Prerpints.org logo
Preprint
Review

Key points in attention deficit hyperactivity disorder

Altmetrics

Downloads

125

Views

37

Comments

0

This version is not peer-reviewed

Advances in Diagnostics, Brain Delivery Systems and Therapeutics of Neurodegenerative Disease

Submitted:

30 August 2023

Posted:

01 September 2023

You are already at the latest version

Alerts
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) it is known as a neuropsychiatric disorder. Anatomicaly components with implications in this previously mentioned disorder, are the anterior cingulate gyrus and dorsolateral prefrontal cortex (DLFPC) that are are found having a role in appearing this disease. ADHD is associated with cognitive and functional deficits that relate to diffuse abnormalities in the brain. ADHD is a specific pathology in children but may persisit to youth and also not so hard to find to adults.Till now, hard to find the curative treatment knowing ADHD as a neuropsychiatric disorder with enlarge unknown scientific points. Genetic and environmental component play an important role in diagnosis. Patients life style, a relevant history of individual geneticsand environmental factors are important in diagnosisThe management of ADHD, is also an important part togeter with future trends.
Keywords: 
Subject: Public Health and Healthcare  -   Public Health and Health Services

1. Introduction

The specific particularities of children and young people relevant for healthy include disease and theyr health-risk profiles. There are known age vulnerability to demographic factors, social status, and their human right. In this direction, adulthood, play a significant signal referring to affecting individual human healthy. [1] Pregnancy and early childhood, are period of life, with different stressors points. as poverty, violence, but not only. In this field, bad results founds in research studies, referring to human healthy, including previously mentioned stressors factors. [2] [3] Individual person diagnosed with ADHD, creates a burden for the human individ, for their family, and for enlarge community. This is why need atention patients. [4] There are plans and strategies for study, for evaluate and for management and future trends in this neuropsychiatric disorder which nowadays exist.Strategies and policy include womens as vulnerable gender, children and adolescents. This political strategies include specific programmes and services. [5,6] Diagnostic in this neuropsychiatric disorder is possible clinically. In ADHD at least 6 of the 9 symptoms are mentioned by medical specialists. This pathology does not have specific tests as laboratory or imagistically investigations. More than, we can mention that the neuropsychological tests are not sensitive for diagnosis. Individs at early child period of life, including youth as a risk group, represent a enlarge segment of persons in research studies. [7]

2. Analytic strategy

Is possible to use a cumulative logistic model. This model is consider being proper.
log(fj1−fj)=a+βX,
In the previous formula, are explanatory variables. There are known models used for establishing affected key points to human individs diagnosed with ADHD. So, from model one to model six till now. (Figure 1)
Models I to VI, following step by step, concure to establishing a medical profile of patients diagnosed with ADHD. Monte Carlo technique is a well known method. [8] Within research techniques curentlly used, is possible to establish particularities in ADHD, depending of poit of view on this pathology. [9] There are known different and various types of objectives used in ADHD studies, knowing from historical researchers (Figure 2):

3. Specific key points in attention deficit hyperactivity disorder

One of specific objective in ADHD pathophysiology, consist of molecular genetic profile. So are known different research studies where was found a coniderable number of genes with implications in ADHD diagnostic. Candidate genes were also found with implications in ADHD, as. DBH, MAOA, SLC6A2, TPH-2, SLC6A4, CHRNA4, GRIN2 and also more than with next group including, genes coding for DRD4, DRD5, SLC6A3, SNAP-25, and HTR1B with implications in the etiology of this disorder. Beside this, also important to apply in practicum, the pharmacotherapy for treat simptoms to patient diagnosed with ADHD. [10,11] There are known seven types of ADHD, knowing from previously research studies conclusions. So, patient from each type need particulary medical abordation.

4. Key points in diagnosis

There are known to be two different relatively similar disorders. Has been diagnoses Attention Deficit Disorder (ADD) vs. Attention Deficit Hyperactivity Disorder (ADHD). Subtypes ADHD are predominantly inattentive, predominantly hyperactive, or combined type. During history, in ADHD, has been studied and developing in medical concepts. So that nowadays is not a new condition. As 'minimal brain dysfunction', in the 1930s, scientists changed names in ADD and ADHD. The symptoms in persons diagnosed with ADHD, begin at a young age.

