Beyond childhood: Understanding ADHD in adults
1Brittney Hulsey is an associate professor and program director of the PA Studies program at A.T. Still University in Mesa, AZ, and practices family medicine at Village Medical in Phoenix, AZ. Clay Walker is an assistant professor of PA studies and director of didactic education in the PA program at A.T. Still University in Mesa, AZ, and is an assistant professor of family medicine at Mayo Clinic in Phoenix, AZ. C. Walker discloses service as an external clinical expert on the GlaxoSmithKline UTI Consultancy Panel; service as a medical consultant and advisor for Cosmas Health's Pyrls; and service as a mentor for PAs and NPs in clinical practice through Medgeeks. The authors have disclosed no other potential conflicts of interest, financial or otherwise.
Attention-deficit/hyperactivity disorder (ADHD) in adults often stems from childhood symptoms, not true adult onset. Primary care is crucial for diagnosis and managing this neurodevelopmental disorder.
Area of Science:
- Neurodevelopmental Disorders
- Adult Psychiatry
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently persisting into adulthood.
- Adult ADHD diagnoses often occur in primary care, sometimes linked to unrecognized childhood symptoms.
Purpose of the Study:
- To outline the epidemiology, pathophysiology, clinical features, diagnostic strategies, and evidence-based treatments for adult ADHD.
- To emphasize the role of primary care in recognizing and managing adult ADHD.
Main Methods:
- Systematic review of literature on adult ADHD.
- Analysis of diagnostic criteria and differential diagnoses for adult ADHD.
- Review of evidence-based treatment modalities for adult ADHD.
Main Results:
- "Adult-onset ADHD" is often explained by previously subthreshold childhood symptoms or other conditions.
- Mimicking conditions like mood disorders, anxiety, substance use, and sleep disorders must be ruled out.
- Multimodal treatment plans are essential for improving patient outcomes.
Conclusions:
- Primary care clinicians are vital for early identification and management of adult ADHD.
- Accurate diagnosis requires ruling out mimics before confirming adult ADHD.
- Effective management involves a comprehensive, evidence-based approach tailored to adult patients.
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