title: Attention deficit hyperactivity disorder in the European adult population: prevalence, disease awareness, and treatment guidelines.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder with childhood onset and persistence into adolescence and adulthood.
  
  
  METHODS
  Our literature review reports scientific publications and guidelines on the treatment of adult ADHD, with a particular focus on European countries, identified by literature searches in Medline and Embase. The final literature search was performed in July 2012, incorporating literature from 1974 to 2012. The primary research parameters were 'Europe' (including single European countries), 'ADHD', 'attention deficit disorder', 'attention deficit', 'attention disorder', and 'hyperactivity'. Secondary search parameters were 'comorbid', 'epidemiology' or 'prevalence', 'disease management', 'drug therapy', or 'therapy'. The main searches were also limited to adults and English language publications. The papers identified by this literature review were selected for inclusion by consensus of the authors based on clinical relevance.
  
  
  RESULTS
  Appropriate resources for the diagnosis and treatment of adult ADHD in Europe are scarce, and many cases go untreated, particularly because of the frequent presence of psychiatric comorbidities. Apart from atomoxetine, and an extended-release form of methylphenidate in Germany, no other medications have been approved for starting treatment in adult ADHD patients in the European Union. However, a variety of stimulant and non-stimulant medications are used off-label, and a number of studies have confirmed that these medications are well tolerated and effective in adult patients with ADHD.
  
  
  CONCLUSIONS
  Our results emphasize the need for broader access to effective treatments for adult ADHD patients in Europe.
authors.affiliation: Adult ADHD Program, Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain. jaramos@vhebron.net
authors.forename: Josep Antoni
authors.initials: JA
authors.lastname: Ramos-Quiroga
authors.forename: Alonso
authors.initials: A
authors.lastname: Montoya
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kutzelnigg
authors.forename: Walter
authors.initials: W
authors.lastname: Deberdt
authors.forename: Esther
authors.initials: E
authors.lastname: Sobanski
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000328:Adult; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011437:Propylamines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000697:Central Nervous System Stimulants; D011437:Propylamines; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride