Syndrome of deficit of attention and hyperactivity

Description:

Syndrome of deficit of attention and hyperactivity (in abbreviated form SDVG; English Attention-Deficit/Hyperactivity Disorder (ADHD)) — the neurologic and behavioural disorder of development beginning at children's age. It is shown by such symptoms as difficulties of concentration of attention, a hyperactivity and badly managed impulsiveness.

SDVG and its treatment causes much controversy beginning since 1970. A number of physicians, teachers, politicians, parents and mass media doubts existence of SDVG. One consider that SDVG does not exist in general, others believe that there are genetic and physiological reasons of this state.

Symptoms of the Syndrome of deficit of attention and hyperactivity:

A. The CARELESSNESS diagnosis requires existence of six or more of the listed carelessness symptoms which remain at the child for at least six months and are expressed so that confirm insufficient adaptation and discrepancy to normal age characteristics:

  1. It is often incapable to keep attention on details; because of negligence, levity makes mistakes in school tasks, in the performed work and other types of activity.
  2. Usually hardly keeps attention when performing tasks or during the games.
  3. Often there is an impression that the child does not listen to the speech turned to it.
  4. She is often not able to adhere to the offered instructions and to cope up to the end with performance of lessons, homework or duties in a workplace (that is not connected in any way with negative or protest behavior, inability to understand a task).
  5. Often experiences difficulties in the organization of independent performance of tasks and other types of activity.
  6. Usually avoids involvement in performance of tasks which demand long preservation of intellectual tension (for example, school tasks, homework).
  7. Often loses the things necessary at school and at home (for example, toys, school supplies, pencils, books, working tools).
  8. Easily is distracted by foreign incentives.
  9. Often shows forgetfulness in daily situations.

B. HYPERACTIVITY. Existence of six or more of the listed symptoms of a hyperactivity and impulsiveness which remain for at least six months and are expressed so that confirm insufficient adaptation and discrepancy to normal age characteristics:

  1. The uneasy movements in brushes and feet are often observed; sitting on a chair, turns, spins.
  2. Often rises from the place in a class during lessons or in other situations when it is necessary to remain on site.
  3. Often shows an aimless physical activity: runs, turns, tries to climb somewhere, and in such situations when it is unacceptable.
  4. Usually cannot quietly, quietly play or be engaged in something at a leisure.
  5. Often is in the constant movement and behaves so, "as though attached the motor to it".
  6. Often happens talkative.

IMPULSIVENESS

  1. Often answers questions without thinking, without having listened to them up to the end.
  2. Usually hardly waits for the turn in various situations.
  3. Often disturbs others, sticks to people around (for example, interferes with conversations or games).

II. (B.) Some symptoms of impulsiveness, a hyperactivity and a carelessness begin to cause concern of people around at the age of the child up to seven years.

III. (C.) The problems caused by above-mentioned symptoms arise in two and more types of a surrounding situation (for example, at school and houses).

IV. (D.) There are convincing data on clinically significant disturbances in social contacts or school training.

Reasons of the Syndrome of deficit of attention and hyperactivity:

The exact origin of SDVG is not known, but there are several theories. Can be origins of organic disturbances:

    * General deterioration in an ecological situation.
    * Infections of mother during pregnancy and the effect of drugs, alcohol, drugs, smoking during this period.
    * Immunological incompatibility (on a Rhesus factor).
    * Threats of an abortion.
    * Chronic diseases of mother.
    * Premature, fulminating or long births, stimulation of patrimonial activity, poisoning with an anesthesia, Cesarean section.
    * Patrimonial complications (the wrong presentation, encirclement its umbilical cord) lead to fruit spine injuries, asfiksiya, internal brain hemorrhages.
    * Any diseases of babies with high temperature and reception of strong drugs.
    * Asthma, pneumonia, heart failure, diabetes, diseases of kidneys can act as the factors breaking normal work of a brain [29].

