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  • 1.
    Edvinsson, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Attention Deficit/Hyperactivity Disorder in Adults: Prevalence, Psychiatric Comorbidities and Long-term Outcome2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Attention Deficit/Hyperactivity Disorder (ADHD) was originally thought to occur only in children, but is increasingly recognised as causing functional impairment also in adulthood. The overall aim of this thesis was to achieve a comprehensive understanding of ADHD in adulthood.

    A questionnaire based on the DSM-IV criteria of ADHD, reported childhood symptoms, reading and spelling problems, difficulties and suffering and general assessment of functioning (GAF) was distributed to three samples: the general population (GP), outpatient psychiatry (OPP) and female prison inmates. Symptoms consistent with ADHD were more than three times higher in the OPP sample than in the GP sample (6.6 versus 2.1%). ADHD symptoms and related problems occurred in 50% of the prison inmates.

    A cohort of 168 patients diagnosed with ADHD in adulthood was interviewed about current ADHD symptoms and psychiatric comorbidity on axis I and II. The lifetime prevalence of psychiatric comorbidity on axis I was 92% and current comorbidity, including autism spectrum disorders and Tourette’s syndrome, was 47%. The sex-specific pattern of the comorbid disor-ders was similar to that in the general population. Forty-six per cent of the patients endorsed the specific criteria for at least one personality disorder.

    After a mean follow-up of six years, there was remission of adult ADHD in about 30% of the patients, regardless of whether there was ongoing medication or not. There were no differences in function and quality of life, except for global general improvement, which was better in patients currently on medication.

    The most prevalent long-term side effects of pharmacological treatment with mainly stimulants were decreased appetite, dry mouth, anxiousness/restlessness and an increase in pulse frequency. The discontinuation rate was about 50%: 29% discontinued because of a perceived lack of effect, followed by elevated mood or hypomania (11%). No detectable evidence of tolerance and increased need for dosage over time was observed.

    To conclude, Symptoms of ADHD is highly overrepresented in OPP and in female inmates compared with the GP. Furthermore, adults diagnosed with ADHD have a high lifetime prevalence of psychiatric comorbidity. Long-term pharmacological treatment with stimulants is safe with relatively mild and tolerable adverse effects. Continued medication, however, is not related to remission.

    Delarbeid
    1. ADHD-related symptoms among adults in out-patient psychiatry and female prison inmates as compared with the general population
    Åpne denne publikasjonen i ny fane eller vindu >>ADHD-related symptoms among adults in out-patient psychiatry and female prison inmates as compared with the general population
    2010 (engelsk)Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, nr 1, s. 30-40Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective. To compare the prevalence of symptoms consistent with attention deficit hyperactivity disorder (ADHD) and related problems in adults in the general population, out-patient psychiatry (where females are in majority), and female convicts. Method. A questionnaire based on the DSM-IV criteria of ADHD, reported childhood symptoms, reading and spelling problems, difficulties and suffering, and general assessment of functioning (GAF) was distributed to samples of the general population, open care psychiatry, and female prison inmates. Completed questionnaires were received from 517/1000, 349/400, and 50/65 of the three samples, respectively. Results. Symptoms consistent with ADHD were more than three times higher in out-patient psychiatry than in the general population (6.6% versus 2.1%), with a male-to-female ratio of 1.6-1.7. The severity of symptoms and frequencies of associated disabilities were similar in men and women. ADHD symptoms and related problems occurred in 50% of the female prisoners, which is similar to male prisoners according to the literature. Conclusion. The high prevalence of symptoms and disabilities of ADHD in women should lead to awareness of the disorder in both sexes and be addressed in terms of diagnostic work-up, treatment, and rehabilitation.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-136943 (URN)10.3109/03009730903532333 (DOI)000275061700005 ()20085506 (PubMedID)
    Tilgjengelig fra: 2010-12-15 Laget: 2010-12-14 Sist oppdatert: 2017-12-11bibliografisk kontrollert
    2. Gender differences of axis I and II comorbidity in subjects diagnosed with attention-deficit hyperactivity disorder as adults
    Åpne denne publikasjonen i ny fane eller vindu >>Gender differences of axis I and II comorbidity in subjects diagnosed with attention-deficit hyperactivity disorder as adults
    Vise andre…
    2013 (engelsk)Inngår i: Acta Neuropsychiatrica, ISSN 0924-2708, E-ISSN 1601-5215, Vol. 25, nr 3, s. 165-174Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: To investigate gender differences in psychiatric comorbidity patients diagnosed with attention-deficit hyperactivity disorder (ADHD) as adults. Methods: Interviews about current ADHD symptoms and psychiatric comorbidity on axis I and II (Structured Clinical Interview for DSM-IV axis I and axis II) were conducted in a clinical cohort of 168 patients (78 women, 90 men). Independent information on childhood and current symptoms was collected from parents, partners and patient files. Results: The lifetime prevalence of psychiatric comorbidity on axis I reached 92%, and current comorbidity, including autism spectrum disorders and Tourette's syndrome, was 47%. Women had a higher lifetime prevalence of mood and eating disorders compared with men, where substance-use disorders were more frequent. Ten per cent of patients fulfilled diagnostic criteria for a personality disorder. When excluding the general diagnostic criteria, 46% of the patients endorsed the specific criteria for at least one personality disorder. Gender differences were identified with predominance of histrionic personality traits in women and conduct disorder in men. Conclusion: Patients diagnosed with ADHD as adults display an extremely high lifetime axis I comorbidity with a gender-specific pattern similar to the general population. No gender differences were identified with regard to personality disorders; however, an increased prevalence of deviant personality traits was confirmed. This study stresses the importance of evaluating comorbidity among patients diagnosed with ADHD as adults to secure optimal treatment.

