Materiały źródłowe

• #1 Attention-Deficit/Hyperactivity Disorder in Adults – CMHA British Columbia

  https://bc.cmha.ca/documents/attention-deficithyperactivity-disorder-in-adults-2/

  Attention-deficit/hyperactivity disorder, or ADHD, is a mental illness that affects the way you act and focus. ADHD is usually diagnosed in school-aged children, but it can continue to cause problems into adulthood. About two-thirds of people living with ADHD continue to experience symptoms as an adult. […] You may be diagnosed as an adult with ADHD, but you must have experienced some ADHD symptoms as a child—there is no such thing as ADHD that starts when you’re an adult. […] ADHD can be harder to diagnose in adults for some of these reasons: Other mental illnesses can cause problems with attention or behaviour. […] About 4% of adults experience some or all ADHD symptoms. It affects men and women almost equally. […] ADHD is usually treated with a combination of medication, counselling and self-care.

• #1 Attention-Deficit Hyperactivity Disorder (ADHD) – Harvard Health

  https://www.health.harvard.edu/a_to_z/attention-deficit-hyperactivity-disorder-adhd-a-to-z

  The causes of ADHD are not fully understood. There are numerous factors that are associated with the development of ADHD. It may be difficult to avoid these factors, but addressing them may reduce the risk of developing the disorder. […] The activity component is less apparent in adults, who tend to have problems with memory and concentration. They may have trouble staying organized and meeting commitments at work or at home. The consequence of poor functioning may be anxiety, low self-esteem, or mood problems. Some people turn to substances to manage these feelings. […] Although no treatment eliminates ADHD completely, many helpful options are available. The goal of treatment is to help children improve social relationships, do better in school, and keep their disruptive or harmful behaviors to a minimum. Medication can be very helpful, and it is often necessary.

• #1 Clinical Implications of Attention-Deficit/Hyperactivity Disorder in Adults: What New Data on Diagnostic Trends, Treatment Barriers, and Telehealth Utilization Tell Us

  https://www.psychiatrist.com/jcp/implications-adult-adhd-diagnostic-trends-treatment-barriers-telehealth/

  New data from the US Centers for Disease Control and Prevention (CDC) highlight the need for the development of guidelines for the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. […] When left untreated, ADHD is associated with increased morbidity and mortality, low earning potential, poor physical health, relationship instability, and elevated comorbid mental health conditions. […] Untreated adult ADHD is often complex and comorbid with depression, anxiety, bipolar disorder, insomnia, substance use disorders, and trauma-related conditions. […] The risks and benefits of individualized ADHD treatment must carefully be considered in these complex conditions as ADHD and comorbid disorders present both diagnostic and treatment challenges. […] Common treatment barriers include delayed diagnosis or misdiagnosis, limited access to available care, systemic inequities in marginalized communities, and limited education in the medical community regarding the persistent nature of ADHD in adulthood.

• #1 Adult ADHD: Symptoms, Statistics, Causes, Types, and Treatments

  https://www.webmd.com/add-adhd/adhd-adults

  Since ADHD runs in families, you can’t prevent it. […] But if you’re pregnant, avoiding drugs, smoking, and alcohol could reduce the odds that your child will get ADHD and have other health problems later on.

• #1 What Is ADHD? Symptoms, Treatment, and More

  https://www.everydayhealth.com/adhd/guide/

  Although genetics are thought to be one of the main risk factors for ADHD, there are a few health behaviors that may reduce the likelihood that a child will have the disorder, according to the Mayo Clinic. During pregnancy, avoid any activities or substances that could harm the development of the fetus. Examples include alcohol, smoking, and recreational drugs. […] Children should be protected from pollutants and toxins such as lead paint or cigarette smoke. […] Although a direct link between screen time and ADHD has not been established, experts recommend limiting the amount of TV and video games in the first five years of life.

• #1 Adult ADHD: Symptoms, Test, Diagnosis, and Medication

  https://www.medicinenet.com/adult_adhd/article.htm

  Is it possible to prevent adult ADHD? […] Research indicates that breastfeeding up to 6 months of age may help prevent the development of ADHD. Since environmental and social problems like drug use in the mother, medical, and emotional challenges increase the likelihood of developing this condition, prevention or treatment of those issues can help prevent ADHD. In addition, early treatment of children with ADHD can decrease the impact the illness has on the individual’s life into adulthood.

