PSEUDO ADHD

Pathologies and conditions mimicking ADHD

By Dr. Claudio Ajmone

"An accurate differential diagnosis allow to discover the real cause and it is a test for the nosography of ADHD"

A - Psychological factors

  1. Adaptation disorder with symptoms of conduct disorder
  2. Ambidextrous children
  3. Bulimia
  4. Child genius
  5. Child vitiated
  6. Child undisciplined
  7. Adopted children
  8. Compulsive obsessive disorder 
  9. Conduct disorder
  10. Depriving institutional care
  11. Disorder of language comprehension
  12. Disrupted and discordant relationships in the families
  13. Depression
  14. Enuresi
  15. Encopresis
  16. Gambling
  17. Generalized Anxiety
  18. Gilles de la Tourette syndrome
  19. Humor disorders
  20. Motivation - Lack of


    21. Learning disability

  21. Dyscalculia (mathematics)
  22. Executive function - Cognitive measures
  23. Dislexya (reading)
  24. Dysgraphia (writing)
  25. Motor coordination disorder (DSM-IV), Specific developmental disorder of the motor function (ICD- 10)
  26. Working memory deficit
    ..................
  27. Mental retardation (enviromental)
  28. Oppositive-Provocative disorder


    29. Pervasive Developmental Disorders

  29. Childhood autism
  30. Rett Syndrome
  31. Childhood Disintegrative Disorder
  32. Asperger's Syndrome
  33. Pervasive Developmental Disorder Not Otherwise Specified ( including Atypical autism ICD-1O)
  34. Overactive disorder associated with mental retardation and stereotyped movements (ICD-10)

    35. ......................
  35. Post traumatic stress disorder


    36. Psychosis

  36. Dissociative
  37. Bipolar disorder
  38. Personality disorders
  39. Mania
  40. Parents with bipolar disorder
  41. Schizophrenia

    42. ---------------
  42. "Influence of relative age" in the school
  43. Maternal Stress during pregnancy
  44. Social phobia
  45. Separation Anxiety
  46. Sexual abuses
  47. Physical abuses
  48. Situational problems, environmental, family, school, quality of life
  49. Tics

    50. B - Medical factors

  50. Abscess subclinic post-traumatic
  51. Adenotonsillar hypertrophy and obstructive sleep disordered breathing
  52. Akathisia
  53. Allergic rhinitis
  54. Allergies (15 to 20 percent of the people have some type of allergy, particularly for food)
  55. Anemia
  56. Anesthesia - young children and infants
  57. Basal ganglia - dysregulation in the circuitry
  58. Bronchial asthma
  59. Caudate (functional alterations)
  60. Complement system (blood proteins that play an important role in defending against viral and bacterial infections; i.e. C4B protein)
  61. Carbon Monoxide poisoning
  62. Cardiacs (diseases and disorders)
  63. Celiac disease
  64. Cerebral cysts
  65. Cervical kyphosis
  66. Chronic fatigue syndrome
  67. Corpus callosum - macrostructural and microstructural abnormalities
  68. Creatine plus phosphocreatine ( Cr + PCr significantly lower right prefrontal lobe)
  69. Delivery (complications from)
  70. Dermatitis
  71. Mycobiome fungal dysbiosis and intestinal permeability linked
  72. Elecrtical hypersensitivity
  73. Epilepsy
  74. Fibromyalgia syndrome


    75. Genetic anomalies

  75. 5 HTT variant
  76. 10/3 DAT1 haplotype (spatial inattention)
  77. 16p13.11- excess of chromosome duplications
  78. Aarskog-Scott syndrome
  79. BAIAP2
  80. BDNF variation rs6265
  81. C-1291G - polymorphism (rs1800544) in the promoter region of the (alpha)2A-adrenoceptor gene (ADRA2A)
  82. Congenital or juvenile myotonic dystrophy
  83. Corpus callosum (macrostructural and microstructural abnormalities)
  84. Dopamine beta hydroxylase ( decreased)
  85. Down syndrome
  86. DRD4-7r allele ( additional presence)
  87. Dubowitz syndrome
  88. Fetal alcohol syndrome (FAS)
  89. Hemophilia
  90. hypothalamus-pituitary-adrenal axis ( dysfunctional)
  91. Increased cellular nucleotidase activity
  92. Klinefelter syndrom
  93. Length of the Y chromosome
  94. MAO-B lower
  95. MAO-B variants
  96. Mosaicism for trisomy 17
  97. NRXN1 deletion
  98. Paternal Age at Childbearing - over 45
  99. PARKIN deletion
  100. Pars triangularis - right smaller length
  101. Phenylketonuria
  102. Prader-Willi syndrome
  103. Rett syndrome
  104. Ring chromosome 8 syndrome
  105. Serotonin 1A receptor C-1019G singlenucleotide polymorphism (HTR1A C-1019G SNP)
  106. Serotonin HRT1B gene 861G allele
  107. SNP chromosome 3p21
  108. SNP chromosome 10q24
  109. SNP gene CACNA1C (calcium channel, voltage-dependent, L type, alpha 1C subunit)
  110. SNP gene CACNB2 (calcium channel, voltage-dependent, beta 2 subunit )
  111. Succinyl-CoA: 3-oxoacid CoA-transferase deficiency
  112. TaqI - A polymorphism of ANKK1 (DRD2) gene
  113. Thalamus (Morphological abnormalities)
  114. Temporal information processing impaired
  115. SNAP25 (dysregulation of calcium dynamics)
  116. Val158Met COMT polymorphism
  117. Velocardiofacial syndrome
  118. Ventro-Striatal Reductions
  119. Weinberg syndrome
  120. Wilson disease
  121. Williams syndrome
  122. X fragile syndrome
    -----------------------
  123. Gray matter - significantly smaller volume
  124. Hearing disorders
  125. Hypertension (prymary)
  126. Hyperthyroidism
  127. Hypothyroidism
  128. Hypoglycemia (Low blood sugar caused by: thyroid, liver, pancreas, adrenal gland, diet)
  129. Hurt and damages to the head
  130. Hypoxia (congenital heart disease, sleep-disordered breathing, asthma, chronic ventilatory impairment, respiratory instability)
  131. Intestinal parasitics ( infestation )
  132. ischemic-hypoxic in utero
  133. Legg-Calve-Perthes disease
  134. Lesions of the basal forebrain cortical cholinergic system
  135. Lymphocyte muscarinic cholinergic receptor binding (l-MR) lower
  136. Kidney (chronic renal disease)
  137. Korea
  138. Lupus erythematosus (systemic)
  139. Mental retardation (biological and genetic)
  140. Metabolic disorders
  141. Migraine
  142. Obesity
  143. Otitis media
  144. Paraganglioma & Pheochromocytoma
  145. Perinatali (unfavorable factors)
  146. Physiological Vivacity
  147. Platelet monoamine oxidase activity - lower
  148. Porphyria
  149. Post traumatic subclinical access
  150. Premature diabetes
  151. Prenatal (insufficient health and malnutrizione of the mother, drug use)
  152. Putamen ( Structural and functional alterations)
  153. Restless Legs Syndrome
  154. Sensory integration (dysfunction)
  155. Spinal problems
  156. Smith-Magenis Syndrome
  157. Sleep (disturbs of)
  158. Substantia nigra - Structural abnormality of
  159. Toxine exposure


    160. Tumors

  160. Incipient cerebral tumors
  161. Neoplasie of the frontal Lobe
  162. Neuroepiteliale disembrioplastico
  163. Neurofibromatosis type 1 (Von Recklinghausen)
  164. Neurofibromatosis type 2

    165. -----------------

    Vascular cerebral

  165. Lenticulostriate vasculopathy

    166. ----------------
  166. voiding dysfunction and incontinence
  167. Voluntary or involuntary inhalation of substances


    168. Infections

  168. Adenoids
  169. AIDS - Acquired Immune Deficiency Syndrome
  170. Candida Albicans
  171. Enterovirus 71
  172. Meningitis
  173. Streptococcus Beta-Emolitico
  174. Tonsillitis
  175. Viral encephalitis

    176. ------------------

    Vison disorders

  176. Accommodative dysfunction
  177. Tracking
  178. Convergence
  179. Visual Acuity - Far
  180. Stereopsis
  181. Visual Acuity - Near
  182. Hyperopia
  183. Color Vision
  184. Visual Motor Integration

    185. ------------------

    C - Psicotropic Substance

  185. Alcohol
  186. Caffeine
  187. Cocaine
  188. D-lysergic acid (LSD)
  189. Eroine
  190. Marijuana
  191. Medicines
  192. Nicotine
  193. Phencyclidine (PCP)

    194. D - Feedeng

    Amino acids (deficit)

  194. Isoleucine
  195. Phenylalanine
  196. Tyrosine
  197. Tryptophan
  198. Histidine


    199. ----------------

  199. Breastfeedeing - Lack of
  200. Calcium (deficiency of)
  201. Copper (deficiency of)
  202. Food preservative
  203. Food synthetic colouring
  204. Glycyrrhizine - liquorice (high level of)
  205. Iodine (deficiency of)
  206. Ionic Magnesium (low level of Mg(2+))
  207. Iron (deficiency of)
  208. Magnesium (deficiency of)
  209. Malnutrition
  210. Manganese (high level of)
  211. Omega 3 (deficiency of)
  212. Vitamins (excess of)
  213. Vitamin B (deficiency of)
  214. Wrong diet
  215. Zinc (deficiency of)

    216. E - Unfavorable Situations

  216. Chemotherapy for cancer
  217. Hunger
  218. Movement (exercise lack)
  219. New technologies (intensive and/or premature use of the computer, video games, TV)
  220. Physical pain
  221. Wearying


    222. MEDICAMENT

  222. Allergy medication contain anthistamine or stimulants
  223. Antibiotics: frequently cause fatique, same of them have been associated with mental alterations; e.g. cephalosporin
  224. Paracetamol/Acetaminophen - used during pregnancy
  225. Pitocin (synthetic oxytocin)
  226. Cold medication contain anthistamine or stimulants
  227. Sinus medication contain anthistamine or stimulants
  228. Sleeping medication that can impair alertness and concentration


    229. Antidepressants

  229. Citalopram Hydrobromide
  230. Escitalopram
  231. Fluoxetine
  232. Fluvoxamine
  233. Paroxetine
  234. Sertraline


    235. Antiepileptic medication

  235. Carbamazepine
  236. Phenytoin
  237. Divalproex Sodium
  238. gabapentin


    239. Antipsychotics

  239. Chlorpromazine
  240. Thioridazine
  241. Fluphenazine
  242. Prochlorperazine
  243. Haloperidol
  244. Thiothixene
  245. Olanzapine
  246. Quetiapine
  247. Risperidone


    248. Asthma medication

  248. Antihistaminics
  249. Ephedrine
  250. Pseudoephedrine
  251. Theophylline


    252. Barbiturates

  252. Phenobarbital: 5-ethyl-5-phenyl-1,3-diazinane-2,4,6-trione
  253. Amobarbital: 5-ethyl-5-(3-methylbutyl)-1,3-diazinane-2,4,6-trione
  254. butabarbital: 5-sec-Butyl-5-ethylbarbituric acid
  255. pentobarbital: 5-Ethyl-5-(1-methylbutyl)-2,4,6(1H,3H,5H)-pyrimidinetrione
  256. Secobarbital: 5-(1-methylbutyl)-5-prop-2-enyl-hexahydropyrimidine-2,4,6-trione


    257. Minor tranquilizer, sedatives, sleep medications

  257. Alprazolam
  258. Clonazepam
  259. Chlordiazepoxide
  260. Diazepam
  261. Flurazepam
  262. Lorazepam
  263. Triazolam


    264. Mood stabilizer

  264. Lithium Carbonate
  265. Verapamil


    266. Stimulants, included same used drugs in order to cure the ADHD

  266. Desoxyephedrine
  267. Dextroamphetamine
  268. Methylphenidate
  269. Pemoline


    270. Steroids

  270. 4-chlordehydromethyltestosterone
  271. Betamethasone
  272. Boldenone Undecylenate
  273. Dexamethasone
  274. Fluoxymesterone
  275. Testosterone
  276. Mesterolone
  277. Methandrostenolone / methandienone
  278. Methenolone Enanthate
  279. Mibolerone
  280. Nandrolone Decanoate
  281. Nandrolone Phenylpropionate
  282. Oxandrolone
  283. Oxymetholone
  284. Prednisone/steroid hormones: 17-hydroxy-17-(2-hydroxyacetyl)-10,13-dimethyl-7,8,9,10,12,13,14,15,16,17-decahydro-6H- cyclopenta[a]phenanthrene-3,11-dione
  285. Stanozolol
  286. Trenbolone