5. Differential diagnosis

In differential diagnosis of ADHD from other disorders, medical interdisciplinary team must establish diagnostic, knowing specific symptoms. More than, psychiatric disorders, implie a complex medical specialty and in this direction, and for a proper diagnostic must be honest and high qalificated medicaly team. Individual signs and simptoms which diagnosed depression or anxiety can be false diagnosed in a patient with ADHD. Symptoms as memory loss, could be observe in individuals with ADHD disorder but must be very good establish for differential diagnosis from other psychiatric disorder. Substance abuse disorders should be examined in children with ADHD and differentiate from other psychiatric disorders. [10]

6. Treatment key points

ADHD treatment, such as actually it is known, with limits or doubts, is important to apply practicum for symptoms diminuation.
In this direction, untreated ADHD can cause greatest dysfunctions in human life.[11,12]
In patients diagnosed with ADHD, pharmacological therapy is important to apply. Medical curative drugs are divided into two major categories. Medicins include typical drugs. The bad effect of medicines in ADHD treatment is dependency. This is why the treatment for patients diagnosed with ADHD, must be proper. [17,18] The long-term goals of the ADHD treatment can be achieved. Also an integrated healthcare plan should be followed for the treatment of ADHD. [19] It is better known that in patients diagnosed with ADHD, without a good treatment, their status continue to deteriorate and more than, possible for patients, a non integration status, social and financial. [20,21,22] MTA Cooperative Group in 1999 reffer to the ADHD treatment, as monotherapy or combination treatment,as a common first-line medication. [23] “New Formulations of Stimulants for Attention-Deficit Hyperactivity Disorder” was published in 2004. [24,25] Genetical profile and biomolecular mechanism are described in related drugs administration in ADHD. [26,27,28] Research studies, show us genetic profile in patients. diagnosed with ADHD.. [29,30] Adherence to treatment in youth, is one of the important rule for best results with implications on human health.stimulants is modest, especially in adolescents who often discontinue medication, despite persistence of symptoms. [31,32,33] In the last years, as a results of various studies, new ADHD medication formulations have appeared. In this direction, IR formulations have been FDA approved from 2004. [34] In 1930 was approved for clinical use by the FDA specific therapy in ADHD and publish in 1976. . [35,36,37,38]
“An adhesive-based matrix transdermal system (MTS)” patch were established and published by FDA.[39,40,41] and also in 2010 by Arnold et al. [42] in 2014 by Findling and Dinh [43] and in 2015 by Pastore et al.[44] In transdermal treatment, the dl-MPH is incorporated into an adhesive, for a proper transcutaneouslly effect. ADHD treatment has different scientifically directions. Finally, hope to have good results in patients diagnosed with ADHD, for their benefits in human life.

7. Management directions

The management in ADHD involves previously mentioned interprofessional team. Collaborative team includes the specialist psychiatrist, pediatrician, pharmacist, and others specialists. Beside the interprofessional team, play a role nurse practitioners with warm helpfull. Family become important in ADHD management, because know the exactly history of the events in patient life.
Each clinician from the ADHD management team , must be able to decide about diagnosed status in ADHD patient. [13]
More important to avoid noncompliance to treatment using medications including also paleative treatments. Without a proper individual treatment, following personalized medicine principles, ADHD simptoms will be not treat for promote a healthy life of patients. [14,15,16]

8. Conclusion

Psychiatric disorder namely ADHD is somethimes controversy treated. There are known comorbidities beside ADHD, which including anxiety, depression but not only from psychiatric disorders, that need attention in drugs administration. Also metabolic or endocrine alterations helt together in ADHD. So, the treatment of ADHD can treat as well, the symptoms for comorbidities in patients with ADHD. Uuntreated ADHD can cause long-term inability to work, from diagnosed patients, with a negative impact in youth patients. We look for establishing globally future research directions.

References

  1. Goodwin, R.D.; Sourander, A.; Duarte, C.S.; Niemelä, S.; Multimäki, P.; Nikolakaros, G.; Helenius, H.; Piha, J.; Kumpulainen, K.; Moilanen, I.; et al. Do mental health problems in childhood predict chronic physical conditions among males in early adulthood? Evidence from a community-based prospective study. Psychol. Med. 2008, 39, 301–311. [Google Scholar] [CrossRef]
  2. Brito, N.H.; Noble, K.G. Socioeconomic status and structural brain development. Front. Neurosci. 2014, 8, 276. [Google Scholar] [CrossRef]
  3. Champagne, F.A. Nurturing Nature: Social Experiences and the Brain. J. Neuroendocr. 2009, 21, 867–868. [Google Scholar] [CrossRef] [PubMed]
  4. Gallo, E.F.; Posner, J. Moving towards causality in attention-deficit hyperactivity disorder: overview of neural and genetic mechanisms. Lancet Psychiatry 2016, 3, 555–567. [Google Scholar] [CrossRef] [PubMed]
  5. Shonkoff, J.P.; Richter, L.; van der Gaag, J.; Bhutta, Z.A. An Integrated Scientific Framework for Child Survival and Early Childhood Development. PEDIATRICS 2012, 129, e460–e472. [Google Scholar] [CrossRef] [PubMed]
  6. Fleming, T.P.; Watkins, A.J.; Velazquez, M.A.; Mathers, J.C.; Prentice, A.M.; Stephenson, J.; Barker, M.; Saffery, R.; Yajnik, C.S.; Eckert, J.J.; et al. Origins of lifetime health around the time of conception: causes and consequences. Lancet 2018, 391, 1842–1852. [Google Scholar] [CrossRef]
  7. A Bhutta, Z.; Chopra, M.; Axelson, H.; Berman, P.; Boerma, T.; Bryce, J.; Bustreo, F.; Cavagnero, E.; Cometto, G.; Daelmans, B.; et al. Countdown to 2015 decade report (2000–10): taking stock of maternal, newborn, and child survival. Lancet 2010, 375, 2032–2044. [Google Scholar] [CrossRef]
  8. Rubin, DB. Multiple imputation in sample surveys: A phenomenological Bayesian approach to nonresponse. Proceedings of the survey research methods section of the American Statistical Association. 1978:20–34.
  9. Allison, PD. Missing data. Thousand Oaks, CA: Sage; 2001.
  10. Wilens, T.E.; Spencer, T.J. Understanding Attention-Deficit/Hyperactivity Disorder from Childhood to Adulthood. Postgrad. Med. 2010, 122, 97–109. [Google Scholar] [CrossRef]
  11. Steingard, R.; Taskiran, S.; Connor, D.F.; Markowitz, J.S.; Stein, M.A. New Formulations of Stimulants: An Update for Clinicians. J. Child Adolesc. Psychopharmacol. 2019, 29, 324–339. [Google Scholar] [CrossRef]
  12. van der Burg D, Crunelle CL, Matthys F, van den Brink W. Diagnosis and treatment of patients with comorbid substance use disorder and adult attention-deficit and hyperactivity disorder: a review of recent publications. Curr Opin Psychiatry 2019, 32, 300–306. [CrossRef]
  13. Cortese, S.; Coghill, D. Twenty years of research on attention-deficit/hyperactivity disorder (ADHD): looking back, looking forward. Évid. Based Ment. Heal. 2018, 21, 173–176. [Google Scholar] [CrossRef] [PubMed]
  14. Salvi, V.; Migliarese, G.; Venturi, V.; Rossi, F.; Torriero, S.; Viganò, V.; Cerveri, G.; Mencacci, C. ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr 2019, 54, 84–89. [Google Scholar] [PubMed]
  15. Mikami, A.Y.; Miller, M.; Lerner, M.D. Social functioning in youth with attention-deficit/hyperactivity disorder and autism spectrum disorder: transdiagnostic commonalities and differences. Clin. Psychol. Rev. 2019, 68, 54–70. [Google Scholar] [CrossRef]
  16. Leahy, L.G. Diagnosis and treatment of ADHD in children vs adults: What nurses should know. Arch. Psychiatr. Nurs. 2018, 32, 890–895. [Google Scholar] [CrossRef] [PubMed]
  17. Brikell I, Chen Q, Kuja-Halkola R, D'Onofrio BM, Wiggs KK, Lichtenstein P, Almqvist C, Quinn PD, Chang Z, Larsson H. Medication treatment for attention-deficit/hyperactivity disorder and the risk of acute seizures in individuals with epilepsy. Epilepsia 2019, 60, 284–293. [CrossRef] [PubMed]