• #1

  https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx

  The diagnosis of adult ADHD is a clinical one, arrived at based on a carefully collected history of symptoms (ruling out other causes), without placing too much weight on neuropsychological testing or screening instruments. […] Given the current conceptualization of adult ADHD as persistence of childhood symptoms into adulthood, diagnosing ADHD in adults requires establishing the presence of ADHD symptoms in childhood (prior to the age 12 in DSM-5). […] The available evidence suggests that for patients taking medications for adult ADHD, cognitive-behavioral therapy improves outcomes for at least 12 months. […] The risks of stimulant treatment for adult ADHD are generally underappreciated, as long-term efficacy and safety data on stimulant use in adults with ADHD are lacking.

• #1 Attention deficit hyperactivity disorder in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/814

  Adult attention deficit hyperactivity disorder (ADHD) is a common adult disorder, thought to be persistence of childhood ADHD. […] ADHD as a primary condition is most clearly diagnosed when mood or anxiety disorders are not active. […] Psychological therapies including cognitive behaviour therapy, metacognitive therapy, and dialectical behaviour therapy can be effective in reduction of symptoms in combination with medication. […] ADHD is a neurodevelopmental disorder characterised by persistent inattention, hyperactivity, and impulsivity. […] Diagnosis of ADHD in adulthood requires ancillary information supporting onset of symptoms in childhood (before 12 years of age). […] Another key element of the definition is that symptoms manifest in two or more settings, for example both at home and in work.

• #1 APSARD ADHD Diagnosis Guidelines for Adults in U.S. ForthcomingFooterLogo

  https://www.additudemag.com/adhd-diagnosis-adults-guidelines-apsard/?srsltid=AfmBOop3ZgPdQKLAvabIZEOwjx4pZ6ZJWFRZv7QN9KHRciGFFncWTF_x

  ADHD diagnoses among adults are growing faster than ever in the U.S. despite the absence of formal clinical guidelines for the accurate evaluation and treatment of the condition after childhood. […] Guidelines give evidence-based recommendations for the assessment and treatment of medical disorders. We have U.S. guidelines for the treatment of ADHD in children and adolescents, but none for adults. Guidelines will help practitioners who previously may have felt uncomfortable evaluating and treating adults with ADHD, and these will improve access to high-quality care. […] ADHD in adults is not just a minor inconvenience — it is a major public health problem. Consequences of adult ADHD can include lower educational achievement, increased risk of unemployment, financial instability, higher rates of divorce, and increased risky behaviors resulting in higher rates of traffic infractions and unplanned pregnancies compared to peers without ADHD.

• #1 Attention deficit hyperactivity disorder – adults | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/attention-deficit-hyperactivity-disorder-adults

  Attention deficit hyperactivity disorder (ADHD) was once thought only to affect children, but symptoms and the effects of ADHD can continue into adulthood. […] Treatment for ADHD can include: education to help the person understand and better manage their condition, lifestyle improvement such as cutting back or quitting drugs and alcohol, and taking up regular exercise, medication stimulant and non-stimulant medications are used, psychotherapy to address self-esteem problems or substance abuse, therapy such as behaviour therapy and cognitive behaviour therapy, to teach anger management, organisational skills or social skills, depending on the needs of the individual, vocational counselling to increase the persons chances of success and satisfaction in the workplace, family therapy when one family member has ADHD, the whole family needs support, joining a support group. […] Brain imaging techniques and function measures of how your brain solves problems hold current promise for being able to better understand and personalise treatments.

• #1 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. […] Proper diagnosis and treatment can improve daily functioning. […] Clinical guidelines recommend stimulants and the nonstimulant atomoxetine as first-line treatments, followed by antidepressants. […] Cognitive behavior therapy has also been shown to be helpful as adjunctive treatment with medication. […] To monitor for misuse or diversion of stimulants, family physicians should consider using a controlled substances agreement and random urine drug screening in addition to regular follow-up visits. […] The mainstay of ADHD treatment is pharmacotherapy.

• #1 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Clinical guidelines recommend stimulants and atomoxetine (Strattera) as first-line treatments, followed by antidepressants. […] Medications should be started at a low dose and titrated slowly until maximal benefit is achieved or adverse effects become intolerable. […] Small studies have found that cognitive behavior therapy is helpful as an adjunct to medication in the treatment of ADHD in adults. […] In general, depression should be treated before ADHD is treated. […] The combination of an antidepressant and stimulants has been shown to be safe and effective. […] Stimulants should be avoided in patients with bipolar disorder, and mood stabilizers or atypical antipsychotics should be used instead. […] For patients with comorbid anxiety disorders, stimulants are a first-line treatment, followed by selective serotonin reuptake inhibitors and cognitive behavior therapy.

• #1 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Because there is no compelling evidence regarding the specific point at which the family physician should refer patients to behavioral health services, that decision may best be based on other comorbidities for which the family physician would generally refer. […] Family physicians should consider several strategies to prevent misuse or diversion of stimulants prescribed for adults with ADHD.

• #1 Attention-Deficit/Hyperactivity Disorder in Adults – CMHA British Columbia

  https://bc.cmha.ca/documents/attention-deficithyperactivity-disorder-in-adults-2/

  It’s important to remember that different medications may not be a good option for all people. […] Cognitive-behavioural therapy (CBT) teaches you the relationship between your thoughts, moods and behaviours. […] Strategies like maintaining a consistent schedule and using notes, lists or charts to keep you on track may help.

• #1

  https://www.cumminsbhs.org/community-resources/diagnosis-guides/adhd-adults/

  ADHD is very treatable, and even adults who have been struggling with undiagnosed ADHD for years can improve their quality of life. They just need some help managing their disorder. […] ADHD is typically treated with either stimulants, non-stimulants, or antidepressants. Although each type of medication works differently, they all increase the levels of the neurotransmitters dopamine and/or norepinephrine in the brain, which in turn helps to regulate impulsive behavior and improve attention span. […] Professional therapy and counseling are important components of treatment for many people with ADHD. Treatments like individual therapy, group therapy, and skills training are important for helping individuals learn how to manage symptoms of ADHD. […] Let your loved one know that you care about them, are concerned for their well-being, and are there to support them. This can help quiet any doubts they may have and reassure them that you are on their side.

• #1 Adult Attention-DeficitHyperactivity Disorder Drug Development Diagnosis and Treatment – A Workshop | National Academies

  https://www.nationalacademies.org/our-work/adult-attention-deficit-hyperactivity-disorder-drug-development-diagnosis-and-treatment-a-workshop

  A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize a public workshop that will provide an opportunity for professionals who typically diagnose attention-deficit/hyperactivity disorder (ADHD) (e.g., physicians, psychologists, social workers, nurse practitioners, and other licensed counselors or therapists), drug developers, researchers, regulators, patients, and other stakeholders to examine the diagnosis and treatment of adults with ADHD and explore the challenges and opportunities for the development of new therapeutics. […] The public workshop will feature invited presentations and discussions to: […] Consider what is known and unknown about the risks and benefits of ADHD medication use in adult populations. […] Consider potential strategies for assessing the risks and benefits of ADHD medication treatment in adult populations, including the intersection with opioid use, that support the public health goal of safely and effectively treating adults with ADHD.

• #2

  https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx

  Requests for the evaluation of potential adult attention-deficit/hyperactivity disorder (ADHD) is on the rise across primary care clinics. Many health care providers, however, may feel ill equipped to diagnose and manage adults presenting with inattention and impulsivity. The diagnosis of ADHD is often complicated by medical and psychiatric conditions that can contribute to inattention symptoms. In this article, the authors provide a pragmatic clinical approach for evaluating and managing adult ADHD in the primary care setting. […] Adult attention-deficit/hyperactivity disorder (ADHD), with a prevalence of about 2.8%, is currently conceptualized as the persistence of childhood ADHD symptoms into adulthood that is associated with impairments in social and occupational functioning. […] This clinical review will provide a pragmatic approach to the diagnosis and treatment of adult ADHD in primary care settings.

• #2 Attention deficit hyperactivity disorder in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/814

  Comorbid disorders are present in more than 75% of adults with ADHD. […] This topic covers the management of ADHD in adults only. […] ADHD without concomitant mood, anxiety, or substance use disorder. […] ADHD with concomitant substance use disorder. […] ADHD with depression (with or without prominent anxiety). […] ADHD with bipolar disorder. […] ADHD with anxiety disorder alone.

• #2

  https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/ADHD_Resource_Center/Home.aspx

  ADHD often runs in families. […] The good news is that there are safe and effective treatments for children and adolescents with ADHD. Treatment is most effective when it begins early and when intervention is individualized to the needs of the child. […] Getting help is the most important thing that parents can do for children and adolescents with a mental health concern. Parents should try to find a mental health professional with advanced training and experience evaluating and treating children and adolescents with attention-deficit/hyperactivity disorder.

