ADHD - the scourge of the 21st century? / ADHD ­ plaga XXI wieku?

Currently, attention deficit hyperactivity disorder (ADHD) is intensively studied by world medical community, its understanding expands, for example, it has now been diagnosed not only in children but also in adults. On the other hand, ADHD raises a number of discussions on the need of its treatment and, if there is a need, how it shall be treated, it is doubtful whether this disorder overall exists, because its "morphological component" has not been identified so far, and all the symptoms of ADHD, including anxiety, concentration difficulties, motor hyperactivity, cognitive disorders or social disadaptation, can be found in a number of mental disorders and somatic diseases. Modern attention, emotional and behavioral changes can be considered as a result of changing human social portrait. Those who question ADHD existence argue that this disorder is likely temperament and parenting matter, rather than the illness, and that the diagnosis and treatment of this illness can be a matter invented by doctors and pharmacists, the aim of which is to tame individuals disregarding public standards of conduct and get the maximum profit from medicines in the treatment of this illness. Due to the fact that ADHD is diagnosed more often, it is even called the twenty-first-century scourge. In this article we will review the historical aspect of formation of ADHD diagnosis, illness etiology, comorbidity with other mental and somatic diseases as well as treatment necessity and opportunities, paying attention to adult ADHD as well.

[Parameters of ante-mortem delirium]. / Parametry przedsmiertnego majaczenia.

OBJECTIVES: The aim of this study was to investigate the parameters of ante-mortem delirium of the patients in a closed psychiatric institution and to compare them with the ante-mortem psychopathology of the medical patients. METHODS: There were 139 medical records of the patients analyzed, who died during the period of 1997-2003 at the in-patient psychiatric institution. The diagnoses were recorded according to the International Classification of Diseases, 10th Revision (ICD-10) criteria. Patients' data included age, gender, previous psychiatric disorders, current somatic and psychiatric morbidity, and comorbidity. RESULTS: The incidence of delirium was 83.7%. The delirium group included more elder, male persons who were more likely to have dementia and less inclined to depression. Surprisingly the incidence of delirium among non-dementia men was quite high--76.9%, as compared to non-dementia women--23.1% (P = 0.008). The duration of delirium differed from 1 to 1335 days. Longer delirium was observed among elder than 75 years (87.7, SD 183.9 vs 52.6, SD 121.4 days; P = 0.019) and dementia (8.6, SD 173.6 vs 13.5, SD 11.6 days; P < 0.001) patients, but did not differ in gender groups. CONCLUSIONS: Ante-mortem delirium occurred more commonly in more elder and demented patients The duration of ante-mortem delirium was shorter in younger and non-dementia patients. Patients of the psychiatric institution tend to have longer deliriums than medical patients. The patients with depression and the history of alcohol abuse were not likely to get ante-mortem delirium. Before death in many persons hyperactive and mixed delirium transformed into hypoactive.