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Dietary modifications may be of benefit to some children with ADHD . A 2013 meta @-@ analysis found less than a third of children with ADHD see some improvement in symptoms with free fatty acid supplementation or decreased eating of artificial food coloring . These benefits may be limited to children with food sensitivities or those who are simultaneously being treated with ADHD medications . This review also found that evidence does not support removing other foods from the diet to treat ADHD . A 2014 review found that an elimination diet results in a small overall benefit . A 2016 review did not support a clear link between celiac disease and ADHD , and stated that routine screening for celiac disease in people with ADHD and the use of a gluten @-@ free diet as standard ADHD treatment are discouraged . Iron , magnesium and iodine may also have an effect on ADHD symptoms . There is a small amount of evidence that lower tissue zinc levels may be associated with ADHD . In the absence of a demonstrated zinc deficiency ( which is rare outside of developing countries ) , zinc supplementation is not recommended as treatment for ADHD . There is evidence of a modest benefit of omega 3 fatty acid supplementation , but it is not recommended in place of traditional medication .
= = Prognosis = =
An 8 @-@ year follow up of children diagnosed with ADHD ( combined type ) found that they often have difficulties in adolescence , regardless of treatment or lack thereof . In the US , fewer than 5 % of individuals with ADHD get a college degree , compared to 28 % of the general population aged 25 years and older . The proportion of children meeting criteria for ADHD drops by about half in the three years following the diagnosis and this occurs regardless of treatments used . ADHD persists into adulthood in about 30 – 50 % of cases . Those affected are likely to develop coping mechanisms as they mature , thus compensating for their previous symptoms .
= = Epidemiology = =
ADHD is estimated to affect about 6 – 7 % of people aged 18 and under when diagnosed via the DSM @-@ IV criteria . When diagnosed via the ICD @-@ 10 criteria rates in this age group are estimated at 1 – 2 % . Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East ; this is believed to be due to differing methods of diagnosis rather than a difference in underlying frequency . If the same diagnostic methods are used , the rates are more or less the same between countries . It is diagnosed approximately three times more often in boys than in girls . This difference between sexes may reflect either a difference in susceptibility or that females with ADHD are less likely to be diagnosed than males .
Rates of diagnosis and treatment have increased in both the United Kingdom and the United States since the 1970s . This is believed to be primarily due to changes in how the condition is diagnosed and how readily people are willing to treat it with medications rather than a true change in how common the condition is . It is believed that changes to the diagnostic criteria in 2013 with the release of the DSM @-@ 5 will increase the percentage of people diagnosed with ADHD , especially among adults .
= = History = =
Hyperactivity has long been part of the human condition . Sir Alexander Crichton describes " mental restlessness " in his book An inquiry into the nature and origin of mental derangement written in 1798 . ADHD was first clearly described by George Still in 1902 .
The terminology used to describe the condition has changed over time and has included : in the DSM @-@ I ( 1952 ) " minimal brain dysfunction " , in the DSM @-@ II ( 1968 ) " hyperkinetic reaction of childhood " , in the DSM @-@ III ( 1980 ) " attention @-@ deficit disorder ( ADD ) with or without hyperactivity " . In 1987 this was changed to ADHD in the DSM @-@ III @-@ R and the DSM @-@ IV in 1994 split the diagnosis into three subtypes , ADHD inattentive type , ADHD hyperactive @-@ impulsive type and ADHD combined type . These terms were kept in the DSM @-@ 5 in 2013 . Other terms have included " minimal brain damage " used in the 1930s .
The use of stimulants to treat ADHD was first described in 1937 . In 1934 , Benzedrine became the first amphetamine medication approved for use in the United States . Methylphenidate was introduced in the 1950s , and <unk> dextroamphetamine in the 1970s .
= = Society and culture = =
= = = Controversies = = =
ADHD , its diagnosis , and its treatment have been controversial since the 1970s . The controversies involve clinicians , teachers , policymakers , parents , and the media . Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition . Other areas of controversy include the use of stimulant medications in children , the method of diagnosis , and the possibility of overdiagnosis . In 2012 , the National Institute for Health and Care Excellence , while acknowledging the controversy , states that the current treatments and methods of diagnosis are based on the dominant view of the academic literature . In 2014 , Keith Conners , one of the early advocates for recognition of the disorder , spoke out against overdiagnosis in a New York Times article . In contrast , a 2014 peer @-@ reviewed medical literature review indicated that ADHD is underdiagnosed in adults .
