2022. […] ADHD was split into the current three sub-types because of a field trial completed by Lahey and colleagues.
These should all be edited for consistency and I think "presentation" is the more accurate up-to-date term to use in the main article body. Kimen8 ( talk) 16:47, 20 October 2023 (UTC)Under the DSM-5, there are three ADHD presentations, including one which lacks the hyperactivity component.
This
edit request to
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The diamine oxidase (DAO) enzyme, which metabolizes histamine extracellularly, may play a key role in the pathophysiology of ADHD. A decreased DAO activity may lead to an accumulation of histamine, which could contribute to ADHD symptoms.
reference Blasco-Fontecilla H. Is Histamine and Not Acetylcholine the Missing Link between ADHD and Allergies? Speer Allergic Tension Fatigue Syndrome Re-Visited. J Clin Med. 2023 Aug 17;12(16):5350. doi: 10.3390/jcm12165350. PMID: 37629392; PMCID: PMC10455974. Jofeenstra ( talk) 00:57, 24 October 2023 (UTC)
Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. PianoDan ( talk) 21:18, 24 October 2023 (UTC)
ADD SECTIONS OR CREATE A SOMARY, because the article is very long. (Sorry for the english) BlueDevil455054 ( talk) 02:20, 27 January 2023 (UTC)
Suggest revising "ADHD is diagnosed approximately twice as often in boys as in girls..." to "ADHD is diagnosed approximately twice as often in boys than in girls..."
This is a minor change. For what it's worth, I had to read the sentence a few times to understand the meaning. 2603:6000:DC01:AC86:4D7B:52CE:5C39:7452 ( talk) 19:19, 1 December 2023 (UTC)
I heard (from my psychiatrist, actually) that ADHD is just a nomenclature and even that being the name of the disorder, people may or may not develop hyperactivity. I'm a bit busy at the moment and away from my Computer. But I'll try to find any reliable source on that as soon as I can. — Nanami73 talk 17:17, 20 December 2023 (UTC)
In this on 22 October 2023, Димитрий Улянов Иванов changed the lead sentence of the article from:
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
to
"Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by executive dysfunction occasioning inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and otherwise age-inappropriate."
The edit summary states: "Revised the initial description to be more accurate concerning the disorder and its symptoms. As noted in the paragraph below (with citations), ADHD symptoms arise from executive dysfunction (the underlying deficit in ADHD is EF) and emotional dysregulation is often considered a core symptom."
While the user is correct that this article does note that the article does state that "ADHD symptoms arise from executive dysfunction", this is not necessarily accurate about ADHD, nor are the statements claiming it well supported. (I do not object to the "emotional dysregulation" aspect being added.)
For example, let's examine that statement in the second paragraph of the article: "ADHD symptoms arise from executive dysfunction..." To support this, three references are given; however, only two actually discuss "executive dysfunction" in ADHD. (The Malenka does not mention “executive dysfunction" in regards to ADHD and would be an WP:OR interpretation). The first is a 2008 article with the single author, Thomas Brown, in which the author acknowledges that his opinion that ADHD is "cognitive disorder, a developmental impairment of executive functions (EFs)" is a departure from the belief of "many clinicians". This article fails WP:MEDRS and also likely fails WP:FRINGE and/or WP:DUE, as the author notes his opinion is in conflict with “many clinicians” and is also in conflict with the WP:MEDRS compliant article below. The second is a single-author manuscript by Diamond from 2012–13, which only mentions ADHD twice, and the references to it appear to be “provided in passing” per WP:CONTEXTMATTERS. In any case, it is also not a WP:MEDRS complaint source.
Other areas of the article also seem to have similar statements: The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." To support this, a single reference is given with the supporting quote, "Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention." The source merely notes that "early results" show that those with ADHD, as a group, may have thinning in areas that impact "working memory and attention." It does not say "symptoms of ADHD arise from a deficiency in certain executive functions". Attempts to say otherwise would be, at best, WP:OR.
