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Hyperkinetic or Attention Deficit Disorder

Published online by Cambridge University Press:  02 January 2018

Seija Sandberg*
Affiliation:
The Child & Family Consultation Service, The Royal London Hospital, Whitechapel, London E1 1BB

Abstract

Background

In the face of rapidly expanding empirical knowledge about this common childhood condition, there is a need for an up-to-date synthesis, especially for the use of practising clinicians.

Method

The main epidemiological, experimental and clinical studies over the past decade are selectively reviewed.

Results

Hyperkinetic/attention deficit hyperactivity disorder is common, with young school-age males most frequently affected. The prevalence figures vary depending on the criteria used. Overlap with conduct disorder is high. The causes are likely to stem from a combination of biological, often genetically determined neurochemical disturbances, and environmental disadvantages, with the biological risk tending to be highest in severely hyperactive girls. Good clinical management combines pharmacological, psychological and educational approaches in a sustained manner. Even then, the outcome is often equivocal and the long-term psychosocial adaptation unpredictable.

Conclusions

Clinically significant hyperactivity is rooted in biological, often genetically transmitted vulnerabilities, upon which environmental disadvantages transact. It may be viewed as a disorder of self-regulation with its roots partly in strained early caregiver–child interactions and disrupted primary attachments.

Type
Review Article
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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