scholarly journals Adult attention-deficit hyperactivity disorder: A database analysis of South African private health insurance

2017 ◽  
Vol 23 ◽  
Author(s):  
Renata Schoeman ◽  
Manie De Klerk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Health Insurance ◽  
Attention Deficit ◽  
Private Health Insurance ◽  
Adult Adhd ◽  
Cost Effective ◽  
Database Analysis ◽  
Access To Treatment ◽  
Hyperactivity Disorder ◽  
Funding Model

Background: Adult attention-deficit hyperactivity disorder (ADHD) is a chronic, costly and debilitating disorder. In South Africa (SA), access to funding for care and treatment of ADHD is limited, and research is lacking.Aim: This study aimed to establish the current situation with regard to the psychiatric management of and funding for treatment of adult ADHD in the private sector in SA.Methods: A diagnostically refined retrospective claims database analysis was conducted. We examined the prevalence, costs and funding profile of claims over a 2-year period for adult beneficiaries with possible ADHD of a large medical administrator in SA.Results: The prevalence of adult ADHD was lower than published international rates. The presence of adult ADHD increased the prevalence of comorbidity and doubled the health care costs of beneficiaries. Contrary to public belief, comorbidities (including their medicine costs) rather than psychiatric services or medicines were the main cost drivers.Conclusion: The current private health insurance funding model for ADHD limits access to funding. This affects early diagnosis and optimal treatment, thereby escalating long-term costs. Improved outcomes are possible if patients suffering from ADHD receive timely and accurate diagnosis, and receive chronic and comprehensive care. Balanced regulation is proposed to minimise the risk to both medical schemes and patients. A collaborative approach between stakeholders is needed to develop an alternative cost-effective funding model to improve access to treatment and quality of life for adults with ADHD in SA.

scholarly journals Adult attention-deficit hyperactivity disorder: A database analysis of South African private health insurance

2017 ◽  
Vol 23 (1) ◽  
pp. 6 ◽  
Author(s):  
Renata Schoeman ◽  
Manie De Klerk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Health Insurance ◽  
Attention Deficit ◽  
Private Health Insurance ◽  
Adult Adhd ◽  
Cost Effective ◽  
Database Analysis ◽  
Access To Treatment ◽  
Hyperactivity Disorder ◽  
Funding Model

<p><strong>Background:</strong> Adult attention-deficit hyperactivity disorder (ADHD) is a chronic, costly and debilitating disorder. In South Africa (SA), access to funding for care and treatment of ADHD is limited, and research is lacking.</p><p><strong>Aim:</strong> This study aimed to establish the current situation with regard to the psychiatric management of and funding for treatment of adult ADHD in the private sector in SA.</p><p><strong>Methods:</strong> A diagnostically refined retrospective claims database analysis was conducted. We examined the prevalence, costs and funding profile of claims over a 2-year period for adult beneficiaries with possible ADHD of a large medical administrator in SA.</p><p><strong>Results:</strong> The prevalence of adult ADHD was lower than published international rates. The presence of adult ADHD increased the prevalence of comorbidity and doubled the health care costs of beneficiaries. Contrary to public belief, comorbidities (including their medicine costs) rather than psychiatric services or medicines were the main cost drivers.</p><p><strong>Conclusion:</strong> The current private health insurance funding model for ADHD limits access to funding. This affects early diagnosis and optimal treatment, thereby escalating long-term costs. Improved outcomes are possible if patients suffering from ADHD receive timely and accurate diagnosis, and receive chronic and comprehensive care. Balanced regulation is proposed to minimise the risk to both medical schemes and patients. A collaborative approach between stakeholders is needed to develop an alternative cost-effective funding model to improve access to treatment and quality of life for adults with ADHD in SA.</p>

scholarly journals The Adult ADHD Self-Report Scale: utility and reliability in college students with attention deficit hyperactivity disorder

2013 ◽  
Author(s):  
Sarah Gray ◽  
Steven Woltering ◽  
Karizma Mawjee ◽  
Rosemary Tannock
Keyword(s):  
College Students ◽  
Attention Deficit Hyperactivity Disorder ◽  
Secondary Education ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Cost Effective ◽  
Self Report ◽  
Post Secondary Education ◽  
Post Secondary ◽  
Hyperactivity Disorder