    Emneord
    ADHD, adults, comorbidity, gender
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-204118 (URN)10.1111/j.1601-5215.2012.00682.x (DOI)000320550800006 ()
    Tilgjengelig fra: 2013-07-22 Laget: 2013-07-22 Sist oppdatert: 2017-12-06bibliografisk kontrollert
    3. Six-Year Outcome in Subjects Diagnosed with Attention-Deficit/Hyperactivity Disorder as Adults
    Åpne denne publikasjonen i ny fane eller vindu >>Six-Year Outcome in Subjects Diagnosed with Attention-Deficit/Hyperactivity Disorder as Adults
    2018 (engelsk)Inngår i: European Archives of Psychiatry and Clinical Neuroscience, ISSN 0940-1334, E-ISSN 1433-8491, Vol. 268, nr 4, s. 337-347Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    There are very few studies on the long-term outcome in subjects diagnosed with ADHD as adults. The objective of the present study was to assess this and relate the outcome to whether there was current medication or not and to other potential predictors of favourable outcome. A prospective clinical cohort of adults diagnosed with ADHD according to DSM-IV criteria was followed-up on an average of 6 years after first evaluation (n = 124; mean age 42 years, 51% males). ADHD symptom trajectories were assessed as well as medication, global functioning, disability, health-related quality of life, and alcohol and drug consumption at follow-up. Ninety percent of those diagnosed were initially treated pharmacologically and half of them discontinued treatment. One-third reported remission, defined as not fulfilling any ADHD subtype and a GAF-value last year ≥ 70, which was not affected by comorbidity at baseline. Current medication was not associated with remission. Subjects evaluated and first diagnosed with ADHD as adults are functionally improved at follow-up 6 years later despite a high percentage of psychiatric comorbidity at baseline. Half dropped out of medication, and there was no difference in ADHD remission between subjects with on-going medication at follow-up or subjects without medication, although current medication was related to a higher degree of self-reported global improvement.

    HSV kategori
    Forskningsprogram
    Psykiatri
    Identifikatorer
    urn:nbn:se:uu:diva-327890 (URN)10.1007/s00406-017-0850-6. (DOI)000432412500003 ()29143159 (PubMedID)
    Forskningsfinansiär
    Swedish Research Council
    Tilgjengelig fra: 2017-08-11 Laget: 2017-08-11 Sist oppdatert: 2018-07-30bibliografisk kontrollert
    4. Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study
    Åpne denne publikasjonen i ny fane eller vindu >>Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study
    2018 (engelsk)Inngår i: Journal of Clinical Psychopharmacology, ISSN 0271-0749, E-ISSN 1533-712X, Vol. 38, nr 4, s. 370-375Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder typically treated with stimulants and atomoxetine. Data on long-term tolerability and safety of such pharmacological treatment in subjects diagnosed in adulthood are limited.

    Methods: A cohort of adults diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria was followed-up on an average of 6 years after first evaluation. Of 168 adults, 112 (67%) who initiated medication were available for follow-up. Data were obtained from patient record data, self-report forms, and a telephone interview.

    Results: Of the 112 participants assessed, 57 (51%) were still on treatment with methylphenidate (MPH) at follow-up and 55 (49%) had discontinued. The 3 leading reasons for discontinuing treatment with MPH were lack of effect (29%), elevated mood or hypomania (11%), and losing contact with the prescribing physician (9%). The most common adverse effects in subjects still on treatment with MPH were decreased appetite (28%), dry mouth (24%), anxiousness/restlessness and increased pulse frequency (19% each), decreased sexual desire (17%), and perspiration (15%). Subjects still on treatment reported increased quality of life, a higher level of functioning, and a greater understanding of their way of functioning from those being close compared with nonmedicated subjects.

    Conclusions: The high attrition rate underscores the need for further research to identify possible modes to increase retention to treatment. Those diagnosed with ADHD and on long-term treatment with stimulants experience mild and tolerable adverse effects.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-327891 (URN)10.1097/JCP.0000000000000917 (DOI)000438053700016 ()29927781 (PubMedID)
    Merknad

    Title in dissertation reference list: Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder

    Tilgjengelig fra: 2017-08-11 Laget: 2017-08-11 Sist oppdatert: 2018-09-24bibliografisk kontrollert
  • 2.
    Edvinsson, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study2018Inngår i: Journal of Clinical Psychopharmacology, ISSN 0271-0749, E-ISSN 1533-712X, Vol. 38, nr 4, s. 370-375Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Attention-deficit/hyperactivity disorder (ADHD) is a behavioral disorder typically treated with stimulants and atomoxetine. Data on long-term tolerability and safety of such pharmacological treatment in subjects diagnosed in adulthood are limited.

    Methods: A cohort of adults diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria was followed-up on an average of 6 years after first evaluation. Of 168 adults, 112 (67%) who initiated medication were available for follow-up. Data were obtained from patient record data, self-report forms, and a telephone interview.

    Results: Of the 112 participants assessed, 57 (51%) were still on treatment with methylphenidate (MPH) at follow-up and 55 (49%) had discontinued. The 3 leading reasons for discontinuing treatment with MPH were lack of effect (29%), elevated mood or hypomania (11%), and losing contact with the prescribing physician (9%). The most common adverse effects in subjects still on treatment with MPH were decreased appetite (28%), dry mouth (24%), anxiousness/restlessness and increased pulse frequency (19% each), decreased sexual desire (17%), and perspiration (15%). Subjects still on treatment reported increased quality of life, a higher level of functioning, and a greater understanding of their way of functioning from those being close compared with nonmedicated subjects.

    Conclusions: The high attrition rate underscores the need for further research to identify possible modes to increase retention to treatment. Those diagnosed with ADHD and on long-term treatment with stimulants experience mild and tolerable adverse effects.