    287. Vaccine

  287. With mercury

    288. ---------------------

    F - Pollution

  288. Aluminium (high level of)
  289. Arsenic
  290. Prenatal fluoride exposure

    291. Brominated Flame Retardants

  291. Polybrominated diphenyl ethers (PBDEs)
  292. Hexabromocyclododecane (HBCD or HBCDD)
  293. Tetrabromobisphenol A (TBBPA or TBBP-A)
  294. Polybrominated biphenyl (PBBs)
  295. Other brominated flame retardants

    296. -------------------

  296. Bisphenol
  297. Cadmium
  298. DDT
  299. Fluoride

    300. Insecticide

  300. Acetamiprid (Inhalation during pregnancy)
  301. Imidacloprid (Inhalation during pregnancy)

    302. Pyrethroid insecticide

  302. Allethrin
  303. Bifenthrin
  304. Cyfluthrin
  305. Cypermethrin 
  306. Cyphenothrin
  307. Deltamethrin
  308. Esfenvalerate
  309. Etofenprox
  310. Fenpropathrin
  311. Fenvalerate
  312. Flucythrinate
  313. Flumethrin
  314. Imiprothrin
  315. lambda-Cyhalothrin
  316. Metofluthrin
  317. Permethrin
  318. Prallethrin
  319. Resmethrin
  320. Silafluofen
  321. Sumithrin
  322. Tau-Fluvalinate
  323. Tefluthrin
  324. Tetramethrin
  325. Tralomethrin
  326. Transfluthrin
    -------------------------
  327. Lead (Mild to high levels)
  328. Mercury (high level of)
    -------------------------

    Pesticide Organophosphates

  329. Parathion
  330. Melation
  331. Metil parathion
  332. Chlorpyrifos
  333. Diazinon
  334. Dichlorvos
  335. Phosmet
  336. Tetrachlorvinphos
  337. Azinphos metile

    338. -----------------------

  338. PCB (Polychlorinated biphenyls)
  339. Phthalates
  340. Polifluoroalkyl
  341. Polycyclic Aromatic Hydrocarbons
  342. Sniffing materials ( intentionally or unintentionally): such as modeling glue or other house hold products
  343. Traffic-Related Air Pollution Exposure (TRAP)
  344. Trichlorophenol
  345. Secondhand (SHS) and Thirdhand (THS) smoke exposure



This is Table 2 of the guidelines developed by the Italian Society of Child and Adolescent Psychiatry (SINPIA) adopted by our National Health Institute (ISS), which lists the differential diagnoses.

Table 2. Differential diagnosis and comorbidity (?)

Psychiatric Disorders

  1. Oppositional-defiant disorder
  2. Conduct Disorder
  3. Mood Disorders
  4. Bipolar Disorder
  5. Anxiety disorders
  6. OCD
  7. Adaptation disorders with symptoms of conduct D.
  8. Gilles de la Tourette syndrome / multiple tics
  9. Personality Disorders
  10. Specific learning disabilities
  11. Mental retardation
  12. Pervasive developmental disorder

    Medical and neurological disorders

  13. Sensory disturbances (deafness, visual defict)
  14. Side effects of medications (antihistamines, beta-agonists, benzodiazepines, phenobarbital)
  15. Epilepsy
  16. Thyroid disease
  17. Abscesses, tumors of the frontal lobe
  18. TBI
  19. Substance Abuse
  20. Lead poisoning

    Developmental Disorders

  21. Physiological Vivacity
  22. Situational problems, environmental, familiars
  23. Inadequate support at school (slight delay, or vice versa, particularly lively intellectual curriculum with "standard")
  24. Altered support environmental, social, family (chaotic environment, divorce, abandonment, abuse)

 

proxima jpg