Clinical considerations for the diagnosis and treatment of ADHD in the managed care setting.
Although symptoms of attention-deficit/ hyperactivity disorder (ADHD) are certainly most visible in children, the syndrome persists into adolescence in 40% to 70% of cases and into adulthood in 50% or more of cases. Accurate recognition of the disorder is clouded by the frequent presence of psychiatric comorbidities. Contributing to these challenges, managed care providers in primary care are often inexperienced in identifying and treating ADHD in adults because of a lack of formalized training. As such, special consideration must be given to each individual age group and includes identifying common clinical presentations, characterizing the disorder and its comorbidities, applying validated rating scales as screening and treatment outcome measures, and individually assessing patients' optimal response to determine the best course of therapy. Pharmacotherapy is often initiated to target ADHD symptoms with either a stimulant medication or nonstimulants. In addition, behavioral interventions are often applied to treat comorbidities and associated impairments of ADHD.
Jensen
Peter S
PS
The REACH Institute, 450 Seventh Ave, Ste 1107, New York, NY 10123, USA. peter.jensen@thereachinstitute.org
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003913:Dextroamphetamine / Q000627:therapeutic use; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D006801:Humans; D008329:Managed Care Programs; D008774:Methylphenidate / Q000627:therapeutic use; D011437:Propylamines / Q000627:therapeutic use
D018759:Adrenergic Uptake Inhibitors; D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D011437:Propylamines; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride; D003913:Dextroamphetamine