Attention-deficit/hyperactivity disorder: insights, advances and challenges in research and practice

Purpose:
This review mainly focuses on the aetiology of attention-deficit/hyperactivity disorder (ADHD) including genetic, neurobiological, biochemical and environmental factors. It also emphasizes the possible management of the disorder. This knowledge will be essential for developing therapeutic interventions and prevention measures.

Views:
ADHD is a neurodevelopmental psychiatric disorder, characterized by pervasive patterns of inattention, hyperactivity, or impulsivity. Globally, it affects up to 7-10% of elementary school children, and symptoms frequently persist into adulthood. Among adults, 2-5% experience ADHD symptoms worldwide. The aetiology and developmental trajectory of the disorder remain unknown. ADHD is caused by a combination of genetic, psychological, physiological, biochemical, and environmental factors. All of these factors are thought to permanently change the development of the dopaminergic and noradrenergic system, which is a fundamental neurobiological mechanism behind the disorder.

Conclusions:
Untreated ADHD can have long-term effects on individuals throughout their lifetime and cause adverse life trajec­tories such as poor educational and occupational outcomes, substance addiction, accidents, suicide, criminal activity, and co-occurring mental and physical health disorders. Principal management options include psychopharmacological treatments such as group cognitive behavioural therapy and social skills training, parent education programmes, and school-based initiatives, as well as medication employing stimulants and non-stimulants.