Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. The prevalence among school-age samples in multiple studies suggests that 4% to 12% of the school-age population meets criteria for ADHD. It accounts for up to 50% of all referrals to child mental health clinics in the United States, and 10% of the behavioral problems noted in general pediatric settings. When similar criteria are used, rates of the disorder have generally been the same in other countries, including England.17

Males with ADHD outnumber females by a ratio of 4:1 to 9:1, depending on the sampling technique.

Outcome

Although ADHD is classified as being among those disorders that begin in childhood,7 as many as 70% of children continue to meet criteria for ADHD during adolescence. These adolescents tend to show significant behavior problems, symptoms of conduct disorder, increasing difficulties with peers, and school problems (e.g., poor academic performance, school suspensions).

Long-term follow-up studies of children with ADHD reveal that 50% continue to have a significant degree of psychopathology, including antisocial behaviors and drug use.46

Approach

ADHD is also one of the most studied of all the psychiatric disorders. The diagnosis has historically generated controversy but, in recent years, it has gained increasing acceptance. For some children, the diagnosis is clear and the treatment approach is straightforward. For many children, however, the diagnosis is complicated by comorbid medical and psychiatric disorders and developmental disabilities. For these youngsters, treatment is often complex and challenging. The field of pediatric psychopharmacology is gaining new scientific knowledge at an exponential rate and is increasingly studying subjects with comorbid conditions.

Adapted from: Hirsch GS and Koplewicz HS. Attention-deficit hyperactivity disorder. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;187–204.
With permission from Elsevier (www.elsevier.com).
Reviewed and revised June 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.