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Adult ADHD: Better Late Than Never

Studies have shown that up to 80% of those diagnosed for ADHD in childhood will continue to suffer from symptoms into adulthood. Those symptoms can be quite debilitating and a proper diagnosis and treatment can be literally life saving
Children arrive for their first day of school at the Paula Ben Gurion school in Jerusalem on September 1, 2015. (Hadas Parush/Flash 90)
Children arrive for their first day of school at the Paula Ben Gurion school in Jerusalem on September 1, 2015. (Hadas Parush/Flash 90)

ADHD was once thought be be a problem of childhood. Studies have shown, however, that up to 80% of those diagnosed in childhood will continue to suffer from symptoms of ADHD into adulthood. Those symptoms can be quite debilitating. Proper diagnosis and treatment can be literally life saving. This post will take a look at adult ADHD including an overview of impairments, diagnosis and treatment.

Studies world-wide indicate that the prevalence of adult ADHD is between 3-4% of the population. Rates of ADHD seem to be equal in both men and women, as opposed to the higher prevalence noted in boys in the pediatric population. Many adults with ADHD will have at least one or more co-occurring disorders such as anxiety or depression. Unfortunately, in untreated adults with ADHD, there seem to be significantly higher rates of addiction, occupational difficulties, legal problems, marital problems, traffic accidents and poor health. A recent study published in The Lancet found a higher rate of death in those with ADHD, mostly related to accidents.

The diagnostic process for an adult begins with a thorough exploration of current symptoms and impairments. Questionnaires are used to help identify both quantity and quality of key symptoms. Often, corroboratory information is provided by a spouse or other close family member. In order to qualify for a diagnosis of adult ADHD, it is essential that a clear pattern of symptoms be traceable back to child-hood. Every evaluation must include a complete review of the individual’s medical history including any current medications that might interact with ADHD medications to be prescribed. A physical examination is important in ruling out other medical causes that can mimic symptoms of ADHD such as hypothyroidism, anemia or a neurological problem. As noted, it is important to screen for other conditions that commonly co-occur with adult ADHD such as depression and anxiety.

The Adult ADHD Self-Report Scale (ASRS) is a useful screening tool to rapidly detect individuals who should be evaluated for ADHD. Those who have a positive score (4 or more on the first 6 questions) have a high probability of having ADHD and should undergo formal evaluation.

Once ADHD has been diagnosed, a holistic treatment plan should be designed based on the individual’s needs. Lifestyle modification is one the most important elements of treatment as many individuals with ADHD suffer from poor nutrition, lack of sleep and exercise. Cognitive behavioral therapy (CBT) has been shown to be an effective treatment for adults with ADHD. Dedicated personal coaches who specialize in ADHD can teach and oversee implementation of key organizational and time management skills. Medications used in treating ADHD provide for immediate and dramatic symptom relief but should always be one element of a broader treatment program. Finally, many trendy and scientifically unvalidated treatments such as food elimination diets, vitamin supplementation and neuro-feedback should be avoided.

About the Author
Jonah Kruger is a doctor who lives and works in Jerusalem. He studied medicine at McMaster University in Canada and completed his specialty training in pediatrics at Hadassah Medical Center, Mount Scopus. He treats children and adults privately for ADHD at Jerusalem's Wolfson clinic. He can be contacted at drjonahkruger@gmail.com
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