In 2004, the world Association of child and adolescent psychiatry and related professions (IACAPAP) recognized ADHD as the “# 1 problem” in the field of child and adolescent mental health. This may seem strange, because if for us children with ADHD are just cute in their” disobedience ” Petya Pyatochkin from the famous cartoon, who just once realize the consequences of their actions, and his behavior will correct, it is difficult to understand why the problems of “Pyatochkin” acquire such weight. Scientific research in recent decades, as well as accumulated clinical experience, has led to a departure from many previous ideas about ADHD – in particular, as a disorder exclusively of childhood, which in General does not create any serious problems, so it is still unknown whether it should be classified as a disorder. Perhaps it was from such ideas that the common advice to parents to wait until “the child will outgrow” and “leave it alone – just a boy needs to move.” The facts, the reliability of which is no longer in doubt, since they are confirmed by more than one study and in more than one country, force us to rethink the importance of the problem of ADHD and act.
First, there are statistics on the epidemiology of the disorder. According to them, ADHD is one of the most common behavioral disorders in children. According to the broad criteria of the DSM-IV, the prevalence of ADHD is from 3 to 20 % according to various studies (review in Goldstein, Goldstein, 1998, Pp. 67-71), the official indicator in the DSM-IV itself is 3-5 %. That is, at least one in thirty children has ADHD, which really means that there is at least one such student in every grade of a comprehensive school. Even under the stricter criteria of ICD-10, the prevalence of the disorder according to various studies is not lower than 1.5 % (Taylor, Doepfner, Sergeant et al., 2004). According to official data from the Centers for disease control and prevention in the United States in 2002, 7 % of children aged 6 to 11 years were diagnosed with ADHD – a total of 1623 million children! Therefore, it is not surprising that in the United States, for example, ADHD is the main reason for referrals to child psychiatrists. Moreover, statistics on the prevalence of ADHD in different countries differ little-deviations are within 1-2 % (Barkley, 1996. Pp. 61-66). However, unfortunately, despite this prevalence, this disorder is often diagnosed untimely, incorrectly or not detected at all – accordingly, most children do not receive timely and appropriate care. In particular, Taylor (Taylor, Doepfner, Sergeant et al., 2004. P.9) notes that in many European countries, the rate of ADHD in official reports is close to zero, which really indicates that this disorder is not properly diagnosed.
ADHD is not an exclusively childhood disorder, because most children do not get RID of it (although the symptoms vary slightly), and it is assumed that 2-3% of adults have ADHD (Barkley, 1996). In other words, according to research data, most children with ADHD will not get rid of it in adolescence (70-80 %) and in adulthood (50-65%) (Barkley, 1996, Pp. 114-125). Thus, ADHD can manifest throughout life – to some extent, we can equate it with other lifelong developmental disorders, such as cerebral palsy or mental retardation, with the only difference that the limitations of a child with ADHD are less visible. Although these children have real, biologically based difficulties in managing and organizing their own behavior throughout their lives, this is usually not taken into account. Others explain the problem behavior as malicious intent of the child or improper upbringing in the family.
The lifelong nature of this disorder and the limitations it imposes can lead (in the absence of proper understanding, support, and competent assistance) to serious secondary consequences. One of the main reasons for recognizing ADHD as a major problem in child psychiatry is that it is, unfortunately, very often misdiagnosed and mistreated around the world. And without proper help in an adverse environment, ADHD can contribute to the development of a child’s negative self-esteem, disrupt social adaptation, and cause secondary psychiatric diseases (Sandberg, 2002; Weiss, Hechtman, Weiss, 1999; Barkley, 1996; Goldstein, 1998).
The presence of ADHD in a child significantly increases the risk of secondary problems, such as:
✓ problems with school performance and behavior;
✓ increased risk of anti-social behavior and criminal actions, belonging to anti-social groups-both in childhood and in adolescence and adulthood;
✓ problems in interpersonal relationships, social isolation – both in childhood and in adulthood;
✓ mental health problems-significantly increased risk of many mental disorders in children and adults with ADHD, such as substance abuse/dependence, anxiety disorders, mood disorders, personality disorders, etc.
✓ risk-taking behavior-as a result, people with ADHD, particularly in adolescence and adulthood, are much more likely to become “producers” and victims of accidents, road accidents, they have an increased risk of unplanned teenage pregnancy, infection with venereal diseases, and so on.
This is, of course, only a brief overview of possible difficulties. In the future, the prognosis of a child with ADHD will be analyzed in more detail.
It is clear that the cost of these secondary disorders for the child, his family and society as a whole is very high. It should be noted that most problems are not a verdict for the child and can be treated; moreover, they can be prevented if timely, competent assistance is provided. And there is such help, because ADHD is one of the most studied behavioral disorders, which is devoted to thousands of scientific articles, dozens of monographs, numerous conferences, symposiums, etc.
Based on a large number of studies and accumulated clinical experience, modern science – based therapies have been developed.if they are used correctly, they can significantly reduce the severity of symptoms of the disorder and prevent secondary complications-and thus improve the prognosis of the life of the family, child and society.
With appropriate support, children with ADHD can have a happy, fulfilling future. The introduction of programs to help such children at the public and state level is extremely important, because it can really reduce a lot of social problems and improve the mental health of society as a whole.
The importance of ADHD is also linked to the many speculations and myths surrounding this disorder, which can make it much more difficult to identify and provide effective care in a timely manner. The “circulation” of these myths and many contradictory pseudoscientific speculations both on the Internet and in the public consciousness confuses parents and specialists and often leads to the use of pseudoscientific methods of treatment, which waste time, energy and financial resources of the family to no avail.