  • 3.
    Edvinsson, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Six-Year Outcome in Subjects Diagnosed with Attention-Deficit/Hyperactivity Disorder as Adults2018Inngår i: European Archives of Psychiatry and Clinical Neuroscience, ISSN 0940-1334, E-ISSN 1433-8491, Vol. 268, nr 4, s. 337-347Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There are very few studies on the long-term outcome in subjects diagnosed with ADHD as adults. The objective of the present study was to assess this and relate the outcome to whether there was current medication or not and to other potential predictors of favourable outcome. A prospective clinical cohort of adults diagnosed with ADHD according to DSM-IV criteria was followed-up on an average of 6 years after first evaluation (n = 124; mean age 42 years, 51% males). ADHD symptom trajectories were assessed as well as medication, global functioning, disability, health-related quality of life, and alcohol and drug consumption at follow-up. Ninety percent of those diagnosed were initially treated pharmacologically and half of them discontinued treatment. One-third reported remission, defined as not fulfilling any ADHD subtype and a GAF-value last year ≥ 70, which was not affected by comorbidity at baseline. Current medication was not associated with remission. Subjects evaluated and first diagnosed with ADHD as adults are functionally improved at follow-up 6 years later despite a high percentage of psychiatric comorbidity at baseline. Half dropped out of medication, and there was no difference in ADHD remission between subjects with on-going medication at follow-up or subjects without medication, although current medication was related to a higher degree of self-reported global improvement.

  • 4.
    Edvinsson, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lindström, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bingefors, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
    Lewander, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Gender differences of axis I and II comorbidity in subjects diagnosed with attention-deficit hyperactivity disorder as adults2013Inngår i: Acta Neuropsychiatrica, ISSN 0924-2708, E-ISSN 1601-5215, Vol. 25, nr 3, s. 165-174Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate gender differences in psychiatric comorbidity patients diagnosed with attention-deficit hyperactivity disorder (ADHD) as adults. Methods: Interviews about current ADHD symptoms and psychiatric comorbidity on axis I and II (Structured Clinical Interview for DSM-IV axis I and axis II) were conducted in a clinical cohort of 168 patients (78 women, 90 men). Independent information on childhood and current symptoms was collected from parents, partners and patient files. Results: The lifetime prevalence of psychiatric comorbidity on axis I reached 92%, and current comorbidity, including autism spectrum disorders and Tourette's syndrome, was 47%. Women had a higher lifetime prevalence of mood and eating disorders compared with men, where substance-use disorders were more frequent. Ten per cent of patients fulfilled diagnostic criteria for a personality disorder. When excluding the general diagnostic criteria, 46% of the patients endorsed the specific criteria for at least one personality disorder. Gender differences were identified with predominance of histrionic personality traits in women and conduct disorder in men. Conclusion: Patients diagnosed with ADHD as adults display an extremely high lifetime axis I comorbidity with a gender-specific pattern similar to the general population. No gender differences were identified with regard to personality disorders; however, an increased prevalence of deviant personality traits was confirmed. This study stresses the importance of evaluating comorbidity among patients diagnosed with ADHD as adults to secure optimal treatment.