With widely differing rates of diagnosis across countries , states within countries , races , and ethnicities , some suspect factors other than the presence of the symptoms of ADHD are playing a role in diagnosis . Some sociologists consider ADHD to be an example of the medicalization of deviant behavior , that is , the turning of the previously non @-@ medical issue of school performance into a medical one . Most healthcare providers accept ADHD as a genuine disorder , at least in the small number of people with severe symptoms . Among healthcare providers the debate mainly centers on diagnosis and treatment in the much larger number of people with less severe symptoms .
As of 2009 , 8 % of all United States Major League Baseball players had been diagnosed with ADHD , making the disorder common among this population . The increase coincided with the League 's 2006 ban on stimulants , which has raised concern that some players are mimicking or falsifying the symptoms or history of ADHD to get around the ban on the use of stimulants in sport .
= = = Media commentary = = =
A number of public figures have given controversial statements regarding ADHD . Tom Cruise has described the medications Ritalin ( methylphenidate ) and Adderall ( a mixed @-@ salt amphetamine formulation ) as " street drugs " . <unk> S. Neill criticized this view , stating that the doses of stimulants used in the treatment of ADHD do not cause addiction and that there is some evidence of a reduced risk of later substance addiction in children treated with stimulants . In the UK , Susan Greenfield spoke out publicly in 2007 in the House of Lords about the need for a wide @-@ ranging inquiry into the dramatic increase in the diagnosis of ADHD , and possible causes . Her comments followed a BBC Panorama program that highlighted research that suggested medications are no better than other forms of therapy in the long term . In 2010 , the BBC Trust criticized the 2007 Panorama program for summarizing the research as showing " no demonstrable improvement in children 's behaviour after staying on ADHD medication for three years " when in actuality " the study found that medication did offer a significant improvement over time " although the long @-@ term benefits of medication were found to be " no better than children who were treated with behavior therapy . "
= = Special populations = =
= = = Adults = = =
It is estimated that between 2 – 5 % of adults have ADHD . Around 25 @-@ 50 % of children with ADHD continue to experience ADHD symptoms into adulthood , while the rest experiences fewer or no symptoms . Most adults remain untreated . Many have a disorganized life and use non @-@ prescribed drugs or alcohol as a coping mechanism . Other problems may include relationship and job difficulties , and an increased risk of criminal activities . Associated mental health problems include : depression , anxiety disorder , and learning disabilities .
Some ADHD symptoms in adults differ from those seen in children . While children with ADHD may climb and run about excessively , adults may experience an inability to relax , or they talk excessively in social situations . Adults with ADHD may start relationships impulsively , display sensation @-@ seeking behavior , and be short @-@ tempered . Addictive behavior such as substance abuse and gambling are common . The DSM @-@ IV criteria have been criticized for not being appropriate for adults ; those who present differently may lead to the claim that they outgrew the diagnosis .
= Chimes at Midnight =
Chimes at Midnight ( UK release : Falstaff ( Chimes at Midnight ) , Spanish release : <unk> a <unk> ) , is a 1966 English @-@ language Spanish @-@ Swiss co @-@ produced film directed by and starring Orson Welles . The film 's plot centres on William Shakespeare 's recurring character Sir John Falstaff and the father @-@ son relationship he has with Prince Hal , who must choose between loyalty to Falstaff or to his father , King Henry IV .
Welles said that the core of the film 's story was " the betrayal of friendship . " It stars Welles as Falstaff , Keith Baxter as Prince Hal , John Gielgud as Henry IV , Jeanne Moreau as Doll <unk> and Margaret Rutherford as Mistress Quickly . The script contains text from five of Shakespeare 's plays ; primarily Henry IV , Part 1 and Henry IV , Part 2 , but also Richard II , Henry V , and uses some dialogue from The Merry Wives of Windsor . Ralph Richardson 's narration is taken from the works of chronicler Raphael Holinshed .
Welles had previously produced a Broadway stage adaptation of nine Shakespeare plays called Five Kings in 1939 . In 1960 , he revived this project in Ireland as Chimes at Midnight , which was his final on @-@ stage performance . Neither of these plays was successful , but Welles considered portraying Falstaff to be his life 's ambition and turned the project into a film . Throughout its production , Welles struggled to find financing and at one point , to get money , he lied to producer Emiliano Piedra about intending to make a version of Treasure Island . Welles shot Chimes at Midnight throughout Spain between 1964 and 1965 , and premiered it at the 1966 Cannes Film Festival , where it won two awards .
Initially dismissed by most film critics , Chimes at Midnight is now regarded as one of Welles ' highest achievements , and Welles himself called it his best work . Welles felt a strong connection to the character of Falstaff and called him " Shakespeare 's greatest creation " . Some film scholars and Welles 's collaborators have made comparisons between Falstaff and Welles , while others see a resemblance between Falstaff and Welles 's father . Disputes over the ownership of Chimes at Midnight made it difficult to view the film legally until recently . It was released in the UK on DVD and Blu @-@ ray in 2015 . A new restoration by Janus Films and The Criterion Collection was screened at the Film Forum in New York January 1 – 12 , 2016 . The Criterion Collection will release the film on Blu @-@ ray and DVD on August 30 , 2016 .
= = Plot = =
The film opens with Sir John Falstaff and Justice Shallow walking through the snow , then to a warm fire inside the Boar 's Head Tavern as the two reminisce . After a main credit sequence , the narrator explains that King Henry IV of England has succeeded Richard II , whom he had killed . Richard II 's true heir , Edmund Mortimer , is a prisoner in Wales , and Mortimer 's cousins Northumberland , Worcester and Northumberland 's son Hotspur demand that Henry rescue Mortimer . Henry refuses and Northumberland , Worcester and Hotspur begin to plot his overthrow .
To Henry 's great dissatisfaction , his son Prince Hal spends most of his time at the Boar 's Head Tavern drinking and carousing with prostitutes , thieves and other criminals under John Falstaff 's patriarchal influence . Falstaff insists that he and Hal should think of themselves as gentlemen , but Hal warns Falstaff that one day he will reject both this lifestyle and Falstaff . The next morning Hal , Falstaff , Bardolph , Peto , and Poins disguise themselves in <unk> to prepare to rob a group of traveling pilgrims . After Falstaff , Bardolph and Peto rob the pilgrims , Hal and Poins jump out in disguises and take the stolen treasure from Falstaff as a joke .
Back at the Boar 's Head Tavern , Falstaff begins to tell Hal and Poins with increasing exaggeration the story of how the money was stolen from him . Hal and Poins poke holes in Falstaff 's tale until they reveal their joke to the entire group . In celebration of the newly recovered stolen treasure , Falstaff and Hal take turns impersonating Henry , with a cooking pot crown and vocal impressions . Falstaff 's Henry chastises Hal for spending his time with common criminals , but names Sir John Falstaff as his one virtuous friend . Hal 's Henry calls Falstaff a " <unk> of youth . "
Hal visits the King at the castle and Henry scolds him for his criminal and unethical lifestyle . Henry warns Hal about Hotspur 's growing army and its threat to his crown . Hal passionately vows to his unimpressed father that he will defend Henry and redeem his good name . The King 's army , including Falstaff , parades through the streets and off to war . Before the battle , Henry meets with Worcester and offers to forgive all of Hotspur 's men of treason if they surrender immediately . Hal vows to personally kill Hotspur . Worcester returns to his camp and lies to Hotspur , telling him that Henry intends to execute all traitors .
The two armies meet in the Battle of Shrewsbury , but Falstaff hides in shrubs for most of the conflict . After a long and bloody fight the King 's men win the battle , after which , Hotspur and Hal meet alone and duel . Falstaff watches as Hal kills Hotspur . Henry sentences Worcester to death and takes his men as prisoners . Falstaff brings Hotspur 's body to Henry , claiming that he killed Hotspur . Henry does not believe Falstaff but looks disapprovingly at Hal and the ignoble company that he chooses to keep .
