— How many children with ADHD are there in Russia?
– However, as in the case of any disease that is not disabling at most, no one counts the number of such children centrally. But judging from our work in St. Petersburg and our colleagues in Moscow, the figures are approximately the same as abroad: 5-7% of the population. In men, as a rule, ADHD occurs 4-6 times more often.
– Is there really an overdiagnosis abroad, when the syndrome is attributed to children who do not have it?
– I cannot say that such a problem really exists. For example, ADHD has been investigated in the United States for a much longer time than in our country, scientific studies have been published for many years, but the figures on the prevalence of the syndrome practically do not change. Yes, the detection rate has increased slightly over the last decade, but not enough to consider these changes significant and indicate an increase in the number of misdiagnoses.
In Russia, attention was drawn to ADHD in the 1990s, so today doctors are already quite familiar with the diagnostic criteria and are able to detect it.
When people talk about ADHD, they usually mean restlessness and uncontrollability. The most characteristic symptom of this disorder?
The main symptom of ADHD is inattention. There are physically active children with a lively temperament. But if a child is constantly distracted while doing his schoolwork, cannot concentrate on them even at school age like his peers, if he always forgets something, then this is already a reason to be careful.
There are several subtypes of the syndrome. In some cases, hyperactivity does not manifest itself at all, but there are always problems with attention and concentration.
Hyperactivity is less common, especially in girls. In them, the disorder is generally milder in principle and is diagnosed at a later age. But if there is a distraction, sooner or later it becomes visible, leading to problems in learning, maladjustment at school.
– There are still disagreements among non-doctors: someone believes that ADHD is normal childhood behavior, someone – believes that it is just a manifestation of bad behavior. At what point do inattention and restlessness turn into pathology?
– The International Classification of Diseases formulates criteria that allow us to distinguish this disease from the norm. Inattention, distraction, disorganization, haste, restlessness must be adequately expressed for at least six months.
One of the important points is that the symptoms of the disease appear both at home and at the nursery or school. That is, if a child abuses his parents at home and no complaints are received from the children’s institution, these are most likely educational problems. It’s also important to rule out other diseases, i.e. anything that might affect behavior, by taking certain medications.
There are now psychophysiological tests that measure the patient’s ability to concentrate. The TOVA test is used for attention variability in our center, and the MOXO continuous productivity test has recently become widespread abroad.
The doctor considers each specific case separately, taking into account the diagnostic criteria, complaints of parents. Some analyzes and instrumental reviews are not very informative here. For example, although a special quantitative EEG shows certain changes, which makes it possible to determine whether it is really a violation of attention or something else, for example, motivation problems.
How does brain function differ from normal in a person with ADHD?
– We can exaggerately say that the anterior, anterior regions of the brain, the prefrontal cortex, work a little “slowly” compared to their healthy peers. There is functional immaturity of the brain. In other words, the prefrontal cortex regulates thinking and motor activity depending on one’s plans and tasks.
Is ADHD a genetic disorder? Or are there other reasons?
“First of all, it is a hereditary disease. If you examine the parents of children with ADHD, symptoms can be found in the fathers in half the cases and in the mothers in 29% of the cases. However, perinatal factors can also influence whether the disorder manifests itself and to what extent. Pregnancy and birth pathologies increase the risks; ADHD is more common in premature babies.
How does the social environment affect it?
– The social environment can change the manifestation of the disease – increase, decrease. But that’s not the reason.
Attention Deficit Disorder is not the result of certain family problems. There is still confusion in the society, some believe that the lack of attention is due to the lack of attention of the parents to the child.
But, of course, if the family situation is complex, if parents have different approaches to education, if there are frequent conflicts, this can exacerbate the manifestations of the syndrome.
How likely is ADHD to continue into adulthood?
– On average, in half the time. Sometimes children simply surpass it, the brain matures immediately after their peers.
Can the syndrome develop in an adult?
– NO. And this is very important. Patients come to me who read about ADHD and try to explain everything that has happened to them: problems at work, in the family, in terms of illness.
The disease may remain undiagnosed until adulthood, but cannot appear suddenly in an adult. So “How were you as a kid?” we ask. And if there were no symptoms of the syndrome before, the root of the problem should be sought elsewhere.
How does ADHD manifest in adults?
– Increased motor activity during the adult years is usually less pronounced, but attention problems persist. For example, such people change lanes on the road without looking in the mirror.
On average, they change jobs more frequently, change spouses less often, and have less income on average than their healthy peers. ADHD, of course, also leaves its mark on social life.
In addition, adolescents and adults with ADHD are at risk of developing alcoholism and drug addiction. Of course, it is not necessary for them to encounter alcoholism at all, but for them the probability will be higher.
What other diseases do people with ADHD experience?
– The disorder is usually accompanied by dyslexia and tics. Depression and anxiety disorders may develop at older ages. Often the symptoms of ADHD and other disorders can overlap, mask each other, and the doctor’s job here is to unravel this confusion and find the root cause of all the problems.
Do children with ADHD always need medication?
– There is such a stereotype that with ADHD it is necessary to take psychostimulants or other drugs. But it is not. The first stage is always psychological correction, psychotherapy. This is a very important issue. The work is done in the family, with the parents. It is important to convey to them that there is no pill to teach a child to behave properly. Parents should learn to understand him, interact with him, taking into account his features.
What should parents of children with ADHD pay attention to in the first place?
– Such a child should not be scolded or criticized. Children with ADHD are not very sensitive to criticism and prohibitions in principle.
If a child has done something wrong, it’s important to convey the thought: “You’re fine, but you did it wrong.” So, don’t scold him for his personality, for who he is. This generally applies to healthy children. But with ADHD, a positive pattern of parental behavior towards a child is extremely important.
It is also very important for such children to structure the time as much as possible so that the child has specific time slots for certain tasks and creates a schedule. It’s hard for people with ADHD to stick with it, but without a schedule, their lives will turn into complete chaos. If parents want their children to later get an education, a job, not be disabled, and feel on par with their healthy peers in society, then we must strive to maintain some sort of routine. Absolute obedience is certainly not worth demanding, but leniency cannot be allowed either.
– Does the syndrome have positive aspects? Can you make it work for you?
– Earlier, with regard to ADHD, they talked about double exclusivity, when a person simultaneously has mental or behavioral disorders and some extraordinary abilities or talents. However. In general, children with ADHD are not intellectually different from their peers, and some are highly gifted. It has nothing to do with the syndrome. ADHD does not provide any advantage in life or work. It’s a disease. And it’s better not to be.