주의장애와 과행동장애질환

ADHD

 

ADHD(AttentionDeficit Hyperactivity Disorder)

주의력장애 및 과행동장애는 마국 어린이의 150만~350만 학령기 아동에서 나타난다. 한국에서는?. 남아의 5% 및 여아의 2%. 현재로는 왜 여아에서보다 남아에서 더 흔하게 나타나는지 모른 다. 이들의 60%는 어른이 되어도 증상을 가진다. 미국 국립보건원(NIH)에 따르면 백만명 이상의 아동들이 과행동을 통제하기 위하여 약물치료를 받고 있다고 한다. 경제적인 평가는 약 300만 달러가 사용된다고 한다.

학생이 ADHD를 가졌다면 책에서 한문장을 마져 다 읽기도 전에 딴데 정신이 팔리게 된다. 그리고 방안의 여러가지를 둘러보고 한 곳에 집중하지 못한다. 일어나서 이리저리 다니게 된다. 그러므로 학교에서 수업시간 중 수업이나 집에서 숙제 등을 할 수 없을 것이다.

Signs to Look For

Almost all people at some point exhibit some of the symptoms of ADHD. We all get distracted at times; we all have had trouble finishing work or tasks. However, children with ADHD are, in general, less able to care for themselves, less able to recognize appropriate social behavior, and less able to communicate than children without ADHD of the same age. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) published by the American Psychiatric Association has a very specific listing of behaviors that must be observed before a diagnosis of ADHD is made.

There are many reasons other than ADHD why children may have these behaviors. Infections, learning disabilities, or educational issues may result in symptoms similar to ADHD.

Patterns of behavior that may indicate ADHD:

Inattention

• Being easily distracted

• Failing to pay attention to details and making careless mistakes

• Forgetting things, such as pencils, that are needed to complete a task

• Rarely following directions completely or properly

Hyperactivity

• Not being able to sit still

• Talking non-stop

• Leaving seat when sitting is expected/instructed

Impulsivity

• Being unable to suppress impulses such as making inappropriate comments

• Shouting out answers before a question is finished

• Hitting other people

• Behavior which puts one in danger, such as dashing into the street

Some days, for some reason, these symptoms may be absent, leading others to think that the person with ADHD can control the behaviors. A definite diagnosis is difficult because there are no tests that consistently detect ADHD. A physician can only observe behaviors and guess whether the child has ADHD. Many children have trouble concentrating, or may not be in a mood to cooperate on the day they see the doctor. This could lead to an incorrect diagnosis. ADHD must be diagnosed by a health care professional who specializes in these types of disorders in cooperation with parents and teachers.

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Examining the Cause

The cause of ADHD is not clear-cut. It appears that certain receptors in the brain which normally respond to the neurotransmitter called dopamine are not working properly. Most likely, dopamine is not being produced at normal levels in the brain. Recent work in adults points to a defect in an enzyme called dopa decarboxylase which helps make dopamine. This defect in dopamine production occurs in the anterior frontal cortex, an area associated with cognitive processes such as focusing and attention.

Evidence shows that children who were born weighing less than 1500 grams (3.3 pounds) or who had birth complications may be more prone to ADHD. Additionally, studies have linked resistance to thyroid hormones to hyperactivity and lack of impulse control, but it is unclear how this impacts ADHD.

Other factors which are being investigated to see what role they may play in ADHD are exposure during pregnancy to:

• Toxins (such as lead)

• Drugs (such as alcohol or cocaine)

According to the National Institutes on Health, ADHD is not usually caused by:

• Too much TV

• Food allergies

• Excess sugar

• Poor home life

• Poor schools

Increasing evidence suggests that ADHD is an inherited condition. If one identical twin has symptoms of ADHD, the other twin has a 75-91% chance of sharing the same trait. Children who have ADHD are likely to have one close relative who also has ADHD. One-third of all fathers who had ADHD when they were young have children who have ADHD.

Adoption studies provide more evidence of a genetic link to ADHD: biological relatives of children with ADHD have a higher chance of having ADHD than adoptive relatives of children with ADHD.

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