Skip to main content Accessibility help
×
Home

Special Considerations in Diagnosing and Treating Attention-Deficit/Hyperactivity Disorder

  • Sharon B. Wigal (a1) and Timothy L. Wigal (a2)

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent chronic condition that affects people of all ages, including young children, school-aged children, adolescents, and adults. Symptoms can be noted as early as preschool age, tend to progress into functional impairment and behavioral problems in later childhood, and typically persist into adulthood. Contrary to previous belief, the disorder does not resolve with puberty for the majority of children; rather, the symptoms are manifested differently throughout the lifecycle. Presentation in adults is heavily biased toward inattentive symptoms, which are less likely to draw notice than hyperactive or impulsive symptoms and may contribute to the underrecognition of ADHD in this patient population. Diagnosis is particularly difficult due in large part to the pronounced comorbidity of psychiatric disorders in this patient population. Identification may be even more difficult in adults than children as the diagnostic criteria are not as clear, adults have difficulty remembering symptoms prior to 7 years of age, and there is a high prevalence of comorbid psychiatric disorders in adults. Early identification and treatment of symptoms of ADHD in preschool-age children is essential to effective long-term management of the disorder. Both medication and behavioral treatments appear to alleviate the symptoms of ADHD, and evidence suggests that discontinuation of treatment leads to the reemergence of the condition. Efforts are currently continuing toward understanding the genetic underpinnings of ADHD.

This expert review supplement will address the prevalence, comorbidity, treatment issues, and special considerations surrounding ADHD management throughout each stage of the lifecycle beginning with ADHD in preschool-aged children, continuing with school-aged children and adolescents, and ending with adulthood.

Copyright

References

Hide All
1.Lavigne, JV, Gibbons, RD, Christoffel, KK, et al.Prevalence rates and correlates of psychiatric disorders among preschool children. J Am Acad Child Adolesc. 1996;32:204214.
2.Campbell, SB. Parent-referred problem three-year-olds: developmental changes in symptoms. J Child Psychol Psychiatry. 1987;28:835845.
3.DuPaul, GJ, McGoey, KE, Eckert, TL, VanBrakle, J. Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning. J Am Acad Child Adolesc. 2001;40:508515.
4.Lahey, BB, Pelham, WE, Stein, MA, et al.Validity of DSM-IV attention-deficit/hyperactivity disorder for younger children. J Am Acad Child Adolesc. 1998;37:695702.
5.LaHoste, GJ, Swanson, JM, Wigal, SB, et al.Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder. Mol Psychiatry. 1996;1:121124.
6.Lahey, BB, Pelham, WE, Loney, J, et al.Three-year predictive validity of DSM-IV attention deficit hyperactivity disorder in children diagnosed at 4Y6 years of age. Am J Psychiatry. 2004;161:20142020.
7.Pierce, EW, Ewing, LJ, Campbell, SB. Diagnostic status and symptomatic behavior of hard-to-manage preschool children in middle childhood and early adolescence. J Clin Child Psychol. 1999;28:4457.
8.Wilens, TE, Biederman, J, Brown, S, Monuteaux, M, Prince, J, Spencer, TJ. Patterns of psychopathology and dysfunction in clinically referred preschoolers. J Dev Behav Pediatr. 2002;23:S31S36.
9.Medco Health Solutions. 2004 Drug Trend Report. Available at: www.medcohealth.com. Accessed May 17, 2004.
10.Zito, JM, Safer, DJ, dosReis, S, Gardner, JF, Boles, M, Lynch, F. Trends in the prescribing of psychotropic medications to preschoolers. JAMA. 2000;283:10251030.
11.Kollins, S, Greenhill, L, Swanson, J, et al.Rationale, design, and methods of the Preschool ADHD Treatment Study (PATS). J Am Acad Child Adolesc Psychiatry. 2006;45(11):12751283.
12.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
13.Manidiaki, K, Sonuga-Barke, E, Kakouros, E, Karaba, R. Parental beliefs about the nature of ADHD behaviours and their relationship to referral intentions in preschool children. Child Health Care Dev. 2007;33:188.
14. NIMH ADHD site. Available at: www.nimh.nih.gov/publicat/adhd.cfm#diag. Accessed May 13, 2007.
15.Consensus Development Panel. Defined Diets and Childhood Hyperactivity. National Institutes of Health Consensus Development Conference Summary. 1982; Vol 4, No 3.
16.Biederman, J, Faraone, SV, Keenan, K, Knee, D, Tsuang, MF. Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. J Am Acad Child Adolesc Psychiatry. 1990;29:526533.
17.Faraone, SV, Biederman, J. Neurobiology of attention-deficit hyperactivity disorder. Biol Psychiatry. 1998;44;951958.
18.Faraone, SV, Perlis, RH, Doyle, AE, et al.Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57:13131323.
19.Kennedy, JL. Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder. Mol Psychiatry. 2004;1:121124.
20.Lowe, N, Kirley, A, Hawi, Z, et al.Joint analysis of the DRD5 marker concludes association with attention-deficit/hyperactivity attention-deficit/hyperactivity disorder confined to the predominantly inattentive and combined subtypes. Am J Hum Genet. 2004;74:348356.
21.McGough, JJ. Attention-deficit/hyperactivity disorder pharmacogenomics. Biol Psychiatry. 2005;57:13671373.
22.El-Faddagh, M, Laucht, M, Maras, A, et al.Association of dopamine D4 receptor (DRD4) gene with attention-deficit/hyperactivity disorder (ADHD) in a high-risk community sample: a longitudinal study from birth to 11 years of age. J Neur Trans. 2004;111: 883889.
23.Swanson, JM, Kraemer, HC, Hinshaw, SP, et al.Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. J Am Acad Child Adolesc. 2001:40;168179.
24.Thapar, A, Langley, K, Fowler, T, et al.Catechol o-methyltransferase gene variant and birth weight predict early-onset antisocial behavior in children with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2005;62:12751278.
25.Thapar, A, Langley, K, O'Donovan, M, et al.Refining the attention deficit hyperactivity disorder phenotype for molecular genetic studies. Mol Psychiatry. 2006;11:714720.
26.MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention deficit hyperactivity disorder. Arch Gen Psychiatry. 1999;56:10731086.
27.Wender, PH. ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford University Press. 2002:9.
