A guide to the treatment of adults with ADHD

While child and adolescent physicians are familiar with the treatment of attention-deficit/hyperac-tivity disorder (ADHD), many adult physicians have had little experience with the disorder. It is difficult to develop clinical skills in the management of residual adult manifestations of developmental disorders without clinical experience with their presentation in childhood. Adult patients are increasingly seeking treatment for the symptoms of ADHD, and physicians need practice guidelines. Adult ADHD often presents differently from childhood ADHD. Because adult ADHD can be comorbid with other disorders and has symptoms similar to those of other disorders, it is important to understand differential diagnoses. Physicians should work with patients to provide feedback about their symptoms, to educate them about ADHD, and to set treatment goals. Treatment for ADHD in adults should include a medication trial, restructuring of the patient's environment to make it more compatible with the symptoms of ADHD, and ongoing supportive management to address any residual impairment and to facilitate functional and developmental improvements.