Attention-deficit/hyperactivity disorder: insights, advances and challenges in research and practice

This review mainly focuses on the aetiology of attention-deficit/hyperactivity disorder (ADHD) including genetic, neuro-biological, biochemical and environmental factors. It also emphasizes the possible management of the disorder. This knowledge will be essential for developing therapeutic interventions and prevention measures.

ADHD is a neurodevelopmental psychiatric disorder, characterized by pervasive patterns of inattention, hyperactivity, or impulsivity. Globally, it affects up to 7-10% of elementary school children, and symptoms frequently persist into adulthood. Among adults, 2-5% experience ADHD symptoms worldwide. The aetiology and developmental trajectory of the disorder remain unknown. ADHD is caused by a combination of genetic, psychological, physiological, biochemical, and environmental factors. All of these factors are thought to permanently change the development of the dopaminergic and noradrenergic system, which is a fundamental neurobiological mechanism behind the disorder.

Untreated ADHD can have long-term effects on individuals throughout their lifetime and cause adverse life trajectories such as poor educational and occupational outcomes, substance addiction, accidents, suicide, criminal activity, and co-occurring mental and physical health disorders. Principal management options include psychopharmacological treatments such as group cognitive behavioural therapy and social skills training, parent education programmes, and school-based initiatives, as well as medication employing stimulants and non-stimulants.