Background. Attention Deficit Hyperactivity Disorder is a debilitating condition that often persists into adulthood. The past number of decades an increased number of adults with ADHD have gained entrance into the post-secondary education section and register with college or university Disability Service Offices. There is a need to explore utility of affordable materials to gain confidence in validating the original diagnoses and potentially detect feigning. Methods. 135 college students (mean age = 24, 42% males) with ADHD were recruited from post-secondary institutions. The freely available Adult ADHD Self-Report Scale (ASRS) self-report was utilized to assess current ADHD symptomatology. The ASRS was compared to an interview (over the phone) and other-report version (filled out by a significant other) that were directly derived from the original Self-report. Results. Results showed moderate levels of congruency between ASRS-Self and Other Report (correlation = .47). Furthermore, a robust relationship was shown between the ASRS-Self and the interview version (correlation = .66). Discussion. Current findings suggest the telephone-interview version of the ASRS may be an easy-to-use, reliable, and cost-effective supplement in gaining more confidence in determining ADHD in post-secondary education students. More research is required specifically testing its merits to detect feigning or support in diagnosis.

scholarly journals Adult attention-deficit hyperactivity disorder: Why should we pay attention?

2017 ◽  
Vol 23 ◽  
Author(s):  
Renata Schoeman ◽  
Ruth Albertyn ◽  
Manie De Klerk
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Health Care Professionals ◽  
Adult Adhd ◽  
Qualitative Content Analysis ◽  
Neurodevelopmental Disorder ◽  
Diagnosis And Treatment ◽  
Structured Interviews ◽  
Access To Treatment ◽  
Hyperactivity Disorder

Background: Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with a chronic, costly and debilitating course if untreated. Limited access to diagnosis and treatment for adults with ADHD contributes to the cost of the disorder and the burden of disease.Aim: This study aims to identify the barriers to care for adults with ADHD.Methods: A qualitative analysis of semi-structured interviews with 10 key opinion leaders in the field of adult ADHD in SA was conducted to obtain narratives regarding frustrations experienced when treating adults with ADHD and needs of patients regarding management of ADHD. Qualitative content analysis was completed using Atlas.ti (version 7).Results: Four key themes which emerged from the interviews were ‘lack of recognition of the disorder’, ‘lack of access to diagnosis’, ‘lack of access to treatment’ and ‘a life of perpetual failure’. Core to these themes are the lack of knowledge amongst health care professionals, funders, and society at large.Conclusion: Our findings expand on previous research regarding the need to increase the knowledge base on adult ADHD. A collaborative stakeholder approach is needed to provide research and training for improved diagnosis and treatment for adults with ADHD in the South African context.

scholarly journals The Adult ADHD Self-Report Scale: utility and reliability in college students with attention deficit hyperactivity disorder

2013 ◽  
Author(s):  
Sarah Gray ◽  
Steven Woltering ◽  
Karizma Mawjee ◽  
Rosemary Tannock
Keyword(s):  
College Students ◽  
Attention Deficit Hyperactivity Disorder ◽  
Secondary Education ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Cost Effective ◽  
Self Report ◽  
Post Secondary Education ◽  
Post Secondary ◽  
Hyperactivity Disorder

Background. Attention Deficit Hyperactivity Disorder is a debilitating condition that often persists into adulthood. The past number of decades an increased number of adults with ADHD have gained entrance into the post-secondary education section and register with college or university Disability Service Offices. There is a need to explore utility of affordable materials to gain confidence in validating the original diagnoses and potentially detect feigning. Methods. 135 college students (mean age = 24, 42% males) with ADHD were recruited from post-secondary institutions. The freely available Adult ADHD Self-Report Scale (ASRS) self-report was utilized to assess current ADHD symptomatology. The ASRS was compared to an interview (over the phone) and other-report version (filled out by a significant other) that were directly derived from the original Self-report. Results. Results showed moderate levels of congruency between ASRS-Self and Other Report (correlation = .47). Furthermore, a robust relationship was shown between the ASRS-Self and the interview version (correlation = .66). Discussion. Current findings suggest the telephone-interview version of the ASRS may be an easy-to-use, reliable, and cost-effective supplement in gaining more confidence in determining ADHD in post-secondary education students. More research is required specifically testing its merits to detect feigning or support in diagnosis.

Epidemiology, Impairments, and Differential Diagnosis in Adult ADHD: Introduction

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S12) ◽  
pp. 4-5 ◽  
Author(s):  
Lenard A. Adler
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Differential Diagnosis ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Hyperactivity Disorder ◽  
Childhood Disorder

In the mid-1970s, attention-deficit/hyperactivity disorder (ADHD) was still believed to be a childhood disorder that disappeared with the onset of adolescence. At this time, Wender studied a cohort of adults presenting with ADHD-like symptoms, all of whom had been diagnosed with ADHD in childhood. Wender prescribed psycho-stimulants, which successfully produced a response in the adults, thus fostering research into adult ADHD.

Medical Mimics and Differential Diagnosis in Adult ADHD

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S15) ◽  
pp. 14-16 ◽  
Author(s):  
Mark A. Stein
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Differential Diagnosis ◽  
Adult Patient ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Diagnostic Evaluation ◽  
Response To Treatment ◽  
Hyperactivity Disorder ◽  
Rule Out

When performing a diagnostic evaluation for an adult patient with possible adult attention-deficit/hyperactivity disorder (ADHD), clinicians must pay particular attention to possible mimics. ADHD mimics are conditions responsible for the symptoms or impairments that superficially resemble, and may be confused with ADHD. These mimics may produce symptoms and impairments similar to those seen in adults with ADHD, but differ in etiology, course, or response to treatment of ADHD. When evaluating someone for ADHD, clinicians should first rule out the possibility of medical, psychiatric, and social mimics of ADHD.

Pharmacotherapy of ADHD in Adults

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S8) ◽  
pp. 11-13 ◽  
Author(s):  
Timothy E. Wilens
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Therapeutic Options ◽  
Major Depressive ◽  
Children With Adhd ◽  
Hyperactivity Disorder

There is a complex overlap between major depressive disorder (MDD) and attention-deficit/hyperactivity disorder (ADHD). The different therapeutic options for adult ADHD mirror those used for children with ADHD. Both stimulant and nonstimulant medications are used to treat the disorder.

scholarly journals Shared alterations in resting-state brain connectivity in adults with attention-deficit/hyperactivity disorder and their unaffected first-degree relatives

2019 ◽  
pp. 1-11
Author(s):  
Valentino Antonio Pironti ◽  
Deniz Vatansever ◽  
Barbara Jacquelyn Sahakian
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Resting State ◽  
Adult Adhd ◽  
External Validation ◽  
Negative Consequences ◽  
Default Mode ◽  
Hyperactivity Disorder ◽  
First Degree Relatives ◽  
Human Connectome Project

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that often persists into adulthood with extensive negative consequences on quality of life. Despite emerging evidence indicating the genetic basis of ADHD, investigations into the familial expression of latent neurocognitive traits remain limited. Methods In a group of adult ADHD probands (n = 20), their unaffected first-degree relatives (n = 20) and typically developing control participants (n = 20), we assessed endophenotypic alterations in the default mode network (DMN) connectivity during resting-state functional magnetic resonance imaging in relation to cognitive performance and clinical symptoms. In an external validation step, we also examined the dimensional nature of this neurocognitive trait in a sample of unrelated healthy young adults (n = 100) from the Human Connectome Project (HCP). Results The results illustrated reduced anti-correlations between the posterior cingulate cortex/precuneus and right middle frontal gyrus that was shared between adult ADHD probands and their first-degree relatives, but not with healthy controls. The observed connectivity alterations were linked to higher ADHD symptoms that was mediated by performance in a sustained attention task. Moreover, this brain-based neurocognitive trait dimensionally explained ADHD symptom variability in the HCP sample. Conclusions Alterations in the default mode connectivity may represent a dimensional endophenotype of ADHD, hence a significant aspect of the neuropathophysiology of this disorder. As such, brain network organisation can potentially be employed as an important neurocognitive trait to enhance statistical power of genetic studies in ADHD and as a surrogate efficacy endpoint in the development of novel pharmaceuticals.

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