The acronym ADHD stays for Attention Deficit Hyperactivity Disorder. It’s one of the common disorders of childhood. It’s estimated that 5% of children and 2,5% of adults in the world are affected.

The growth of early diagnosis is also motivated by the greater knowledge that has acquired the different professional figures involved. A theme that also attracted attention is the possibility of diagnosis in adulthood.

It is not uncommon for an adult to discover that he or she has ADHD when the same disorder is diagnosed in his or her child.


The Attention Deficit and Hyperactivity Disorder is a neurodevelopmental disorder that is diagnosed in most cases in the first twelve years of life, but that very often lasts in adult life.

We can divide symptomatology into three main categories:

  • impulsivity,
  • hyperactivity,
  • and lack of attention.


The subject acts without thinking. Even in his relationship with others, he is impatient, it is difficult to maintain a dialogue without interrupting. Moreover, he strikes for his, sometimes inappropriate, sincere.


The subject seems to be driven by an engine, and it’s in constant motion. For him, for example, all those tasks that require sitting for a long time are very complicated. For example, during a lesson, it is not uncommon for the person to move his legs or hands almost uncontrollably. This behaviour is also evident during recreational activities


It’s the most obvious symptom in school age. The subject has reduced attention and organization capacity and will be easily distracted. He also shows a total disregard for details. Even the memory is involved, in fact, the subject with ADHD often has forgetfulness, both in everyday life and in school or work.

The manifestation of symptomatology is very subjective, it changes a lot from one subject to another. In the last studies have been evidenced remarkable differences between males, more predisposed to hyperactivity, and females more predisposed to the deficit of attention.

It’s still possible to identify three models of ADHD manifestation.

The impulsive/hyperactive type in which the characteristic features of 'hyperactivity' and 'impulsivity' are dominant.

In the type with predominance of the attention deficit are just predominant all those symptoms related to attention, memory and organization.

In the third model, the combined model, the three symptomatological categories converge simultaneously.


The diagnosis is a fairly elaborate and long process involving various professional figures, including child neuropsychiatrist, psychologist and psychiatrist. The complexity is that the same manifestations are present in children who do not have ADHD, albeit to a lesser extent.

Usually, the process starts with a teacher reporting because it’s in the school context that the symptoms can be better observed.

The next step is the observation and screening phase. This happens in all environments that are in contact with the child, that is, family, school and recreational.

The doctor also uses physical, radiological and laboratory tests, especially to rule out other causes and to check if it is in the presence of comorbidity.

The diagnosis process is currently based on the symptoms described in the two main diagnostic manuals:

  • DSM-V, used in the USA,
  • and ICD-10, used in Europe.

To be considered for diagnostic purposes, symptoms must occur for at least six months and to an extent disproportionate to the age of the subject. It must also be demonstrated that these demonstrations are not the consequence of other problematic situations, such as school, domestic or social.

It’s important to remember that the variety of symptoms is really expanding and that some manifestations are common to other diseases.

For example, depression, bipolar disorder, and some intellectual disabilities may present symptoms that can be mistaken for ADHD at first. For this reason, it is essential that the screening and observation process be early and continuous.


The specific cause of ADHD is still unknown, but the one that has the most consent is genetic. The various professional figures sometimes recognize that this must be integrated with environmental risk factors, which can undoubtedly affect the onset and gravitation of ADHD.

These factors also include all those conditions to which the child is exposed during pregnancy and childbirth.

For example, the use of alcohol, drugs or nicotine during pregnancy can interfere with the development of the central nervous system with a higher risk that the child may suffer ADHD.

Environmental risk factors include infections, both from viruses and bacteria, and complications during childbirth.

In recent years, dietary risk factors have also been included. Some believe, for example, that the abuse of sugars, dyes and additives can be the cause of the disorder, but there is no concrete evidence to support this last argument.

To date, the interpretation that has the most consensus in the academic world is that it actively integrates genetic predisposition with external factors.


As regards the interventions that the professional figure can use, they can be divided into two areas of action:

  • pharmacological
  • psychoeducational

Drug therapy consists in the administration of drugs, psychostimulants and not, which help to maintain at manageable levels hyperactivity' and impulsivity', and that helps the individual to increase his threshold of attention and concentration.

The administration of stimulants to minors is not always well seen. It is widely believed that in doing so they are exposed to a greater risk of addiction to drugs. In contrast, recent studies have shown that boys undergoing drug treatment for ADHD have been less at risk than their peers who exhibit the same disorder but are not treated.

The results are well visible even in the short term but it is advisable to integrate the use of drugs with psychological and educational therapies.

In this sense, therapies with a cognitive-behavioural approach enjoy a lot of consensuses. This consists in teaching the child strategies to deal in a constructive way with their deficits and the resulting conduct. It is therefore addressed to all aspects of the person and involves school, family and society.

More in detail, it includes activities that involve both the subject with ADHD and those who take care of it and aim to achieve good self-regulation in all aspects.

Another approach that integrates well with all the others is the conduct modification therapy.

This acts by positive reinforcements if the conduct is adequate, and negative if instead, the subject manifests incorrect behaviour.

Other useful and well-integrated techniques are those of relaxation and control of anxiety and stress, encourage the practice of sports activities and train social skills, often lacking in those who have the disorder.

