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.

Differentiating 'attachment difficulties' from autism spectrum disorders and attention deficit hyperactivity disorder: Qualitative interviews with experienced health care professionals

2021 ◽  
Author(s):  
Barry Coughlan ◽  
Marinus H. van IJzendoorn ◽  
Matt Woolgar ◽  
Emma Weisblatt ◽  
Robbie Duschinsky
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Health Care Professionals ◽  
Qualitative Interviews ◽  
Autism Spectrum ◽  
Structured Interviews ◽  
Hyperactivity Disorder ◽  
The United Kingdom ◽  
Attachment Difficulties ◽  
Foundation Trusts

Objectives: Attachment difficulties is an umbrella term often used to describe various forms of non-secure attachment. Differentiating ‘attachment difficulties’ from autism spectrum disorder (hereafter autism) and attention deficit hyperactivity disorder (hereafter ADHD) has been characterised as challenging. Few studies have explored how this happens in practice, from the perspective of the professionals. Design: Qualitative study. Method: We conducted in-depth semi-structured interviews with (n=17) healthcare professionals from five NHS Foundation Trusts in the United Kingdom. Participants were recruited using a combination of snowballing, convenience and purposive sampling. Data were analysed using a thematic approach. Results: We identified six interrelated themes that might reflect difficulties with differential conceptualisation. These include: a clinical lexicon of attachment; approaching attachment with caution; contextual factors; perceived characteristic behaviours; assessing attachment and adjacent supports; spotlighting intervention and dual conceptualisation. Conclusion: Our results indicate some of the ways suspicions around attachment are raised in practice. We advocate for more dialogue between research and practice communities on issues of differential conceptualisation. We call for collaboration between a panel of experts consisting of attachment and neurodevelopmental orientated practitioners and researchers, to clarify issues around differentiating between attachment difficulties, ASD and ADHD.

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.

Treating adult ADHD and comorbid substance-related disorders

2016 ◽  
Vol 33 (S1) ◽  
pp. S54-S54
Author(s):  
J.A. Ramos-Quiroga
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Stimulant Medication ◽  
Behavioral Therapy ◽  
Neurodevelopmental Disorder ◽  
Hyperactivity Disorder ◽  
Competing Interest

Attention-deficit/hyperactivity disorder (ADHD) is a complex, and multifactorial and chronic neurodevelopmental disorder. Comorbid psychiatric disorders are highly prevalent in individuals with a diagnosis of ADHD. There is a solid overlap between ADHD and substance use disorders (SUD). Prevalence of SUD is high among patients with ADHD, so that SUD are approximately double as common among individuals with ADHD than in general population, and individuals with SUD have much higher rates than expected of a comorbid ADHD. Studies shown that treatment during childhood of attention-deficit/hyperactivity disorder with stimulant medication neither protects nor increases the risk of later substance use disorders. Nevertheless, recent studies found that patients with ADHD and SUD can reduce ADHD symptoms and SUD with stimulants and cognitive-behavioral therapy. Treatment of ADHD in patients with SUD requires a comprehensive diagnostic assessment. It is recommendable to stabilize the addiction prior to treating the ADHD. In this talk, the recent literature for the treatment of adults with co-occurring ADHD and SUD will be reviewed.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Treatment of adult ADHD: a clinical perspective

2017 ◽  
Vol 8 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Josh Geffen ◽  
Kieran Forster
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Diagnosis And Treatment ◽  
Clinical Perspective ◽  
Negative Outcomes ◽  
Psychotherapeutic Intervention ◽  
Hyperactivity Disorder ◽  
Vulnerable Patients ◽  
Treatment Responsiveness

Adult attention deficit/hyperactivity disorder (ADHD) has moved from the blurred edge of clinical focus to clear recognition as a prevalent and significant disorder in its own right. It is a relatively common comorbidity which if identified and treated may open the door to better outcomes for hard-to-treat patients. Conversely, failure to identify and treat adult ADHD is linked to negative outcomes. The recognition of the importance of adult ADHD in a subset of our patients challenges us to overcome our anxiety about this diagnosis and prevent the societal marginalization of vulnerable patients. Adult ADHD responds well to integrated pharmacological and psychotherapeutic intervention. Its treatment responsiveness reduces disability and allows the comorbidity which is typically present to be addressed. Mastering this challenge can make the diagnosis and treatment of adult ADHD a rewarding experience.

