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Attention-deficit/hyperactivity disorder (ADHD) in adults: Specific clinical and therapeutic issues

Published online by Cambridge University Press:  15 April 2020

B. Rolland ,
D. Da Fonseca ,
M. Fatseas  and
N. Simon
B. Rolland*
Affiliation:
Service d’Addictologie, CHRU de Lille, Inserm U1171, Université de Lille, Lille
D. Da Fonseca
Affiliation:
Service de Pédopsychiatrie, AP–HM, Marseille
M. Fatseas
Affiliation:
Service d’Addictologie, CHU de Bordeaux, Bordeaux
N. Simon
Affiliation:
Service d’Addictologie, AP–HM, Marseille
*
*Corresponding author. E-mail address: benjamin.rolland@chru-lille.fr (B. Rolland)

Abstract

Attention-deficit/hyperactivity disorder (ADHD) was initially considered as a childhood psychiatric disorder. However, longitudinal observations have revealed that ADHD symptoms may persist in adulthood among approximately 50% of the patients . Adult ADHD is associated with impaired social outcome and frequent comorbidities such as mood disorders, personality disorders, and substance use disorders [2,3]. Correctly identifying and treating ADHD can significantly improve the global functioning and cognition of adult subjects, and reduce the intensity and frequency of the comorbid states [2,3]. Nonetheless, the clinical features of adult ADHD are clearly different from the youth form [1,2], and ADHD symptoms are easily mixed up in adults with symptoms of the comorbid conditions [2,3]. These clinical intricacies can make the diagnosis of ADHD difficult in adults. Moreover, the management of methylphenidate in adult subjects is also associated with specific risks and pitfalls, such as abuse and tampering behaviors, and additional safety risks . Put together, it appears crucial to identify and treat ADHD in adults, but the clinical and therapeutic complexities of adult ADHD require improved expertise and caution from adult psychiatrists and addiction specialists. In this thematic session of the 2015 French Psychiatry Congress, three French leading experts of adult ADHD will address the aforementioned clinical and therapeutic issues of the adulthood form of this disorder. David Da Fonseca, professor of child psychiatry in Marseille, will disentangle the clinical features of adult ADHD from the typical symptoms observed in the youth form. Mélina FATSEAS, associate professor of psychiatry and addiction medicine in Bordeaux, will specifically focus on the many and complex relationships observed between adult ADHD and substance use disorders. Last, Nicolas Simon, professor of addiction medicine and psychopharmacology in Marseille, will synthesize what are the very risks and issues with prescribing methylphenidate in adults.

Keywords

Attention-deficit/hyperactivity disorderAdultDiagnosisDiagnosisDifferentialmethylphenidate
Type
Congrès français de psychiatrie: Rencontres avec l’expert
Information
European Psychiatry , Volume 30 , Issue S2: HS1 - Congrès Français de Psychiatrie 2015 , November 2015 , pp. S27 - S28
Copyright
Copyright © European Psychiatric Association 2015

Disclosure of interest

The authors declare that they have no competing interest.

References

Simon, V.Czobor, P.Blint, S.Mészros, A.Bitter, I.Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry 2009; 194(3): 204–211.CrossRefGoogle ScholarPubMed
Da Fonseca, D.Adida, M.Belzeaux, R.Azorin, J.M.Trouble déficitaire de l’attention et/ou trouble bipolaire ? Encephale 2014; 40(Suppl. 33): S23–S26.CrossRefGoogle Scholar
Fatseas, M.Debrabant, R.Auriacombe, M.The diagnostic accuracy of attention-deficit/hyperactivity disorder in adults with substance use disorders. Curr Opin Psychiatry 2012; 25(3): 219–225.CrossRefGoogle ScholarPubMed
Simon, N.Rolland, B.Karila, L.Use and monitoring specificities of methylphenidate in adults with comorbid substance use disorder and attention-deficit hyperactivity disorder. Curr Pharm Des. 2015 [accepted in Press]Google Scholar
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