![]() Overall, 22 articles were excluded and 91 were included. In total, 113 unique articles were identified 8 were excluded at the title filtering stage, 7 at the abstract filtering stage, and another 7 after a full-text review. Clinical trials, guidelines, meta-analyses, and systematic reviews were selected by the authors for inclusion in this review. ![]() PubMed was searched for articles in English published between 19, using the following search terms: “adult ADHD” in combination with anxiety addiction affective dysregulation alcohol bipolar burden catecholamine deficit cocaine cognition depression dimension dimensional disability executive functioning functioning guideline heritability life expectancy mania marijuana mortality neurobiology nicotine personality disorders prevalence prevention recommendation risk factors and substance use. With the recognition that the evidence base continues to evolve and that there is a lack of quality evidence to guide the management of complex patient presentations, this article answers some common clinical questions based on available evidence as well as our collective experience in the management of adult ADHD and comorbidities. Thus, the goals of this article are to review the available evidence on the prevalence, burden, and neurobiology of adult ADHD, to describe how a practical, dimensional approach can help clinicians identify ADHD in patients with complex presentations, and to inform appropriate management decisions in order to improve patient outcomes in this under-treated population. It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs. This makes the recognition and successful management of ADHD in adults extremely gratifying for clinicians. Despite the challenges of recognizing ADHD in adults with complex clinical presentations, there are effective treatments available that have been demonstrated to improve clinical and functional outcomes, including important elements of psychosocial functioning such as social relationships, workplace performance, and parenting skills. This can complicate the recognition and diagnosis of ADHD in adults, and despite ongoing clinical controversy, the bulk of evidence suggests that ADHD remains under-recognized and under-treated in the adult population. As many as 80% of adults with ADHD have at least one coexisting psychiatric disorder, including mood and anxiety disorders, substance use disorders (SUD), and personality disorders. Today, practicing clinicians recognize the heritability of ADHD and the wide variability in clinical presentation of adult ADHD. ![]() ![]() Often, adult ADHD has a more heterogeneous clinical presentation that transcends the typical motor symptoms described in pediatric populations, and includes a wider spectrum of emotional dysregulation and functional impairment.Īs our diagnostic systems are evolving towards a more dimensional approach to the classification of mental disorders, so too is our understanding of adult ADHD. While ADHD is well recognized in the pediatric population, where it was first described as a clinical diagnosis in the 1930s, focus has shifted to include the recognition and management of the condition in adults. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.Īttention-deficit/hyperactivity disorder (ADHD) is a psychiatric disorder associated with considerable personal and societal burden. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Įarly recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. ![]() There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |