ADHD In Adults
What is ADHD?
ADHD, or attention deficit hyperactivity disorder is the current term used in DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition which was published in May 2013 by the American Psychiatric Association) which describes a life long pattern of inattention, hyperactivity and impulsivity of a severity that is causing impairment . Subtypes include ADHD inattentive subtype where symptoms are predominantly inattentive; ADHD, hyperactive/impulsive subtype, where predominantly hyperactive/impulsive symptoms occur and ADHD, combined subtype where inattentive, hyperactive and impulsive symptoms are all present. You may come across the term ADD or attention deficit disorder which is an older term used particularly in US to describe ADHD, inattentive subtype. Hyperkinetic disorder is described in ICD-10 (WHO 1992) is broadly equivalent to ADHD combined subtype, so a more severe form of ADHD.
ADHD is a neurodevelopmental disorder, present in about 5% of children. It continues into adulthood to present with symptoms and associated impairment in up to 50% of cases. There is under diagnosis of ADHD in adults for a variety of reasons including a lack of awareness and expertise in NHS services and a lack of specialist services and ADHD can be tricky to detect in adults as the physical restlessness and hyperactivity which can be marked in children may be less prominent, adults may have developed coping strategies so that symptoms are hidden and symptom of ADHD may be thought to be caused by other conditions such as depression, anxiety or personality disorder.
Treating ADHD in adults
If ADHD is confirmed in an adult, treatment should be offered and this can take the form of medication or psychotherapy. The National Institute for Health and Care Excellence (NICE) recommends that medication, including stimulants (methylphenidate, dexamfetamine and lisdexamfetamine) and non stimulants (atomoxetine), should be used where clinical appropriate in adults with ADHD and there is evidence that medication can improve quality of life, reduce symptoms burden and reduce functional impairment.
Cognitive behavioural therapy (CBT) has a growing evidence base for effectiveness in ADHD in adults and it can be vital to develop skills and tools to reduce impairment secondary to ADHD.