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Arch Hellen Med, 29(5), September-October 2012, 562-576


Attention deficit hyperactivity disorder (ADHD) in adults:
Clinical recognition, diagnosis and therapeutic interventions

A. Pehlivanidis, A. Spyropoulou, A. Galanopoulos, C.A. Papachristou, G.N. Papadimitriou
First Department of Psychiatry, National and Kapodistrian University of Athens, "Eginition" Hospital, Athens, Greece

Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder of childhood that in most cases persists into adulthood, causing significant impairment. Adult psychiatrists may be confronted by lack of experience in the diagnosis and treatment of ADHD. The clinical picture of ADHD in adults is expressed differently from that in children, due to a growing need in adulthood for self-determined action, autonomy and higher performance in fields such as executive functioning and attention. Comorbid psychiatric syndromes, such as impulse control disorders, substance abuse, anxiety and mood disorders, may contribute to the complex clinical manifestations of ADHD. Diagnosis is based on specific clinical criteria and requires standardized methodology. The assessment of childhoodonset ADHD, the continuous presence of the symptomatology into adulthood and the degree of functional impairment should be taken into consideration. Bipolar disorder and borderline personality disorder are included in the differential diagnosis. ADHD treatment is generally multimodal. Comorbid psychiatric disorders should be treated first. The beneficial effects of stimulants (methylphenidate, dexamphetamine) and atomoxetine on the core symptoms of ADHD have been demonstrated, while antidepressants (venlafaxine, bupropion) are considered to be second line agents. Psychosocial treatment, such as coaching, psychoeducation and cognitive therapy, are also commonly used. Expertise in the diagnosis and treatment of adult ADHD may ameliorate the health and quality of life of the patients and minimize the burden of the disease on their overall family life.

Key words: ADHD, Adults, Attention deficit hyperactivity disorder, Diagnosis, Treatment.

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