Genetic factors:

By specialists of Medicogenetic scientific center of the Russian Academy of Medical Science and faculty of psychology of MSU it is established that "most of researchers agrees in opinion that the uniform origin of a disease does not manage to be established and, seemingly, it will never not be possible". The scientific USA, Holland, Colombia and Germany made the assumption that for 80% emergence of SDVG depends on genetic factors. From more than thirty candidate genes chose three — a dopamine carrier gene, and also two genes of dopamine receptors. However genetic premises to development of SDVG are shown in interaction with Wednesday which can strengthen or weaken these premises.

Treatment of the Syndrome of deficit of attention and hyperactivity:

In the different countries approaches to treatment and correction SDVG and available methods can differ. However, despite of these distinctions, most of specialists consider the most effective an integrated approach which combines several methods which are individually picked up in each case. Methods of modification of behavior, psychotherapy, pedagogical and neuropsychological correction are used. "Medicinal therapy is appointed according to individual indications when disturbances from cognitive functions and a problem of behavior at the child with SDVG cannot be overcome only by means of non-drug methods."  In the USA for treatment Ritalinum causing accustoming is used.

Pharmakokorrektion. At treatment of SDVG as an auxiliary method medicines are applied. The most known of them are psychostimulants, such as methylphenidate, декстроамфетамин with amphetamine and декстроамфетамин. One of shortcomings of these drugs — need to accept them several times a day (action time about 4 hours). Now appeared methylphenidate and декстроамфетамин with amphetamine of long action (till 12 o'clock). Also use drugs of other groups, for example — атомоксетин.

Extra care is necessary at purpose of stimulators for children as a number of researches showed that their high doses (for example Methylphenidate more than 60 mg/put) or the wrong use causes accustoming and can induce teenagers to use higher doses for achievement of narcotic effect. According to the research conducted in the USA among cocaine addicts at persons from SDVG using stimulators at teenage age probability of addiction to cocaine is twice higher, than at those who was диагнозирован SDVG, but did not use stimulators.

In 2010 in Australia the research about futility and inefficiency of treatment of SDVG was published by stimulators. The research covered people whom watched for 20 years.

The committee on the rights of the child of the United Nations published recommendations in which the following is told: "The committee expresses concern in data that the syndrome of deficit of attention with a hyperactivity (SDVG) and the syndrome of deficit of attention (SDA) is diagnosed mistakenly and that as a result psychostimulants, despite the increasing number of certificates on harmful effects of these drugs excessively register. The committee recommends to conduct further researches concerning diagnosis and treatment of SDVG and SDV, including possible negative effects of psychostimulants on physical and psychological wellbeing of children, and also to use other forms of settling and treatment at the appeal to behavioural frustration to the maximum".

The approach widespread in the CIS are the nootropic drugs, substances improving the work of a brain, exchange, power increasing a bark tone. Also the drugs consisting of amino acids which, according to statements of producers, improve a brain metabolism are appointed. There are no proofs of efficiency of such treatment.

    * Psychostimulants
          o Phenaminum
          o Ritalinum (Methylphenidate)
    * Antidepressants
          o Venlafaksin
          o Imipraminum
          o Nortriptilin
          o Atomoksetin

Not pharmacological approaches.

At the moment there are several not pharmacological approaches to methods of treatment of SDVG which can be combined with a pharmakokorrektion, or be used independently.

    * Neuropsychological (by means of various exercises).
    * Syndromal.
    * The behavioral or behavioural psychotherapy is accented on these or those behavioural templates, either creating, or extinguishing them by means of encouragement, punishment, coercion and a vdokhnovleniye. It can be applied only after neuropsychological correction and maturing of structures of a brain, otherwise behavioural therapy is inefficient.
    * Work on the personality. Family psychotherapy which creates the personality and which defines where to direct these qualities (disinhibition, aggression, hyperactivity).

All this complex of methods of psychocorrection and drug treatment at timely diagnosis will help hyperactive children to compensate disturbances in time and to be implemented fully in life.