Understanding ADD and ADHD: Symptoms and Co-Occurrence

The terms ADD and ADHD often come up in discussions about attention disorders. Historically, ADD was a separate category used from 1980 to 1987, but the subsequent diagnosis of ADHD in 1987 marked a significant change. This article provides insights into the evolution of these terms, the symptoms associated with ADD and ADHD, and the possibility of co-occurring conditions.

The Evolution of Terms

The term ADD is no longer used in clinical settings. It was merely the old name for ADHD, a condition first studied in 1902. Over the years, the disorder has had several names, including Organic Driveness, Minimal Brain Disorder, and Hyperactivity. However, these names did not reflect the full spectrum of symptoms that individuals might experience.

In 1937, stimulant medications were discovered to be effective in treating ADHD, and Ritalin was invented in 1957. This breakthrough coincided with a growing interest in the disorder in the 1960s, which led to various subcategories and diagnostic criteria. The 1970s saw significant advancements in diagnosis, treatment, and research, particularly in the United States.

The Diagnosis of ADHD

In 1980, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was released, marking a new chapter in the classification of ADHD. The term ADD became synonymous with Attention Deficit Disorder, which had three sets of criteria: attention deficit, impulsivity, and hyperactivity.

ADD with hyperactivity and ADD without hyperactivity differentiated cases based on whether patients met all criteria or only inattention and impulsivity. However, this distinction often led to confusion, as ADD was primarily associated with hyperactivity and behavior issues.

The Birth of ADHD

In 1987, the text revision of DSM 3 (DSM 3 TR) changed the name of the condition to ADHD, eliminating the term ADD. This decision was made to better reflect the full spectrum of symptoms, including those not primarily based on hyperactivity.

Initially, ADHD had no subtypes. It was only defined by a combined list of symptoms, but concern over underdiagnosed cases without hyperactivity led to the addition of subtypes in 1994 with DSM 4. These subtypes included:

Inattentive ADHD (formerly known as ADD) Hyperactive/Impulsive ADHD Combined Type ADHD

Each subtype was defined by a specific set of symptoms, with inattentive ADHD being characterized by difficulty focusing and impulsivity ADHD by hyperactivity and impulsivity.

Introducing Cognitive Disengagement Syndrome

While the majority of ADHD cases fall under combined type ADHD, there is another condition that affects individuals who do not experience hyperactivity or impulsivity. This condition, previously known as Sluggish Cognitive Tempo (SCT), is now referred to as Cognitive Disengagement Syndrome (CDS).

CDS includes significant issues with focus, daydreaming, and underactivity, without hyperactivity or impulsivity. People with CDS may also experience brain fog, fatigue, and a prolonged sense of mental slowness. Unlike ADD and ADHD, CDS is not widely recognized and was not included in the DSM subtypes until a later revision.

Co-Occurrence of Conditions

It is important to note that individuals with CDS are unlikely to meet the criteria for ADD or ADHD. However, some individuals may exhibit symptoms of CDS in addition to those of ADD or ADHD, leading to a more complex and nuanced presentation of symptoms.

The co-occurrence of CDS and ADHD or ADD is a topic of ongoing research. While CDS is not a separate diagnostic category, healthcare professionals may use it to better understand and treat individuals who do not fit neatly into the existing ADHD subtypes.

Conclusion

The history of ADHD and the evolution of diagnostic terminology reflect our growing understanding of attention disorders. While ADD is no longer used, the term ADHD encompasses a broad range of symptoms, including those that do not primarily involve hyperactivity. Additionally, conditions like Cognitive Disengagement Syndrome provide further insights into the diverse nature of attention disorders.

For accurate diagnosis and treatment, it is essential to consult healthcare professionals who can provide a thorough evaluation and tailor the treatment plan to the individual's specific needs.