28.Geller, B, Williams, M, Zimerman, B, Frazier, J, Beringer, L, Warner, KL. Prepubertal and early adolescent bipolarity differentiate from ADHD by manic symptoms, grandiose delusions, ultra-rapid or ultradian cycling. J Affect Disord. 1998;51:8191.
29.Barkley, RA, The effects of methylphenidate on the interactions of preschool ADHD children with their mothers. J Am Acad Child Adolesc. 1998;27:336341.
30.Cohen, NJ. Evaluation of the relative effectiveness of methylphenidate and cognitive behavior modification in the treatment of kindergarten-aged hyperactive children. J Abnormal Child Psychol. 1981;9:4354.
31.Handen, BL, Feldman, HM, Lurier, A, Murray, PJ. Efficacy of methylphenidate among preschool children with developmental disabilities and ADHD. J Am Acad Child Adolesc. 1999;38:805812.
32.Swanson, J, Greenhill, L, Wigal, T, et al.Stimulant-related reductions of growth rates in the PATS. J Am Acad Child Adolesc. 2006;45:13041313.
33.Wigal, S, Gupta, S, Greenhill, L, et al.Pharmacokinetics of methylphenidate in preschoolers with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol. In press.
34.Greenhill, L, Kollins, S, Abikoff, H, et al.Rationale, design, and methods of the preschool ADHD treatment study (PATS). J Am Acad Child Adolesc. 2006;45:11.
35.Sonuga-Barke, EJ, Daley, D, Thompson, M, Laver-Bradbury, C, Weeks, A. Parent-based therapies for preschool attention-deficit/hyperactivity disorder: a randomized, controlled trial with a community sample. J Am Acad Child Adolesc. 2001;40:402408.
36.Olfson, M. Diagnosing mental disorders in office-based pediatric practice. J Dev Behav Pediatr. 1992;13:363365.
37.Frazier, T, Youngstrom, E, Glutting, J, Watkins, M. ADHD and achievement: meta-analysis of the child, adolescent, and adult literature and a concomitant study with college students. Journal of Learning Disabilities. 2007;40:4965.
38.Bagwell, C, Molina, B, Pelham, W, Hoza, B. Attention deficit hyperactivity disorder and problems in peer relations: predictions from childhood to adolescence. J Am Acad Child Adolesc Psychiatry. 2001;40:12851292.
39.Pelham, W, Foster, M, Robb, J. The Economic impact of attention-deficit/hyperactivity disorder in children and adolescents. Ambulatory Pediatrics. 2007;7:121131.
40.Biederman, J, Farone, S, Milberger, S, et al.A prospective 4-year follow-up study of attention-deficit/hyperactivity and related disorders. Arch Gen Psychiatry. 1996;53:437446.
41.Ingram, S, Hechtman, L, Morgenstern, G. Outcome issues in ADHD: adolescent and adult long-term outcome. Ment Retard Dev Disabil Res Rev. 1999;5:243250.
42.Biederman, J, Newcorn, JH, Sprich, S. Comorbidity of attention-deficit hyperactivity disorder with conduct, depressive, anxiety and other disorders. Am J Psychiatry. 1991;148:251256.
43.Abikoff, H, Courtney, M, Pelham, WE, Koplewicz, HS. Teachers' ratings of disruptive behaviors: the influence of halo effects. J Abnorm Child Psychol. 1993;21:519533.
44.Schachar, R, Sandber, S, Rutter, M. Agreement between teachers' ratings and observations of hyperactivity, inattentiveness and defiance. J Abnorm Child Psychol. 1986;14:331345.
45.Pliszka, SR. Effect of anxiety on cognition, behavior and stimulant response in ADHD. J Am Acad Child Adolesc Psychiatry. 1989;28:882887.
46.Rappley, MD, Gardiner, JC, Jetton, JR, Houang, RT. The use of methylphenidate in Michigan. Arch Pediatr Adolesc Med. 1995;149:675679.
47.Rowland, AS, Lesesne, CA, Abramowitz, AJ. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Ret Dev Dis Res Rev. 2002;8:162170.
48.NIMH. Attention Deficit Hyperactivity Disorder. 2006. Available at: http://www.nimh.nih.gov/publicat/adhd.cfm#intro. Accessed April 19, 2007.
49.Mental health in the United States: prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder--United States, 2003.MMWR Morb Mortal Wkly Rep. 2005;54(34);842847.
50.Wilens, T. Alcohol and other drug use and attention deficit hyperactivity disorder. Alcohol Health Res World. 1998;22:127130.
51.Gittelman, R, Mannuzza, S, Shenker, R, Bonagura, N. Hyperactive boys almost group up: I. Psychiatric status. Arch Gen Psychiatry. 1985;42:937947.
