Attention deficit hyperactivity disorder in adults: what the non-specialist needs to know

2020 ◽  
Vol 81 (3) ◽  
pp. 1-11
Author(s):  
Joe Johnson ◽  
Sarah Morris ◽  
Sanju George
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Pharmacological Treatment ◽  
Neurodevelopmental Disorder ◽  
Significant Proportion ◽  
Pharmacological Intervention ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Psychiatric Conditions ◽  
Core Features

Attention deficit hyperactivity disorder is a persistent, pervasive neurodevelopmental disorder, characterised by the core features of hyperactivity, impulsivity and inattention. While previously thought to be a condition that only affects children, it is now well recognised that in a significant proportion of cases both symptoms and associated impairment will persist into adulthood. Nevertheless, many cases are missed or misdiagnosed because of the lack of awareness of attention deficit hyperactivity disorder as a potential diagnosis in adults, the number of symptoms that overlap with other psychiatric conditions, and the high rates of comorbidity. However, once correctly diagnosed, attention deficit hyperactivity disorder responds well to treatment, particularly pharmacological intervention. This article gives an overview of attention deficit hyperactivity disorder with special emphasis on the diagnosis and pharmacological treatment of attention deficit hyperactivity disorder in adults.

scholarly journals Clinical effects of nonpharmacological treatment of ADHD

2021 ◽  
Author(s):  
Matheus Almeida Ribeiro da Cunha ◽  
João Gustavo dos Anjos Morais Oliveira ◽  
Gabriela Sarno Brandão ◽  
Ana Flávia Paiva Bandeira Assis ◽  
Leonardo Mattos Santos ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Pharmacological Treatment ◽  
Methodological Quality ◽  
Pharmacological Therapy ◽  
Pharmacological Intervention ◽  
Clinical Effects ◽  
Nonpharmacological Treatment ◽  
Hyperactivity Disorder ◽  
School Of Medicine

Background: Though pharmacotherapy of Attention Deficit Hyperactivity Disorder (ADHD) is widespread, some patients suffer with side effects or do not improve with it. Objectives: Evaluate clinical outcomes of non-pharmacological therapy on ADHD. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health. Methods: Articles published between 2011 and 2021 were taken from PubMed, using the following search: (“Non-pharmacological treatment” OR “Non- pharmacological therapy” OR “Non-pharmacological intervention” OR “Non-drug treatment” OR “Non-drug therapy” OR “Adjuvant treatment” OR “Adjuvant therapy”) AND (“ADHD” OR “Attention Deficit-Hyperactivity Disorder”). Studies that did not match this review’s objectives were excluded. Results: 20 of the 57 articles found, were selected. Reviews that approach treatment in general indicate non-pharmacological therapy specially when there are obstacles to use of drugs, but highlight the lack of studies with methodological quality in this field. Clinical studies indicate reduction of symptoms through neurofeedback, transcranial magnetic stimulation, and aerobic exercises. One of the interventions with the most articles was nutritional supplementation, though most of them did not find significant improvement. Conclusions: Non-pharmacological treatment of ADHD is a relevant alternative, especially when there is no response to medication, but studies with better methodological quality are necessary.

scholarly journals Pharmacological treatment for attention deficit hyperactivity disorder in adults

2021 ◽  
Vol 64 (1) ◽  
pp. 49-56
Author(s):  
Kukju Kweon
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Self Report ◽  
Hyperactivity Disorder ◽  
The Core ◽  
Symptom Patterns ◽  
Long Acting ◽  
Core Symptoms

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by attention deficits, hyperactivity, and impulsivity. In the past, ADHD was considered to be limited to children and adolescents. However, ADHD has now been reconceptualized as a lifelong disorder, and two-thirds of ADHD patients continue to have core symptoms and dysfunction in adulthood. Currently, the public and clinicians’ interest in adult ADHD is rapidly increasing in Korea. In addition to interviews with patients for an adult ADHD diagnosis, interviews with family members, existing school records, and neuropsychological tests help clinicians to make a diagnosis. It is necessary to check whether the core symptoms of ADHD were expressed in childhood. Since adults’ symptom patterns differ from those of children, a self-report tool designed for adult ADHD is useful. The medications currently approved for ADHD in adults by the Ministry of Food and Drug Safety of Korea are long-acting methylphenidate and atomoxetine. Both methylphenidate and atomoxetine improve the core symptoms of ADHD as well as daily function. Methylphenidate and atomoxetine can be used safely as first-line treatments, and the overall adverse effects are tolerable. However, attention should be paid to possible cardiovascular adverse events and misuse. Bupropion, modafinil, alpha2-agonist, and tricyclic antidepressants can also be used off-label.

scholarly journals A Cross-Sectional Study of 0.6 Million Children with Attention-Deficit/Hyperactivity Disorder in the United States

2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki
Keyword(s):  
United States ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Family Income ◽  
Neurodevelopmental Disorder ◽  
Multiple Logistic Regression Analysis ◽  
The United States ◽  
Cross Sectional ◽  
Children With Adhd ◽  
Hyperactivity Disorder

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.

scholarly journals SLEEP: intervention with weighted blankets for children with attention deficit hyperactivity disorder (ADHD) and sleep problems: study protocol for a randomised control trial

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e047509
Author(s):  
Ingrid Larsson ◽  
Katarina Aili ◽  
Jens M Nygren ◽  
Pia Johansson ◽  
Håkan Jarbin ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Peer Review ◽  
Attention Deficit ◽  
Sleep Problems ◽  
Randomised Control Trial ◽  
Pharmacological Intervention ◽  
Hyperactivity Disorder ◽  
Life Years ◽  
Increased Risk ◽  
Health Related

Introduction and objectivesChildren with attention deficit hyperactivity disorder (ADHD) have an increased risk of sleep problems. Weighted blankets are one possible non-pharmacological intervention for these problems in this group of children. However, the effectiveness of weighted blankets is insufficiently investigated. This study aims to investigate the effectiveness of weighted blankets in terms of sleep, health-related outcomes and cost-effectiveness as well as to explore children’s and parents’ experiences of a sleep intervention with weighted blankets.Methods and analysisThis study is a randomised placebo-controlled crossover trial comparing the effect of weighted fibre blankets (active) with fibre blankets without weight (control). Children aged 6–13 years, recently diagnosed with uncomplicated ADHD with verified sleep problems, were included in the study. The study period is 4 weeks for each condition, respectively, and then an 8-week follow-up. A total of 100 children diagnosed with ADHD and sleep problems will enter the study. The primary outcomes are sleep and cost per quality-adjusted life years. The secondary outcomes are health-related quality of life, ADHD symptoms, psychological distress and anxiety. Interviews with a subsample of the participating children and parents will be conducted for exploring the experiences of the intervention.Ethics and disseminationEthical approval of the trial has been obtained from the Swedish Ethical Review Authority (number 2019–-2158) and conforms to the principles outlined in the Declaration of Helsinki (WMA, 2013). Results will be reported as presentations at peer-review conferences, in articles in peer-review journals and meetings with healthcare providers.Trial registration numberNCT04180189.

scholarly journals Shared genetic background between children and adults with attention deficit/hyperactivity disorder

2019 ◽  
Author(s):  
Paula Rovira ◽  
Ditte Demontis ◽  
Cristina Sánchez-Mora ◽  
Tetyana Zayats ◽  
Marieke Klein ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Genetic Variants ◽  
Genetic Background ◽  
Genetic Architecture ◽  
Neurodevelopmental Disorder ◽  
Genome Wide Association Studies ◽  
Hyperactivity Disorder ◽  
Common Genetic Variants ◽  
Shared Genetic

AbstractAttention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by age-inappropriate symptoms of inattention, impulsivity and hyperactivity that persist into adulthood in the majority of the diagnosed children. Despite several risk factors during childhood predicting the persistence of ADHD symptoms into adulthood, the genetic architecture underlying the trajectory of ADHD over time is still unclear. We set out to study the contribution of common genetic variants to the risk for ADHD across the lifespan by conducting meta-analyses of genome-wide association studies on persistent ADHD in adults and ADHD in childhood separately and comparing the genetic background between them in a total sample of 17,149 cases and 32,411 controls. Our results show nine new independent loci and support a shared contribution of common genetic variants to ADHD in children and adults. No subgroup heterogeneity was observed among children, while this group consists of future remitting and persistent individuals. We report similar patterns of genetic correlation of ADHD with other ADHD-related datasets and different traits and disorders among adults, children and when combining both groups. These findings confirm that persistent ADHD in adults is a neurodevelopmental disorder and extend the existing hypothesis of a shared genetic architecture underlying ADHD and different traits to a lifespan perspective.

