The Beginnings of Attention Deficit in a Dutch 18th Century Medical Treatise.

OBJECTIVE: An early description, possibly the earliest, of attention deficit disorder in a 1753 Dutch medical book by Cornelius Kloekhof is presented. METHOD: The author of this text is briefly introduced and contextualized. The text is translated from Latin and afterwards, its impact on later scientific literature is discussed. RESULTS AND CONCLUSIONS: Kloekhofs description of attention deficit was one of the first and thoroughly inspired the subsequent literature, such as Adam Weikard, making this text an important moment in the rich history of ADHD.

Brief history of the medical and non-medical use of amphetamine-like psychostimulants.

The alkaloid ephedrine derived from Ephedra vulgaris is at the origin of psychostimulant-drugs as amphetamine. These drugs have been principally utilized for medical treatments in the past, while their utilization has been largely reduced from the 1970s when the high risk of addiction and abuse has been recognized. The first reported treatments were as anti-asthmatics and to contrast narcolepsy until their recreational stimulant and anorexic effects were reported. Benzedrine and Pervitin use were of great importance during the Second World War due to their abundant utilization among military troops. Nowadays the use of selective amphetamine-like drugs is limited to ADHD treatment.

Genomic analysis of the natural history of attention-deficit/hyperactivity disorder using Neanderthal and ancient Homo sapiens samples.

Attention-deficit/hyperactivity disorder (ADHD) is an impairing neurodevelopmental condition highly prevalent in current populations. Several hypotheses have been proposed to explain this paradox, mainly in the context of the Paleolithic versus Neolithic cultural shift but especially within the framework of the mismatch theory. This theory elaborates on how a particular trait once favoured in an ancient environment might become maladaptive upon environmental changes. However, given the lack of genomic data available for ADHD, these theories have not been empirically tested. We took advantage of the largest GWAS meta-analysis available for this disorder consisting of over 20,000 individuals diagnosed with ADHD and 35,000 controls, to assess the evolution of ADHD-associated alleles in European populations using archaic, ancient and modern human samples. We also included Approximate Bayesian computation coupled with deep learning analyses and singleton density scores to detect human adaptation. Our analyses indicate that ADHD-associated alleles are enriched in loss of function intolerant genes, supporting the role of selective pressures in this early-onset phenotype. Furthermore, we observed that the frequency of variants associated with ADHD has steadily decreased since Paleolithic times, particularly in Paleolithic European populations compared to samples from the Neolithic Fertile Crescent. We demonstrate this trend cannot be explained by African admixture nor Neanderthal introgression, since introgressed Neanderthal alleles are enriched in ADHD risk variants. All analyses performed support the presence of long-standing selective pressures acting against ADHD-associated alleles until recent times. Overall, our results are compatible with the mismatch theory for ADHD but suggest a much older time frame for the evolution of ADHD-associated alleles compared to previous hypotheses.

"Snips and Snails and Puppy Dog Tails": Boys and Behaviour in the USA.

In The Adventures of Tom Sawyer and Huckleberry Finn, Mark Twain introduced two of the most iconic boys in American literature. Tom and Huck become heroic figures, despite their penchant for bad behaviour. Indeed, it is their propensity to be impulsive, break rules and defy authority that win them the day. Today, however, Tom Sawyer and Huck Finn have become the posterboys for a psychiatric disorder, Attention Deficit Hyperactivity Disorder, or ADHD. I trace how and why attitudes about pathological boys' behaviour reversed during the twentieth century, from a focus on shy, introverted, and physically passive boys to the very opposite - boys like Tom and Huck. I argue that, rather than imposing limits on childhood behaviour, we should be more accepting and encouraging of all types of children.

Psicoestimulantes para el TDAH: análisis integral para una medicina basada en la prudencia / Psychostimulants for ADHD: a comprehensive analysis for a prudence-based medicine

Objetivo: Analizar en profundidad la evolución del diagnóstico y las alternativas actuales de tratamiento del TDAH, prestando atención a los argumentos del modelo neurobiológico, los datos estadísticos, distintos aspectos de eficacia y seguridad, las tendencias en población adulta y las alternativas de abordaje no farmacológico. Métodos: Búsqueda bibliográfica actualizada a diciembre de 2017 sobre TDAH y términos asociados en Medline y Cochrane Library, ampliada a guías clínicas (NICE, Guía Española), bases de datos de agencias reguladoras (AEMPS, EMA, FDA) y otras fuentes de información complementaria (boletines de fármacos, medios de comunicación, webs). Se solicitaron datos de prescripción al Departamento de Salud del Servicio Navarro de Salud-Osasunbidea (SNS-O) y de consumo farmacéutico nacional a la Dirección General de Cartera Básica de Servicios del Sistema Nacional de Salud. Resultados y conclusiones: El TDAH se presenta como un fenómeno con prevalencia variable y consumo de fármacos creciente. La evolución de su constructo ha experimentado cambios sustanciales, permaneciendo desconocida su etiología. Los argumentos a favor de una hipótesis biológica son poco consistentes y, a falta de marcadores biológicos fiables, las escalas de síntomas no se correlacionan bien con la funcionalidad de los individuos. La terapia no farmacológica merece ser mejor investigada, destacando la terapia conductual por su potencial utilidad. Los medicamentos podrían aportar cierta eficacia en síntomas a corto plazo, sin garantía de mejora en variables relevantes a largo plazo. Crecen los tratamientos en población adulta y se reemplaza progresivamente el metilfenidato por la lisdexanfetamina. Destacan los efectos adversos cardiovasculares, psiquiátricos y endocrinos. De acuerdo con la medicina basada en la prudencia, deberían considerarse un recurso de uso breve y excepcional