  18. Fosi, T.; Lax-Pericall, M.T.; Scott, R.C.; Neville, B.G.; Aylett, S.E. Methylphenidate treatment of attention deficit hyperactivity disorder in young people with learning disability and difficult-to-treat epilepsy: Evidence of clinical benefit. Epilepsia 2013, 54, 2071–2081. [Google Scholar] [CrossRef]
  19. Cortese, S.; Coghill, D. Twenty years of research on attention-deficit/hyperactivity disorder (ADHD): looking back, looking forward. Évid. Based Ment. Heal. 2018, 21, 173–176. [Google Scholar] [CrossRef]
  20. Salvi, V.; Migliarese, G.; Venturi, V.; Rossi, F.; Torriero, S.; Viganò, V.; Cerveri, G.; Mencacci, C. ADHD in adults: clinical subtypes and associated characteristics. Riv Psichiatr 2019, 54, 84–89. [Google Scholar]
  21. Mikami, A.Y.; Miller, M.; Lerner, M.D. Social functioning in youth with attention-deficit/hyperactivity disorder and autism spectrum disorder: transdiagnostic commonalities and differences. Clin. Psychol. Rev. 2019, 68, 54–70. [Google Scholar] [CrossRef]
  22. Leahy, L.G. Diagnosis and treatment of ADHD in children vs adults: What nurses should know. Arch. Psychiatr. Nurs. 2018, 32, 890–895. [Google Scholar] [CrossRef]
  23. Feldman ME, Charach A, Bélanger SA. ADHD in children and youth: Part 2—Treatment. Paediatr Child Health 2018, 23, 462–472. [CrossRef] [PubMed]
  24. Connor, D.F.; Steingard, R.J. New Formulations of Stimulants for Attention-Deficit Hyperactivity Disorder. CNS Drugs 2004, 18, 1011–1030. [Google Scholar] [CrossRef] [PubMed]
  25. Stein, M.A.; Waldman, I.D.; Charney, E.; Aryal, S.; Sable, C.; Gruber, R.; Newcorn, J.H. Dose Effects and Comparative Effectiveness of Extended Release Dexmethylphenidate and Mixed Amphetamine Salts. J. Child Adolesc. Psychopharmacol. 2011, 21, 581–588. [Google Scholar] [CrossRef] [PubMed]
  26. Patrick, K.S.; A González, M.; Straughn, A.B.; Markowitz, J.S. New methylphenidate formulations for the treatment of attention-deficit/hyperactivity disorder. Expert Opin. Drug Deliv. 2005, 2, 121–143. [Google Scholar] [CrossRef]
  27. Patrick KS, Radke JL, Raymond JR, Koller L, Nguyen LV, Rodriguez W, Straughn AB. Drug regimen individualization for attention-deficit/hyperactivity disorder: Guidance for methylphenidate and dexmethylphenidate formulations. Pharmacotherapy 2018.
  28. Patrick, K.S.; Straughn, A.B.; Perkins, J.S.; González, M.A. Evolution of stimulants to treat ADHD: transdermal methylphenidate. Hum. Psychopharmacol. Clin. Exp. 2008, 24, 1–17. [Google Scholar] [CrossRef] [PubMed]
  29. Quinn, D. Does chirality matter?: Pharmacodynamics of enantiomers of methylphenidate in patients with attention-deficit/hyperactivity disorder. J Clin Psychopharmacol 2008, 28, S62–S66. [Google Scholar] [CrossRef] [PubMed]
  30. Zhu, H.-J.; Patrick, K.S.; Yuan, H.-J.; Wang, J.-S.; Donovan, J.L.; DeVane, C.L.; Malcolm, R.; Johnson, J.A.; Youngblood, G.L.; Sweet, D.H.; et al. Two CES1 Gene Mutations Lead to Dysfunctional Carboxylesterase 1 Activity in Man: Clinical Significance and Molecular Basis. Am. J. Hum. Genet. 2008, 82, 1241–1248. [Google Scholar] [CrossRef]
  31. Adler, L.A.; Frick, G.; Yan, B. A Long-Term, Open-Label, Safety Study of Triple-Bead Mixed Amphetamine Salts (SHP465) in Adults With ADHD. J. Atten. Disord. 2017, 24, 434–446. [Google Scholar] [CrossRef]
  32. Adler, L.D.; Nierenberg, A.A. ; Ba; Md Review of Medication Adherence in Children and Adults with ADHD. Postgrad. Med. 2010, 122, 184–191. [Google Scholar] [CrossRef]
  33. FDA. Center for Drug Evaluation and Research, Benzedrine® medical review: Application Number: 83900. 1976a. https://wwwaccessdatafdagov/drugsatfda_docs/anda/pre96/83900_Amphetamine%20Sulfate_Medrpdf Accessed March13, 2019.