scholarly journals Attention-deficit/hyperactivity disorder and risk for psychiatric and neurodevelopmental disorders in siblings

2018 ◽  
Vol 49 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Elina Jokiranta-Olkoniemi ◽  
Keely Cheslack-Postava ◽  
Petteri Joelsson ◽  
Auli Suominen ◽  
Alan S. Brown ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Neurodevelopmental Disorder ◽  
Population Based ◽  
Autism Spectrum ◽  
Schizophrenia Spectrum Disorders ◽  
Hyperactivity Disorder ◽  
Increased Risk ◽  
Spectrum Disorders

AbstractBackgroundProbands with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for several psychiatric and neurodevelopmental disorders. The risk of these disorders among the siblings of probands has not been thoroughly assessed in a population-based cohort.MethodsEvery child born in Finland in 1991–2005 and diagnosed with ADHD in 1995–2011 were identified from national registers. Each case was matched with four controls on sex, place, and date of birth. The full siblings of the cases and controls were born in 1981–2007 and diagnosed in 1981–2013. In total, 7369 cases with 12 565 siblings and 23 181 controls with 42 753 siblings were included in the analyses conducted using generalized estimating equations.Results44.2% of the cases and 22.2% of the controls had at least one sibling diagnosed with any psychiatric or neurodevelopmental disorder (risk ratio, RR = 2.1; 95% CI 2.0–2.2). The strongest associations were demonstrated for childhood-onset disorders including ADHD (RR = 5.7; 95% CI 5.1–6.3), conduct and oppositional disorders (RR = 4.0; 95% CI 3.5–4.5), autism spectrum disorders (RR = 3.9; 95% CI 3.3–4.6), other emotional and social interaction disorders (RR = 2.7; 95% CI 2.4–3.1), learning and coordination disorders (RR = 2.6; 95% CI 2.4–2.8), and intellectual disability (RR = 2.4; 95% CI 2.0–2.8). Also, bipolar disorder, unipolar mood disorders, schizophrenia spectrum disorders, other neurotic and personality disorders, substance abuse disorders, and anxiety disorders occurred at increased frequency among the siblings of cases.ConclusionsThe results offer potential utility for early identification of neurodevelopmental and psychiatric disorders in at-risk siblings of ADHD probands and also argue for more studies on common etiologies.

Pre-, Peri-, and Post-Natal Risk Factors in ADHD

2021 ◽  
pp. 43-54
Author(s):  
Pangajam Ponnuswamy ◽  
Ann Sarah Paul ◽  
Aneesha Brigitte Jose
Keyword(s):  
Risk Factors ◽  
Attention Deficit Hyperactivity Disorder ◽  
Postnatal Development ◽  
Environmental Risk ◽  
Attention Deficit ◽  
Critical Period ◽  
Neurodevelopmental Disorder ◽  
Therapeutic Interventions ◽  
Hyperactivity Disorder ◽  
Core Symptoms

Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder most commonly found in childhood with its core symptoms manifesting as inattention, impulsiveness, and hyperactivity. As ADHD generates a substantial rate of burden to the society in terms of economic and medical resources used, priority is given to explore the risk factors that contributes towards the multifactorial origin of this disorder to offer possible preventive and therapeutic interventions. With heritability accounting for 75% to 80% of the variability seen in ADHD, the remaining are explained through environmental risk factors that are exposed during critical period of pre-, peri-, and postnatal development. Though literature on the risk factors have been mostly controversial, certain associations have been made with regards to ADHD pathophysiology.

scholarly journals A hybrid AI approach for supporting clinical diagnosis of attention deficit hyperactivity disorder (ADHD) in adults

