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Attention Deficit Hyperactivity Disorder

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Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder

Abstract

Attention deficit hyperactivity disorder (ADHD) is characterised by inattention or hyperactivity/ impulsivity or both. The onset of ADHD is in childhood, but in a proportion of cases some symptoms continue into adulthood. There is a strong association among ADHD, intellectual disability (ID), problem behaviour, and autism spectrum disorder (ASD). The prevalence of ADHD in persons with ID and ASD is significantly higher than the general population, ranging between 10% and 28%. It might be difficult to diagnose ADHD in persons with ID and low-functioning ASD. The stringent use of categorical diagnostic criteria might limit the identification of the disorder since some criteria may not be applicable, particularly for those with more severe cognitive and communication impairments. Observation of a person’s distractibility that is not consistent with their developmental level may help when considering the symptom of inattention in an individual with ID, while hyperactivity and impulsivity are better indicated by fidgeting most of the time, appearing ‘on the go’, and being unable to remain seated for a long time and to wait for one’s turn, which can often lead to verbal or physical aggression, irritability, mood fluctuations, or self-harming behaviour.

Although ADHD in the non-ID population is a widely researched area, the lack of high-quality research in ADHD in ID has been a barrier to the advancement of treatment in this patient group, with most studies having named ID as an exclusion criterion. Drug treatment such as psychostimulants like methylphenidate along with psychosocial interventions is effective in a high proportion of cases to improve ADHD symptoms. In people with ID, the overall effect size of psychostimulants is smaller than that reported in the general population, while the adverse effect profile is similar in both populations.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Brain Sciences, Imperial College London, London, UK

    Shoumitro Shoumi Deb

  2. Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK

    Bhathika Perera

  3. CREA (Research and Clinical Centre), Fondazione San Sebastiano, Misericordia di Firenze, Florence, Italy

    Marco O. Bertelli

Authors
  1. Shoumitro Shoumi Deb
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  2. Bhathika Perera
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  3. Marco O. Bertelli
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Correspondence to Shoumitro Shoumi Deb .

Editor information

Editors and Affiliations

  1. CREA (Research and ClinicalCentre), Fondazione San Sebastiano, Misericordia di Firenze, Florence, Italy

    Marco O. Bertelli

  2. Faculty of Medicine, Department of Brain Sciences, Imperial College London, London, UK

    Shoumitro (Shoumi) Deb

  3. Developmental Medicine Centre, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Kerim Munir

  4. Division of Psychiatry, University College London and Camden & Islington Foundation Trust, London, UK

    Angela Hassiotis

  5. Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia

    Luis Salvador-Carulla

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Deb, S.S., Perera, B., Bertelli, M.O. (2022). Attention Deficit Hyperactivity Disorder. In: Bertelli, M.O., Deb, S.(., Munir, K., Hassiotis, A., Salvador-Carulla, L. (eds) Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-95720-3_17

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