Occasionally it is good to an adult ADHD resumend lest we miss the basic idea of \u200b\u200bADHD in adults and therefore I put this summary of ADHD in adults
• Introduction
• Epidemiology
• Clinical manifestations of ADHD in adults
• Evolution of ADHD in adults
• Assessment of ADHD in adults
• Pharmacological treatment of ADHD in adults
• Psychological treatment of ADHD in adults
INTRODUCTION Since 1976 he has published several studies that have provided strong evi
trends about the validity of
l
diagnosis of ADHD in adults. Thus, both clinical correlates, family history, treatment response, laboratory studies, the course and evolution, supporting its validity in adults.
In adults with ADHD have abnormalities in the academic performance, ada
ptación the workplace, interpersonal relationships, problems in driving, as well as mental state and a high risk of substance abuse.
EPIDEMIOLOGY
In adult population is less available epidemiological data, but studies also indicate that ADHD manifested in adults and more often highlighted. The results of these studies have found prevalence of ADHD between 4% and 5%. Currently in Spain have been diagnosed only 3% of adults with ADHD, and
n many primary care and psychiatry, many adults come to them and are treated pat
ologies such as anxiety, depression, abuse disorder substances, when really at the bottom of these pathology
comorbid ies are pictures of an undiagnosed adult ADHD.
OF ADHD IN ADULTS
From DSM-III (1980) means that the disorder can affect adults
. From DSM-III-R is formally described
the possibility of diagnosing ADHD in adults.
order to make a diagnosis of ADHD in an adult needs to estépresente disorder from childhood, from at least 7 years. The subject must continue to present a significant clinical disorder or impairment in more than two important areas of activity such as social work, labor, academic or familial. Adults with ADHD often manifest primarily symptoms of inattention and impulsivity, and that hyperactivity decreases with age.
Also, the symptoms of hyperactivity tend to have slightly different clinical manifestations found in children. For example, one of the symptoms of hyperactivity in children may be the run around, climb furniture steadily, whereas in adulthood the same symptoms manifested as a subjective feeling of restlessness. UNmotor it takes to be continually generating activities, is an endogenous activity that generates anxiety in the adult.
EVOLUTION OF ADHD IN ADULTS
Overall, ADHD patients achieved a lower educational background (school failure in some cases) compared with control groups, even with similar levels of intelligence. Bilderman said to feed you with ADHD reach a notch below what your level of inteligiencia could obtain, for example a patient with ADHD with a coefficient of
intligencia sure you would get a higher level university degree, come to a diploma, and if able to take a high school diploma would take the top and so on. The studies report that people with ADHD have a worse job adaptation with respect to individuals without a discontinuity trastorno.presentando work, especially if your job is very specialized. The difficulties in social adaptation may persist in adults with ADHD, even worse, if one takes into account growing social demands that must be confronted in adulthood.
have been reported more difficulties in interpersonal relationships and, more specifically, in relationships. With a double-figure divorce than the general population in different publications have shown that the ability to drive vehicles can be found altered in ADHD, with serious consequences from a social point of view and personal.
Persistence of ADHD in adulthood, comorbid psychiatric disorders and substance abuse
In the review by Goldstein of studies on the evolution of ADHD in adulthood, the author concludes that 10 -20% of adults with ADHD experience history of minor problems, 60% continue to have symptoms of ADHD, and changes in social adjustment, academic and emotional problems clinically significant, and 10-30% develop problems associated with antisocial behavior to disturbances caused by ADHD and other comorbid disorders. As happens in childhood, the presence of other psychiatric disorders associated with ADHD is common in adults. It is considered that 70% of adults with ADHD have psychiatric comorbidity.
psiquiátricoscomórbidos disorders with ADHD in adults are similar to those found in childhood, with
the difference in the increased prevalence of drugs and the emergence of personality disorders. Of possible comorbid psychiatric disorders in adults with ADHD include drug addiction. Studies show that people with ADHD in childhood initiate substance use at an earlier age and that the evolution to an abuse or dependence is faster than in people without ADHD.