• #2 What Is ADHD? Symptoms, Treatment, and More

  https://www.everydayhealth.com/adhd/guide/

  Although genetics are thought to be one of the main risk factors for ADHD, there are a few health behaviors that may reduce the likelihood that a child will have the disorder, according to the Mayo Clinic. During pregnancy, avoid any activities or substances that could harm the development of the fetus. Examples include alcohol, smoking, and recreational drugs. […] Children should be protected from pollutants and toxins such as lead paint or cigarette smoke. […] Although a direct link between screen time and ADHD has not been established, experts recommend limiting the amount of TV and video games in the first five years of life.

• #2 Adult ADHD: Symptoms, Test, Diagnosis, and Medication

  https://www.medicinenet.com/adult_adhd/article.htm

  Is it possible to prevent adult ADHD? […] Research indicates that breastfeeding up to 6 months of age may help prevent the development of ADHD. Since environmental and social problems like drug use in the mother, medical, and emotional challenges increase the likelihood of developing this condition, prevention or treatment of those issues can help prevent ADHD. In addition, early treatment of children with ADHD can decrease the impact the illness has on the individual’s life into adulthood.

• #2

  https://journals.lww.com/hrpjournal/fulltext/2020/03000/approach_to_evaluating_and_managing_adult.3.aspx

  The diagnosis of adult ADHD is a clinical one, arrived at based on a carefully collected history of symptoms (ruling out other causes), without placing too much weight on neuropsychological testing or screening instruments. […] Given the current conceptualization of adult ADHD as persistence of childhood symptoms into adulthood, diagnosing ADHD in adults requires establishing the presence of ADHD symptoms in childhood (prior to the age 12 in DSM-5). […] The available evidence suggests that for patients taking medications for adult ADHD, cognitive-behavioral therapy improves outcomes for at least 12 months. […] The risks of stimulant treatment for adult ADHD are generally underappreciated, as long-term efficacy and safety data on stimulant use in adults with ADHD are lacking.

• #2 Attention-Deficit/Hyperactivity Disorder in Adults – CMHA British Columbia

  https://bc.cmha.ca/documents/attention-deficithyperactivity-disorder-in-adults-2/

  Attention-deficit/hyperactivity disorder, or ADHD, is a mental illness that affects the way you act and focus. ADHD is usually diagnosed in school-aged children, but it can continue to cause problems into adulthood. About two-thirds of people living with ADHD continue to experience symptoms as an adult. […] You may be diagnosed as an adult with ADHD, but you must have experienced some ADHD symptoms as a child—there is no such thing as ADHD that starts when you’re an adult. […] ADHD can be harder to diagnose in adults for some of these reasons: Other mental illnesses can cause problems with attention or behaviour. […] About 4% of adults experience some or all ADHD symptoms. It affects men and women almost equally. […] ADHD is usually treated with a combination of medication, counselling and self-care.

• #2 Clinical Implications of Attention-Deficit/Hyperactivity Disorder in Adults: What New Data on Diagnostic Trends, Treatment Barriers, and Telehealth Utilization Tell Us

  https://www.psychiatrist.com/jcp/implications-adult-adhd-diagnostic-trends-treatment-barriers-telehealth/

  New data from the US Centers for Disease Control and Prevention (CDC) highlight the need for the development of guidelines for the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. […] When left untreated, ADHD is associated with increased morbidity and mortality, low earning potential, poor physical health, relationship instability, and elevated comorbid mental health conditions. […] Untreated adult ADHD is often complex and comorbid with depression, anxiety, bipolar disorder, insomnia, substance use disorders, and trauma-related conditions. […] The risks and benefits of individualized ADHD treatment must carefully be considered in these complex conditions as ADHD and comorbid disorders present both diagnostic and treatment challenges. […] Common treatment barriers include delayed diagnosis or misdiagnosis, limited access to available care, systemic inequities in marginalized communities, and limited education in the medical community regarding the persistent nature of ADHD in adulthood.

• #2 Attention Deficit Hyperactivity Disorder (ADHD) | NAMI

  https://www.nami.org/about-mental-illness/mental-health-conditions/adhd/

  ADHD is managed and treated in several ways: […] A treatment plan is most effective when tailored to an individual’s needs, and implemented early on. ADHD treatment plans should consider learning style and include medication prescribed by a professional. […] Many of the strategies that help youth with ADHD, including structure, organizational tips and coaching as well as medication can be helpful for adults living with ADHD as well. An individualized approach to treatment that focuses on strengths and circumstances is critical for adult and children. […] ADHD coaching has developed over the last few decades as a component to the treatment of ADHD. It is a support that is well-suited to the needs of people living with ADHD, including adults and youth. […] ADHD is one of the most common conditions in children, so first you should know that you and your child are not alone.

