ADHD is a genetic Neurodevelopmental Disorder

Attention-deficit/hyperactivity disorder, commonly known as ADHD, is a genetic condition. The study, funded by the Wellcome Trust is published in the latest issue of The Lancet. The researchers, from the Medical research council (MRC) center in Neuropsychiatric Genetics and Genomics and department of Psychological Medicine and Neurology, Cardiff University, Wales, UK, conclude that ADHD is a brain development disorder.

ADHD makes children fidgety, agitated, impulsive and easily distracted. Experts say that approximately 1 in 50 children is affected by ADHD. Although a number of factors have suggested genetics probably plays a major role, ADHD has frequently been attributed to a diet with too much sugar and poor upbringing.

Previous studies had shown that a parent with ADHD is more likely to have a child who also has a condition compared to parent without ADHD- a factor which points to some likely genetic association. If an identical twin has ADHD, there is a 75% chance that other twin will also have it.

The Authors explain that ADHD has no cure, but behavioral interventions and pharmacological therapy can help treat the symptoms.

The latest study, researchers analyzed the DNA of 336 children who had ADHD and 1,047 children who did not have the condition (controls).

The DNA analyses revealed that those with ADHD were more likely to have missing DNA segments, or segments of DNA that were duplicated compared to the controls. The authors explain that this kind of genetic variation is more widespread in brain disorders.

Thus the new study provides the first direct evidence that ADHD is a neurodevelopmental disorder.

Significant overlap was also detected between the segments, as well as those associated with schizophrenia and autism.

Although ADHD and autism are classed entirely separately, some overlap does exist between the two in terms of learning difficulties and symptoms. This study suggests there may also be some biological overlap between the two conditions, especially an overlap on chromosome 16 which had been implicated in schizophrenia and some other psychiatric disorders and spans a number of genes, including one know that is vital for brain development.

Professor Anita Thapar the Lead investigator said:

 Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brain of children with this condition develop differently to those of other children.

Doctor Nigel Williams said:

Children with ADHD have a significantly higher rate of missing or duplicated DNA segments compared to other children and we have seen a clear genetic link between these segments as other brain disorders. These findings give us tantalizing clues to the changes that can lead to ADHD.

Doctor Kate Langley explained:

ADHD is not caused by a single genetic change, but is likely caused by a number of genetic changes, including CNVs, interacting with as yet unidentified environmental factors. Screening children for the CNV’s that we have identified will not help diagnose their condition.

 A people with ADHD find it much more difficult to focus on something without being distracted.  They have greater difficulty in controlling what they are doing or saying and are less able to control how much physical activity is appropriate for a particular situation compared to somebody without ADHD, a person with ADHD is much more impulsive and restless.

Health care professionals may use any of the following terms when describing a child (or adult) who is overactive and has difficulty concentrating- attention deficit, attention feficit hyperactivity disorder, hyperkinetic disorder, hyperactivity.

ADHD in children is completely different from normal childhood exited and boisterous behavior. Many children, especially very young ones, are inattentive and restless without necessarily being affected by ADHD.

“Rare chromosomal deletions and duplications in attention- deficit hyperactivity disorder: a genome- wide analysis”

Stay tuned to this blog if you want to know more about the above lines….

 Ankit

The Many Faces of ADHD: Adult's

“What do you mean I have ADHD? That’s just a kids' thing!”

Everyone used to think that only kids had ADHD (attention-deficit/hyperactivity disorder). We now know that adults have it too and that, for millions of people, it's a lifelong disorder. Many adults only find out they have ADHD years after they have left school. If you only recently learned you have the disorder, you are not alone!

ADHD makes it very difficult to pay attention and stay focused. Many adults with ADHD have a hard time controlling their impulses or "holding their horses." Other signs –or symptoms— include forgetting things easily, having a hard time staying motivated to do chores, and difficulty knowing how to organize daily life. ADHD can cause problems at work, at home, and with everyday living. ADHD tends to run in families. It is not your fault, but it IS your responsibility to get the help you need so that ADHD’s impact on your life is minimized.

Some people have symptoms that are mild and easily managed. Others have more pronounced ones. No two people with the disorder are the same.

How is ADHD diagnosed?

There is no single test for ADHD. To see if you have the disorder, a clinical professional uses several different sources of information. They include:

 The problems that you report.

 Questionnaires you fill out about how you act and how you feel today and in the past.

 Information from a spouse/partner, or someone else close to you.

 A physical exam to make sure the problems you are reporting aren't caused by something else.

