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Attention-deficit/hyperactivity disorder (ADHD)

Updated: Jun 13, 2020




INTRODUCTION:

With the level of spirituality in Nigeria, a child that zones in and out of conversations, forgets and misplaces belongings and performs badly in school can be dubbed a cursed child. If the child in addition, shows excessive energy, such as running about inappropriately and has destructive behaviors, they may be referred to as possessed and sent off for prayer and deliverance sessions. In a situation where the person interrupts conversations consistently, or is unable to wait their turn (e.g. staying in a queue), the individual might be described as unruly or badly raised. These different scenarios, are some of the presentations of a common but rarely discussed and diagnosed childhood mental condition, called Attention Deficit/Hyperactivity Disorder (ADHD)


WHAT IS ADHD?

ADHD falls under the classification of Neurodevelopmental disorders. It is a mental disorder “characterized with attention deficits, hyperactivity, or impulsiveness.” The onset of ADHD is at childhood, with certain criteria being present before adolescent years, or 12 years of age to be specific, and these symptoms should be manifested in more than one setting (e.g., home and school, place of worship).


HOW COMMON IS ADHD?

According to the DSM-5 manual, the prevalence of ADHD in most cultures is tagged at about 5% of children and 2.5% of adults. In African countries, the prevalence of ADHD in the child population varies between 5.4% to 8.7%. In Nigeria the prevalence of ADHD among children is tagged about 3.2%. The prevalence of ADHD also differs in Nigeria, one study carried out in urban areas of South-West and South-South, showed 8.7%, versus 7.6% respectively. However, a rural study showed a prevalence of 6%, a similar rate to the Urban samples.


WHAT CAUSES ADHD?


No single cause is known, however the aetiology of ADHD can be divided into two, environmental and Genetic causes.

Environmental causes include: children born with low birth weight (in most cases however, children born with low birth weight don’t manifest the symptoms of ADHD); smoking during pregnancy has also been associated with the onset of ADHD in children; a small number of the population of ADHD is related to the type of diet.

ADHD is seen to run in families, thus a history of ADHD in a parent, increases the risk in children.


CLASSIFICATION OF ADHD INTO TYPES

There are three types of ADHD. This classification is dependent on the prominence of the symptoms manifested in the individual. These types include: the inattentive type, the hyperactive/ impulsive type, and the third type is a combination of the first two.


The inattentive type include individuals or children that have limited attention span. As a result of their inattentiveness, children within this group, often find it difficult to remember or follow through with activities (lectures or play tasks), instructions. They often show dislike for activities that require a lot of mental efforts, and can be careless with their properties.


The hyperactive/impulsive type, include individuals or children that show excessive use of motor skills, or feelings of restlessness (in adults). An individual with hyperactive/impulsive ADHD may struggle with situations that require maintaining position for a long time; so they are seen to squirm or fidget a lot, they run about and climb when expected to sit. They can be perceived as rude, as they could jump right into conversations, blurt out answers before the question is completed or use things without the permission of the owners.


The combined type includes individuals that manifest the criteria for the inattentive group and the hyperactive/impulsive group.


DOES ADHD OCCUR IN ADULTHOOD?

ADHD begins in childhood, and could persist into adolescent and adult years. The problem with making a diagnosis in adulthood is the unreliable information, regarding the onset of ADHD symptoms in childhood, hence diagnosis of ADHD in adulthood accepts information from other family members. The symptoms of ADHD in adulthood may slightly differ, as inattention, impulsivity persist, while hyperactivity diminishes or is hardly present. Other symptoms include temper outburst over little or no provocation, low threshold for frustration, poor self organization.


MANAGEMENT AND TREATMENT OF ADHD

  • The treatment of ADHD begins with a Diagnosis from a mental health expert (Child psychiatrist or a clinical psychologist)

  • The treatment of Attention Deficit/Hyperactivity Disorder, is carried out with the use of medication, and psychotherapy.

  • Pharmacological therapy includes the administration of stimulants, selective norepinephrine reuptake inhibitors, and antidepressants. The psychological therapies work towards improving the behavior of the child with ADHD.

  • Therapy such as Cognitive-Behavior Therapy (CBT) is effective in the treatment of ADHD.

  • Family training is also included to help the family, cope with the individual with ADHD, and also improve relationships.

  • Individuals with ADHD are also placed under dietary supplements.


ADHD affects children, and can persist beyond adolescent years into Adulthood. If not managed or treated, ADHD could cause impairment in major life domains , resulting in underachievement. This condition affects personal relationships, academic performances and social interactions.


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