Understanding ADHD Combined Type

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects both children and adults. It manifests in different ways, with symptoms of inattention, hyperactivity, and impulsivity. There are three types of ADHD, namely ADHD predominantly inattentive type (ADHD-PI), ADHD predominantly hyperactive-impulsive type (ADHD-PHI), and ADHD combined type (ADHD-CT).

What is ADHD Combined Type?

ADHD combined type, often referred to as ADHD-CT, is the most common subtype of ADHD. It is diagnosed when a person presents with six or more symptoms of inattention and six or more symptoms of hyperactivity and impulsivity that have persisted for at least six months. ADHD-CT is characterized by a combination of both inattentive and hyperactive-impulsive symptoms.

Children with ADHD-CT may find it challenging to focus on tasks, sustain attention for long periods, and organize tasks or activities. They may also struggle with remembering details, following instructions, and become easily distracted by environmental stimuli. Additionally, children with ADHD-CT may exhibit impulsive behaviors, such as interrupting others, fidgeting, and restlessness.

ADHD-CT is not just a childhood disorder. It often persists into adulthood, becoming a lifelong condition that can seriously impact daily functioning. Adults with ADHD-CT may have difficulties with time management, maintaining relationships, and achieving professional goals. They may also struggle with taking on responsibilities that require consistent attention or planning.

Symptoms of ADHD Combined Type

The symptoms of ADHD combined type are usually divided into two categories:

Inattentive symptoms

  • Difficulty paying attention to details
  • Difficulty sustaining attention in tasks or activities
  • Often does not listen when spoken to directly
  • Difficulty following instructions, planning, or organizing tasks
  • Loses things necessary for tasks or activities
  • Often forgetful in daily activities

Hyperactive-impulsive symptoms

  • Fidgets or squirms in seat
  • Leaves seat in situations when remaining seated is expected
  • Runs about or climbs excessively in situations where it is inappropriate
  • Difficulty playing or engaging in leisure activities quietly
  • Talks excessively
  • Interrupts or intrudes on others’ conversations or activities
  • Difficulty waiting for their turn

These symptoms may negatively affect academic, work, and social life. Failure to diagnose and treat ADHD-CT may lead to significant problems and impairments that can cause lifelong challenges.

Diagnosis of ADHD Combined Type

Diagnosing ADHD-CT involves a comprehensive evaluation by a licensed mental health professional or a physician. The assessment involves interviews with the patient and other significant informants, such as family members, teachers, or colleagues. Screening tools such as rating scales, questionnaires, or checklists may also be used.

The diagnosis is based on the DSM-5 criteria that require the presence of at least six symptoms of inattention and six symptoms of hyperactivity-impulsivity that have persisted for at least six months. The symptoms should also be present in two or more settings, such as home, school, work, or social settings.

Treatment of ADHD Combined Type

The treatment of ADHD-CT usually involves a combination of medication, therapy, and behavioral management strategies. The appropriate treatment plan depends on individual needs, symptom severity, medical history, and other factors.

Medication

Stimulant medications such as methylphenidate (Ritalin) and amphetamines (Adderall) are commonly used to treat ADHD-CT. These medications work by increasing the levels of dopamine and norepinephrine in the brain, improving attention and reducing hyperactivity and impulsivity. Other non-stimulant medications such as atomoxetine (Strattera) and guanfacine (Intuniv) may also be prescribed for managing ADHD-CT symptoms.

Therapy

Behavioral therapy, such as cognitive-behavioral therapy (CBT), social skills training, or parent-child interaction therapy, may also be helpful in managing ADHD-CT symptoms. These therapies aim to teach coping strategies, problem-solving skills, and effective communication to individuals with ADHD-CT and their families.

Behavioral Management

Behavioral management strategies such as setting up a routine, using a reward system, and improving organizational skills can help individuals with ADHD-CT manage their symptoms. These strategies can also help improve academic, work, and social performance.

Conclusion

ADHD-CT is a subtype of ADHD that is identified by a combination of symptoms of inattention, hyperactivity, and impulsivity. It is one of the most common childhood disorders that persists into adulthood. The diagnosis of ADHD-CT involves a comprehensive evaluation by a licensed mental health professional or a physician. Treatment of ADHD-CT involves a combination of medication, therapy, and behavioral management strategies. The appropriate treatment plan depends on individual needs and symptom severity.

FAQs

What is ADHD Combined Type?

ADHD Combined Type is a subtype of Attention Deficit Hyperactivity Disorder. It is characterized by symptoms of both hyperactive-impulsive behavior and inattention. This type is the most common and affects approximately two-thirds of individuals with ADHD.

What are the symptoms of ADHD Combined Type?

The symptoms of ADHD Combined Type include difficulty sustaining attention, being easily distracted, forgetfulness, restlessness, fidgeting, impulsivity, difficulty waiting turns, and excessive talking. Such symptoms must persist for at least six months and cause significant disruption in daily life.

How is ADHD Combined Type treated?

The treatment for ADHD Combined Type involves a combination of medication, therapy, and lifestyle changes. Stimulant medication such as Ritalin and Adderall are commonly used, along with non-stimulant medications. Behavior therapy, cognitive-behavioral therapy, and parent training can be effective in managing symptoms. Lifestyle changes such as regular exercise, healthy diet and sleep patterns, and a structured routine can also help manage symptoms. Treatment is individualized and based on the severity of symptoms and the person’s needs.

References

1) Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review. Neurotherapeutics, 9(3), 490-499.
2) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
3) Anastopoulos, A. D., Smith, T. F., Garrett, M. E., Morrissey-Kane, E., Schatz, N. K., Sommer, J. L., & Kollins, S. H. (2011). Self-regulation of emotion, functional impairment, and comorbidity among children with AD/HD. Journal of Attention Disorders, 15(7), 583-592.

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