How do I know if I need help?

There is no "magic formula" for knowing when to see a professional, but most adults who end up with an ADHD diagnosis report the following:

 They have trouble keeping jobs either because they keep quitting or they get fired often.

 They have trouble being on time for appointments, or finishing what they start.

 Household chores often don't get done; bills go unpaid because they get forgotten.

 They have problems with relationships because it's hard to remember important dates, they forget to make good on promises or because they get annoyed easily.

 They feel worried and stressed a lot because of the difficulty in meeting goals and responsibilities.

 They have strong feelings of frustration, guilt or low self-esteem.

As with every other diagnosis in medicine, there are some guidelines for determining whether you have ADHD or not. It's not enough to just have all of the symptoms. They have to be strong enough to cause you problems such as those listed in the bullet points, above; if they don’t get in your way, then you are not impaired, and you won't be diagnosed. Finally, you must have problems due to the symptoms in at least two areas of your life – such as at work and at home.

How do I find a professional qualified to diagnose ADHD?

One good place to start with is your primary care doctor. Let him or her know about your concerns and ask for a referral to a professional with expertise in evaluating an adult for ADHD. Another great starting place is a support group for people with ADHD and related disorders. The people who attend those groups often have years of experience finding professionals in their community. They could give you word-of-mouth referrals.

Who is qualified to diagnose ADHD?

There are several types of professionals who are qualified to diagnose ADHD. They include psychiatrists, clinical psychologists and other types of mental health practitioners. It’s a good idea to make sure the person you are seeing isn’t just qualified, but also has a lot of experience treating ADHD. Don't be afraid to ask the person about his or her experience.

How should I prepare for the evaluation?

There's no preparation needed. Many adults are nervous or anxious at the thought of seeking an evaluation. That's understandable. However, keep in mind that the professional you see has probably heard about many situations like yours. He or she won't judge or criticize you. The more open you are about the problems you are having, the better you can be helped. Remember: you didn’t cause your ADHD, so there's nothing to be ashamed of.

What happens during the evaluation?

During an evaluation, the clinical professional will ask you questions about your life and health. He or she will want to know how you are doing in your job and with friends. A clinician will also ask whether you had problems at school as a kid. Did you get into trouble often, or find the classwork hard? He or she will ask you to fill out some brief questionnaires which have multiple-choice answers. It can be helpful to bring along someone close to you who can share his or her perspective. The two of you might not agree on some things. That's ok. The professional just wants to spot basic

patterns and trends. Be as honest as you can during your evaluation and treatment. Remember that the clinician can't give an accurate diagnosis or treatment plan without your help.

You may be diagnosed with ADHD – or with something else. Lots of adults with ADHD have other conditions like anxiety, substance abuse and depression. Any and all disorders have to be identified and treated together, otherwise, efforts to treat just the ADHD, if it exists, won't be as successful.

I've been diagnosed – now what?

If you are diagnosed with ADHD, don't panic. The good news is, you've identified the problem. Your symptoms might seem overwhelming right now, but there is treatment. An effective treatment plan may involve several interventions at the same time. They can include medication, psychotherapy, ADHD coaching, and educating loved ones on how they can best support you. Many people with ADHD go on to lead happy and successful lives. You can be one of them.

Most successful persoanality with ADHD

Will Smith, Actor/Producer/Rapper

The fresh prince has done it all in his illustrious career — from creating one of the greatest sitcoms of all time to putting out bangers in the 90s, big Willy is that dude! He never settled for one lane and this is a direct result of his ADHD. Will once described himself as the "fun one who had trouble paying attention." He even admitted before that he has trouble reading movie scripts. So he just does what any great actor does — wing it

Causes of ADHD??

