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Course and Prevalence of Attention-Deficit/ Hyperactivity Disorder (ADHD)

By definition, the symptoms of ADHD begin in childhood before age 7. According to some American surveys, over 8% of all children and adolescents ages 8-15 meet the diagnostic criteria for ADHD [ref], and about 4% of adults do as well [ref]. Data from other countries tend to show similar rates [ref].

ADHD is usually first noticed by teachers or parents, especially when disruptive behaviors are involved. Children with predominantly Inattentive symptoms are not as easily identified and may go on for years without being diagnosed.

There has been much controversy about whether ADHD should even be considered a true psychiatric disorder. If close to 1 in 10 children have the condition, then how could it be something abnormal? Being put into classrooms from a very young age and being expected to sit still and pay attention to a teacher, or being kept indoors at home for many hours a day, may not be the natural or most appropriate conditions for many children.

Nevertheless, the fact remains that individuals who have this syndrome have higher rates of poor academic performance, emotional difficulties, poor peer relationships, trouble with the law, and concurrent psychiatric conditions than individuals without ADHD [ref]. This suggests that having this syndrome is at least a marker or risk factor for various other potential difficulties.

Not all individuals with ADHD necessarily suffer serious consequences. About 20% of children with ADHD will have a difficult course with significant problems in emotional, educational and social adjustment, 60% will have some problems in these areas, and 20% will do well in all three domains [ref]. Those individuals with greater levels of impairments tend to have more Impulsivity symptoms, to suffer from other psychiatric conditions, to live in large households and to have mothers who suffer from psychiatric conditions [ref].

The symptoms of ADHD tend to diminish with time. About 15% of individuals who had ADHD in childhood and adolescence will continue to have the full disorder in adulthood, and about 65% will continue to have several symptoms of the condition [ref].


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Gender differences