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Ilias Tachmazidis ◽  
Tianhua Chen ◽  
Marios Adamou ◽  
Grigoris Antoniou
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Health Systems ◽  
Clinical Diagnosis ◽  
Attention Deficit ◽  
Neurodevelopmental Disorder ◽  
Hybrid Approach ◽  
Public Health Issue ◽  
Hyperactivity Disorder ◽  
The Past ◽  
Increased Risk

AbstractAttention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness. It is considered as an important public health issue and prevalence of, as well as demand for diagnosis, has increased as awareness of the disease grew over the past years. Supply of specialist medical experts has not kept pace with the increasing demand for assessment, both due to financial pressures on health systems and the difficulty to train new experts, resulting in growing waiting lists. Patients are not being treated quickly enough causing problems in other areas of health systems (e.g. increased GP visits, increased risk of self-harm and accidents) and more broadly (e.g. time off work, relationship problems). Advances in AI make it possible to support the clinical diagnosis of ADHD based on the analysis of relevant data. This paper reports on findings related to the mental health services of a specialist Trust within the UK’s National Health Service (NHS). The analysis studied data of adult patients who underwent diagnosis over the past few years, and developed a hybrid approach, consisting of two different models: a machine learning model obtained by training on data of past cases; and a knowledge model capturing the expertise of medical experts through knowledge engineering. The resulting algorithm has an accuracy of 95% on data currently available, and is currently being tested in a clinical environment.

scholarly journals Attention-deficit hyperactivity disorder shares copy number variant risk with schizophrenia and autism spectrum disorder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Olafur O. Gudmundsson ◽  
G. Bragi Walters ◽  
Andres Ingason ◽  
Stefan Johansson ◽  
Tetyana Zayats ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Copy Number ◽  
Neurodevelopmental Disorder ◽  
Copy Number Variant ◽  
Pleiotropic Effect ◽  
Autism Spectrum ◽  
Copy Number Variations ◽  
Hyperactivity Disorder

Abstract Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable common childhood-onset neurodevelopmental disorder. Some rare copy number variations (CNVs) affect multiple neurodevelopmental disorders such as intellectual disability, autism spectrum disorders (ASD), schizophrenia and ADHD. The aim of this study is to determine to what extent ADHD shares high risk CNV alleles with schizophrenia and ASD. We compiled 19 neuropsychiatric CNVs and test 14, with sufficient power, for association with ADHD in Icelandic and Norwegian samples. Eight associate with ADHD; deletions at 2p16.3 (NRXN1), 15q11.2, 15q13.3 (BP4 & BP4.5–BP5) and 22q11.21, and duplications at 1q21.1 distal, 16p11.2 proximal, 16p13.11 and 22q11.21. Six of the CNVs have not been associated with ADHD before. As a group, the 19 CNVs associate with ADHD (OR = 2.43, P = 1.6 × 10−21), even when comorbid ASD and schizophrenia are excluded from the sample. These results highlight the pleiotropic effect of the neuropsychiatric CNVs and add evidence for ADHD, ASD and schizophrenia being related neurodevelopmental disorders rather than distinct entities.

scholarly journals Pharmacological Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Clinical Strategies

2012 ◽  
Vol 5 ◽  
pp. JCNSD.S6691 ◽  
Author(s):  
Anna C. Shier ◽  
Thomas Reichenbacher ◽  
Harinder S. Ghuman ◽  
Jaswinder K. Ghuman
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Pharmacological Treatment ◽  
First Line ◽  
Pharmacological Agents ◽  
Ample Evidence ◽  
Hyperactivity Disorder ◽  
Impaired Quality

Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood that can result in significant functional impairment, and if not adequately treated can lead to impaired quality of life. Pharmacotherapy is considered the first-line treatment for ADHD in children and adolescents. We review both recent literature and seminal studies regarding the pharmacological treatment of ADHD in children and adolescents. There is ample evidence for the efficacy and safety of both stimulants and non-stimulants in the treatment of ADHD. We review important aspects of evaluation and assessment and discuss first-line pharmacological treatments and as well as when to consider using alternative pharmacological agents. Treatment approaches to manage frequently seen comorbid disorders with ADHD are also covered.

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