Attention deficit hyperactivity disorder in adults: a guide for the primary care physician

Attention deficit hyperactivity disorder (ADHD) persists into adulthood in up to 60% of cases with childhood onset. A childhood history of ADHD is a prerequisite for making the ADHD diagnosis in an adult. The Utah, Copeland, and Brown self-rating scales are useful in helping the primary care physician confirm the diagnosis. A thorough developmental history, a substance abuse history, and a medical and neurologic examination should be obtained to rule out other causes of poor concentration and attention. Medication interventions can include the stimulants and/or noradrenergic and dopaminergic antidepressants. Nonmedication intervention should include education, referral to support groups, and referral for individual and/or couples therapy. If the diagnosis is unclear or if there is inadequate response to an intervention, referral to a psychiatrist or psychologist is indicated.