Abstract
Attention-deficit/hyperactivity disorder (ADHD; also known as hyperkinetic disorder) is a common neurodevelopmental condition that affects children and adults worldwide. ADHD has a predominantly genetic aetiology that involves common and rare genetic variants. Some environmental correlates of the disorder have been discovered but causation has been difficult to establish. The heterogeneity of the condition is evident in the diverse presentation of symptoms and levels of impairment, the numerous co-occurring mental and physical conditions, the various domains of neurocognitive impairment, and extensive minor structural and functional brain differences. The diagnosis of ADHD is reliable and valid when evaluated with standard diagnostic criteria. Curative treatments for ADHD do not exist but evidence-based treatments substantially reduce symptoms and/or functional impairment. Medications are effective for core symptoms and are usually well tolerated. Some non-pharmacological treatments are valuable, especially for improving adaptive functioning. Clinical and neurobiological research is ongoing and could lead to the creation of personalized diagnostic and therapeutic approaches for this disorder.
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Change history
15 April 2024
A Correction to this paper has been published: https://doi.org/10.1038/s41572-024-00518-w
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Acknowledgements
S.V.F. is supported by the European Union’s Horizon 2020 research and innovation programme (grant agreement 965381), NIMH (grants U01AR076092-01A1, 1R21MH1264940, R01MH116037 and 1R01NS128535-01), Oregon Health and Science University, Otsuka Pharmaceuticals, Noven Pharmaceuticals Incorporated, and Supernus Pharmaceutical Company. M.A.B. is supported by a Senior Research Fellowship (level B) from the Australian National Health and Medical Research Council (NHMRC; 1154378). His research programme is supported by the NHMRC (2010899) and Medical Research Future Fund of Australia (MRF2006438, EPCD000002). I.B. is supported by the European Union’s Horizon 2020 research and innovation programme (grant agreement 965381). S.C., NIHR Research Professor (NIHR303122), is funded by the NIHR for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, NHS or the UK Department of Health and Social Care. S.C. is also supported by NIHR grants NIHR203684, NIHR203035, NIHR130077, NIHR128472 and RP-PG-0618-20003 and by grant 101095568-HORIZONHLTH-2022-DISEASE-07-03 from the European Research Executive Agency. C.A.H. is supported by the European Union’s Horizon 2020 research and innovation programme (grant agreement 965381), and ZonMW (grants 636340003 and 636340002). C.H. is supported by the NIHR (grants MIC-2016-003 and NIHR203310), and by the UKRI Medical Research Council (grant MR/T046864/1). J.H.N. is supported by grants from the National Institute of Child Health and Human Development (R01; HD093612) and the National Institute on Drug Abuse (R21; DA054281). A.P. is currently supported by funding from the National Institute for Health and Care Research (grant NIHR203035), the European Union’s Horizon 2020 research and innovation programme (grant agreement 945151), German Research Foundation (grant PH 177/7-1), Ministry of Culture and Science of the State of North Rhine-Westphalia (grant IBehave), Ministry of Research and Education (grants 01NVF20004 and 01IS22085D (Eureka Cluster on software innovation)). G.V.P. is supported by São Paulo Research Foundation (FAPESP) (grant 2016/22455-8), and National Council for Scientific and Technological Development (CNPq; grant 310582/2017-2). K.R. is supported by the National Institute of Health Research (grants NIHR130077 and NIHR203684) and the UK Department of Health and Social Care via the NIHR Biomedical Research Centre (BRC) for Mental Health at South London and the Maudsley National Health Service (NHS) Foundation Trust and the IoPPN, King’s College London. M.H.S. is supported by the Institute of Education Sciences (grant R305A210462) and the National Institute of Mental Health (grants R34 MH125037 and R34 MH122225). J.K.B. is supported by the European Union’s Horizon 2020 research and innovation programme (grant agreements 115300 and 777394 (EU-AIMS and AIMS-2-TRIALS), 847818 (CANDY), and 847879 (PRIME)).
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Introduction (S.V.F. and J.K.B.); Epidemiology (C.A.H. and G.V.P.); Mechanisms/pathophysiology (I.B., K.R., M.A.B. and S.V.F.); Diagnosis and screening (M.H.S. and S.C.); Management (J.H.N., S.C., A.P., M.H.S., J.K.B., M.A.B., K.R. and C.H.); Quality of life (G.V.P. and A.P.); Outlook (J.K.B. and S.V.F.). Aside from the first and last authors, authorship is alphabetical. All authors extensively commented on each other’s sections.
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S.V.F. in the past year received income, potential income, travel expenses, continuing education support and/or research support from Aardvark, Aardwolf, AIMH, Tris, Otsuka, Ironshore, Kanjo, Johnson & Johnson/Kenvue, KemPharm/Corium, Akili, Supernus, Atentiv, Noven, Sky Therapeutics, Axsome and Genomind; with his institution, he has US patent US20130217707 A1 for the use of sodium–hydrogen exchange inhibitors in the treatment of ADHD; he also receives royalties from books published by Guilford Press (Straight Talk about Your Child’s Mental Health), Oxford University Press (Schizophrenia: The Facts) and Elsevier (ADHD: Non-Pharmacologic Interventions); and he is Program Director of www.ADHDEvidence.org and www.ADHDinAdults.com. S.C. declares honoraria and reimbursement for travel and accommodation expenses for lectures from the following non-profit associations: Association for Child and Adolescent Central Health (ACAMH), Canadian ADHD Resource Alliance (CADDRA), British Association for Psychopharmacology (BAP), and Healthcare Convention for educational activity on ADHD. C.H. was a member of the UK National Institute for Health and Care Excellence (NICE) ADHD Guideline Committee (CG87); has received honoraria for lectures from BAP; and is a member of the European ADHD Guideline Group (EAGG) (eunethydis.eu/eunethydis-initiatives/european-adhd-guideline-group/). J.H.N. in the past year is/has been an adviser and/or consultant for Corium, Hippo T&C, Ironshore, Lumos, Medice, MindTension, OnDosis, Otsuka, Signant Health and Supernus; he has received research support from the National Institute on Drug Abuse (NIDA), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and Otsuka; he also has received honoraria from for disease state presentations from Otsuka, and served as a consultant for the US National Football League. A.P. declares that she served on advisory boards, gave lectures, performed phase III studies and received travel grants within the last 5 years from MEDICE Arzneimittel, Pütter GmbH and Co KG, Takeda, Boehringer and Janssen-Cilag, and receives royalties from books published by Elsevier, Hogrefe, MWV, Kohlhammer, Karger, Oxford University Press, Thieme, Springer and Schattauer; she is a member of the German ADHD Guideline Group, and is an author of the Updated European Consensus Statement. G.V.P. has served as a speaker and/or consultant to Abbott, Ache, Medice, Novo Nordisk, Pfizer and Takeda, and receives authorship royalties from Manole Editors. K.R. has received a grant from Takeda Pharmaceuticals for another project and consulting fees from Supernus and Lundbeck. M.H.S. has consulted with Supernus Pharmaceuticals and Tieffenbacher Pharmaceuticals in the past 12 months, and receives book royalties from Guilford Press. J.K.B. has been in the past 3 years a consultant to/member of advisory board of and/or speaker for Takeda, Roche, Medice, Angelini, Boehringer-Ingelheim and Servier; he is not an employee of any of these companies, and is not a stock shareholder of any of these companies; he has no other financial or material support, including expert testimony, patents and royalties. M.A.B. declares travel expenses and speaking fees attached to conference presentations and professional groups. I.B. and C.A.H. declare no competing interests.
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Faraone, S.V., Bellgrove, M.A., Brikell, I. et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 10, 11 (2024). https://doi.org/10.1038/s41572-024-00495-0
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DOI: https://doi.org/10.1038/s41572-024-00495-0
