The art of prescribing pharmacological management of adult ADHD: implications for psychiatric care.
OBJECTIVE
For several years I have seen more adults presenting with attention-deficit/ hyperactivity disorder (ADHD). I realize that historically ADHD has been considered a childhood disorder, but I would like to know more about diagnosing and treating adult ADHD.


CONCLUSIONS
Your observations about the prevalence and challenges that confront psychiatric nurses concerning the diagnosis and treatment of adult ADHD are correct. ADHD is a relatively common psychiatric disorder with a high occurrence of 2-6% in adults (Kessler et al., 2006). Though generally regarded as a childhood diagnosis, emerging evidence indicates that symptoms of ADHD remain into adulthood, affecting 4.4% of the adult population (Biederman, Monuteaux, et al., 2006). ADHD in adults frequently goes undiagnosed and untreated. This is largely associated with adults minimizing the severity of symptoms and being unaware that they actually have ADHD. Predictably, adult ADHD is associated with increased morbidity. Higher divorce rates, traffic violations, and negative occupational, economic, and psychosocial functions and concomitant psychiatric disorders are common findings in adults with ADHD (Kessler, Adler, Ames, Barkley, et al., 2005). Approximately 70-75% of adults presenting for treatment of ADHD have at least one co-existing psychiatric diagnosis (Kessler et al., 2006; Wilens, Biederman, & Spencer, 2002). Social phobia, bipolar disorder, major depression, and alcohol dependence are the most common co-existing psychiatric disorders in adults with ADHD (Kessler et al., 2006).
Antai-Otong
Deborah
D
Department of Veterans Affairs, Fort Worth Outpatient Clinic, Fort Worth, TX, USA. deborah.antai-otong@va.gov
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000451:nursing; D000697:Central Nervous System Stimulants / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D016903:Drug Monitoring / Q000451:nursing; D011307:Drug Prescriptions / Q000451:nursing*; D006801:Humans; D024802:Nurse's Role; D009730:Nursing Assessment; D018579:Patient Selection; D015995:Prevalence; D011568:Psychiatric Nursing / Q000458:organization & administration*; D017751:Safety Management; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants