{"id":2132,"date":"2020-03-30T19:43:55","date_gmt":"2020-03-30T19:43:55","guid":{"rendered":"https:\/\/imedicalsociety.org\/?p=2132"},"modified":"2020-03-30T19:43:55","modified_gmt":"2020-03-30T19:43:55","slug":"adhd","status":"publish","type":"post","link":"https:\/\/imedicalsociety.org\/adhd\/","title":{"rendered":"ADHD: Symptoms, causes, treatment"},"content":{"rendered":"<section>\n<div>\n<div>\n<h2 index-text=\"Kurz\u00fcbersicht\" id=\"mcetoc_1e4nt764d3\"><strong>Attention Deficit Hyperactivity Disorder (ADHD)<\/strong><\/h2>\n<p index-text=\"Kurz\u00fcbersicht\" id=\"mcetoc_1e4nt654t2\"><span>ADHD stands for attention deficit hyperactivity disorder (<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3927422\/\" target=\"_blank\" rel=\"noopener noreferrer\">6<\/a>). Inattention, hyperactivity (<a href=\"https:\/\/www.nimh.nih.gov\/health\/publications\/adhd-listing.shtml\" target=\"_blank\" rel=\"noopener noreferrer\">7<\/a>) and impulsiveness are the main characteristics (<a href=\"https:\/\/www.theguardian.com\/society\/commentisfree\/2020\/jan\/15\/a-new-life-being-diagnosed-with-adhd-in-my-40s-has-given-me-something-quite-magical\" target=\"_blank\" rel=\"noopener noreferrer\">5<\/a>). If the disorder is not treated (<a href=\"https:\/\/doi.org\/10.1097\/01.chi.0000222787.57100.d8\" target=\"_blank\" rel=\"noopener noreferrer\">8<\/a>), it impairs academic and professional performance and social contacts (<a href=\"https:\/\/www.deadiversion.usdoj.gov\/drug_chem_info\/methylphenidate.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">1<\/a>). ADHD is one of the most common psychological disorders in childhood (<a href=\"https:\/\/www2.ed.gov\/rschstat\/research\/pubs\/adhd\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">9<\/a>) (<a href=\"https:\/\/doi.org\/10.1016\/j.ridd.2011.01.019\" target=\"_blank\" rel=\"noopener noreferrer\">10<\/a>). In many cases, it remains for life (<a href=\"https:\/\/www.dea.gov\/factsheets\/amphetamines\" target=\"_blank\" rel=\"noopener noreferrer\">4<\/a>), despite several treatments available (<a href=\"https:\/\/www.dea.gov\/taxonomy\/term\/346\" target=\"_blank\" rel=\"noopener noreferrer\">3<\/a>), some of them with controlled substances (<a href=\"https:\/\/www.dea.gov\/press-releases\/2014\/02\/19\/treasury-designates-columbian-narcotics-trafficker\" target=\"_blank\" rel=\"noopener noreferrer\">2<\/a>). You can read here how to recognise ADHD and how the disorder can be treated.<\/span><\/p>\n<h2 index-text=\"Kurz\u00fcbersicht\" id=\"mcetoc_1e4nt4r5p1\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/imedicalsociety.org\/wp-content\/uploads\/2020\/03\/adhs-1-jpg_id_85710-b87839bf7f0f60718c0e47e0fc9564.jpg\" alt=\"ADHD\" width=\"1200\" height=\"630\" class=\"aligncenter wp-image-2133 size-full\" srcset=\"https:\/\/imedicalsociety.org\/wp-content\/uploads\/2020\/03\/adhs-1-jpg_id_85710-b87839bf7f0f60718c0e47e0fc9564.jpg 1200w, https:\/\/imedicalsociety.org\/wp-content\/uploads\/2020\/03\/adhs-1-jpg_id_85710-b87839bf7f0f60718c0e47e0fc9564-300x158.jpg 300w, https:\/\/imedicalsociety.org\/wp-content\/uploads\/2020\/03\/adhs-1-jpg_id_85710-b87839bf7f0f60718c0e47e0fc9564-1024x538.jpg 1024w, https:\/\/imedicalsociety.org\/wp-content\/uploads\/2020\/03\/adhs-1-jpg_id_85710-b87839bf7f0f60718c0e47e0fc9564-768x403.jpg 768w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/><\/h2>\n<h2 id=\"adhs-kurzuebersicht\" index-text=\"Kurz\u00fcbersicht\">ADHD: Brief overview<\/h2>\n<ul>\n<li><span><strong>Main symptoms:<\/strong> inattention, hyperactivity and impulsiveness. Some also have dreaminess<\/span><\/li>\n<li><span><strong>Possible consequences:<\/strong> Learning or professional difficulties, behavioural problems, problems in dealing with others<\/span><\/li>\n<li><span><strong>Causes:<\/strong> probably mainly genetic, but also unfavourable environmental influences as triggers<\/span><\/li>\n<li><span><strong>Diagnostics:<\/strong> inquiring about typical characteristics, observing behaviour, excluding other mental and physical illnesses as causes<\/span><\/li>\n<li><span><strong>Therapy:<\/strong> Behavioural therapy, possibly in combination with medication. Training of the parents for dealing with the children.<\/span><\/li>\n<li><span><strong>Prognosis:<\/strong> Often persists as &#8220;ADS&#8221; into adulthood. Hyperactivity then decreases. If left untreated, serious consequences for professional and private life may occur to the patient.<\/span><\/li>\n<\/ul>\n<p>ICD code for this condition is F90.0. <span>Attention-deficit hyperactivity disorder, predominantly inattentive type. F90. 0 is a billable\/specific\u00a0<\/span><b>ICD<\/b><span>-10-CM\u00a0<\/span><b>code<\/b><span>\u00a0that can be used to indicate a diagnosis for reimbursement purposes.<\/span><\/p>\n<\/div>\n<\/div>\n<\/section>\n<section>\n<h2 id=\"adhs-symptome\" index-text=\"Symptome\"><strong>Symptoms Of ADHD<\/strong><\/h2>\n<p>If children or adults are fidgety, unfocused, chaotic and uncontrollably impulsive or even constantly dreamy, attention deficit hyperactivity disorder (ADHD) may be the cause of the problems. In the vernacular language, one also speaks of &#8220;fidgeting&#8221;.<\/p>\n<p>According to the definition of ADHD, the disorder is accompanied by the following main symptoms:<\/p>\n<ul>\n<li><span>Attention Deficit<\/span><\/li>\n<li><span>strong impulsiveness<\/span><\/li>\n<li><span>extreme agitation (hyperactivity)<\/span><\/li>\n<\/ul>\n<h3 id=\"h4-drei-untergruppen\">Three Subgroups Of Symptoms<\/h3>\n<p>The symptoms of ADHD can be pronounced to varying degrees. Not all symptoms always occur in a patient. There are three subgroups of ADHD in total<\/p>\n<ul>\n<li><span>predominantly hyperactive-impulsive: &#8220;fidgeting<\/span><\/li>\n<li><span>predominantly attention deficit disorder<\/span><\/li>\n<li><span>Mixed type: attention deficit impaired and hyperactive<\/span><\/li>\n<\/ul>\n<h3 id=\"mcetoc_1e8f79hq10\">ADHD Symptoms According To Age Groups<\/h3>\n<p>ADHD is considered a congenital disorder that becomes apparent before the age of six. The disorder can persist for a long time. However, ADHD symptoms manifest themselves differently in infants, toddlers, adolescents and adults.