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Attention Deficit Hyperactivity Disorder

History of ADHD

10/08/1998

Question:

When was ADHD first identified? Is it becoming more prevalent or just more often diagnosed?

Answer:

I am not sure what you mean by "as such". It was first put into the Psychiatric Diagnostic and Statistical Manual by that title during the last decade. During that time period, the neurochemical basis of ADD became well established. In Medications for ADD, a book by Drs. Copeland and Copps, they suggest that the first mention of ADD in the literature was in 1762. They are referring to John Locke's mention of "A proper and effectual remedy for this wandering of the thoughts...". ADD, or components of ADD (e.g., the hyperactive child) have been in the medical literature for many decades. It has had various names over the years including Minimal Brain Dysfunction and Minimal Brain Damage. The latter are clearly fraught with severely negative stigma. Thus, it is easy to understand why the name has been changed since then. Interestingly, I think it is likely to change again during the next decade since we now recognize that, rather than being a "deficit of attention" it is more a focusing problem (e.g., many persons with ADD can focus quite well on things of interest, but find it nearly or completely impossible to focus on things that are disinteresting to them). We have no good data on any changes in ADD prevalance (how many people have it). In my opinion, it appears unlikely that the neurotransmitter ratios have changed over the last few centuries. On the other hand, all psychologic disorders are defined, at least partially, by the society and history at the time of definition. It may be easier to see the dysfunctional nature of ADD when a person is challenged with a classroom with 33 classmates and only one teacher, or in a work environment that demands careful scheduling and follow up.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati