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Retired

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Is it correct that the definitions of ADHD and ADD have been rewritten and that what was defined as ADD is no longer used??

Is ADD now being called either "ADHD" or ADHD non-attentive type" (in other words ADHD without the H)? If this is correct, would you point me in the right direction for references and up to date definitions please?
 

David Baxter

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http://www.behavenet.com/capsules/disorders/adhd.htm

Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder

A. Either (1) or (2):

(1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities

(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or often acts as if "driven by a motor"
(f) often talks excessively

Impulsivity
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).

Code based on type:

314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months
314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months
314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months
Coding note: For individuals (especially adolescents and adults) who currently have symptoms that no longer meet full criteria, "In Partial Remission" should be specified.
 

Steph

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I don't understand your post Dr. Baxter.

Are you saying that there is no more ADD, or is there?

Would you please clarify.? Thanks, Steph
 

David Baxter

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There used to be two separate diagnoses: ADD and Hyperactivity.

They are combined now into a syndrom called ADHD: Attention Deficit/Hyperactivity Disorder.

ADHD has certain subgroups, depending on whether or not the synmptoms include hyperactivity:

Attention-Deficit/Hyperactivity Disorder, Combined Type (Inattentive and Hyperactive)
Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type
Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
 

stargazer

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That's useful information. I have two (adult) friends who say they have been diagnosed ADD. Perhaps they mean ADHD? In any case, one of them is on adderall in the morning and klonopin at night, and she seems pretty focused to me, though often only on her own "trip." If I want to get her to listen, I usually wait until after 9pm to call her, because by that time, the klonopin has kicked in. In any case, she's definitely less scattered than she was.

The other has only recently been diagnosed, and he's taking ritalin. He seems to me to be doing well, but he's reported having done work-related all-nighters lately, and he looks thinner. Could weight loss and sleeplessness be related to the ritalin? He left me a confusing e-mail the other morning stating that "ritalin is helping him to understand [my] mania." I wrote back asking for a clarification, but he hasn't replied yet.

Both, by the way, are highly charged and motivated people. He owns a Broadband business that advertises as being 50 times faster than Cable or DSL, and ten times faster than T-1. She is the head of an elementary school music program and administrator of summer education activities in her community (also owns a company advising people on how to write grants, has written and published books on grant-writing, etc.) Both are brilliant, and they've both been extremely productive for as long as I've known them, though scattered at times. I'm just curious how this all relates to ADHD.
 

David Baxter

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If he's feeling "manicky" on Ritalin, he may be taking too much of it or it may be inappropriately prescribed. Those who need Ritalin may notice improved focus but many don't feel any different - it's often others who see the difference in behavior.

Ritalin is basically like speed to most people. For those with certain forms of ADHD, it has the paradoxical effect of slowing them down.
 

stargazer

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I'm actually not sure what he meant. I'll have to pin him down to an e-mail reply. I visited him about a month ago, and stayed the weekend after a family gathering at his house. He seemed just the same to me, only perhaps a little better focused. Both nights I was there, he seemed to sleep normally. However, he alluded to having done all-nighters, and was markedly thinner. I'll see if I can find out what his dose is (although I suppose that also varies from one person to the next).
 

stargazer

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I see. That's probably why he's so thin, then. Will the loss of appetite subdue over time and acclimation to the med?
 

David Baxter

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Not usually. In children, they usually adjust the dose so it wears off after school so they can eat, and often they'll not use the Ritalin on weekends and holidays.
 

stargazer

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Hmmm. Well, he's got to eat somehow. But I'll admit I haven't seen him in about a month (he lives on the Coast, some distance from me). Next time I talk with him or his wife, I'll probably be able to find out if he's been eating. I was a little concerned with how thin he looked, but he and I were both attributing that to work-related stress at the time.
 

busymom

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Hi there

Just want to share my personal experience, I have TS plus (ADHD and OCD). I have tried Ritalin and was feeling like I was panicking at times and it was that the dose was too high, I tried slow release over 8 hours and felt the benefits instantly especially my tolerance levels but it did affect my appetite. Then for 12 hour release I tried Concerta, it didn't affect my appetite and the impact was less noticeable for me but it was for the people I worked with.

BusyMom
 

Holly

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Hi Everyone,
Thank you for this update information on ADHD vs ADD!
 

JRock

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What should an adult who is prescribe Ritalin/Adderall do so they don't lose weight. Assuming they are already on the leaner side. Drink weight gainer shakes? lol

Thanks
 

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