-
Created September 25, 2025, last updated 2 months ago.
Collection: 173, Score: 100, Trend score: 0, Read count: 101, Articles count: 5, Created: 2025-09-25 02:39:28 UTC. Updated: 2025-09-25 04:01:19 UTC.Notes
Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterised by inattention, hyperactivity, and impulsivity. It is most commonly diagnosed in childhood, with a male predominance (approximately 2-3:1), though symptoms often persist into adulthood. Global prevalence is estimated at ~5-7% in children and ~2-3% in adults. Meta-analyses show ADHD is primarily genetic with 70–80% heritability.
Anesthesia issues
- Medication considerations
- Stimulants (methylphenidate, amphetamines)
- May increase sympathetic tone (tachycardia, hypertension, arrhythmias)
- Possible attenuation of response to indirect-acting vasopressors (e.g. ephedrine, metaraminol); prefer direct-acting agents (phenylephrine, epinephrine)
- Withdrawal or omission perioperatively may cause fatigue, irritability, behavioural instability.
- Possible altered anaesthetic requirements; stimulants may increase MAC slightly, though evidence is inconsistent.
- Non-stimulants (atomoxetine, guanfacine, clonidine) - α2-agonists (guanfacine, clonidine) can potentiate sedation and hypotension.
- Stimulants (methylphenidate, amphetamines)
- Behavioural and perioperative management
- Difficulty with preoperative cooperation and anxiolysis (may need structured preparation, early anxiolytic use, or parental presence in paediatrics); Increased anxiety or agitation in unfamiliar environments.
- Impulsivity may increase risk of perioperative non-adherence (e.g. fasting rules, device removal).
- Higher risk of emergence agitation or delirium, especially in children.
- May display increased postoperative anxiety, irritability, or oppositional behaviour
- Pain perception and reporting may be inconsistent, complicating assessment and analgesia planning.
- Comorbidities
- High association with anxiety, depression, and substance use disorders (impact on anaesthetic planning and perioperative risk)
- Sleep disturbances common, may complicate recovery and pain management
Daniel Jolley
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*,_underline_or**bold**. - Superscript can be denoted by
<sup>text</sup>and subscript<sub>text</sub>. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3., hyphens-or asterisks*. - Links can be included with:
[my link to pubmed](http://pubmed.com) - Images can be included with:
 - For footnotes use
[^1](This is a footnote.)inline. - Or use an inline reference
[^1]to refer to a longer footnote elseweher in the document[^1]: This is a long footnote..
Collected Articles
-
Annu Rev Clin Psychol · May 2018
ReviewAttention Deficit Hyperactivity Disorder (ADHD): Controversy, Developmental Mechanisms, and Multiple Levels of Analysis.
Controversy abounds regarding the symptom dimensions of attention problems, impulsivity, and hyperactivity, developmentally extreme and impairing levels of which compose the diagnostic category of attention deficit hyperactivity disorder (ADHD). I highlight causal factors, underlying mechanisms, developmental trajectories, and female manifestations of ADHD, integrating the psychobiological underpinnings of this syndrome with contextual factors related to its clinical presentation, impairments, and soaring increases in diagnosed prevalence. ⋯ Moreover, intervention strategies must take into account both pharmacologic and behavioral modalities if the goal is to enhance competencies, rather than symptom reduction per se. A comprehensive understanding of ADHD mandates multiple levels of analysis-spanning genes, neurotransmission, brain pathways, individual skill levels, family socialization, peer relationships, and educational and cultural forces-which must be integrated and synthesized to surpass reductionist accounts, reduce stigma, and maximize the impact of prevention- and intervention-related efforts.
-
Attention-deficit hyperactivity disorder (ADHD) is a disorder of inattention, impulsivity, and hyperactivity that affects 8-12% of children worldwide. Although the rate of ADHD falls with age, at least half of children with the disorder will have impairing symptoms in adulthood. ⋯ Studies during the past decade have shown the safety and effectiveness of new non-stimulant drugs and long-acting formulations of methylphenidate and amfetamine. Other investigations have also clarified the appropriate role of targeted psychosocial treatments in the context of ongoing pharmacotherapy.
-
Meta Analysis
Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis.
The estimates of attention-deficit hyperactivity disorder (ADHD) prevalence across various studies are significantly variable, contributing to uncertainty in ADHD prevalence estimation. Previous systematic reviews and meta-analyses have attributed this variability primarily to the methodological characteristics of the studies, including the diagnostic criteria, source of information, and impairment requirement for the diagnosis. ⋯ Exact comparisons among studies with different diagnostic criteria and types of sampling can impact prevalence estimates. When comparing data from methodologically different studies, these factors need to be considered.
-
The prevalence of Attention Deficit Hyperactivity Disorder (ADHD) has seen a consistent rise in recent years. These numbers spark a debate over the reason for the observed trends, with some concerned about over diagnosis and over prescription of stimulant medications, and others raising the issue of diagnostic disparities, particularly in underrepresented populations. In this paper we look at both sides, starting with the history of ADHD and its diagnostic criteria changes, from early concepts of alterations in attention and hyperactivity in the 19th and 20th century, to its introduction in the Diagnostical and Statistical Manual of Mental Disorders (DSM), and its evolution into how it is defined today. ⋯ However, there continues to be disparities in detection of ADHD in these groups. There are significant consequences to a patient's social, interpersonal, and professional life when ADHD is left unrecognized and untreated. Thoughtful evaluation, accurate diagnosis, and adequate treatment can make a big difference.
-
Journal of global health · Feb 2021
Meta AnalysisThe prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis.
Adult attention-deficit hyperactivity disorder (ADHD) has recently attracted much attention, however, an up-to-date estimation on the prevalence of adult ADHD is lacking. In this study, we aimed to assess the global prevalence of adult ADHD in the general population through a systematic review and meta-analysis. ⋯ This study provides an up-to-date estimation of the global prevalence of both persistent and symptomatic adult ADHD. A well-defined strategy for diagnosing adult ADHD and large-scale investigations on the epidemiology of adult ADHD are needed.
- Medication considerations