Çocuk ve Ergenlerde Dikkat Eksikliği ve Hiperaktivite Bozukluğu
Synopsis
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder starting in early childhood, characterized by inattention, hyperactivity, and impulsivity. Symptoms such as a short attention span, excessive restlessness, impatience, and acting without considering the consequences stand out in its clinical presentation. While its global prevalence is determined to be 3.4% on average, this rate is 8.6% in Turkey, and it is more common among boys. Genetic predisposition, neurochemical factors such as dopamine and norepinephrine, volume reductions in the prefrontal cortex and caudate, as well as environmental factors like maternal smoking during pregnancy and premature birth play a role in its etiology. According to DSM-5 diagnostic criteria, symptoms must begin before age 12 and be observed in at least two different settings. Intellectual disability and learning disorders should be considered in the differential diagnosis. ADHD is divided into three subtypes: predominantly inattentive, predominantly hyperactive/impulsive, and combined type. Psychiatric comorbidities such as oppositional defiant disorder, conduct disorder, learning disorders, and anxiety disorders are present in at least half of the patients. Pharmacological agents such as psychostimulants and atomoxetine—a non-stimulant alternative—are preferred in treatment. Combining pharmacotherapy with psychosocial approaches, including parent training and behavioral therapy, provides the strongest therapeutic effect. In the course of the disorder, symptoms disappear in adulthood in 30% of cases, persist continuously in 40%, and progress with developmental impairment accompanied by substance use and social adjustment issues in 30% of cases.
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