Brain Functioning in ADHD ADHD is not the result of laziness, poor motivation, low intelligence, disobedience, poor upbringing or selfishness—to name a few. Although having ADHD doesn’t exclude you from having some of these difficulties, these problems do not cause chronic inattention, hyperactivity and impulsiveness—the core symptoms of ADHD. ADHD is a medical disorder, and it can be caused by a number of factors that affect how the brain develops and functions. Current research indicates the frontal lobe, basal ganglia, caudate nucleus, cerebellum, as well as other areas of the brain, play a significant role in ADHD because they are involved in complex processes that regulate behavior (Teeter, 1998). These higher order processes are referred to as executive functions. Executive functions include such processes as inhibition, working memory, planning, self-monitoring, verbal regulation, motor control, maintaining and changing mental set and emotional regulation. According to a current model of ADHD developed by Dr. Russell Barkley, problems in response inhibition is the core deficit in ADHD. This has a cascading effect on the other executive functions listed above (Barkley, 1997). What factors could account for neurological differences in brain development and functioning that could contribute to ADHD? The main factors studied to date have been: fetal exposure to toxic substances (e.g., alcohol and tobacco) during pregnancy, exposure to lead, trauma to the brain from head injury or illness and differences that could be attributed to heredity. These causes are discussed below. Heredity as a Cause of ADHD Heredity is the most common cause of ADHD. Most of our information about the heritability of ADHD comes from family studies, adoption studies, twin studies and molecular genetic research. Family Studies: If a trait has a genetic basis we would expect the rate of occurrence to be higher with the biological family members (e.g., brown-eyed people tend to have family members with brown eyes). Dr. Joseph Biederman (1990) and his colleagues at the Massachusetts General Hospital have studied families of children with ADHD. They have learned that ADHD runs in families. They found that over 25% of the first-degree relatives of the families of ADHD children also had ADHD, whereas this rate was only about 5% in each of the control groups. Therefore, if a child has ADHD there is a five-fold increase in the risk to other family members. Adoption Studies: If a trait is genetic, adopted children should resemble their biological relatives more closely than they do their adoptive relatives. Studies conducted by psychiatrist Dr. Dennis Cantwell compared adoptive children with hyperactivity to their adoptive and biological parents. Hyperactive children resembled their biological parents more than they did their adoptive parents with respect to hyperactivity. Twin Studies: Another way to determine if there is a genetic basis for a disorder is by studying large groups of identical and non-identical twins. Identical twins have the exact same genetic information while non-identical twins do not. Therefore, if a disorder is transmitted genetically, both identical twins should be affected in the same way and the concordance rate—the probability of them both being affected—should be higher than that found in non-identical twins. There have been several major twin studies in the past few years that provide strong evidence that ADHD is highly heritable. They have had remarkably consistent results in spite of the fact that they were done by different researchers in different parts of the world. In one such study, Dr. Florence Levy and her colleagues studied 1,938 families with twins and siblings in Australia. They found that ADHD has an exceptionally high heritability as compared to other behavioral disorders. They reported an 82 percent concordance rate for ADHD in identical twins as compared to a 38 percent concordance rate for ADHD in non-identical twins. Molecular Genetic Research: Twins studies support the hypothesis of the important contribution that genes play in causing ADHD, but these studies do not identify specific genes linked to the disorder. Genetic research in ADHD has taken off in the past five years. This research has focused on specific genes that may be involved in the transmission of ADHD. Dopamine genes have been the starting point for investigation. Two dopamine genes, DAT1 and DRD4 have been reported to be associated with ADHD by a number of scientists. Genetic studies revealed promising results, and we should look for more information about this soon. Exposure to Toxic Substances as a Cause of ADHD Researchers have found an association between mothers who smoked tobacco products or used alcohol during their pregnancy and the development of behavior and learning problems in their children. A similar association between lead exposure and hyperactivity has been found, especially when the lead exposure occurs in the first three years. Nicotine, alcohol, and lead can be toxic to developing brain tissue and may have sustained effects on the behavior of the children exposed to these substances at early ages. However, it is unlikely that such exposure accounts for differences in brain development in the vast majority of children and adolescents with ADHD. Injury to the Brain from Trauma, Brain Tumors, Strokes or Disease Injury to the brain can be the result of trauma (serious blow to the head), brain tumor, stroke or disease. These factors can cause problems with inattention and poor regulation of motor activity and impulses. While such circumstances can result in a diagnosis of ADHD, the occurrence of such is atypical. What Does Not Cause ADHD Diet: In the 1970’s it became popular to view ADHD as resulting from allergies or sensitivities to certain food substances. However, much of the research done over the past two decades was unable to support the claim that diet played a significant role in causing ADHD. Despite this, the popular media continues to discuss the role of food in ADHD, particularly that sugar may cause children to become hyperactive and impulsive. There is no research to back up this claim. In fact, Dr. Mark Wolraich and his colleagues found no significant effects of sugar on either behavior or learning in children. Hormones: No studies have found any significant connection between problems with hormone functioning and hyperactivity or ADHD. The vestibular system: . For a number of years some clinicians have proposed the theory that ADHD and some learning and emotional problems could be the result of problems within the vestibular system of the brain which affects balance. They contend that treatment with anti-motion sickness medicine could correct these problems. This theory is unsupported by scientific research and is inconsistent with what is known about ADHD and the vestibular system . Poor parenting or problems in family life: No studies support the idea that ADHD is the result of poor parenting practices or other family environment variables. While parents of children with ADHD are likely to give more negative commands to their ADHD child and less positive attention, this may be due to the fact that ADHD children are often non-compliant and, therefore, parents are more likely to be more negative in their interaction with them. Furthermore, the interactions of parents of ADHD children whose behavior was not oppositional were no different than they were from non-ADHD children. It is important to note, however, that symptoms of ADHD and the degree to which such symptoms can impact the child’s functioning, can be reduced by parents who provide appropriate accommodations and interventions . Television: No studies have found any connection between television viewing and ADHD. Nor have any studies indicated that children with ADHD watch more television than do those without ADHD.

