ADHD most often affects boys: around 3 to 4 boys for every girl, but these differences are reduced in adults. Explanations with Professor Diane Purper, psychiatrist and specialist in psychological medicine for children and adolescents at Montpellier University Hospital.
Attention deficit disorder with or without hyperactivity, better known as ADHD, affects 5% of school-age children and 3% of adults, or nearly 2 million people in France according to the Ministry of Health. The disorder is generally identified at school, because the symptoms interfere with school learning or community life.
When does ADHD start? “The first symptoms generally appear around the age of 5 or 6” answers Professor Diane Purper, psychiatrist and specialist in psychological medicine for children and adolescents at Montpellier University Hospital. “The diagnostic criteria then require that the bothersome symptoms must have occurred before the age of 12. continues our interlocutor. It is therefore in the 5-12 age group that ADHD is evident. The diagnosis is made on average at 9-10 years old, according to Health Insurance. Girls are often diagnosed later than boys.because their symptoms are less invasive and can go unnoticed.”
“The symptoms of ADHD are present over time, lasting and persistent. They are not one-off or isolated behaviors. On the contrary, they occur in several environments of life: at home, at school, during extra-curricular activities, etc.” explains Pre Purper. Three signs alert doctors: impulsivity, hyperactivity and inattention. “Impulsivity manifests itself differently depending on age. Young children will first present with motor instability in the foreground, then impulsivity in their relationships, with abrupt interactions, difficulty waiting, waiting for their turn to speak or raising their hand at school. School-age children tend to cut off speech or be intrusive in the group” explains Pre Purper. In adolescents or young adults “impulsivity most often manifests itself at the relational level, with difficulties in relationships, reactions that are too lively and too rapid. These behaviors impact professional and emotional trajectories.”
The attention disorder manifests itself through organizational difficulties, the child forgets instructions, does not finish what he has started, does not manage to automate routines such as dressing or brushing his teeth. He also has difficulty tidying his room, putting his environment in order and sequencing activities. Hyperactivity creates a constant need to move. “The young adult or adolescent with ADHD becomes bored, disengages from conversations or loses the thread of a verbal exchange.”
A thorough medical examination is essential to make the diagnosis of ADHD. “The signs are repeated especially during times in the community, when the child is very stimulated. Impulsive and inattentive behavior is rather well identified by teachers. The latter alert the family and depending on the age of the child, a consultation in PMI, with the treating doctor or with the pediatrician is recommended. The child is then referred to professionals such as psychiatrists.”
Care is based on the arrangement of the child’s environment and possibly treatments if necessary. Support is individual, case by case. A parental program based on cognitive-behavioral therapy (CBT) is offered to evolve in a caring environment. Psychoeducation is also part of the treatment. Medications are useful to improve symptoms, especially to avoid risks and complications such as anxiety, risky behavior or other disorders. They allow a significant improvement of symptoms in 80% of people affected by ADHD.
Interview with Professor Diane Purper, child and adolescent psychiatrist and head of department at Montpellier University Hospital and attached to the Research Center in Epidemiology and Population Health (INSERM U 1018) in Villejuif.