  • 5.
    Kooij, J. J. S.
    et al.
    Expertise Ctr Adult ADHD, PsyQ Psychomed Programs, Carel Reinierszkade 197, NL-2593 HR The Hague, Netherlands;Amsterdam UMC, Dept Psychiat, Location VUMc, Amsterdam, Netherlands.
    Bijlenga, D.
    Expertise Ctr Adult ADHD, PsyQ Psychomed Programs, Carel Reinierszkade 197, NL-2593 HR The Hague, Netherlands.
    Salerno, L.
    INS, Inst Neurosci, Florence, Italy.
    Jaeschke, R.
    Jagiellonian Univ, Dept Psychiat, Sect Affect Disorders, Med Coll, Krakow, Poland.
    Bitter, I
    Semmelweis Univ, Dept Psychiat, Budapest, Hungary.
    Balazs, J.
    Eotvos Lorand Univ, Inst Psychol, Vadaskert Child Psychiat Hosp, Budapest, Hungary;Eotvos Lorand Univ, Outpatient Clin, Budapest, Hungary.
    Thome, J.
    Univ Med Rostock, Thome Klin & Poliklin Psychiat Psychotherapie, Rostock, Germany.
    Dom, G.
    Antwerp Univ UA, CAPRI, Boechout, Belgium.
    Kasper, S.
    Med Univ Vienna, Dept Psychiat & Psychotherapy, Vienna, Austria.
    Nunes Filipe, C.
    Univ NOVA Lisboa, Nova Med Sch, Lisbon, Portugal.
    Stes, S.
    Katholieke Univ Leuven, Univ Psychiat Ctr, Kortenberg, Belgium.
    Mohr, P.
    Natl Inst Mental Hlth, Klecany, Czech Republic;Charles Univ Prague, Fac Med, Prague, Czech Republic.
    Leppamaki, S.
    Univ Helsinki, Dept Psychiat, HUS, Cent Hosp, Helsinki, Finland.
    Casas, M.
    Hosp Univ Vall dHebron, Dept Psychiat, Barcelona, Spain;Vall dHebron Res Inst VHIR, Psychiat Genet Unit, Barcelona, Spain;Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain;Univ Autonoma Barcelona, Dept Psychiat & Forens Med, Barcelona, Spain.
    Bobes, J.
    Univ Autonoma Barcelona, Dept Psychiat & Forens Med, Barcelona, Spain;Univ Oviedo, Sch Med, Dept Psychiat, CIBERSAM,Ctr Invest Biomed & Red Salud Mental, Oviedo, Spain.
    Mccarthy, J. M.
    Kings Coll London, London, England;Midland Reg Forens Serv, Hamilton, New Zealand.
    Richarte, V
    Hosp Univ Vall dHebron, Dept Psychiat, Barcelona, Spain;Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain;Univ Autonoma Barcelona, Dept Psychiat & Legal Med, Barcelona, Spain.
    Philipsen, A. Kjems
    DPC Naestved, Naestved, Region Sjaellan, Denmark.
    Pehlivanidis, A.
    Univ Athens, Eginit Hosp, Dept Psychiat, Med Sch, Athens, Greece.
    Niemela, A.
    Wellmind Terveys Oy, Oulu, Finland.
    Styr, B.
    Mccabi Hlth Serv HMO, Tel Aviv, Israel.
    Semerci, B.
    Hasan Kalyoncu Univ, Istanbul, Turkey.
    Bolea-Alamanac, B.
    Univ Toronto, Ctr Addict & Mental Hlth, Gen Syst Div, Dept Psychiat, Toronto, ON, Canada.
    Edvinsson, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Baeyens, D.
    Katholieke Univ Leuven, Parenting & Special Educ, Leuven, Belgium.
    Wynchank, D.
    Expertise Ctr Adult ADHD, PsyQ Psychomed Programs, Carel Reinierszkade 197, NL-2593 HR The Hague, Netherlands.
    Sobanski, E.
    Mannheim Univ, Cent Inst Mental Hlth, Med Ctr Mainz, Mainz, Germany.
    Philipsen, A.
    Univ Bonn, Dept Psychiat & Psychotherapy, Bonn, Germany.
    McNicholas, F.
    Univ Coll Dublin, Dublin, Ireland.
    Caci, H.
    Hop Pediat Nice CHU Lenval, Nice, France.
    Mihailescu, I
    Alexandra Obregia Clin Hosp Psychiat, Bucharest, Romania.
    Manor, I
    Geha MHC, Petah Tiqwa, Israel.
    Dobrescu, I
    Univ Med & Pharm Carol Davila, Child & adolescent Psychiat Dept, Prof Dr Alex Obregia Psychiat Hosp, Bucharest, Romania.
    Saito, T.
    Hokkaido Univ, Grad Sch Med, Dept Child & Adolescent Psychiat, Kita Ku, North 15,West 7, Sapporo, Hokkaido 0608638, Japan.
    Krause, J.
    Outpatient Clin, Ottobrunn, Germany.
    Fayyad, J.
    Balamand Univ, Univ Med Ctr, Inst Dev Res Advocacy & Appl Care, St George Hosp,Dept Psychiat & Clin Psychol,Fac M, Lebanon, NH USA.
    Ramos-Quiroga, J. A.
    Hosp Univ Vall dHebron, Dept Psychiat, Barcelona, Spain;Vall dHebron Res Inst VHIR, Psychiat Genet Unit, Barcelona, Spain;Biomed Network Res Ctr Mental Hlth CIBERSAM, Barcelona, Spain.
    Foeken, K.
    Vieux Chemin Cagnes La Gaude, La Gaude, France.
    Rad, F.
    Univ Med & Pharm Carol Davila, Child & adolescent Psychiat Dept, Prof Dr Alex Obregia Psychiat Hosp, Bucharest, Romania.
    Adamou, M.
    Univ Huddersfield, Wakefield, England;South West Yorkshire Partnership NHS, Manygates Clin, Wakefield, England.
    Ohlmeier, M.
    Klinikum Kassel, Dept Psychiat & Psychotherapy, Kassel, Germany.
    Fitzgerald, M.
    Trinity Coll Dublin, Dublin, Ireland.
    Gill, M.
    Trinity Coll Dublin, Sch Med, Dept Psychiat, Dublin, Ireland.
    Lensing, M.
    Oslo Univ Hosp, NevSom Norwegian Ctr Expertise Neurodev Disorders, Dept Rare Disorders, Oslo, Norway.
    Mukaddes, N. Motavalli
    Istanbul Inst Child & Adolescent Psychiat, Istanbul, Turkey.
    Brudkiewicz, P.
    Ctr Dobrej Terapii, Krakow, Poland.
    Gustafsson, P.
    Lund Univ, Child & Adolescent Psychiat, Clin Sci Lund, Lund, Sweden.
    Tani, P.
    Univ Helsinki, Dept Psychiat, HUS, Clin Neuropsychiat,Cent Hosp, Helsinki, Finland.
    Oswald, P.
    CRP Les Marronniers, High Secur Hosp, Tournai, Belgium.
    Carpentier, P. J.
    Reinier van Arkel Mental Hlth Inst, sHertogenbosch, Netherlands.
    De Rossi, P.
    Univ Sapienza Rome, Sapienza Univ Rome, Fac Med & Psychol, Dept Neurol & Psychiat, Rome, Italy.
    Delorme, R.
    Robert Debre Hosp, Child & Adolescent Psychiat Dept, Paris, France.
    Simoska, S. Markovska
    Macedonian Acad Sci & Arts, Skopje, Macedonia.
    Pallanti, S.
    Univ Florence, Stanford Univ Med Ctr, INS Inst Neurosci, Florence, Italy.
    Young, S.
    Psychol Serv Ltd, Croydon, England.
    Bejerot, S.
    Orebro Univ, Sch Med Sci, Campus USO, Orebro, Sweden.
    Lehtonen, T.
    Neuropsykologkonsult Taina Lehtonen, Hjdrup, Sweden.
    Kustow, J.
    Enfield & Haringey NHS Mental Hlth Trust, Barnet Adult ADHD Serv, London, England;Barnet Hosp, Springwell Ctr, Barnet Adult ADHD Serv, Barnet, England.
    Mueller-Sedgwick, U.
    Enfield Ea Haringey NHS Mental Hlth Trust, Adult ADHD Serv, North London, England;Univ Cambridge, Springwell Ctr, Dept Psychiat, Adult ADHD Serv,Barnet Hosp, London, England.
    Hirvikoski, T.
    Karolinska Inst KIND, CAP Res Ctr, Ctr Neurodev Disorders, Stockholm, Sweden.
    Pironti, V
    Cambridge Adult ADHD BASD Clin, Cambridge, England.
    Ginsberg, Y.
    Karolinska Inst, Stockholm Ctr, Dept Clin Neurosci, Eating Disorder R&D Unit, Stockholm, Sweden.
    Felegyhazy, Z.
    ADHD Kozpont Ctr Budapest, Budapest, Hungary.
    Garcia-Portilla, M. P.
    Univ Oviedo, Sch Med, Dept Psychiat, Psychiat, Oviedo, Spain.
    Asherson, P.
    Kings Coll London, Inst Psychiat Psychol & Neurosci, SGDP Bldg, London, England.
    Updated European Consensus Statement on diagnosis and treatment of adult ADHD2019Inngår i: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 56, s. 14-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.

    Methods

    The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.

    Results

    Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?

    Conclusions

    ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.

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