ADHD across the lifespan. (November 2016)

• Record Type: Journal Article
• Authors: Asherson, Philip
• Is Part Of: Medicine. Volume 44:Number 11(2016)
• Page Start: 683
• Page End: 686
• Publication Date: 2016-11
• Subjects: ADHD -- atomoxetine -- attention-deficit hyperactivity disorder -- child-onset disorder -- dexamfetamine -- hyperkinetic syndrome -- lisdexamfetamine -- methylphenidate -- neurodevelopmental disorder -- stimulants; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Médecine factuelle -- Périodiques; Medicine; Periodicals; Electronic journals; Electronic journals; 610
• DOI: 10.1016/j.mpmed.2016.08.012
• Languages: English
• ISSNs: 1357-3039

Abstract

Abstract: Attention-deficit hyperactivity disorder (ADHD) is a common mental disorder with neurodevelopmental origins that typically starts in early childhood and follows a persistent trait-like course. It is characterized by inattention, impulsivity and hyperactivity that are persistent over time and lead to clinical and psychosocial impairments. Emotional instability is a common feature of ADHD that is sometimes the main presenting complaint. Neurodevelopmental and psychiatric co-morbidities are common. ADHD can be diagnosed and treated at all ages and persists into adulthood in around two-thirds of individuals. Many adults with ADHD were not diagnosed as children. In children with moderate impairment, psychological approaches, including parent training and cognitive behavioural therapy, are recommended as first-line treatment. Drug treatment should, however, be offered as a first line to children with ADHD with severe impairment, if psychological interventions have not been effective or if patients prefer medication. In adults, drug treatments are the recommended first-line treatments, with psycho-education and cognitive behavioural therapy as complementary approaches. Drug treatments are similar at all ages. Methylphenidate is the recommended first-line drug, followed by atomoxetine or dexamfetamine/lisdexamfetamine. Atomoxetine may be used as first line when there are concerns with potential drug abuse or diversion, or high levels of co-morbid anxiety.