<\/p>\n<h4 id=\"h4-fruehe-anzeichen-beim-saeugling\">Early signs in infants<\/h4>\n<p>A reliable diagnosis of ADHD is not yet possible in infancy. However, researchers have found a connection between ADHD and so-called regulatory disorders in long-term studies.<\/p>\n<p>Babies with regulation disorders cry often and for a long time, sleep badly and are sometimes difficult to feed. They are also very restless and often appear to be in a bad mood. Some babies who develop ADHD later in life reject physical contact. However, such behaviour can also have completely different causes. Only a third of the babies who show such behaviour was later diagnosed with ADHD.<\/p>\n<h4 id=\"h4-adhs-symptome-im-kleinkindalter\">ADHD symptoms in infancy<\/h4>\n<p>Even in small children, ADHD is difficult to detect. An ADHD toddler usually cries a lot, has no desire to play and has only a low ability to pay attention. <a href=\"https:\/\/imedicalsociety.org\/kidney-stone-symptoms\/\" target=\"_blank\" rel=\"noreferrer noopener\">Typical ADHD symptom<\/a> at this age is a pronounced motor restlessness.<\/p>\n<p><strong>Social problems: <\/strong>ADHD often places an equal burden on the child and its parents. Due to their disruptive behaviour, the children find it difficult to make contact. They have problems making friends with other children.<\/p>\n<p><strong>Poor ability to concentrate:<\/strong> Infants with ADHD have great difficulty concentrating on quiet activity for long periods. After a short time, they switch from one game to the next. Their unpredictable behaviour can also result in more frequent accidents.<\/p>\n<p><strong>Pronounced defiant phase:<\/strong> The defiant phase also runs more violently than in other children. ADHD children often burst into conversation. Some strain their parents&#8217; patience by constantly producing sounds.<\/p>\n<p><strong>Conspicuous language acquisition:<\/strong> Language acquisition in infants with ADHD occurs either conspicuously early or with a delay.<\/p>\n<p><strong>Lack of movement coordination:<\/strong> Handling handicraft tools is difficult for many children with ADHD due to their lack of fine and gross motor coordination.<\/p>\n<h4 id=\"h4-adhs-symptome-im-grundschulalter\">ADHD symptoms at primary school age<\/h4>\n<p>Common ADHD <a href=\"https:\/\/imedicalsociety.org\/neurodermatitis-in-children\/\" target=\"_blank\" rel=\"noreferrer noopener\">symptoms in primary school children<\/a> are a low tolerance for frustration and tantrums when things do not go their way. Constant talking and inappropriate facial expressions and gestures are further symptoms. ADHD also manifests itself through clumsiness and frequent accidents while playing. The children suffer from the effects of the disorder and usually have low self-confidence.<\/p>\n<p>Children with ADHD find it difficult to follow rules. In school, they are therefore often considered &#8220;nuisances&#8221;. They speak excessively much and interrupt others. They solve tasks slowly and unsystematically, they are also easily distracted and can hardly tolerate frustration. All this makes them outsiders.<\/p>\n<p>For the teachers, ADHD signs such as disrupting lessons and strong distractibility are a challenge. Not every affected child is constantly fidgeting, but all children with ADHD syndrome are out of the ordinary.<\/p>\n<p>In many cases, the children have a reading, writing or arithmetic disability. These ADHD symptoms make it difficult for children to keep up in school. In addition, their writing is often poorly legible and their orderliness is chaotic.<\/p>\n<h4 id=\"h4-adhs-symptome-im-jugendalter\">ADHD symptoms in adolescence<\/h4>\n<p>Adolescents with ADHD continue to be inattentive and often develop a &#8220;no-nonsense mentality&#8221;. They refuse necessary services and take refuge in an aggressive anti-attitude. To a certain extent, such behaviour is not unusual in puberty anyway, but it is much more pronounced in ADHD.<\/p>\n<p>Adolescents with ADHD tend to behave in a risky manner and are often attracted to socially marginalised groups. Alcohol and drugs often play a role in this. Many suffer from low self-confidence, some experience severe anxiety and even depression. But there are also young people in whom the symptoms improve &#8211; restlessness and impulsiveness decrease.<\/p>\n<h4 id=\"h4-adhs-im-erwachsenenalter\">ADHD in adulthood<\/h4>\n<p>In about 40 per cent of the children who suffer from ADHD, the disease persists for life.<\/p>\n<p>However, the appearance of the disorder changes. In puberty, excessive motor activity is usually lost. Forgetfulness or disorganization then come to the fore. Symptoms such as impulsive behaviour and ill-considered actions are also still present.<\/p>\n<p>The problem is that ADHD is often not recognised in adulthood. The symptoms have then existed for so long that they are perceived as part of the personality of the patient.<\/p>\n<p>However, if the disorder is not treated, it can have serious consequences for the person concerned in terms of social contacts, professional careers and life satisfaction. Through their impulsiveness and ill-considered actions, they often take unnecessary risks and harm themselves.<\/p>\n<p>Frequently, additional mental illnesses then occur, such as depression, anxiety disorders, substance abuse or addictions.<\/p>\n<p>If they succeed in controlling and using the wealth of ideas typical of ADHD, adults with ADHD can also be extremely successful in life<\/p>\n<p>More about ADHD in adulthood can be found in the article about ADHD Adults.<\/p>\n<h3 id=\"h3-positive-symptome-adhs-kann-auch-vorteile-mit-sich-bringen\">Positive symptoms: ADHD can also have advantages<\/h3>\n<p>ADHD can also have positive sides. People with ADHD are often mentally very mobile and can be extremely creative. If they find a task that inspires them, they are highly motivated and extremely efficient. In this case, they can focus their full attention on one thing and be very successful.