Whatever the psychological approach is chosen, the process always takes place in close collaboration with the educational community, that is, parents and teachers.

For this reason are equally important the activities of teacher and parent training, the purpose of which is to train and make both parents and teachers aware, transmitting to them patterns of management of the disorder.

These become active elements through positive communication and imposition and help in the internalization of structures and discipline.

This type of session can be both individual and group. Sharing with other families living in the same condition can be a huge support. Listening to and exchanging your experiences is an opportunity to learn and enrich yourself culturally. And not least, it helps to fight the feeling of loneliness in which families often live.

In recent years, there has been a third approach, the nutritional approach. It consists in treating ADHD with a diet, for example by eliminating sugars, dyes, additives and in some cases gluten.

At the moment there is no evidence that it is an effective and decisive therapy, but in some particular cases correcting the diet has been of help in mitigating, at least in part, the symptoms.

The integration of the various therapies remains the mode that is most successful precisely because you are faced with a disorder with many nuances.

The choice of which treatments and therapies to use also depends on the possible presence of comorbidity.


Comorbidity is defined as the presence of two or more contemporary pathological conditions. According to studies, in ADHD this is very frequent in fact about 67% has at least another psychiatric or developmental disorder.

This makes the diagnosis process much more complex and affects the treatment.

Many experts explain this phenomenon by the fact that these disorders may have common cautious and risk factors. The disorders that present greater comorbidity, with varying degrees of intensity, with ADHD are:

  • Defiant oppositional disorder
  • Anxiety disorder
  • Bipolar disorder
  • Tourette syndrome
  • Depressive disorder

These 5 are those in which the professional figures who study the phenomenon show greater possibilities of comorbidity.

It is therefore evident that in the presence of this phenomenon, the choice of therapy must be adapted to the two or more disorders that coexist in the individual.


The symptoms of this disorder, with their consequences and implications, can manifest themselves in a more or less important way in adult life.

This is because ADHD is a disorder that affects areas of the person that are vitally important.

It interferes in relational, professional and not to a lesser extent in education and training dynamics.

It is possible, however, to recognize two profiles of ADHD subjects in adult life: the constructive and the destructive.

In the first one, even if the symptoms are present, the person does not exhibit problematic or socially inconvenient behaviours. Impulsivity and the presence of an original and unconventional thought become enormous resources in both academic and work. This is fundamental for the subject to feel part of the community and therefore socially accepted.

Achieving a constructive profile is the goal that usually arises the professional figure in charge of therapy and treatment of the subject.

In the destructive profile are manifested highly impulsive and dangerous conducts with a strong, not motivated aggressiveness.

The consequences are a strong conflict, both in the family and in the work and social environment, illegal conduct up to the abuse of drugs and alcohol.

Through these conducts, the individual tries to regulate himself. That is, the individual performs certain behaviours, not by choice, but to defend himself from the stress caused by his deficits and its consequences.

It’s a real defence mechanism against all those stress situations where the subject feels overwhelmed and reacts with misfits behaviour.

It’s just to avoid solidifying a destructive profile that early detection is important. In other words, what allows the individual with ADHD to reach a constructive profile and live as normal a life as possible, is diagnosis and treatment, including in the latter all those interventions aimed at identifying their deficits and working on mechanisms of correct self-regulation.

It is difficult to make a diagnosis in adulthood because of the numerous nuances of symptomatology and the possible comorbidity', a phenomenon more evident and probable with the advancement of the age.

Also, reconstructing a clinical history with years of delay can be complicated because memory and memory interpretation can be compromised and incomplete and incorrect data can be provided.

Although it’s a widespread disorder in the child and adult population, it’s still a taboo theme. This happens because in many cases the symptomatology manifests itself with socially unacceptable and unpleasant behaviours. In the most serious cases, it is impossible to sustain a dialogue with a certain continuity.

The subject with ADHD is often aware of his condition, he feels different from the rest of the people, and this can cause him a strong sense of inadequacy and lead him to isolate himself. It is thus inevitable the worsening of the disorder and quality of life of the person.

On the other hand, often the same company in which the subject with ADHD is anything but collaborative, in fact, issues judgments too hasty and superficial. There are still many who do not recognize the disorder and consequently the condition in which the subject lives.

To say that it is an invented disease is at the limit of the offence, both for the person and for the family that takes care of it in a system that often leaves them alone. It is important to recognize that it is a problem that generates stress in families and teachers who often find themselves unprepared in the management of the child’s behaviour.

At the moment the debate is "only" in the scientific field, and it is a constructive dialogue that aims to identify and establish common strategies, both in diagnosis and in treatment.

The second fundamental step is to pass on these conclusions to the public debate.

It is really very important to combat the misinformation so widespread on this disorder, to prevent the spread of an unrealistic vision and to promote a gradual and effective integration of the person. What is perhaps necessary is a cultural change, starting with the dissemination of information about ADHD disorder and more generally on all those disorders that resonate intrusive for the person.

I wanted to summarize the general lines of the disorder, to treat it in a complete and exhaustive way would not be enough hundreds of pages.

The intent is simple: to make it clear that this disorder exists. And there are a lot of people who, day after day, fight with ADHD.

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