ebook_ADHD2019_engl.
122 Rohde, Buitelaar, Gerlach & Faraone derstand that although ADHD is a biological disorder, their action might buffer the symptoms or increase them. This might be important to motivate them for future parent training interventions. We then describe ADHD as an immaturity or dysregulation of the chemicals in brain areas that are responsible for “our brakes” and for coordinating our ability to plan and execute actions. We localize these areas in the front of our brains empha sizing that our modern understanding of brain suggest that its functions are much more dependent on interactions among diverse brain areas than the action of an iso- lated area. Different analogies here might help such as the one with the brake fluid of the car and how a dysregulation in this fluid will make the brakes not working properly. Then, we present the idea how a failure in the brake system can determine symptoms as different as inattention and hyperactivity, as discussed above. Another interesting analogy is the one between the conductor of an orchestra and our frontal brain areas. If frontal areas that act as the conductor for other are- as (musicians) do not work adequately by immaturity or chemical dysregulation, the orchestra (brain) will not play properly independent on how well the musicians are individually (how intact other brain areas are). Although it might be seen as a time demanding process for appointments in primary care or in a pediatric office, this process is essential to foster initial un- derstanding about ADHD and compliance with any proposed management plan in a disorder where adherence to treatment is one of the biggest problems, as alre- ady mentioned 1 . Indeed, this whole talk might not take more than 10-15 minutes. CONCLUSION This chapter aims to provide a guideline for clinicians to address some of the com- mon doubts and misunderstanding patients with ADHD and their families have about the disorder. It might even be indicated to families to read before or just after an ADHD diagnosis, stimulating them to share their questions with their mental health professionals. Conflicts of interest Luis Augusto Rohde has received grant or research support from, served as a consultant to, and ser- ved on the speakers’ bureau of Eli Lilly and Co., Janssen, Medice, Novartis and Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr Rohde have received unrestricted educational and research support from the following pharmaceutical companies: Eli Lilly and Co., Janssen, and Novartis. Dr Rohde has received authorship royalties from Oxford Press and ArtMed and travel grants from Shire to take part in the 2018 APA annual meeting and from Novartis to take part of the 2016 AACAP annual meeting. Olayinka Omigbodun, Manfred Gerlach and Yi Zheng do not have conflict of interest to disclosure.
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