<\/p>\n<p>They also have good access to their feelings and are considered very helpful. Their sense of justice is also strongly developed. Despite the many difficulties that people with ADHD have because of their symptoms, they often find amazing ways to cope with them.<\/p>\n<h3 id=\"h3-unterschied-ads-adhs\">Difference Between ADHD And Similar Conditions<\/h3>\n<p>The term attention deficit syndrome (ADD) refers to people who are inattentive and have difficulty concentrating but are not hyperactive. Thus they correspond to the &#8220;dreamy&#8221; subtype of ADHD. There is, therefore, no fundamental difference between ADHD and ADD.<\/p>\n<p>ADHD children are less conspicuous than their hyperactive peers. The disorder is therefore often not recognized in them. But they also have great difficulties at school. They are also very sensitive and easily offended.<\/p>\n<h2 id=\"mcetoc_1e8f7r9u20\"><span style=\"color: #111111; font-family: Roboto, sans-serif; font-size: 27px;\">Causes and Risk Factors Of ADHD<\/span><\/h2>\n<p>Why some children develop ADHD is not yet clear. What is certain is that genetic make-up has a major influence. A decisive role in the development of ADHD is played by organic brain changes. With a corresponding predisposition, environmental factors can then become the trigger for ADHD. ADHS is not a modern disease of civilization, as was often assumed in the past. It is not caused by wrong education, bad nutrition or excessive media consumption. Although these factors can have an unfavourable influence on the disease, they are not the actual cause.<\/p>\n<\/section>\n<section>\n<h3 id=\"h3-genetische-ursachen\">Genetic causes<\/h3>\n<p>Researchers assume that the genes have a 70 percent share in the development of ADHD. In many cases, parents, siblings or other relatives also suffer from ADHD. The risk of contracting ADHD is considerably higher, especially for boys, if one parent suffers from the disorder.<\/p>\n<h3 id=\"h3-signalstoerung-im-kopf\">Signal disturbance in the head<\/h3>\n<p>Scientists suspect above all malfunctions in the brain as the cause of ADHD. Certain regions are not active enough &#8211; they are in a kind of &#8220;Sleeping Beauty sleep&#8221;. These include the frontal lobes as well as certain areas of the brainstem ganglia and cerebellum. These areas of the brain are responsible for attention, execution and planning, concentration and perception.<\/p>\n<p>In them, the concentration of special messenger substances, which are necessary for the communication of the nerve cells, is too low. These include serotonin, which regulates impulse control, and norepinephrine and dopamine, which are important for attention, drive and motivation.<\/p>\n<h3 id=\"h3-fehlende-filter\">Missing filters<\/h3>\n<p>Every second countless piece of information reach our brain, but only a few of them become conscious. A filter protects us from stimulus satiation and helps us to distinguish the important from the unimportant.<\/p>\n<p>In ADHD\/ADD children, the brain does not filter out unimportant information sufficiently. The brain of ADHD sufferers is then confronted with too many different stimuli at the same time and is overstrained.<\/p>\n<p>This makes it difficult for them to concentrate. The unfiltered flood of information makes them restless and tense. If the teacher shows something on the blackboard, the child is already distracted by the sounds of his classmates. Children with ADHD without hyperactivity tend to remain calm, but have just as much difficulty paying attention as the classic &#8220;fidgeter&#8221;.<\/p>\n<h3 id=\"h3-umwelteinfluesse\">Environmental influences<\/h3>\n<p>Environmental toxins and <a href=\"https:\/\/imedicalsociety.org\/food-poisoning\/\" target=\"_blank\" rel=\"noreferrer noopener\">food allergies are also suspected to be involved in causing<\/a> ADHS and ADS. Alcohol and drugs during pregnancy as well as a lack of oxygen at birth also increase the child&#8217;s risk of developing ADHD.<\/p>\n<p>The external circumstances in which a child grows up can influence the course of the disorder. Examples of unfavourable conditions are<\/p>\n<ul>\n<li><span>Little emotional attachment<\/span><\/li>\n<li><span>Restricted housing conditions<\/span><\/li>\n<li><span>Constant quarrelling of the parents<\/span><\/li>\n<li><span>Noise<\/span><\/li>\n<li><span>Missing or not transparent structures<\/span><\/li>\n<li><span>Lack of exercise<\/span><\/li>\n<li><span>Time pressure<\/span><\/li>\n<li><span>High level of media consumption<\/span><\/li>\n<\/ul>\n<\/section>\n<section>\n<div>\n<div>\n<p><nd-advertisement id=\"ad-slot-article-ad-8\"><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-8-desktop=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"desktop\" type=\"article-ad-8\"><\/bfa-ad><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-8-mobile=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"mobile\" type=\"article-ad-8\"><\/bfa-ad><\/nd-advertisement><\/p>\n<h2 id=\"adhs-untersuchungen-und-diagnose\" index-text=\"Untersuchungen und Diagnose\"><strong>Diagnosis And Examinations For ADHD<\/strong><\/h2>\n<p>ADHD can manifest itself in very different ways. This makes the diagnosis difficult. Not all <a href=\"https:\/\/imedicalsociety.org\/narcissistic-personality-disorder\/\" target=\"_blank\" rel=\"noreferrer noopener\">signs of the disorder<\/a> are always present. It is also often difficult to distinguish the symptoms of ADHD from age-appropriate behaviour. For this reason, only experienced specialists, such as paediatricians or child and adolescent psychiatrists, can diagnose ADHD.<\/p>\n<p>For the diagnosis of ADHD, certain criteria must be met according to the ICD-10 classification system. Typical of ADHD is an unusual degree of inattention, hyperactivity and impulsiveness. When ADHD is diagnosed, the children are merely inattentive but neither hyperactive nor impulsive.<\/p>\n<h3 id=\"h3-diagnosekriterium-unaufmerksamkeit\">Diagnostic criterion inattention<\/h3>\n<p>In ADHD, at least six of the following ADHD-typical <a href=\"https:\/\/imedicalsociety.org\/skin-fungus\/\" target=\"_blank\" rel=\"noreferrer noopener\">symptoms of inattention can be recognized<\/a>. They have been occurring for at least six months and are not due to an age-appropriate developmental phase. The affected patients<\/p>\n<ul>\n<li><span>Do not pay close attention to details or make careless mistakes,<\/span><\/li>\n<li><span>Have difficulty concentrating in the long term,<\/span><\/li>\n<li><span>Often seem not to listen when they are directly addressed,<\/span><\/li>\n<li><span>Often do not carry out instructions completely or do not complete tasks,<\/span><\/li>\n<li><span>Have difficulty in carrying out tasks and activities according to plan,<\/span><\/li>\n<li><span>Often avoid or refuse tasks that require sustained concentration<\/span><\/li>\n<li><span>Often lose things like toys or homework books,<\/span><\/li>\n<li><span>Are easily distracted by insignificant stimuli,<\/span><\/li>\n<li><span>Are often forgetful in everyday activities.<\/span><\/li>\n<\/ul>\n<h3 id=\"h3-diagnosekriterium-hyperaktivitaet-impulsivitaet\">Diagnostic criterion hyperactivity &#8211; impulsiveness<\/h3>\n<p>ADHD also manifests itself in at least six of the following ADHD-typical hyperactivity impulsiveness symptoms. These have also been occurring for at least six months and are not due to an age-appropriate developmental phase. The affected patients normally:<\/p>\n<ul>\n<li><span>Fidgeting or squirming on the chair,<\/span><\/li>\n<li><span>Are reluctant to sit and often leave their seats, even when seats are expected,<\/span><\/li>\n<li><span>Often run around or climb up everywhere, even in unsuitable situations,<\/span><\/li>\n<li><span>Are restless or often behave as if driven by an engine,<\/span><\/li>\n<li><span>Are usually very loud when playing,<\/span><\/li>\n<li><span>Often talk excessively,<\/span><\/li>\n<li><span>Often burst out with the answer before questions are completely asked,<\/span><\/li>\n<li><span>Often have difficulty waiting their turn,<\/span><\/li>\n<li><span>Often interrupt or disturb others during conversations or games.<\/span><\/li>\n<\/ul>\n<p>In children with ADHD, these symptoms are typically observed before the age of seven. They occur not only at home or only at school, but in at least two different environments. For a diagnosis of ADHD, there must also be significant suffering or difficulties in social contacts, learning or professional activities.<\/p>\n<h3 id=\"h3-untersuchungen-fuer-die-diagnose-adhs\">Examinations for the diagnosis ADHD<\/h3>\n<p>In order to determine ADHD, the specialist uses special questionnaires with which certain ADHD-typical behaviour can be recorded.<\/p>\n<p>Important here are behavioural abnormalities and peculiarities that affect learning, performance or, later, the job. Further topics are the family situation and diseases in the family. He also asks about particularities during pregnancy, birth and development as well as previous illnesses and other current complaints.<\/p>\n<p>For adult patients, he will also ask questions about nicotine, alcohol, drug use and psychiatric illnesses.<\/p>\n<h3 id=\"h3-wie-eltern-den-arztbesuch-vorbereiten-koennen\">How parents can prepare for a visit to the doctor<\/h3>\n<ul>\n<li><span>Observe and describe the behaviour of your child: Are there current critical events that could be the cause of restless behaviour? When do the attention disorders occur, at what time of day, on what days of the week (school days, weekends)?<\/span><\/li>\n<li><span>Talk to your child&#8217;s caregivers: Kindergarten, school, after-school care, grandparents.<\/span><\/li>\n<\/ul>\n<h3 id=\"h3-befragung-der-eltern-bezugspersonen-und-lehrer\">Interview with parents, caregivers and teachers<\/h3>\n<p>To diagnose ADHD in children, the specialist asks parents and other caregivers about the child&#8217;s social, learning and performance behaviour and personality structure. The doctor could ask the following questions in initial consultation:<\/p>\n<ul>\n<li><span>Can your child concentrate on one activity for a long time?<\/span><\/li>\n<li><span>Is your child fidgety when sitting still?<\/span><\/li>\n<li><span>Does your child talk frequently in between or does he or she talk a lot?<\/span><\/li>\n<li><span>Is your child easily distracted?<\/span><\/li>\n<\/ul>\n<p>Teachers can provide valuable information on the intellectual performance and attention behaviour of the little patient. Exercise books also provide indications of a possible disorder on the basis of order, guidance, writing and classification. Certificates document school performance.<\/p>\n<h3 id=\"h4-koerperliche-untersuchungen-bei-verdacht-auf-adhs\">Physical examinations in case of suspected ADHS<\/h3>\n<p>The doctor examines the child&#8217;s motor coordination ability and evaluates his or her behaviour during the examination. For this purpose, he observes the child&#8217;s ability to cooperate, gestures, facial expressions, speech and vocalisations. It is only necessary to measure the outward currents in the EEG if, for example, epilepsy is suspected.<\/p>\n<h3 id=\"h4-verhaltensbeobachtung-bei-verdacht-auf-adhs\">Behavioural observation in case of suspected ADHD<\/h3>\n<p>During the examinations and anamnesis, the doctor and ADHD specialist observes the child and pays attention to behavioural abnormalities.<\/p>\n<p>Sometimes video recordings help to confirm the diagnosis of ADHD. With videos, the specialist can also demonstrate to parents the conspicuousness of their child&#8217;s facial expressions, gestures and body language or the attention deficit deficits. The recordings also show the parents&#8217; reaction and later document the course of therapy.<\/p>\n<p>&nbsp;<\/p>\n<h3 id=\"h3-viele-fehldiagnosen\">Many misdiagnoses<\/h3>\n<p>Experts believe that ADHD is often diagnosed prematurely in children. Not every particularly active or lively child has ADHD. Some children may simply not get enough exercise to live out their energy.<\/p>\n<p>Others need more moments of retreat and recovery than other children and are therefore overexcited. Then changes in lifestyle are often enough to relax the situation. It is therefore important to have a precise diagnosis by an experienced paediatrician or paediatric and adolescent psychiatrist.<\/p>\n<h3 id=\"h3-adhs-hochbegabung-ist-selten\">ADHD: Giftedness is rare<\/h3>\n<p>If children fail at school, this is not necessarily due to a lack of intelligence. Some children with ADHD have above-average intelligence and yet have great difficulty in class. However, the combination of ADHD+high ability is rather rare.<\/p>\n<p>Highly gifted children, however, are often under-challenged at school and are therefore restless and disruptive. They are then sometimes wrongly diagnosed with ADHD.<\/p>\n<p>Children are considered highly gifted if they score over 130 points on an intelligence test. Such children are usually characterised by a particularly good ability to concentrate, which does not exist in ADHD.<\/p>\n<p>It is important to find out which treatment is optimal in each individual case. The specialists work together with parents, teachers, educators and other caregivers to do this. Often no clear cause of ADHD can be found.<\/p>\n<p>The aim of ADHD therapy is to enable patients to develop normally and to lead as normal a life as possible. An attention deficit hyperactivity disorder does not go away by itself. But with an individually tailored therapy and a lot of patience, a lot can be achieved. The well-coordinated cooperation of all those involved is crucial for success.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section>\n<h2 id=\"therapie\" index-text=\"Therapie\"><strong>Treatment Of ADHD<\/strong><\/h2>\n<h3 id=\"h3-therapiebausteine\">Therapy modules<\/h3>\n<p>The following components are important for the successful ADHD treatment of children:<\/p>\n<ul>\n<li><span>Information and advice for parents, the child\/youth and the educator or class teacher<\/span><\/li>\n<li><span>Parent training, the involvement of the family (including family therapy) to reduce symptoms in the family environment<\/span><\/li>\n<li><span>Kindergarten\/School: Cooperation with educators and teachers<\/span><\/li>\n<li><span>Cognitive behavioural therapy of the child\/adolescent (from school age): Learning to control impulsive and disorganised behaviour<\/span><\/li>\n<li><span>Therapy with appropriate medication (mostly amphetamines such as methylphenidate) to reduce symptoms at school, kindergarten, in the family circle or in other environments<\/span><\/li>\n<\/ul>\n<p>The combination of medication, behaviour therapy and parent training has proven to be very effective. The components that are used or combined with others, may vary, depending on the age of the child and the severity of ADHD.<\/p>\n<p><nd-advertisement id=\"ad-slot-article-ad-12\"><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-12-desktop=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"desktop\" type=\"article-ad-12\"><\/bfa-ad><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-12-mobile=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"mobile\" type=\"article-ad-12\"><\/bfa-ad><\/nd-advertisement><\/p>\n<h3 id=\"h3-therapie-im-vorschulalter\">Therapy in pre-school age<\/h3>\n<p>In pre-school age, the focus is on parent training and on informing the environment about the disorder. Cognitive therapy is not yet possible at this age. If the children have difficulties in staying with one thing for a longer period of time, play training can promote this ability. Some clinics offer a special mother-child cure. ADHD is treated in these clinics with a combination of learning training and relationship work, among other things.<\/p>\n<p>Experts warn against treating pre-school children with medication for ADHD. It is not clear how the drugs affect the development of the children. There is little experience to date with the use of methylphenidate in children under six years of age. Some experts fear that ADHD drugs might affect brain development.<\/p>\n<h3 id=\"h3-therapie-im-schulalter\">Treatment at school age<\/h3>\n<p>For school children and adolescents, the basis of therapy is the education and counselling of children and parents as well as parent training. An important first measure is the so-called self-instruction training. In a linguistic self-instruction, the children give themselves their next steps in action.<\/p>\n<p>The motto &#8220;act first, think later&#8221; is thus reversed to &#8220;think first, then act&#8221;. The ability to give oneself concrete instructions strengthens self-control and helps to rethink one&#8217;s own behaviour.<\/p>\n<p>Self-instruction for the treatment of ADHD can be learned in five steps:<\/p>\n<ul>\n<li><span>The therapist or educator reads the &#8220;self-instructions&#8221; in a model way and acts accordingly.<\/span><\/li>\n<li><span>The child acts according to the instructions just heard from the teacher (external behaviour control).<\/span><\/li>\n<li><span>The child directs its behaviour by its own self-instruction (open self-instruction) with loud speech.<\/span><\/li>\n<li><span>The child whispers the self-instruction (hidden self-instruction).<\/span><\/li>\n<li><span>The child should learn to control itself through internalized self-instruction (covert self-instruction).<\/span><\/li>\n<\/ul>\n<p>If the child is extremely restless or aggressive despite therapy and training, additional medication can be useful.<\/p>\n<h3 id=\"h3-verhaltenstherapie\">Behavioural Therapy<\/h3>\n<p>Behavioural therapy involves working with the children, their parents and also the school. The children learn to structure their everyday life and to control their behaviour better. In many cases, it is useful to have a professional helper support the children for some time, also at school.<\/p>\n<p>Practising in model situations can also be helpful. Within the framework of role plays, for example among peers, the ADHD children practice behaviour in a practical situation that they can later apply at home or at school. If they experience recognition, they will quickly incorporate the new behaviour pattern into their repertoire.<\/p>\n<h3 id=\"h3-elterntraining\">Parent Training<\/h3>\n<p>An important component of ADHD therapy is parent training. To better support their offspring, parents learn a consistent but loving parenting style. This includes, among other things:<\/p>\n<ul>\n<li><span>Provide clear structures, express yourself unambiguously<\/span><\/li>\n<li><span>Bring your own behaviour in accordance with the instructions<\/span><\/li>\n<li><span>Avoid distraction from a task at hand<\/span><\/li>\n<li><span>Give feedback on whether they find the behaviour positive or negative<\/span><\/li>\n<li><span>Rewarding desired behaviour in a clearly recognizable way<\/span><\/li>\n<\/ul>\n<p>Many parents also seek help with parent initiatives. The exchange with others helps them out of isolation and can reduce possible feelings of guilt. Often parents of ADHD children only manage to accept their hyperactive child as it is thanks to the support of the groups.<\/p>\n<h3 id=\"h3-medikamente-in-der-adhs-behandlung\">Medication In ADHD Treatment<\/h3>\n<p>Drugs for the <a href=\"https:\/\/imedicalsociety.org\/heart-failure\/\" target=\"_blank\" rel=\"noreferrer noopener\">treatment of ADHD can help with strongly pronounced ADHD symptoms that otherwise cause<\/a> considerable difficulties in everyday life. They usually work quickly and well. In the case of severe behavioural problems, they often create the conditions for behavioural therapy. In less pronounced cases, the children should only receive <a href=\"https:\/\/imedicalsociety.org\/shingles-treatment\/\" target=\"_blank\" rel=\"noreferrer noopener\">medication if behaviour therapy treatment<\/a> is not sufficient.<\/p>\n<p>Medication cannot cure the disorder. Therefore, patients often have to take them for years, sometimes even into adulthood. To stabilise ADHD permanently, they must be taken regularly. The treatment should not be interrupted on one&#8217;s own initiative.<\/p>\n<p>In addition, the doctor should check the <a href=\"https:\/\/imedicalsociety.org\/lyme-disease\/\" target=\"_blank\" rel=\"noreferrer noopener\">course of the disease<\/a> at least once a year and determine whether the active substance and dose are still optimal. If the ADHD <a href=\"https:\/\/imedicalsociety.org\/muscle-strain\/\" target=\"_blank\" rel=\"noreferrer noopener\">symptoms have improved significantly over a longer period of time<\/a>, the medication can possibly be discontinued.<\/p>\n<h4 id=\"h4-methylphenidat\">Methylphenidate<\/h4>\n<p>The most commonly used drug to treat ADHD is methylphenidate. Methylphenidate is <strong>not a sedative<\/strong>\u00a0but promotes activity. This seems contradictory at first because children with ADHD are hyperactive anyway.<\/p>\n<p>It is mainly known under the trade name Ritalin. It is a controlled substance in the US and in the European Union. The active substance is a psychostimulant from the group of amphetamines. It increases the concentration of the messenger substance dopamine in the brain. Dopamine transmits signals between the nerve cells. It plays a decisive role in controlling movements but is also crucial for mental drive and concentration.<\/p>\n<p>In most affected children, methylphenidate reduces inattention and restlessness and improves their concentration. For some children, methylphenidate enables them to participate in the class at school in the first place and makes social contacts much easier. <span style=\"color: #111111; font-family: Roboto, sans-serif; font-size: 17px;\">Methylphenidate blocks the reabsorption of the messenger substances dopamine and norepinephrine into the nerve cell. The free messenger substances can thus bind more to suitable receptors and thus improve the ability to concentrate.<\/span><\/p>\n<p>Methylphenidate <strong>acts quickly<\/strong>. Patients feel a clear effect after just one hour.<\/p>\n<p>At the beginning of the therapy, the doctor determines the lowest effective dose. To do this, he slowly increases the amount of active ingredient. This dose is different for each patient: it can range from one low-dose tablet to three high-dose tablets per day.<\/p>\n<p>For ADHD children who need all-day stabilisation, tablets taken once in the morning are suitable. They release the active ingredient continuously throughout the day. Taking the tablets regularly is not easily forgotten. Sleep disorders also occur less frequently.<\/p>\n<p>Methylphenidate falls under the <strong>narcotics law in many countries as it is a controlles substance in the US and also in the European Union<\/strong>. To prevent abuse, doctors are only allowed to prescribe such drugs for a limited period of time and only on a special prescription form (narcotics prescription). Methylphenidate does not have a physically addictive effect.<\/p>\n<p>When used properly, the risks of narcotics are low. However, when misused, for example for &#8220;brain doping&#8221;, they can endanger health.<\/p>\n<p><nd-advertisement id=\"ad-slot-article-ad-14\"><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-14-desktop=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"desktop\" type=\"article-ad-14\"><\/bfa-ad><bfa-ad config=\"{\" id=\"\" :=\"\" article-ad-14-mobile=\"\" orientation=\"\" hor=\"\" render=\"\" true=\"\" slot=\"mobile\" type=\"article-ad-14\"><\/bfa-ad><\/nd-advertisement><\/p>\n<h4 id=\"h4-atomoxetin\">Atomoxetine<\/h4>\n<p>A newer active substance for the treatment of ADHD is atomoxetine. It originates from antidepressant research but does not have an antidepressant effect. The active substance tends to work slightly less well than methylphenidate, but it offers an alternative.<\/p>\n<p>Above all, it increases the concentration of norepinephrine in the brain by slowing down its breakdown. The messenger substance thus remains active for longer and ensures that signal transmission in the brain functions better again.<\/p>\n<p>Unlike methylphenidate, atomoxetine does not fall under the narcotics law. It can be used from the age of six years for the treatment of ADHD in children.<\/p>\n<h3 id=\"h3-weitere-medikamente\">Fenetylline And Pemoline<\/h3>\n<p>If methylphenidate and atomoxetine do not work sufficiently, various neuroleptics, antidepressants, sedatives and other amphetamines, as well as fenetylline and pemoline, can also be prescribed.<\/p>\n<p><nd-table unresolved=\"true\"><\/nd-table><\/p>\n<table readabilitydatatable=\"1\">\n<tbody>\n<tr>\n<td>Substance<\/td>\n<td>Stimulant calcium, for example, methylphenidate<\/td>\n<td>Noradrenaline (NA) reuptake inhibitors, for example, atomoxetine<\/td>\n<\/tr>\n<tr>\n<td>Mode of action<\/td>\n<td>Acts on dopamine metabolism in the brain increases dopamine concentration<\/td>\n<td>Influences norepinephrine (NA) metabolism, NA is reabsorbed into the cell more slowly and thus has a longer effect<\/td>\n<\/tr>\n<tr>\n<td>Effectiveness<\/td>\n<td>Helps in the majority of cases<\/td>\n<td>Effectiveness rather lower than that of methylphenidate may be effective in patients who do not respond to methylphenidate<\/td>\n<\/tr>\n<tr>\n<td>Duration of effect<\/td>\n<td>1 to 3 doses per day, newer retard preparations guarantee the duration of effect of 6 or 12 hours<\/td>\n<td>Continuous effect throughout the day<\/td>\n<\/tr>\n<tr>\n<td>Experience<\/td>\n<td>For more than 50 years<\/td>\n<td>On the market in the EU since 2005, study experience since 1998<\/td>\n<\/tr>\n<tr>\n<td>Side effects<\/td>\n<td>In the initial phase for 2-3 weeks:<\/p>\n<p>&#8211; Headaches-<br \/>\nstomach problems-<br \/>\nincreased irritability-<br \/>\nnausea and vomiting<\/p>\n<p>Frequently<br \/>\n:- Loss of appetite &#8211;<br \/>\nWeight loss &#8211;<br \/>\nDizziness &#8211;<br \/>\nMuscle twitching\/ticks &#8211;<br \/>\nAllergic skin reactions<\/p>\n<p>Rare<br \/>\n:- Rise in <a href=\"https:\/\/imedicalsociety.org\/low-blood-pressure\/\" target=\"_blank\" rel=\"noreferrer noopener\">blood pressure<\/a> and pulse-<br \/>\nRare reports of an increase in liver values or inflammation of the liver (hepatitis)<br \/>\n&#8211; Slowing the growth in length and weight gain of children<\/td>\n<td>Especially in the initial phase:<\/p>\n<p>&#8211; Headaches-<br \/>\ndry mouth (adults)<br \/>\n&#8211; abdominal pain-<br \/>\nreduced appetite &#8211;<br \/>\nnausea and vomiting &#8211;<br \/>\nconstipation-<br \/>\nfatigue-<br \/>\nmood swings<\/p>\n<p>Frequently:<\/p>\n<p>&#8211; reduced appetite &#8211;<br \/>\nweight loss &#8211;<br \/>\nslight increase in <a href=\"https:\/\/imedicalsociety.org\/natural-remedies-for-high-blood-pressure\/\" target=\"_blank\" rel=\"noreferrer noopener\">blood pressure<\/a> and pulse<\/p>\n<p>Occasionally<br \/>\n:- allergic reactions<\/p>\n<p>Rare<br \/>\n:- additional behavioural disorders with an aggressive component-<br \/>\nvery rare reports of an increase in liver values, jaundice or inflammation of the liver (hepatitis)<br \/>\n&#8211; Slowing down the growth in length and weight gain of the children probably only temporarily<\/td>\n<\/tr>\n<tr>\n<td>Late effects<\/td>\n<td>No increased rate of late effects, fears of Parkinson&#8217;s disease or brain damage not verifiable.<\/td>\n<td>Late effects not yet foreseeable<\/td>\n<\/tr>\n<tr>\n<td>Risk of addiction<\/td>\n<td>Correctly applied, no increased risk of addiction; even reduced in ADHD (follow-up studies).<\/td>\n<td>No risk of addiction<\/td>\n<\/tr>\n<tr>\n<td>Contraindications<\/td>\n<td>Epileptic seizure disorder. Anxiety and tension. Increased intraocular pressure. Tourette&#8217;s syndrome. Simultaneous intake of medication from the MAO inhibitor group of drugs for the <a href=\"https:\/\/imedicalsociety.org\/depression\/\" target=\"_blank\" rel=\"noreferrer noopener\">treatment of depression<\/a>. Hyperthyroidism. Severe <a href=\"https:\/\/imedicalsociety.org\/angina-pectoris\/\" target=\"_blank\" rel=\"noreferrer noopener\">angina pectoris<\/a>. Cardiac arrhythmias. Severe hypertension. Severe depression. Anorexia. Psychosis. Tic disorders. Drug abuse. Alcohol or drug abuse. Pregnancy and lactation. Prostate enlargement.<\/td>\n<td>Simultaneous intake of drugs from the MAO-inhibitor group of drugs for the treatment of depression &#8211;<br \/>\nincreased intraocular pressure (narrow-angle glaucoma)<\/td>\n<\/tr>\n<tr>\n<td>Regulation<\/td>\n<td>Anaesthetic (BTM) prescription, confirmation of the attending physician required for travel abroad<\/td>\n<td>Normal recipe<\/td>\n<\/tr>\n<tr>\n<td>Approval<\/td>\n<td>For children and teenagers from 6 years<\/td>\n<td>For children and adolescents from 6 years of age, also for further treatment into adulthood<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<h3 id=\"h3-neurofeedback-adhs-therapie-am-computer\">Neurofeedback &#8211; ADHD therapy on the computer<\/h3>\n<p>Neurofeedback is a procedure by which the patient learns to positively influence his brain activities. To do this, electrodes are attached to the scalp which read the brain waves so that they can be seen on a monitor.<\/p>\n<p>This measurement is also called electroencephalography (EEG). By concentrating, the patient is able to keep his brain activity at a certain level. By training for a longer period of time, they can also apply the skills they have learned in everyday life, at school or at work. For many children, neurofeedback is an effective method of increasing concentration.<\/p>\n<h3 id=\"h3-homoeopathie-in-der-adhs-therapie\">Homoeopathy in ADHS Treatment<\/h3>\n<p>There are also alternative trials for the treatment of ADHD. They are intended to supplement conventional medical therapy, and they are not clearly proven by scientific investigation. One of them is homoeopathy. Some parents and patients report an improvement of the symptoms. There is a wide range of homoeopathic remedies. Depending on the symptoms, there are globules based on potassium phosphoricum, which is supposed to promote the ability to concentrate, up to sulphur, which is given in case of impulsiveness and excess energy.<\/p>\n<p>The concept of homoeopathy and its specific effectiveness is controversial in science and not clearly proven by studies.<\/p>\n<h3 id=\"h3-ernaehrung-bei-adhs\">Nutrition in ADHS<\/h3>\n<p>Some parents report that fast food and a sugary diet further increases their children&#8217;s hyperactivity. Scientifically, the connections between such a diet and ADHD are not clearly proven.<\/p>\n<p>The situation is different for children who suffer from ADHD as well as food intolerance or allergy. In these cases, a low-allergen <a href=\"https:\/\/imedicalsociety.org\/celiac-disease-gluten-intolerance\/\" target=\"_blank\" rel=\"noreferrer noopener\">diet improves the symptoms<\/a> of ADHD in many children. Nutrition can then make a positive contribution. In addition to standard treatment, doctors therefore often recommend a change in diet. Some foods that frequently <a href=\"https:\/\/imedicalsociety.org\/sun-allergy-description-trigger-symptoms-treatment\/\" target=\"_blank\" rel=\"noreferrer noopener\">trigger allergies<\/a> include dairy products, eggs, nuts, and colourings and preservatives.<\/p>\n<\/section>\n<section>\n<div>\n<div>\n<h2 id=\"adhs-krankheitsverlauf-und-prognose\" index-text=\"Krankheitsverlauf und Prognose\"><strong>Prognosis Of ADHD<\/strong><\/h2>\n<p>Attention deficit, also called a hyperkinetic disorder, is sometimes difficult to distinguish from other behavioural disorders. That is why there are no exact figures on the frequency of ADHD. Boys are four times more frequently affected than girls. With increasing age, the gender difference becomes more even.<\/p>\n<p>ADHD is not a disease that simply &#8220;grows out&#8221;. In some children, the symptoms disappear over the years, but about 60 per cent will accompany them throughout their lives.<\/p>\n<h3 id=\"h3-adhs-unbehandelt-die-folgen\">ADHD untreated &#8211; the consequences<\/h3>\n<p>For people with ADHD, the correct <a href=\"https:\/\/imedicalsociety.org\/pneumonia\/\" target=\"_blank\" rel=\"noreferrer noopener\">diagnosis and appropriate treatment<\/a> are essential, otherwise, they will have serious problems at school or at work and in social contact.<\/p>\n<ul>\n<li><span>Some do not make it to school or learn a profession that does not correspond to their mental abilities.<\/span><\/li>\n<li><span>Some find it more difficult to establish and maintain social relationships.<\/span><\/li>\n<li><span>The risk of becoming a delinquent during adolescence is higher.<\/span><\/li>\n<li><span>They suffer more accidents, including serious ones.<\/span><\/li>\n<\/ul>\n<p>People with ADHD are also at high risk of developing other mental disorders. These include<\/p>\n<ul>\n<li><span>Developmental disorders<\/span><\/li>\n<li><span>Learning Disabilities<\/span><\/li>\n<li><span>Disorders of social behaviour,<\/span><\/li>\n<li><span>Tic disorders and Tourette&#8217;s syndrome<\/span><\/li>\n<li><span>Anxiety disorders<\/span><\/li>\n<li><span>Depressions<\/span><\/li>\n<\/ul>\n<p>In the <a href=\"https:\/\/imedicalsociety.org\/celiac-disease-gluten-intolerance\/\" target=\"_blank\" rel=\"noreferrer noopener\">course of an ADHD disease<\/a>, the symptoms change. While children with ADHD stand out mainly because of their hyperactivity and impulsiveness, adolescents with ADHD often show themselves to be rather dreamy and inattentive. In adulthood, the hyperactivity usually decreases further.<\/p>\n<p>So far, there are no comprehensive studies on the prognosis of ADHD. It is important that ADHD is recognised and <a href=\"https:\/\/imedicalsociety.org\/prevent-and-treat-wrinkle\/\" target=\"_blank\" rel=\"noreferrer noopener\">treated in good time<\/a>. Professional support enables children to lay the foundations for their professional careers.<\/p>\n<h2 id=\"h3-abgrenzung-von-anderen-stoerungen\"><strong>Difference Between ADHD And Other Conditions<\/strong><\/h2>\n<p>It is important to distinguish ADHD from other problems with similar symptoms. Psychologically, these can be, for example, reduced intelligence or dyslexia (weakness in reading and writing). If possible, the specialist compares the results with previous findings, for example, the examination at school. OCD can also cause ADHD-like hyperactivity.<\/p>\n<p>In some cases, however, hyperactivity is also based on physical <a href=\"https:\/\/imedicalsociety.org\/bipolar-disorder\/\" target=\"_blank\" rel=\"noreferrer noopener\">causes such as metabolic disorders<\/a>, epilepsy, tic disorders, Tourette&#8217;s syndrome or pathological itching, visual or hearing problems, which must be treated accordingly.<\/p>\n<\/div>\n<\/div>\n<\/section>\n<section>\n<div>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>Attention Deficit Hyperactivity Disorder (ADHD) ADHD stands for attention deficit hyperactivity disorder (6). Inattention, hyperactivity (7) and impulsiveness are the main characteristics (5). If the disorder is not treated (8), it impairs academic and professional performance and social contacts (1). ADHD is one of the most common psychological disorders in childhood (9) (10). In many&#8230;<\/p>\n","protected":false},"author":1,"featured_media":2133,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"footnotes":""},"categories":[14],"tags":[],"_links":{"self":[{"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/posts\/2132"}],"collection":[{"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/comments?post=2132"}],"version-history":[{"count":0,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/posts\/2132\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/media\/2133"}],"wp:attachment":[{"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/media?parent=2132"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/categories?post=2132"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/imedicalsociety.org\/wp-json\/wp\/v2\/tags?post=2132"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}