The objection I have to the phrase "executive dysfunction" being used in the way it is used in article is that it implies that executive dysfunction is not only required for a diagnosis of ADHD, but is also the cause of ADHD. I do not feel this is accurate, nor is supported by the weight of the evidence, nor do the DSM nor the ICD mention "executive dysfunction" in regards to ADHD. While executive dysfunction is certainly more common in those with ADHD, it is far from required for a diagnosis, much less the cause of the disorder. A
WP:MEDRS complaint source states: "Specifically, estimates for the proportion of pediatric ADHD cases who exhibit any form of executive dysfunction range from 21% to 60% across studies employing a wide range of tasks and impairment criteria (Biederman et al., 2004; Coghill et al., 2014; Fair, Bathula, Nikolas, & Nigg, 2012; Geurts, van der Oord, & Crone, 2006; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke, Bitsalou, & Thompson, 2010)." (Kofler MJ, Irwin LN, Soto EF, Groves NB, Harmon SL, Sarver DE (February 2019).
"Executive Functioning Heterogeneity in Pediatric ADHD". Journal of Abnormal Child Psychology. 47 (2): 273–286.
doi:
10.1007/s10802-018-0438-2.
PMC
6204311.
PMID
29705926.) My point is more explicitly stated in a WP:RS (but admittedly not a WP:MEDRS due to age): "Indeed, executive dysfunction is not required for the diagnosis of ADHD, which is defined at the behavioral, rather than neuropsychological, level." (Cortese S, Comencini E, Vincenzi B, Speranza M, Angriman M (November 2013).
"Attention-deficit/hyperactivity disorder and impairment in executive functions: a barrier to weight loss in individuals with obesity?". BMC Psychiatry. 13: 286.
doi:
10.1186/1471-244X-13-286.
PMC
4226281.
PMID
24200119.{{
cite journal}}
: CS1 maint: unflagged free DOI (
link))
In summary, I feel the above statements should be modified to remove "executive dysfunction" as a cause of and/or requirement of ADHD. At the absolute minimum, if WP:RS and WP:MEDRS are found to give the viewpoint WP:DUE, WP:CONFLICTING states both viewpoints should be acknowledged. Wikipedialuva ( talk) 10:15, 9 January 2024 (UTC)
Here I examine the nature of and evidence for a frequently cited benefit of ADHD claimed in this article – that being “hyper-focusing (HF).". Despite its widespread belief, this relationship has not been explored much in the scientific literature, with less than 8 studies being identified. The results are conflicting, depending on whether the study used people who just had elevated symptoms of ADHD, and not the disorder, compared to studies of clinically diagnosed individuals who had the full disorder (symptoms and impairments). In general, there does seem to be a significant relationship between ADHD and HF when ADHD is measured as rated symptoms. But in clinically diagnosed people the results are conflicting, with one study finding the relationship and another not ( Groen et al., 2020; Ozel-Kizil et al., 2016). And while HF is often presented as a benefit or gift of ADHD, some studies show that it also has a very negative side, being related to risk for internet addiction ( Ishii et al., 2023) and certain types of offending behaviour ( Worthington & Wheeler, 2023). From my understanding the roots of hyperfocus are in the EF/poor self-regulation that underlies ADHD. People vary in the degree to which their behaviour is controlled by distant rewards (e.g., if I study a lot, I'll get a good job a few years from now) vs. immediate rewards (e.g., when playing a video game, the environment is providing a great deal of continuous and immediate rewards for engagement; placing little demands on EF) ( Jackson & Mackillop, 2016; Marx et al., 2021). For many people with ADHD, immediate rewards are very potent and can lead to such perseverative responding ( Patros et al., 2016), even to the point of an inability to disengage from such environments likely linked to the same deficits in the disorder (i.e., in inhibition and working memory). So, the claim that ADHD is definitely linked to hyper-focusing and that it is a positive trait is not definitively established at this time. More research is clearly needed but such claims of HF as being widespread among those with ADHD, and entirely a benefit, cannot be taken on face value as an established fact. Assertions in this article regarding HF should therefore be amended. Димитрий Улянов Иванов ( talk) 00:34, 16 January 2024 (UTC)