Comment: Many lives?
Rob Rodrigues Pereira
pp 3-3
My six-year-old grandson suddenly ran into the street without looking left and right (or right and left if you prefer). I warned him, ‘Be careful, because you have only one life!’ He answered, ‘No, Grandpa, you have four lives. First you are a child, then a schoolboy, then a father and then a grandfather’. We know that these ‘lives’ transition smoothly one into another. The same goes for attention deficit hyperactivity disorder, where there is heterotypic continuity. But, we also discriminate between preschoolers, schoolchildren, adolescents and adults in scientific research and treatment protocols.
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Teenagers, transition and ADHD: mind the gap
Susan Young
pp 4-6
One of the greatest challenges that healthcare practitioners working with young people with attention deficit hyper activity disorder (ADHD) face is how best to manage a smooth transition between child and adult services. A difficulty in achieving this goal is not particular to ADHD; discontinuity and consequent disruption to mental healthcare during this period has been generally acknowledged as being complicated by complex service structures, arbitrary service boundaries, variation in protocols and policy–practice gaps.
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Transition to adult care for patients with ADHD: the Australian experience
Daryl Efron and Michele Toner
pp 7-9
Attention deficit hyperactivity disorder (ADHD) persists into adulthood in at least 30% of cases. Some individuals are only diagnosed in adulthood, and many are not diagnosed at all. Difficulty accessing medical care for adults with ADHD appears to be an international problem. In Australia, transition of older adolescents with ADHD to adult care is a major problem, and there is no uniform approach or standard process for referral to adult services. The Australian healthcare system presents some opportunities, but also some particular challenges, for developing innovative and equitable models of transition. In this paper, the challenges in achieving transition to adult care for patients with ADHD will be discussed, with a focus on the Australian system, and recommendations for assisting with transition and optimising support will be presented.
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Abstract Watch: Symptom expression and treatment outcomes in ADHD
Nigel Humphrey
pp 10-10
In this edition of abstract watch, we highlight a large outcome study by Setyawan et al, which explores the rate of optimal treatment success in children and adolescents with attention deficit hyperactivity disorder (ADHD). The low optimal treatment success rate clearly demonstrates the need for further exploration, and the authors call for a rethink of the current treatment protocols. We also highlight a study by Ichikawa et al, which investigates facial expression recognition in children with ADHD, something that has traditionally been confined to the sphere of autistic spectrum disorders. Despite the low sample size, the findings, that children with ADHD are more attuned to happy expressions than they are to angry expressions, are interesting and may further knowledge on the lack of danger-awareness principle in ADHD. The final abstract by Segenreich et al explores familial patterns of ADHD and co-morbidity, and raises an interesting point about maternal genetic influence being more dominant than paternal genetic influence.
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Autism and ADHD: two conditions with significant symptom overlap
Sam Goldstein
pp 11-13
In the last ten years, a number of peer-reviewed studies have demonstrated the elevated incidence of attention deficit hyperactivity disorder (ADHD) symptoms within populations of children diagnosed with autism, autism spectrum disorder (ASD), Asperger’s syndrome and pervasive developmental disorder not otherwise specified as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition and fifth edition. Previous research conducted by our group and others has, for example, found a significant overlap between ASD and ADHD.
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Medication management of ADHD in adults
James Kustow
pp 14-18
ADHD is a persistent pattern of inattention and/or hyperactivity that interferes with functioning or development. ADHD begins in childhood, but persists into adulthood in up to 65% of cases. Population surveys suggest that ADHD occurs in most cultures in about 5% of children and 2.5% of adults. Despite criticisms of over diagnosis, in the USA, the National Comorbidity Survey Replication estimates that as many as 75% of people with ADHD have never been diagnosed, and 90% remain untreated.
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ADHD – an adult patient’s perspective
Gary Sendall
pp 19-19
In 2000, at the age of 32, I was diagnosed with ADHD with a comorbid personality disorder. The doctors recommended methylphenidate and started me off on 10 mg, three times a day.
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