Réhab Khalifa
Consultant Psychiatrist
Title: Adult attention deficit hyperactivity disorder: A disorder within debate
Biography
Biography: Réhab Khalifa
Abstract
ADHD is a neurobiological condition characterized by core symptoms and persistent patterns of inattention and/or hyperactivity and impulsiveness. ADHD is a persisting disorder. Of the young people with a sustained diagnosis most will go on to have significant difficulties in adulthood, which may include continuing ADHD, personality disorders, emotional and social difficulties, substance misuse, unemployment and involvement in crime. ADHD is a disorder that changes its presentation in different age groups. In children: Academic/social dysfunction, disruptive behavior and skill deficiencies. In adolescents: Academic failure, alcohol and substance abuse, low self-esteem and parental conflict. In adults: Psychological dysfunction/disability, psychiatric comorbidities, significant job impairment, relationship difficulties, offending behavior and low self-esteem. The identification of ADHD in adults is still uncommon. There are still few specialist or general mental health services for adults with ADHD, however, services are being developed in many areas across the world. There is also a pool of adult patients in whom the diagnosis of ADHD has been unidentified and where ineffective treatments have been put in place for alternative diagnoses, which may account for the high rates of contact, reported with mental health services for adults with ADHD and in turn, associated cost implications. Transition from childhood into adulthood remains a major concern in young people with mental health problems, particularly those with ADHD who are vulnerable and require continuing care into adulthood. In 2007, WHO-WMH survey initiative the estimated worldwide prevalence of adult ADHD was 3.4% in the general adult population. Additional data to consider when estimating the potential prevalence and following on the potential patients are: (1) Release of DSM V which potentially lowers the threshold for adult diagnosis, (2) Increasing recognition and awareness of adult ADHD and (3) Availability of existing pharmacological and psychological interventions. Adults with ADHD generally have a high rate of comorbid conditions that add not only to the impairment associated with ADHD but also the disorder’s economic burden. Approximately, 75% of adults with ADHD have at least one comorbid condition. Common co-existing conditions in adults include personality disorders, bipolar disorder, obsessive-compulsive disorder and substance misuse. ADHD prevalence in general psychiatric outpatient clinics is estimated to be between 17 and 24%.
References
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