What is ADHD??

Attention deficit hyperactivity disorder(ADHD) is similar to hyperkinetic disorder in which there are significant problems of attention and/or hyperactivity and acting impulsively which are not appropriate for a person's age. These symptoms begin from age six to twelve and need more than six months of diagnosis done. In school-age individual have lack of focus which result in poor performance. ADHD is approximately three times more frequent in boys than in girls .About 30 to 50 percent of people diagnosed in childhood continue to have symptoms in the adulthood and between 2 and 5 percent of adults are in same condition. The conditions are difficult to tell except from other disorders as well their high normal activity.

Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. These children:

·         Are in constant motion.

·          Squirm and fidget.

·          Do not seem to listen.

·          Have trouble playing quietly.

·          Often talk excessively.

·          Interrupt or intrude on others.

·          Are easily distracted.

·          Do not finish tasks.  

    Other disorder related to ADHD:

        OPPOSITIONAL-DEFIANT DISORDER

         CONDUCT DISORDER

         PERVASIVE DEVELOPMENTAL DISORDER

        CENTRAL AUDITORY PROCESSING DISORDEr AND HEARING PROBLEMS

        BIPOLAR DISORDER (MANIC DEPRESSION),

        ANXIETY DISORDERS

        SLEEP DISORDERS

         OTHER CONDITIONS

 

 

                                                                                                                                  

·          3 Types of ADHD in Children: Doctors have classify symptoms as the following types of  ADHD:

·         Combined Type (Inattentive/Hyperactive/Impulsive). Children with this type of ADHD show all three symptoms. This is the most common form of ADHD.

·         Hyperactive/Impulsive Type. Children show both hyperactive and impulsive behavior, but for the most part, they are able to pay attention.

·         Inattentive Type. Formerly called attention deficit disorder (ADD). These children are not overly active. They do not disrupt the classroom or other activities, so their symptoms might not be noticed.                                         

Causes of ADHD in children’s are:     Genetics: It indicate that the disorder is often inherited from one's parents with genetics. Genetic factors are also believed to be involved in determining whether or not ADHD persists into adulthood..       Environment: Environmental factors play a lesser role. Alcohol intake during pregnancy can cause fetal alcohol spectrum disorder which can include symptoms similar to ADHD. Exposure to tobacco smoke during pregnancy can cause problem with central nervous system development and can increase the risk of ADHD..      Society: The reason of ADHD represent family ‘s poor educational system rather than an individual problem. Some cases may be explained by increasing academic expectations; with a diagnosis being a method for parents in some countries to get extra financial and educational support for their child. The youngest children in a class have been found to be more likely to be diagnosed as having ADHD possibly due to their being developmentally behind their older classmates. Typical behavior of ADHD are more commonly in  those children who have experienced violence and emotional abuse.

EFFECT of ADHD ON CHILDREN, PARENTS AND SIBLINGS:

·         Attention deficit/hyperactivity disorder (ADHD) is a chronic, debilitating disorder which may impact upon many aspects of an individual’s life, including academic difficulties, social skills problems and strained parent-child relationships.                                                  

·         It was previously thought that children eventually outgrow ADHD, recent studies suggest that 30–60% of affected individuals continue to show significant symptoms of the disorder in their adult age.

·         Children with the disorder are at greater risk for long- term negative outcomes, such as lower educational and employment attainment.

ADHD management usually involves some combination of counseling, lifestyle changes, and medications. Medications are only recommended as a first-line treatment in children who have severe symptoms and may be considered for those with moderate symptoms who either refuse or fail to improve with counseling. Long term effects of medications are not clear and they are not recommended in preschool-aged children. Adolescents and adults tend to develop coping skills which make up for some or all of their impairments.

                                                                                                                                                           

Nikita Nahata