(Ref: ADHD Atten Def Hyp Disord (2010) 2:241–255; The history of attention deficit hyperactivity
disorder Klaus W. Lange et al)
ADHD, in its complete form, is known as Attention Deficit Hyperkinetic Disorder. Dr. Crichton recorded it as early as 1798. Sir Alexander Crichton, a Scottish physician, gave the earliest account of a disorder akin to ADHD. He has described a case analogous to ADHD with such imprints. He characterises a condition that becomes evident very early in life and renders individuals incapable of consistently attending to one task related to the objective of education. However, he also mentions that it may not be severe enough to inhibit all activities and will generally diminish with age.
In 1844, the German physician Heinrich Hoffmann illustrated behaviours resembling ADHD in children’s stories. These illustrations inspired the well-known allegory “Fidgety Phil” (“Zappelphilipp”). Later, in 1902, certain conditions were still termed a “defect of moral control.” His concept of this defect does not correspond with ADHD. It describes various forms of deviant behaviour observed in children, such as oppositional defiant disorder. He noted 15 children exhibiting symptoms, including both boys and girls. Boys are twice as likely to be affected by ADHD than girls
In 1937, Charles Bradley reported a beneficial effect of stimulant medication in children with various behavioural disorders (Bradley 1937). Benzedrine was the first stimulant drug prescribed to hyperactive children; it is no longer in use. Six cardinal symptoms were described by Bradley.
- Unpredictable variability in mood
- Hypermotility
- Impulsiveness
- Short attention span
- Fluctuant ability to recall material previously learned
- Conspicuous difficulty with arithmetic in school
In 1968, a definition of hyperactivity was included in the official diagnostic nomenclature, specifically the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II). It was termed the ‘Hyperkinetic Reaction of Childhood’ and defined in two sentences: ‘The disorder is characterised by overactivity, restlessness, distractibility, and a short attention span, particularly in young children; the behaviour typically diminishes by adolescence.’
ADHD is recognised as a highly heritable condition, with reports suggesting involvement of the prefrontal cortex, subcortical, and cerebellum. In DSM III, released in 1980, the American Psychiatric Association renamed the condition as Attention deficit disorder (ADD) and described it under two categories with and without hyperactivity.
In 1987, the name was changed to Attention Deficit Hyperactivity Disorder (ADHD), and it describes a combination of impulsivity, hyperactivity and inattentiveness. When the fourth edition of the DSM was published in 1994, it listed three types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive, and a combined type. This edition recognises that symptoms do not cease at age 18 and may continue into adulthood as persistent ADHD. In the most recent edition, published in 2013, the American Psychiatric Society designated three presentations of ADHD.
The prevalence of ADHD in children is approximately 5-7%, while in adults it is around 4%. Stimulants have been used historically since the 1950s. Benzedrine, along with amphetamines and methylphenidate, began to be utilised as more evidence emerged regarding the biological processes in the brain responsible for the disorder. ADHD can affect academic performance, relationships, substance use tendencies, and impulsivity, not just in children but also in adults. Underachievement is a significant issue, so we must understand ADHD thoroughly to seek treatment for Adult ADHD if we recognise the symptoms.
Understanding the history of ADHD is crucial for recognizing its symptoms and seeking appropriate Adult ADHD Treatment Options. If you believe you meet the diagnostic criteria for Adult ADHD, our specialists at ChennaiMinds can provide comprehensive Adult ADHD Therapy.
