Adult ADHD: Evaluation and treatment in family medicine

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Primary Care Companion to the Journal of Clinical Psychiatry


Although up to one half of adults who had attention-deficit/ hyperactivity disorder (ADHD) as children continue to experience ADHD symptoms, family physicians are often uncomfortable in evaluating and treating adults. with this disorder. The defining symptoms of ADHD in adults (e.g., restlessness, inability to prioritize) differ subtly from those of ADHD in children; thus, the disorder can be difficult to diagnose in adults using established criteria, which were developed to identify childhood ADHD. Accurate diagnosis of ADHD in adults requires the collection of a substantial amoun of data from patients, including treatment history, patient self-report of symptoms, and current mental status. Physicians must differentiate between ADHD and other psychiatric disorders tha have a similar symptom profile - especially major depression and sub-stance abuse or dependence - and recognize that ADHD is often comorbid with other psychiatric disorders. Psychostimulants are the most commonly prescribed medications for adults with ADHD, but treatment with antidepressants is increasing in frequency. Additionally, pharmacotherapy is enhanced by the incorporation of self-management strategies and psychotherapy.

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