Objective:To carry out an in-depth analysis of the evolution and current management of ADHD, paying attention to the neurobiological model narrative, statistical data, information on drug efficacy and safety, trends in adult population and non-pharmacological alternatives. Methods: A bibliographical search was carried out (December 2017) on ADHD and associated trends through Medline and the Cochrane Library. Clinical practice guidelines (NICE, Spanish guideline), regulatory agencies databases (Spanish Medicines Agency, EMA, FDA) and other complementary sources of information (drug bulletins, news media, websites) were also explored. Moreover, data on drug prescription and national consumption were requested from the Health Department of Navarre and the Department of Basic Common Services Portfolio (Ministry of Health). Results/Conclusions:ADHD is a phenomenon of variable prevalence and increasing drug consumption. The evolution of the ADHD concept has constantly changed in a substantial way and its etiology remains unknown. Arguments in favour of a biologic hypothesis lack consistency and no reliable biological markers have been found. Symptom-based scales are poorly correlated with relevant dysfunction outcomes. More and better designed research studies are expected on non-pharmacological therapies, playing behavioural therapy a lead role because of its potential usefulness. Drug treatment might provide some efficacy in the short term, with no clear improvement in long-term relevant outcomes. While adults are increasingly diagnosed and treated for ADHD, methylphenidate seems to be gradually replaced by lisdexamfetamine. Cardiovascular psychiatric and endocrine adverse events should be closely monitored. According to a prudence-based medicine approach, drugs should always be considered as a short and exceptional help

Attention-deficit hyperactivity disorder in ancient Greece: The Obtuse Man of Theophrastus.

We present an ancient Greek description written by the philosopher Theophrastus in his classic book ' Characters' comparable with modern attention-deficit hyperactivity disorder. The arguments are based in one chapter of this book-The Obtuse Man-presenting features of a character closely resembling the modern description of attention-deficit hyperactivity disorder. In a free comparative exercise, we compared Theophrastus descriptions with modern Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) attention-deficit hyperactivity disorder symptoms. The sentences describing The Obtuse Man written by Theophrastus are similar to several symptoms of attention-deficit hyperactivity disorder and he would probably be currently diagnosed with this disorder as an adult. To our knowledge, this is the oldest description compatible with the current conception of attention-deficit hyperactivity disorder in adults in the Western literature. Differently than the moralistic view of ancient Greece regarding those symptoms, the medical attention-deficit hyperactivity disorder conception may be advantageous to patients since it might reduce prejudice and allow individuals to seek treatment.

C. Keith Conners (1933-2017).

Presents an obituary of C. Keith Conners (1933-2017) who passed away of heart failure in Durham, North Carolina, on July 6, 2017. Conners was a pioneer in attention-deficit/hyperactivity disorder (ADHD) research and treatment. (PsycINFO Database Record

The Zappel-Philipp a historical example of ADHD Clinics.

In his book "Die Geschichte von dem Zappel-Philipp," the German psychiatrist Heinrich Hoffmann (1809-1894) offers a clinical vignette which raises the question of the description of a disobedient child or presenting hyperactivity symptoms. This article describes the historical context and the biographical aspects related to this interesting approach to describing a psychiatric syndrome to children and adults. It also underlines the importance of a global approach of ADHD that considers the familial environment and situational context of symptoms.

Attention-Deficit/Hyperactivity Disorder: A Historical Neuropsychological Perspective.

The behavior patterns of hyperactivity, impulsivity and inattention that would ultimately become recognized as Attention-Deficit Hyperactivity Disorder (ADHD) have been described for centuries. Nevertheless, in the past 35 years, advances in diagnostic methods, identification of biomarkers, and treatments have advanced at an exponential rate. ADHD is now recognized as the most common behavioral disorder of childhood, with risks extending well into adulthood for both males and females, leading to its identification as a significant public health issue. This historical neuropsychological review of ADHD emphasizes scientific highlights in the past 35 years related to ADHD, including the evolution of the diagnosis (from Hyperkinetic Reaction of Childhood to ADHD), influential theories (executive functions, cognitive-energetic, delay aversion), landmark treatment studies (Multimodal Treatment of ADHD [MTA] and Preschool ADHD Treatment Study [PATS]), and advances in brain mapping techniques (anatomic, functional, and resting state magnetic resonance imaging, diffusion tensor imaging). The review concludes by highlighting the challenges of studying and treating a heterogeneous neurodevelopmental disorder like ADHD, with emphasis on associated disorders and conditions (learning disabilities, sluggish cognitive tempo), special populations (girls, preschoolers, adults), and recommendations for scientific inquiry in the next 35 years. Neuropsychologists are well positioned to address the clinical and research challenges of the next generation of studies, especially involving advances in understanding the sexual dimor.phism, full developmental course, and dynamic risks associated with ADHD. (JINS, 2017, 23, 916-929).

Attention-Deficit/Hyperactivity Disorder: A Historical Review (1775 to Present).

As a new school year approaches, nurses will find themselves faced with students with symptoms of attention-deficit/hyperactivity disorder (ADHD). Navigating the diagnostic label changes and numerous psychopharmacological treatment options can prove time-consuming and confusing. The current article explores the early years of symptom identification, various diagnostic labels, and subsequent psychopharmacological treatments from psychostimulants to non-stimulant alternatives (including a prescription medical food). The current article also serves as a discussion guide for nurses and clinicians when providing education to patients and their loved ones, teachers, coaches, and others who may question the diagnosis and treatment of ADHD. This disorder can have a significant impact on one's ability to function within family, school, work, and social settings. A historical context is provided for the evolution of today's diagnostic criteria and the pharmacotherapy used in the treatment of ADHD. [Journal of Psychosocial Nursing and Mental Health Services, 55(9), 10-16.].

Prehistoria del TDAH: aditivos para un diagnóstico insostenible / No disponible

Para defender la validez diagnóstica del TDAH la literatura especializada emplea generalmente un argumento histórico, según el cual dicha validez resultaría indiscutible debido al hecho de que diversas fuentes médicas hablaban ya del TDAH hace varios siglos; esto demostraría que el TDAH no es una creación de nuestro tiempo. Sin embargo, al investigar esas mismas fuentes históricas, se puede comprobar lo injustificado de ese argumento, que contribuye aún más al descrédito de este constructo psiquiátrico tan controvertido. Se analizan en el presente artículo tres ‘hitos’ de la llamada historia o prehistoria del TDAH: Alexander Crichton, Heinrich Hoffmann y George F. Still. El TDAH, al contrario de lo que defiende la literatura dominante, es un invento moderno, y el uso de los argumentos históricos revela su mítica base teórica y una escasez de argumentos que debería ser muy alarmante, debido al número de niños diagnosticados y medicados de TDAH

In order to defend the diagnostic validity of ADHD, the specialized literature usually uses a historical argument, according to which its validity is unquestionable due to the fact that a number of medical sources have referred to ADHD for several hundred years. This proves that ADHD is not a contemporary creation. However, when investigating those same historical sources it is possible to prove that these arguments are unfounded, which contributes even more to undermine this highly controversial psychiatric construct. This paper analyzes the three classic ‘milestones’ of the so-called history or prehistory of ADHD: Alexander Crichton, Heinrich Hoffmann and George F. Still. Contrary to the claims of the dominant literature, ADHD is a modern invention, and the use of these historical arguments reveals its mythical theoretical basis and lack of supporting arguments, which should be a cause for serious concern, due to the number of children being diagnosed and medicated for ADHD

Lucy Maude Montgomery and Anne of Green Gables: An Early Description of Attention-Deficit/Hyperactivity Disorder.

Attention-deficit/hyperactivity disorder (ADHD) was added to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised in 1987. Similar disorders had appeared earlier, and many consider the first description of ADHD to be a lecture in 1902 about children with an "abnormal defect in moral control" but normal intelligence. This definition of ADHD is more alarming than the current one. Anne Shirley, the protagonist of the novel Anne of Green Gables (written by Lucy Maude Montgomery and published in 1908), shares the hyperactive and inattentive qualities that fit the current definition of ADHD. She also lacks the menacing characteristics of the 1902 description. This indicates that ADHD, by its modern definition, was probably present in the early 1900s. Furthermore, the character of Anne Shirley shares many biographical similarities with her author, suggesting that Montgomery herself may have had ADHD. Thus, looking at literature from the past not only provides insight into the timeline of ADHD, but also into the thought process of an individual with ADHD. By viewing literary classics through a medical lens, we may gain insight into other diseases as well. [Pediatr Ann. 2017; 46(7):e270-e272.].

[Children, standardization and mental health: historical figures and current chains of thought in the clinical diagnosis of attention deficit disorder and hyperactivity]. / Infancia, normalización y salud mental: figuras históricas y encadenamientos actuales en la formulación del trastorno por déficit de atención e hiperactividad.

The article describes and analyzes the behavioral and neurological aspects that bring together discussions on attention deficit disorder and hyperactivity and outlines some historical conceptual antecedents. Descriptive statements focusing on the behavior of those diagnosed predominate in the behavioral dimension. Etiological explanations, principally on brain function in the neurological dimension are included. The analysis was based on documentary materials such as historical studies, interviews with health professionals in Buenos Aires between 2008 and 2011, specialized publications, psychometric instruments and psychiatric manuals.