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Attention-Deficit/Hyperactivity Disorder
Thomas J. Spencer, MD
Arch Neurol. 2002;59:314-316.
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INTRODUCTION
Attention-deficit/hyperactivity disorder (ADHD) is an early-onset clinically
heterogeneous disorder of inattention, hyperactivity, and impulsivity. The
nosology has changed during the past century from minimal brain damage to
hyperkinetic reaction of childhood and now to ADHD. These names reflect shifting
causative theories, from an early emphasis on subtle "minimal" brain injuries
to motor hyperactivity and eventually to the primacy of cognitive and attentional
symptoms. Indeed, neuropsychological deficits reported in patients with ADHD
implicate executive dysfunctions and working memory deficits that are similar
to those in patients with acquired frontal lobe damage. In addition, neuroimaging
studies1 implicate frontal-subcortical pathways
in patients with ADHD. While there is undoubtedly a complex interplay between
genetic and environmental interactions, estimates of heritability from twin
studies are high (approximately 80%).1 Moreover,
recently there has been a growing appreciation of the magnitude of impairment
experienced by adults with continuing ADHD after childhood onset.
EARLY REPORTS
The . . . [Full Text of this Article]
THE ORIGINS OF PHARMACOTHERAPY OF ADHD
DIRECTIONALITY OF PARENTAL AND CHILD BEHAVIOR
THE PRIMACY OF ATTENTIONAL DEFICITS VS MOTOR OVERACTIVITY
THE INDEPENDENCE OF ADHD AND CONDUCT DISORDERS
FAMILY GENETICS AND ADHD
PERSISTENCE OF ADHD
From the Pediatric Psychopharmacology Unit, Massachusetts General Hospital,
and the Department of Psychiatry, Harvard Medical School, Boston.
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