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>

Adult Attention-Deficit/Hyperactivity Disorder

2019 ◽  
pp. 395-423
Author(s):  
Beth Krone ◽  
Amanda Kirschenbaum ◽  
Thomas Yang ◽  
Amy Glick ◽  
Alexander Newcorn ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Clinical Manifestations ◽  
Risky Behaviors ◽  
Cognitive Domain ◽  
Marital Problems ◽  
Hyperactivity Disorder ◽  
Axis I

Attention-deficit/hyperactivity disorder (ADHD) is a common, symptomatically heterogeneous, neurodevelopmental disorder. It’s symptoms first appear early in life and evolve as the brain matures and reorganizes over the lifespan. Cognitive dysfunction is a key feature of adult ADHD and typically manifests as a dysregulation of executive control of attention, working memory, inhibitory control, and emotion regulation rather than as a defining deficit in a specific cognitive domain. The heterogeneity of presentation, changing clinical manifestations across development, and variability in functional impairment associated with ADHD contribute to the difficulty of obtaining a “snapshot” diagnosis using a single assessment or representative battery. Careful history-taking of information across raters and settings generally reveals a pattern of symptoms beginning in childhood. Manifested impairment required for diagnosis depends on a variety of supportive or mitigating versus contributory factors. In adulthood, persisted or untreated ADHD may predispose to a variety of other conditions, including low educational and/or academic attainment, decreased earning potential, substance use or abuse, parenting and marital problems, poor health practices, a variety of risky behaviors, and a variety of comorbid Axis I and Axis II psychiatric disorders. High-functioning adults who have not previously come to clinical attention may present for care because of academic underattainment, suboptimal performance in the workplace, or behavioral or mood dysregulation. In addition, ADHD may be discovered as part of a more comprehensive workup of other disorders. A range of psychosocial and psychopharmacological treatments are available; response is often good to excellent once the disorder is properly identified.

scholarly journals Atypical resting-state gamma band trajectory in adult attention deficit/hyperactivity disorder

2021 ◽  
Author(s):  
László Tombor ◽  
Brigitta Kakuszi ◽  
Szilvia Papp ◽  
János Réthelyi ◽  
István Bitter ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Gamma Band ◽  
Gamma Activity ◽  
Hyperactivity Disorder ◽  
Gamma Power ◽  
Gamma Band Activity ◽  
Band Activity

AbstractDecreased gamma activity has been reported both in children and adults with attention deficit/hyperactivity disorder (ADHD). However, while ADHD is a lifelong neurodevelopmental disorder, our insight into the associations of spontaneous gamma band activity with age is limited, especially in adults. Therefore, we conducted an explorative study to investigate trajectories of resting gamma activity in adult ADHD patients (N = 42) versus matched healthy controls (N = 59). We investigated the relationship of resting gamma activity (30–48 Hz) with age in four right hemispheric electrode clusters where diminished gamma power in ADHD had previously been demonstrated by our group. We found significant non-linear association between resting gamma power and age in the lower frequency gamma1 range (30–39 Hz) in ADHD as compared to controls in all investigated locations. Resting gamma1 increased with age and was significantly lower in ADHD than in control subjects from early adulthood. We found no significant association between gamma activity and age in the gamma2 range (39–48 Hz). Alterations of gamma band activity might reflect altered cortical network functioning in adult ADHD relative to controls. Our results reveal that abnormal gamma power is present at all ages, highlighting the lifelong nature of ADHD. Nonetheless, longitudinal studies are needed to confirm our results.

scholarly journals Study of white matter integrity in fathers of children with attention deficit hyperactivity disorder

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Heba H. ElShahawi ◽  
Safeya M. Effat ◽  
Eman M. Shorab ◽  
Hossam M. Sakr ◽  
Safaa E. Azab ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
White Matter ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Neurodevelopmental Disorder ◽  
Occurrence Rate ◽  
Adhd Group ◽  
Corona Radiata ◽  
Hyperactivity Disorder ◽  
The Right

Abstract Background Attention deficit hyperactivity disorder (ADHD) is an early-onset neurodevelopmental disorder that can extend into adulthood with multiple reported neuroimaging abnormalities. The focus of this research was to assess white matter impairments in ADHD children’s fathers with and without potential adult ADHD to see if these differences are connected with the persistence of ADHD into adulthood. Results The occurrence rate of the potential adult ADHD diagnosis among fathers of children with ADHD was 60%. There were statistically significant differences between fathers with ADHD and the non-ADHD population, due to the fact that the mean FA of the left superior corona radiata and the right posterior corona radiata were lower in the ADHD group than in the non-ADHD group, while the FA of the ADHD group was significantly greater than that of the non-ADHD group in terms of the left and right anterior thalamic radiations, the right superior longitudinal fasciculus and the left anterior corona radiata. Conclusions We observed an increased prevalence of ADHD in fathers of children diagnosed with ADHD. Fathers with potential adult ADHD have a variety of white matter abnormalities that reflect the neurobiological basis of ADHD, even in sub-threshold cases. This may provide insight into the neuroanatomical locations associated with the maintenance of ADHD throughout adulthood.

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.

Attention deficit hyperactivity disorder (ADHD): perspective of the general adult psychiatrist

2018 ◽  
Vol 35 (3) ◽  
pp. 247-249
Author(s):  
D. Murray ◽  
P. Devitt
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Ad Hoc ◽  
Neurodevelopmental Disorder ◽  
Psychiatric Services ◽  
Hyperactivity Disorder ◽  
Adhd Treatment

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset in childhood. In Ireland adult ADHD treatment is drifting in an ad hoc manner into general adult psychiatric services. We propose this process should be halted in favour of a delivering a carefully planned adult ADHD service.

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