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Short Communication | DOI: https://doi.org/10.31579/2578-8868/224
1 Third year psychiatry resident
2 Psychiatrist
3 Head of the Psychiatry and Paidopsychiatry Service.Centro Médico Nacional “20 de Noviembre”, ISSST, Ciudad de México.
*Corresponding Author: Cecilia G Rojo Vázquez, Third year psychiatry resident.
Citation: Rojo Vázquez CG, Hernández Martínez HE, Ochoa Madrigal MG. (2022). Attention deficit and hyperactivity disorder (ADHD) in infancy. J. Neuroscience and Neurological Surgery. 11(2); DOI:10.31579/2578-8868/224
Copyright: © 2022 Cecilia G Rojo Vázquez, This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Received: 10 December 2021 | Accepted: 03 January 2022 | Published: 21 February 2022
Keywords: hyperactivity disorder;psychiatric
The main objectiveof this paper was to review recent literature and analyze how ADHD researchand conceptualization has adapted to what we clinically see at our practice. This review is of special importance due to the highly heterogeneous clinicalpresentation of this disease.
The main objective of this paper was to review recent literature and analyze how ADHD researchand conceptualization has adapted to what we clinically see at our practice. This review is of special importance due to the highly heterogeneous clinicalpresentation of this disease. We also review some aspectsinvolving non- pharmacological and pharmacological treatment. The main aspect that is to be noted is that appropriate treatment at the correct time of treatmentlead to a greater qualityof care for our patients. [1]
In this review paper we look at the most recent literature on Attention deficit and hyperactivity disorder (ADHD) in infancy because of the great relevancethis topic has gained in recent years [2]
Ignorance of the enteropathogenesis and pathophysiology of the disorder requiresthat its definition, as a psychiatric entity, remain of clinical nature. Three are the cardinal symptoms: hyperactivity, a period short of attention and impulsiveness [3]
ADHD is one of the main reasons’ patientsreach out to mental healthprofessionals at early age and if notaddressed symptoms can last well along to adulthood, approximately 15% will continue to meet full diagnostic criteria and an additional 50% will continue to have impairing ADHD symptoms as young adults. In contrast to was originally described as ADHD limited to childhood. Children presenting symptoms often lead to low school performance and conductdisorders. [4]
In recent year there has been a focus on the neurobiology of this disorder studying how neurotransmitters like serotonin and dopamine interact with coding and decoding of sensory input and how with medication with these specific targets at central nervous system play an important role in symptom control predominantly in the reticular formation. Geneticstudies on family aggregation have shown how our genetics play an important role on presentation, yet no single gene has been found be responsible for this disorder. Epigenetic factors such as exposition to toxins in pregnancy and early life has also been associated with ADHD. [5-7]
The most accepted neuroanatomical hypothesis developed mainly through brain imaging and neuropsychological testing,states that with the existence of front striated hypoactivity due to monoaminedeficiency, suggests that attention, impulsivity control and stability motor are components of the supervisory systemthat exerts from a wide functional networkinvolving frontal, striatum,limbic and reticular areas. [8-10]
In regardto psychosocial findingsit has been shown that in childrenwith a certain neurobiological predisposition an unfavorable environment can act as a predisposing and precipitating factor [11]
Treatment optionsand first line recommendations vary from geographical area, for examplein the US medication is commonly used and European literature suggest reserving medication for patients who did not respond to the implementation of non-pharmacological strategies. [12] Non-pharmacological measures center upon life skills and psychosocial education that adapt and transform through stages of development. Recently studied interventions includespecific dietary recommendations with little evidence. [14]
Pharmacological interventions require a carefulevaluation of the child and their environment as well as establishing clear treatment goals. [15] In preschool aged children non-pharmacological treatments remain to be first line treatment across various literature [16]. In school aged children two main medication type groups are discussed. Stimulants being represented by metylphenidate and the newer lisdexanfetamine with common side effects being initial insomnia, loss of appetite and irritability. These side effects can be addressed by education patients and care givers. Severe side effectsinclude mania, movement disorders and psychosis in which case medication should be stopped immediately. The other group of medication are non-stimulants such as atomoxetine, clonidine and guanfacine commonside effects includesedation due to their 2 agonism. [17-20]
In conclusion the study of ADHD requires clinical criteria that is flexible and adapts to different stagesof development that includes biomarkers.
It is also necessary carry out early interventions to decrease the development of complications and assess the presence of comorbidities that alter the course of the diseaseand treatment adherence. One of the main objectives should be education and awareness to reduce stigma, as well as promote research and development of new treatments. It is essentialto have the participation of care givers
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