The narrator explains that all of Henry IV 's rebellious enemies had been killed by 1408 , but that Henry 's health has begun to deteriorate . At the castle , Henry becomes upset when told that Hal is once again spending time with Falstaff , and collapses . Hal visits the castle and discovers that Henry is sicker than he had realized . Hal vows to Henry to be a good and noble king . Henry finally has faith in Hal and advises him on how to be a king . Henry dies and Hal tells his men that he is now King Henry V.
Falstaff , Shallow and Silence sit in front of a warm fire , continuing from the first scene of the film . They receive news of Henry IV 's death and that Hal 's coronation will be held that morning . Falstaff becomes ecstatic and goes directly to the castle , thinking that he will become a great and powerful nobleman under King Henry V. At the coronation , Falstaff cannot contain his excitement and interrupts the entire ceremony , announcing himself to Hal . Hal turns his back on Falstaff and proclaims that he is now finished with his former lifestyle . As Falstaff looks up at Hal with a mixture of pride and despair , the new king banishes Falstaff . The coronation continues into the castle as Falstaff walks away , stating that he will be sent for that evening . That night , Falstaff dies at the Boar 's Head Tavern and his friends mourn him , saying that he died of a broken heart . The narrator explains that Hal went on to become a good and noble king .
= = Cast = =
Orson Welles as Sir John Falstaff , a knight and father @-@ figure to Prince Hal
Keith Baxter as Prince Hal , the Prince of Wales and the heir to the throne of England
John Gielgud as King Henry IV , the King of England
Jeanne Moreau as Doll <unk> , a prostitute
Margaret Rutherford as Mistress Quickly , hostess of the Boar 's Head Tavern
Norman <unk> as Henry Percy , called Hotspur , Northumberland 's son and second cousin of Edmund Mortimer
Fernando Rey as Earl of Worcester , Leader of the Rebels . Northumberland 's brother and cousin of Edmund Mortimer
Marina Vlady as Kate Percy , Hotspur 's wife
Alan Webb as Justice Shallow , a country justice and old friend of Falstaff
Walter Chiari as Justice Silence , a country justice
Michael Aldridge as Pistol , a friend of Falstaff
Tony Beckley as Ned Poins , a friend of Falstaff and Hal
Andrew Faulds as Earl of Westmorland , an Earl loyal to the King
José Nieto as Earl of Northumberland , an Earl rebellious of the King and cousin of Edmund Mortimer
Jeremy Rowe as Prince John , Henry IV 's second son
Beatrice Welles as Falstaff 's Page , a servant
Patrick Bedford as Bardolph , a friend of Falstaff and Hal
Charles Farrell
Fernando <unk>
Andrés <unk>
Julio Peña
Keith Pyott
Ralph Richardson as The Narrator ( voice )
= = Original stage productions = =
Welles 's inspiration for Chimes at Midnight began in 1930 when he was a student at the Todd School for Boys in Woodstock , Illinois . Welles tried to stage a three @-@ and @-@ a @-@ half @-@ hour combination of several of Shakespeare 's historical plays called The Winter of Our Discontent in which he played Richard III . School officials forced him to make cuts to the production . Chimes at Midnight originated in 1939 as a stage play called Five Kings , which Welles wrote and partially staged . It was an ambitious adaptation of several Shakespeare plays that chronicled the stories of Richard II , Henry IV , Henry V , Henry VI and Richard III . Its sources were Richard II , Henry IV , Part 1 , Henry IV , Part 2 , Henry V , The Merry Wives of Windsor , Henry VI , Part 1 , Henry VI , Part 2 , Henry VI , Part 3 and Richard III — sometimes collectively called the " War of the Roses cycle " . The grouping of Henry IV , Part 1 , Henry IV , Part 2 and Henry V are often referred to as the <unk> .
= = = Five Kings ( 1939 ) = = =
Five Kings was announced as part of the newly revived Mercury Theatre 's second season in 1938 . John Houseman had secured a partnership with the prestigious Theatre Guild to produce the play for US $ 40 @,@ 000 , with an initial tour of Baltimore , Boston , Washington D.C. and Philadelphia before debuting on Broadway . Welles 's intended to stage only the first part of the play — which was primarily taken from Henry IV Parts 1 and 2 and Henry V — during the tour while simultaneously rehearsing Part Two and finally debuting the full production on Broadway . Houseman stated that the play 's aim was " to combine the immediate quality of the Elizabethan with all the devices and techniques possible in the modern theatre . " The cast included Welles as Falstaff , Burgess Meredith as Prince Hal , John Emery as Hotspur , Morris <unk> as Henry IV and Robert <unk> as the Narrator . The play 's music was composed by Aaron Copland . Welles commissioned an elaborate revolving set to be built , but it was not completed during the five weeks allotted to rehearsals .
