Attention deficit/hyperactivity disorder: complexities and controversies.
OBJECTIVE
Attention deficit/hyperactivity disorder continues to be a prevalent childhood behavioral disorder, with significant clinical and media interest. Providers must be current with research findings that impact the evolving understanding of this complex entity. This article summarizes recent progress in our view of attention deficit/hyperactivity disorder, with emphasis on controversies around diagnosis and treatment, and future management directions.


RESULTS
Literature about attention deficit/hyperactivity disorder in 2005 further enhanced our understanding of the genetic contribution to the expression of attention deficit/hyperactivity disorder, with exploration of sophisticated genetic models and their dynamic interaction with exposures and experiences. Previous literature focuses on conventional treatment; new developments in pharmacological/alternative options add to treatment choices, but have brought well publicized controversies. Furthermore, optimal management continues to gain evidence-based support.


CONCLUSIONS
Attention deficit/hyperactivity disorder is a subject of great interest to families, providers, researchers, and public forums. Scientific investigation supports a primary genetic contribution, but the relationship of molecular bases and environmental exposures appears intricate and complex. With increased awareness of this disorder, diagnostic dilemmas and medication side effects are more widely understood, topics particularly important to clinicians. Stimulant treatment remains the mainstay of intervention, but new delivery forms and nonstimulant options are potential therapies as well.
Schonwald
Alison
A
Children's Hospital, Boston, Massachusetts 02115, USA. alison.schonwald@childrens.harvard.edu
Lechner
Erin
E
D000279:Administration, Cutaneous; D000662:Amphetamines / Q000009:adverse effects; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D001519:Behavior / Q000187:drug effects; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008774:Methylphenidate / Q000008:administration & dosage; D011437:Propylamines / Q000627:therapeutic use; D012307:Risk Factors
D000662:Amphetamines; D000697:Central Nervous System Stimulants; D011437:Propylamines; C449521:SLI381; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride