title: Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review.
abstract: Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school-age children. This review is intended to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents. PubMed, PsychInfo, and Science Citation Index databases were searched from March 1990 to 2015 with the keywords: ADHD, primary care/pediatrics, and children/adolescents. Abstracts addressing diagnosis and/or treatment with 105 citations were identified including supplementary treatment guidelines/books. Adolescent ADHD presents with significant disturbances in attention, academic performance, and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis, and limited training and time for PCPs to conduct thorough evaluations. The evidence base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification, and treatment of conditions associated with ADHD that emerge during adolescence such as substance use disorders. Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care psychiatric models, to assist in determining the optimal care for patients at this critical period.
authors.affiliation: Department of Psychiatry, University of California San Francisco/Langley Porter Psychiatric Institute, San Francisco, California.
authors.forename: Khyati
authors.initials: K
authors.lastname: Brahmbhatt
authors.affiliation: Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, California; Department of Psychiatry and Addiction Medicine, Kaweah Delta Medical Center, Visalia, California. Electronic address: donh032612@gmail.com.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Hilty
authors.affiliation: Department of Psychiatry, BHC Heritage Oaks Hospital, Sacramento, California.
authors.forename: Mina
authors.initials: M
authors.lastname: Hah
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine and Health System, Sacramento, California; Department of Family and Community Medicine, University of California, Davis School of Medicine and Health System, Sacramento, California.
authors.forename: Jaesu
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Developmental Behavioral Pediatrics, University of California, Davis School of Medicine and Health System M.I.N.D. Institute, Sacramento, California.
authors.forename: Kathy
authors.initials: K
authors.lastname: Angkustsiri
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine and Health System, Sacramento, California; Department of Psychiatry and Behavioral Sciences, University of California, Davis School of Medicine and Health System M.I.N.D. Institute, Sacramento, California.
authors.forename: Julie B
authors.initials: JB
authors.lastname: Schweitzer
mesh_terms: D000293:Adolescent; D000662:Amphetamines / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011320:Primary Health Care; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D000662:Amphetamines; D000697:Central Nervous System Stimulants
keywords: ADHD; Adolescent; Attention deficit hyperactivity disorder; Evaluation; Primary care; Treatment