The symptoms of attention deficit hyperactivity disorder (ADHD) have been known for more than 100 years, although the condition was not formally recognized until the 1960s and did not receive its current name until 1980. Globally, ADHD affects up to 8% of children and adolescents, and often persists into adulthood. Rates have been rising quickly over the past few decades, for reasons that are not entirely clear — a mystery that underscores how much we still have to learn about the condition.
That starts with its neurobiological cause. Dopamine signalling has long been a target for treatment, but researchers are still learning how exactly this neurotransmitter affects ADHD. The link is more nuanced than a simple deficit of one brain chemical, however.
Nature Outlook: ADHD
Although ADHD affects both boys and girls, there is a big discrepancy in the rate of diagnosis, with boys being diagnosed two to three times more often. This underdiagnosis puts girls at a higher risk of bad outcomes and requires increased attention from the scientific community.
For decades, there has been one main, and highly effective, treatment for ADHD: oral stimulant drugs such as methylphenidate, commonly known as Ritalin. But stimulants can have problematic side effects, so researchers are working to develop alternatives, including non-stimulant drugs, talk therapy and even therapeutic video games. So far, however, nothing matches the efficacy of stimulants.
There is a big genetic component to ADHD, but environmental factors also have a role. One that made headlines in recent months is the potential link between prenatal exposure to paracetamol and neurological disorders such as ADHD and autism. This complex relationship needs scientific clarity that is currently lacking — and political fights have muddied the waters.
Most teens feel the addictive pull of social media, but those with ADHD are particularly vulnerable because of differences in the way their brains regulate attention and reward. This makes these youths more likely to use social media in risky ways. Getting to grips with this problem is tricky for parents, and requires thoughtful management.
We are pleased to acknowledge the financial support of Otsuka Pharmaceutical in producing this Outlook. As always, Nature retains sole responsibility for all editorial content.