Welles avoided attending the rehearsals or finishing the play 's final script and instead often went out drinking and socializing with co @-@ star Meredith , with the result that only specific scenes or fragments of the play were ever rehearsed . The Baltimore performance was eventually dropped and at the first dress rehearsal in Boston , it was discovered that the play was over five and a half hours long and contained 46 scenes . Welles cut 14 scenes and shortened others , which caused the built @-@ in timer for the revolving set to move out of synchronization . Five Kings , Part 1 premiered at the Colonial Theatre in Boston on February 27 , 1939 , and was a disaster . Critics were either scathing or apologetic , and only the play 's battle scenes received praise . By the end of the Boston run , the Theatre Guild was on the verge of dropping the production , and canceled the D.C. engagement . Welles then edited the show to three and a half hours . The play closed after only a few performances in Philadelphia , and the Theatre Guild terminated its contract with the Mercury Theater . Photographs of the play 's rehearsals show similarities to Chimes at Midnight , including the Boar 's Head Tavern set and the character blocking of the " chimes at midnight " scene with Falstaff , Shallow and Silence .
= = = Chimes at Midnight ( 1960 ) = = =
Welles returned to the project in 1960 , with performances in Belfast and Dublin . This version , now retitled Chimes at Midnight , was produced by Welles 's old friend Hilton Edwards through his Dublin @-@ based company Gate Theatre . The cast included Welles as Falstaff , Keith Baxter as Prince Hal , Hilton Edwards as the Narrator , Reginald Jarman as Henry IV and Alexis Kanner as Hotspur . At one point , Welles and Edwards wanted Micheál Mac <unk> to replace Jarman as Henry IV , but Mac <unk> would only accept the role of Prince Hal . Hilton Edwards was officially credited as director , but Welles is usually acknowledged as the actual director and was often the director throughout rehearsals . Welles 's alleged biological son Michael Lindsay @-@ Hogg also worked on the play as an actor and as Edwards 's personal assistant . Welles 's opinion of Falstaff had intensified since first playing the part , and his new version of the play focused more upon the relationship between Falstaff and Prince Hal than on the historical story of Hal 's defeat of Hotspur . Most of the scenes from Henry V used in the first version before were removed . Welles intended to perform the play in Belfast , Dublin and London before filming it in Yugoslavia .
Rehearsals began in Russell Square , London , with a read through . After a week of rehearsing , Welles left to secure further funding and Edwards directed the play , working on blocking and lighting . Welles returned two days before the premiere and the cast had their first dress rehearsal , which lasted until 3 a.m. After premiering at the Grand Opera House in Belfast on February 13 , 1960 , and receiving a good review from a Variety correspondent , the play closed after five performances because of low attendances . It moved to the Gaiety Theatre in Dublin , where it fared no better . By the end of the second week , Welles had resorted to reading portions of the works of Irish author J. M. Synge , and from Riders to the Sea , to attract an audience . Eventually the play simply became a version of An Evening with Orson Welles , which would often include a question and answer section with the audience and Welles 's solo performance of Moby Dick — <unk> or the works of Isak Dinesen .
Welles continued to adjust the play throughout its short production , and at one point moved Mistress Quickly 's speech about Falstaff 's death to the very beginning of the play . Welles finally abandoned the entire project in late March 1960 , when his friend Laurence Olivier offered him the chance to direct him in Eugène Ionesco 's play Rhinoceros on London 's West End . According to Keith Baxter , Welles ended the play 's run because he was bored with it , and at one point told Baxter " This is only a rehearsal for the movie , Keith , and I 'll never make it unless you play Hal in that too . " Five years later , Baxter was the only cast member from the play to appear in the film . Chimes at Midnight was Welles 's final performance in a theatrical play .
= = Production = =