• #2 Diagnosis and Management of Attention-Deficit/Hyperactivity Disorder in Adults | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/0501/p890.html

  Clinical guidelines recommend stimulants and atomoxetine (Strattera) as first-line treatments, followed by antidepressants. […] Medications should be started at a low dose and titrated slowly until maximal benefit is achieved or adverse effects become intolerable. […] Small studies have found that cognitive behavior therapy is helpful as an adjunct to medication in the treatment of ADHD in adults. […] In general, depression should be treated before ADHD is treated. […] The combination of an antidepressant and stimulants has been shown to be safe and effective. […] Stimulants should be avoided in patients with bipolar disorder, and mood stabilizers or atypical antipsychotics should be used instead. […] For patients with comorbid anxiety disorders, stimulants are a first-line treatment, followed by selective serotonin reuptake inhibitors and cognitive behavior therapy.

• #2 APSARD ADHD Diagnosis Guidelines for Adults in U.S. ForthcomingFooterLogo

  https://www.additudemag.com/adhd-diagnosis-adults-guidelines-apsard/?srsltid=AfmBOop3ZgPdQKLAvabIZEOwjx4pZ6ZJWFRZv7QN9KHRciGFFncWTF_x

  Although some adult patients manage well using behavioral techniques to control symptoms, many still need medication to reduce symptom severity and improve their quality of life. The guidelines will review the existing evidence for treating adult ADHD and make recommendations based on those findings. […] It is important for practitioners to work with their colleagues in primary care, cardiology, and internal medicine to treat patients collaboratively. For many, the benefits often outweigh the risks, but it is important for all specialists to work together to ensure that patient risks are appropriately managed. […] Helping clinicians recognize the difference in presentation of ADHD symptoms in women is important. […] After the APSARD guidelines are published, we will work with CHADD to expand them for specific populations and specialties. There is much interest from colleagues in other agencies, and we plan to partner with them to educate providers.

• #2 Clinical Implications of Attention-Deficit/Hyperactivity Disorder in Adults: What New Data on Diagnostic Trends, Treatment Barriers, and Telehealth Utilization Tell Us

  https://www.psychiatrist.com/jcp/implications-adult-adhd-diagnostic-trends-treatment-barriers-telehealth/

  The CDC’s MMWR emphasizes diagnostic and treatment barriers for adults with ADHD and provides an updated understanding of the prevalence of the condition. […] These data highlight the importance of the upcoming American Professional Society of ADHD and Related Disorders (APSARD) Adult ADHD Guidelines. […] These will be the first US guidelines for the diagnosis and treatment of adults with ADHD and will provide a valuable framework of treatment for clinicians and families.

• #2 Attention-Deficit Hyperactivity Disorder (ADHD) – Harvard Health

  https://www.health.harvard.edu/a_to_z/attention-deficit-hyperactivity-disorder-adhd-a-to-z

  Since such risks vary widely depending on the individual, it is important to discuss the potential benefits and risks of each treatment with your doctor. […] Because many children with ADHD also are troubled by poor grades and school behavior problems, schools may need to provide educational adjustments and interventions (such as an individualized educational plan) to promote the best possible learning environment for the child.

• #2

  https://www.cumminsbhs.org/community-resources/diagnosis-guides/adhd-adults/

  Ask your loved one if they are seeking help for their disorder. If they are not, express to them why you think professional treatment could be helpful. Offer to help them find treatment if they would like you to. […] Criticizing your loved ones behavior or blaming them for their situation will not help anyone. Be supportive in any way possible, and understand that they did not choose the challenges they are experiencing.

• #3 Attention deficit hyperactivity disorder in adults – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/814

  Adult attention deficit hyperactivity disorder (ADHD) is a common adult disorder, thought to be persistence of childhood ADHD. […] ADHD as a primary condition is most clearly diagnosed when mood or anxiety disorders are not active. […] Psychological therapies including cognitive behaviour therapy, metacognitive therapy, and dialectical behaviour therapy can be effective in reduction of symptoms in combination with medication. […] ADHD is a neurodevelopmental disorder characterised by persistent inattention, hyperactivity, and impulsivity. […] Diagnosis of ADHD in adulthood requires ancillary information supporting onset of symptoms in childhood (before 12 years of age). […] Another key element of the definition is that symptoms manifest in two or more settings, for example both at home and in work.

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