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ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more → (attention deficit hyperactivity disorder) matters because it explains a childhood-onset pattern of inattention and/or hyperactivity-impulsivity that persists into adulthood for most people, often changing in how it presents. It is diagnosed as symptoms of inattention, hyperactivity-impulsivity, or both, present before age twelve, occurring in two or more settings, such as home and school, and causing significant impairment. For example, imagine a child who cannot sit still in class, blurts out answers, and also loses belongings constantly at home, not just at school. In practice, that cross-setting pattern is what separates ADHD from a child who is simply badly behaved in one classroom.

Three presentations exist, predominantly inattentive (difficulty sustaining attention, disorganisation, forgetfulness), predominantly hyperactive-impulsive (fidgeting, excessive talking, interrupting), and combined presentation, showing both. In adulthood, overt hyperactivity often fades into inner restlessness, while inattention and impulsivity, such as poor time management, persist. Clinically, this shows up as a child with obvious hyperactivity who, by his thirties, sits still in meetings but still struggles badly with organisation and finishing tasks. In practice, this shift means clinicians should not rule out adult ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more → just because visible hyperactivity has settled. ADHD affects approximately 5% of children. Maternal smoking during pregnancy is a recognised risk factor for the disorder.

• Which medication does NICE recommend first when drug treatment is needed for ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more → in a child aged over five?
• Which measurements must be recorded at baseline and monitored on stimulant treatment for ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more →?
• How does methylphenidate produce its therapeutic effect?

• ADHDAttention-deficit hyperactivity disorder, a condition of inattention, impulsivity and sometimes hyperactivity.Read more → (predominantly inattentive presentation): disorganisation and forgetfulness without prominent hyperactivity, unlike the hyperactive-impulsive presentation's fidgeting and interrupting.
• Normal childhood energy, confined to one setting or context, unlike ADHD's cross-setting impairment at home and school alike.
• Autism spectrum disorder, restricted, repetitive behaviours and social-communication difficulty, rather than ADHD's core inattention and hyperactivity-impulsivity, though the two often co-occur.
• Anxiety disorder, poor concentration driven by worry, whereas ADHD's inattention is present broadly, not tied to a specific anxious trigger.

• Atomoxetine is offered when stimulants are not tolerated or have not worked.
• Guanfacine is a later option rather than first-line.
• Thyroid and bone density testing have no role in this monitoring schedule.
• Weekly blood counts are a clozapine requirement rather than a stimulant one.
• Therapeutic drug monitoring is not used for stimulants.

• Extract the defining phenomenology, duration, severity and functional-impact clues.
• Match the pattern to the most specific diagnostic or assessment construct.
• Actively test the closest look-alike against the missing or contradictory clue.
• Choose the precise term rather than a broader category that is merely compatible.