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Diagnosis and management of adult attention-deficit/hyperactivity disorder.
Am Fam Physician. 2012 May 01; 85(9):890-6.AF

Abstract

Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. A number of conditions, such as thyroid disease, mood disorders, and substance use disorders, have symptoms similar to those of attention-deficit/hyperactivity disorder and should be considered in the differential diagnosis. Steroids, antihistamines, anticonvulsants, caffeine, and nicotine also can have adverse effects that mimic attention-deficit/hyperactivity disorder symptoms. Proper diagnosis and treatment can improve daily functioning. Diagnosis relies on a thorough clinical history, supported by a number of rating scales that take five to 20 minutes to complete, depending on the scale. Clinical guidelines recommend stimulants and the nonstimulant atomoxetine as first-line treatments, followed by antidepressants. Cognitive behavior therapy has also been shown to be helpful as adjunctive treatment with medication. For adults with coexisting depression, the combination of an antidepressant and stimulants has been shown to be safe and effective. To monitor for misuse or diversion of stimulants, family physicians should consider using a controlled substances agreement and random urine drug screening in addition to regular follow-up visits.

Authors+Show Affiliations

Virtua Family Medicine Residency, Voorhees, NJ 08043, USA. rpostmd@gmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22612184

Citation

Post, Robert E., and Stuart L. Kurlansik. "Diagnosis and Management of Adult Attention-deficit/hyperactivity Disorder." American Family Physician, vol. 85, no. 9, 2012, pp. 890-6.
Post RE, Kurlansik SL. Diagnosis and management of adult attention-deficit/hyperactivity disorder. Am Fam Physician. 2012;85(9):890-6.
Post, R. E., & Kurlansik, S. L. (2012). Diagnosis and management of adult attention-deficit/hyperactivity disorder. American Family Physician, 85(9), 890-6.
Post RE, Kurlansik SL. Diagnosis and Management of Adult Attention-deficit/hyperactivity Disorder. Am Fam Physician. 2012 May 1;85(9):890-6. PubMed PMID: 22612184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis and management of adult attention-deficit/hyperactivity disorder. AU - Post,Robert E, AU - Kurlansik,Stuart L, PY - 2012/5/23/entrez PY - 2012/5/23/pubmed PY - 2012/10/17/medline SP - 890 EP - 6 JF - American family physician JO - Am Fam Physician VL - 85 IS - 9 N2 - Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. A number of conditions, such as thyroid disease, mood disorders, and substance use disorders, have symptoms similar to those of attention-deficit/hyperactivity disorder and should be considered in the differential diagnosis. Steroids, antihistamines, anticonvulsants, caffeine, and nicotine also can have adverse effects that mimic attention-deficit/hyperactivity disorder symptoms. Proper diagnosis and treatment can improve daily functioning. Diagnosis relies on a thorough clinical history, supported by a number of rating scales that take five to 20 minutes to complete, depending on the scale. Clinical guidelines recommend stimulants and the nonstimulant atomoxetine as first-line treatments, followed by antidepressants. Cognitive behavior therapy has also been shown to be helpful as adjunctive treatment with medication. For adults with coexisting depression, the combination of an antidepressant and stimulants has been shown to be safe and effective. To monitor for misuse or diversion of stimulants, family physicians should consider using a controlled substances agreement and random urine drug screening in addition to regular follow-up visits. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/22612184/full_citation L2 - https://www.aafp.org/link_out?pmid=22612184 DB - PRIME DP - Unbound Medicine ER -