ASSESSMENT OF ADHD IN ADULTS
A standardized protocol should include a patient history, self-administered questionnaires of symptoms, neuropsychological performance and assessment of comorbid psychopathology. Will be followed by a list of those measures that are translated and / or validated in our environment. There are also structured interviews with this goal:
- Conners Adult ADHD Diagnostic Interview for DSM-IV (CAAD-Party II). Conners et al. 1999.
- Entrevista para TDAH
de Barkley. Barkley et al. 1998.
- ADHD Rating Scale-IV. DuPaul et al. 1998.
- ADHD Symptom
Rating Scale. Barkley et al. 1998.
- Adult Self-Report Scale (ASRS). WHO and Workgroup on Adults ADHD: Adler, Kessler et Spencer, 2003.
- Conners Adult ADHD Rating Scale (CAARS). Conners et al. 1999.
- ADHD Screening Checklist.
- Wender Utah Rating Scale (WURS). Ward et al. 1993, Rodríguez-Jiménez et al. 2001.
- ADHD Symptom Rating Scale. Barkley et al. 1998.
DRUG TREATMENT OF ADHD IN ADULTS
Psychodrugs used in the treatment of adult ADHD are the same as losutilizados in childhood ADHD. The best-studied drugs in adults are methylphenidate and atomoxetine.
efficacy of psychostimulants
different psychostimulants, we have controlled clinical trials have studied its efficacy in adults with ADHD in the case of immediate release methylphenidate and prolonged. You can also use modafinil. The meta-analysis on efficacy and safety of methylphenidate in adults with ADHD were included a total of 243 patients. Of these, 140 received methylphenidate, while 113 received placebo. The results showed that methylphenidate was more effective than placebo in the treatm
ent of ADHD, especially when the dose was equal to or greater than 0.9 mg / kg / day. Psychostimulants not only increase the risk of abuse or dependence substances, but it decreases in adulthood.
Effectiveness of psychostimulant drugs not
currently have controlled clinical trials and numerous non-stimulant drugs to treat ADHD in adults: atomoxetine, bupropion, tricyclic antidepressants, MAOIs , alpha-2 adrenergic agonists such as guanfacine and nicotinic drugs.
PSYCHOLOGICAL TREATMENT OF ADHD IN ADULTS
calls psychoeducational interventions can be used as therapies themselves, or as a component of a broader therapy (Murphy, 1998, Brown, 2000; Young, 2002). These interventions can be carried out under an individual or group format.
Cognitive-behavioral
The most effective approach to treat ADHD in adults is the cognitive behavior therapy, both individual and group intervention (Brown, 2000;
McDermott, 2000; Young, 2002).
The results referenced in this consensus show that ADHD in adults is a clinically relevant. Following the disorder, patients experience significant changes that affect their quality of life. The current literature has provided sufficient evidence of the persistence of ADHD into adulthood. Therefore, we believe that identifying the disorder and appropriate treatment is critical.
Often women are diagnosed after having previously been his child, and when this happens it is easier to work voluntarily in treatment. Women are also more prone to autoculpación, hence, when they are diagnosed have a temporary euphoria to know that your problem has a name.
Many girls and women who have comorbid psychiatric disorders, particularly apathy, depression, bipolar disorder, anxiety and substance abuse, usually alcohol, which almost always hidden. For that reason, before prescribing a neurostimulator has had to discard a dependency. Women are more likely to focus on the responsibility of
keep house and raise children, but in this case is more important to conduct a regulated work hours and specific functions, since the home were less structure. Women with ADHD, its dynamism, can be a super busy mom. However, the greater the number of children more sources of distraction will have.
Coaching.
Adult patients with ADHD, they must be followed by a "COACH" O CAOCHING Ayue him to control his ADHD, to achieve their personal and working objeivos to leave himself and in defenitiva to control their ADHD.
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