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Arch Hellen Med, 39(2), March-April 2022, 151-162


Attention deficit hyperactivity disorder (ADHD): From hyperkinetic to neurodevelopmental disorders

A. Pehlivanidis,1 K. Papanikolaou2
1First Department of Psychiatry, "Eginition" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens,
2Department of Child Psychiatry, "Aghia Sophia" Children's Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Attention deficit hyperactivity disorder (ADHD) is now considered to be a neurodevelopmental disorder (NDD). In order to better understand statements such as "I do not believe in ADHD", or, at the other extreme, "overdiagnosis" we need to know the roots and development of the concept ADHD. We therefore present here, salient historical points related to the evolution of the construct of ADHD over time. Theophrastos in his work Obtuse (Αναίσθητος) from the 4th century BC, and Lord Byron (1788–1824) have both been considered to present symptoms that today are indicative of ADHD. Descriptions of the disorder in the medical literature of the last two centuries are presented. The terms used to describe ADHD in particular periods usually represent the main etiopathological hypotheses of each period. The notion of hyperkinesis has been adopted since 1926, and was related to encephalitis lethargica. In 1937 the beneficial action of stimulants on the condition was discovered. ADHD was first documented in the Diagnostic and Statistical Manual of Mental Disorders (DSM-II, 1968), in which the disorder was referred to as hyperkinetic reaction of childhood. In the International Statistical Classification of Diseases and Related Health Problems (ICD-9, 1978) the condition was called hyperkinetic disorder. In ICD-10 (1999) it belonged to the hyperkinetic disorders, while in ICD-11 (2022) it will be included in the NDDs, as it is already in DSM-5. The term NDD was first established by Rutter in 2008 to indicate the onset of symptoms during infancy or childhood, delay in the biological maturation of the central nervous system (CNS), and a stable course, without exacerbations or remissions. The prefix "neuro-", however, may lead to inappropriate use of the term by administrative or political bodies, while the concept of biological maturation may provoke ethical issues, especially among people with mild manifestations of the disorders.

Key words: Attention deficit hyperactivity disorder, Hyperkinetic disorder, Neurodevelopmental disorder.

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