الفهرس 
History of the Diagnosis of Attention Deficit Hyperactivity
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Abstract
According to the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV-TR, APA, 2000), Attention Deficit Hyperactivity Disorder (ADHD)
“is a persistent pattern of inattention and/or hyperactivity-impulsivity that is
more frequent and severe than is typically observed in individuals at a
comparable level of development.” There are three subtypes of ADHD that are
used to diagnose individuals based on the predominant symptom pattern that
has existed for at least the past 6 months (APA, 2000). Although most
individuals have symptoms of both inattention and hyperactivity-impulsivity,
there are some individuals have symptoms of both inattention and hyperactivityimpulsivity,
there are some individuals in whom one or the other pattern is
predominant.
The long-chain polyunsaturated fatty acids (PUFAs) fall into two main
families: omega-3 and omega-6. The omega-3 PUFAs are derived from fish and
some plants, whereas the omega-6 PUFAs are derived mainly from vegetable
oil. The principal precursors of the omega-3 and omega-6 PUFAs cannot be
endogenously synthesized from carbohydrates (Mazza et al., 2007). Thus, the
source of α-Linolenic acid (ALA) with 18 carbons, 3 double bonds, the first
located at the third carbon from the last (ω) (18:3:ω3), and Linoleic acid (LA-
18:2ω6), is entirely nutritional. ALA is converted in the body to
Eicosapentaenoic acid (EPA-20:5:ω3), and Docosahexaenoic acid (DHA-
22:6:ω3) comprising the omega-3 group. (Gadoth, 2008).
Zinc is an important cofactor for metabolism relevant to
neurotransmitters, prostaglandins, and melatonin, and indirectly affects
dopamine metabolism. It is necessary for 100 different metalloenzymes and
metal–enzyme complexes (Toren et al. 1996), many of them in the central nervous system. It contributes to structure and function of brain (Black 1998).
Specific to ADHD, the dopamine transporter has a zinc binding site that blocks
transport (Lepping and Huber 2010). Both animal data (Halas and Sandstead
1975; Sandstead et al. 1995; Golub et al. 1996) and human findings suggest
involvement of zinc deficiency in hyperactivity. Human zinc deficiency
syndrome includes concentration impairment and jitters (Aggett 1995 , Harris
1979).
The aim of this study is to investigate effects of omega-3 PUFA
supplementation on behavior and literacy in children 6 to 11 y old with ADHD
symptoms in a randomized, placebo-controlled trial. In addition, the changes in
PUFA levels and their correlation with changes in behavior and literacy will be
examined over 3 month.
Review of the literature:
The study comprises three chapters as follows :
Chapter one:
This chapter shows the history of the diagnosis of ADHD, the criteria for
each subtype, genter differences, environmental contributions, pharmacological
treatment , behavior management.
Chapter two:
This chapter discusses dietary influence, fatty acids, fatty acids in diet,
the importance of essential fatty acids in the brain, mechanisms of action of
EFA in the brain, main EFA metabolites, open-label EFA supplementation trials
in ADHD, randomized controlled EFA supplementation trials in ADHD,
subgroup analyses of EFA supplementation trials.Chapter three:
This chapter shows zinc deficiency and ADHD, healthy diet pattern in
prevention and treatment of ADHD, foods to avoid and foods preferred in
children with ADHD, elimination diets.
Subjects:
The present study included 70 children recruited from the child
psychiatry clinic at child pediatric hospital Cairo university. They were
diagnosed by a psychiatridt to have ADHD according to DSM-IV criterion
(APA, 1994), They were follow ups and were already under medication with
methyl phenidate (Ritalin 10 mg. tablets). Children were of both sexes, with
age range from 6-11 years, that were interviewed through the period from
September 2014 to April 2015.
In this study we made Demographic data , Dietary assessment and
Dietary analysis for all children (n =70). Then we choose 30 children and
divided them into 3 groups at random to make Conner’s test , Free Fatty Acids
and Zinc analysis.
Group (1) controls (n=10):
This included 9 males and 1 females with ADHD, They were follow up
cases and were under medication with methyl phenidate (Ritalin 10 mg.) .
Group 2 (n=10):This included 8 males and 2 females with ADHD who were given PUFA
alone