Welcome to our comprehensive overview of the evolving field of adult ADHD. As advancements in research and treatment methods emerge, staying informed is crucial for understanding and managing the complexities of adult ADHD. This post delves into the current state of adult ADHD, highlights recent research, and explores the implications for diagnosis and treatment.
Historically, ADHD diagnostic criteria have been based primarily on studies of young white boys. The DSM-5, which sets these criteria, often fails to capture the experiences of many adults with ADHD. This discrepancy has led to ongoing issues with misdiagnosis and inadequate treatment for individuals who were not diagnosed during childhood.
ADHD continues into adulthood for up to 90% of children diagnosed with the condition. While symptoms may change over time, they do not disappear. The Centers for Disease Control and Prevention (CDC) recognizes ADHD as a significant public health issue with long-term effects. Consequently, many adults are now seeking diagnoses for symptoms that have become more pronounced or troubling with age.
Dr. David Goodman, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine, notes during an ADDitude webinar that while ADHD symptoms may not worsen with age, they become more disruptive personally. Despite increasing demand for adult ADHD evaluations, clinicians currently lack reliable, standardized diagnostic tools. Additionally, many healthcare providers report insufficient training on ADHD during their education.
To address these issues, the American Professional Society of ADHD and Related Disorders (APSARD) has formed a task force to create clinical practice guidelines for diagnosing and treating ADHD in adults. These guidelines aim to be research-based, clinically informed, and patient-focused.
However, there is a significant lack of research on adults over 50, women, people of color, and minority populations, which may impact the comprehensiveness of the guidelines. Despite this, the guidelines, expected to be released in late 2024 or early 2025, are anticipated to significantly impact diagnosis and treatment rates, insurance coverage, and public awareness.
The concept of "subthreshold" ADHD, introduced by APSARD task force members, refers to individuals who do not meet the DSM-5 criteria in childhood but experience significant impairment later in life due to factors like the stress of parenthood or hormonal changes during menopause. Expanding the symptom criteria for adult ADHD to include emotional dysregulation is one proposed improvement.
The task force will also address the safety of ADHD medications for older adults. Recent studies, such as a meta-analysis published in JAMA, indicate that ADHD medications do not increase cardiovascular risks, even in older adults. Despite this, some prescribers remain cautious.
APSARD is collaborating with CHADD to develop tools to aid clinicians in ADHD evaluations. Improved clinician education and routine ADHD screenings during annual doctor visits could significantly enhance diagnosis and treatment outcomes.
As our understanding of adult ADHD continues to grow, staying informed and engaged is essential. By doing so, we can better navigate the complexities of this condition and support those affected by it. Thank you for joining us on this journey toward greater awareness and improved mental health outcomes.
References:
Goodman, D. et al. (2019). Study published in JAMA Psychiatry.
Sibley, M. et al. (2022). Research on ADHD symptom fluctuations.
JAMA (2023). Meta-analysis of ADHD medication safety.
Childress, A. (2022). Study on treatment barriers published in BMC Psychiatry.
For more insights and detailed discussions, please refer to the original article by Anni Layne Rodgers.
Comments