ADHD : ADHD Can Last Into Adulthood

Christen Croley, The Sentinel, Carlisle, Pa.

One area physician says that only a combination of medication and therapy can offset the adverse effects of attention deficit hyperactivity disorder in adulthood and can potentially stave off the onset of other psychiatric disorders, too.

A study in the April edition of the journal American Academy of Pediatrics says 29 percent of children diagnosed with ADHD in the study still had the condition at age 27 and 57 percent of those participants develop at least one other psychiatric disorder.

"It's something that's with you throughout your life," said Jose Delerme, Ph.D,, clinical director for PinnacleHealth Psychological Associates. "This isn't something you're just going to get as an adult unless you've had a head injury."

Researchers from Mayo Clinic in Rochester, Minn., followed 367 children born between 1976 and 1982 who were diagnosed with ADHD at the age of 5 -- 232 of whom participated in the follow up 22 years later.

Although there is no cure for ADHD, 71 percent of the participants said they no longer showed any signs of the disorder.

Delerme said some ADHD symptoms decrease as patients age because there is no longer the pressure of a classroom environment.

"Some of those symptoms may not apply to you anymore," he said. "But that doesn't mean it's cured."

"This study shows that the adverse effects of ADHD are persistent and long-term in a substantial proportion of those with a childhood diagnosis," said Tanya Froehlich, a developmental-behavioral pediatrician at Cincinnati Children's Hospital Medical Center, in a Mar.4 interview with USA Today. "The disorder and its associated conditions have serious public health consequences."

Lead investigator on the study, William Barbaresi, a developmental medicine specialist at Boston Children's Hospital, told USA Today that ADHD should be treated as any other chronic illness.

"When a child is diagnosed, we immediately institute strategies aimed at keeping the child engaged in appropriate treatment for the long haul," he told the newspaper.

Delerme said although medication is the first line of defense for ADHD patients, adding in therapy helps people manage the disorder.

"There is a lot of co-morbidity that goes with ADHD," Delerme said. "Usually related to depression, substance abuse disorders, anti-social personality disorder. Anxiety disorder is a big one."

The study ranked the top psychiatric disorders among its participants, with alcohol dependence being the most prevalent at 26 percent. Anti-social personality disorder came in second at 17 percent of the group, while non-alcoholic substance abuse, hypomanic episodes, anxiety disorder and major depression rounded out the list at 16, 15, 14 and 13 percent respectively.

"The risk for persistent ADHD is considerable, and the risk for at least one mental health condition, including ADHD, is extraordinarily high," Barbaresi told USA Today. "Only 37.5 percent of the children we contacted as adults were free of these really worrisome outcomes."

Therapy, Delerme said, provides coaching for how to deal with jobs, relationships, bills, parenting and other responsibilities that ADHD compromises on a daily basis.

"Some people just do the medication," he said. "That may work briefly, but therapy and medication provides a lot more success."

Delerme said patients who don't recognize ADHD symptoms until adulthood often go undiagnosed as children because many primary-care physicians lack the training necessary to properly evaluate the disorder.

"A lot of it comes through parents who had children with ADHD," he said. "Because family history is important, a lot of times I'll end up evaluating parents as a result."

The National Resource Center on ADHD says the neuro-developmental disorder affects 5 million children ages 3 to 17 and 2 to 4 percent of adults.

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