A new European study finds that up to two-thirds of children with attention deficit hyperactivity disorder (ADHD) continue to have the disorder in adulthood. But only a small proportion of adults ever receive a formal diagnosis and treatment.
ADHD is a neurodevelopmental disorder that begins in childhood, yet may continue into adulthood. Experts now believe that 3 to 4 percent of adults are affected by ADHD, and it is associated with a broad range of psychosocial impairments.
Attention deficit disorder is a condition characterized by high levels of distraction, impulsiveness, an inability to remain still, and a tendency to be abnormally talkative.
Dr. Esther Sobanski investigates the pharmacological management of adult ADHD at the Central Institute of Mental Health in Mannheim, Germany.
“In contrast [to the 3-4 percent prevalence rate], diagnostic prevalence is below 0.5 percent, indicating that a majority of cases go undiagnosed and untreated,” she said.
Sobanski believes adult ADHD often disrupts peer-group relationships and may fuel parenting difficulties.
Additionally, untreated adult ADHD can contribute to poor work and academic performance, as well as a tendency towards dangerous driving habits like speeding and accident proneness in daily living were all associated with the disorder.
“In addition to ADHD core symptoms, patients often experience associated symptoms like emotional dysregulation, sleep disturbances or low self-esteem, as well as suffering from comorbid disorders, particularly depressive episodes, substance use and anxiety disorders,” she said.
Dr Sobanki’s research suggests that medication can have an impact beyond ADHD core symptoms, improving psychosocial functioning like managing on-road driving or parenting while treating symptoms such as emotional dysregulation or sleep problems.
Current guidelines recommend a multimodal approach for treatment of adult ADHD, including psycho-education, pharmacotherapy, disorder-oriented psychotherapy and occupational rehabilitation.
However, although pharmacotherapy has been shown to be highly effective, and a growing body of evidence supports disorder-oriented psychotherapy in residual symptoms, many adults remain untreated.
“New pharmacological treatment approaches not only target ADHD core symptoms but also co-morbid psychiatric disorders like alcohol use disorders or social phobia,” Sobanksi noted. “However, in the European Union only two medications are approved for de novo use in adult ADHD.”
“Available data from a cross national suggest that most adults with ADHD in Europe are untreated,” she added.