  34. FDA. Dexedrine®, Product Monograph, Application Number:ANDA084935. 1976b. https://wwwaccessdatafdagov/drugsatfda_docs/label/2007/017078s042lblpdf Accessed March13, 2019.
  35. FDA. Center for Drug Evaluation and Research; Methylin Oral Solution® medical review: Application Number: 21–419. 2002a. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2002/21–419_Methylin_Medrpdf Accessed March13, 2019.
  36. FDA. Center for Drug Evaluation and Research; Methylin® Oral Solution clinical pharmaceuticals and biopharmaceuticals review: Application Number: 021419. 2002b. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2002/21–419_Methylin_BioPharmrpdf Accessed March13, 2019.
  37. FDA. Center for Drug Evaluation and Research; Methylin® Chewable Tablet clinical pharmaceuticals and biopharmaceuticals review: Application Number: 021475, 2003. 2003a. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2003/021475s000_Methylin_Chewables_ClinPharmRpdf Accessed March13, 2019.
  38. FDA. Center for Drug Evaluation and Research; Daytrana® clinical pharmaceuticals and biopharmaceuticals review (Part 1): Application Number: 021514s000. 2006a. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2006/021514s000_ClinPharmR_P1pdf Accessed March13, 2019.
  39. FDA. Center for Drug Evaluation and Research; Daytrana® clinical pharmaceuticals and biopharmaceuticals review (Part 2): Application Number: 021514s000. 2006b. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2006/021514s000_ClinPharmR_P2pdf Accessed March13, 2019.
  40. FDA. Center for Drug Evaluation and Research; Daytrana® medical review (Part 1): Application Number: 021514s000. 2006c. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2006/021514s000_MedR_P1pdf Accessed March13, 2019.
  41. FDA. Center for Drug Evaluation and Research; Daytrana® medical review (Part 2): Application Number: 021514s000. 2006d. https://wwwaccessdatafdagov/drugsatfda_docs/nda/2006/021514s000_MedR_P2pdf Accessed March13, 2019.
  42. Arnold, L.; Bozzolo, D.; Hodgkins, P.; McKay, M.; Beckett-Thurman, L.; Greenbaum, M.; Bukstein, O.; Patel, A. Switching from oral extended-release methylphenidate to the methylphenidate transdermal system: continued attention-deficit/hyperactivity disorder symptom control and tolerability after abrupt conversion. Curr. Med Res. Opin. 2009, 26, 129–137. [Google Scholar] [CrossRef]
  43. Findling, R.L.; Dinh, S. Transdermal therapy for attention-deficit hyperactivity disorder with the methylphenidate patch (MTS). CNS Drugs 2014, 28, 217–28. [Google Scholar] [CrossRef] [PubMed]
  44. Pastore, M.N.; Kalia, Y.N.; Horstmann, M.; Roberts, M.S. Transdermal patches: history, development and pharmacology. Br. J. Pharmacol. 2015, 172, 2179–2209. [Google Scholar] [CrossRef] [PubMed]
Preprints 83781 g001
Figure 1. Models used for evaluation the association between early-life conditions and adults status in ADHD.
Figure 1. Models used for evaluation the association between early-life conditions and adults status in ADHD.
Preprints 83781 g001
Preprints 83781 g002
Figure 2. Analyse strategies in ADHD.
Figure 2. Analyse strategies in ADHD.
Preprints 83781 g002
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.
Copyright: This open access article is published under a Creative Commons CC BY 4.0 license, which permit the free download, distribution, and reuse, provided that the author and preprint are cited in any reuse.
Prerpints.org logo

Preprints.org is a free preprint server supported by MDPI in Basel, Switzerland.

facebook logotwitter logolinkedin logo
MDPI Initiatives
Important Links
Subscribe

Disclaimer

Terms of Use

Privacy Policy

© 2024 MDPI (Basel, Switzerland) unless otherwise stated