52.Hechtman, L, Weiss, G. Controlled prospective fifteen year follow-up of hyperactives as adults: non-medical drug and alcohol use and anti-social behaviour. Can J Psychiatry. 1986;31:557567.
53.Barkley, R. Driving Impairments in teens and adults with attention-deficit/hyperactivity disorder. Psychiatr Clin North Am. 2004;27:233260.
54.Johnston, C, Mash, E. Families of children with attention deficit hyperactivity disorder: review and recommendations for future research. Clin Child Family Psychol. 2001;4:183207.
55.Biederman, J, Wilens, T, Mick, E, et al.Does attention-deficit hyperactivity disorder impact the developmental course of drug and alcohol abuse and dependence? Biol Psychiatry. 1998;36:3743.
56.Silver, LB. The relationship between learning disabilities, hperactivty, distractibility, and behavioral problems. J Am Acad Child Psychiatry. 1981;20:385397.
57.Biederman, J, Faraone, SV, Mick, E, et al.Attention deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity? J Am Acad Child Adolesc Psychiatry. 1996;35:9971008.
58.Spencer, J, Biederman, J, Mick, E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. Ambulatory Pediatrics. 2007;7:7381.
59.Goldman, S, Genel, M, Bezman, R, Slanetz, P. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. JAMA. 1998;279:11001107.
60.Biederman, J, Newcorn, J, Sprich, S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatry. 1991;148:564577.
61.Biederman, J, Faraone, SV, Milberger, S, et al.Is childhood oppositional defiant disorder a precursor to adolescent conduct disorder? Findings from a 4-year follow-up study of children with ADHD. J Am Acad Child Adolesc Psychiatry. 1996;35:11931204.
62.Klorman, R, Brumaghim, JT, Salzman, LF, et al.Effects of methylphenidate on attention-deficit hyperactivity disorder with and without aggressive/noncompliant features. J Abnorm Psychol. 1988;97:413422.
63.Biederman, J, Faraone, SV, Keenan, K, et al.Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives in psychiatrically and pediatrically referred samples. Arch Gen Psychiatry. 1992;49:728738.
64.Brent, DA, Perper, JA, Goldstein, CE, et al.Risk factors for adolescent suicide: a comparison of adolescent suicide victims with suicidal inpatients. Arch Gen Psychiatry. 1988;45:581588.
65.Biederman, J, Faraone, S, Keenan, K, et al.Family genetic and psychosocial risk factors in attention deficit disorder. Biol Psychiatry. 1989;25:145A.
66.Morgan, A, Hynd, G, Riccio, C, Hall, J. Validity of DSM-IV ADHD predominately inattentive and combined types: relationship to previous DSM diagnoses/subtype differences. J Am Acad Child Adolsec Psychiatry. 1996;35:325333.
67.Paternite, C, Loney, J, Roberts, M. External validation of oppositional disorder and attention deficit disorder with hyperactivity. J Abnorm Child Psychol. 1995;23:453471.
68.Wolraich, M, Hannah, J, Pinnock, T, et al.Comparison of diagnostic criteria for attention-deficit hyperacitivty disorder in a country-wide sample. J Am Acad Child Adolesc Psychiatry. 1996;35:319324.
69.Sleator, E, Ullman, R. Can the physician diagnose hyperactivity in the office? Pediatrics. 1981;67:1317.
70.Mitsis, E, McKay, K, Schulz, K, et al.Parent-teacher concordance for DSM-IV attention-deficit/hyperactivity disorder in a clinic-referred sample. Child Adolesc Psychiatry. 2000;39:308313.
71.Molina, B, Pelham, W, Blumenthal, J, Galiszewski, E. Agreement among teachers' behavior ratings of adolescents with a childhood history of attention-deficit/hyperactivity disorder. J Clin Child Psychol. 1998;27:330339.
72.Kramer, T, Phillips, S, hargis, M, et al.Disagreement between parent and adolescent reports of functional impairment. J Child Psychol Psychiatry. 2004;45:248259.
73.Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). Available at: http://www.wpic.pitt.edu/ksads/default.htm. Accessed April 19, 2007.
74.Achenbach, T, Edelbrock, L. Manual for the Child Behavior Checklist 4-18 and 1991 Profile. Burlington, VT: University of Vermont; 1991.
75.Reynolds, C, Kamphouse, R. BASC: Behavior Assessment System for Children Manual. Circle Pines, MN: American guidance Service; 1992.
76.Brown, TE. Brown ADD Scales for Children and Adolescents. San Antonio, TX: Psychological Corp; 2001.
77.Swanson, J, Nolan, R, Pelham, W. Swanson, Nolan and Pelham Rating Scale (SNAP). Pittsburgh, PA, Department of Psychiatry, Western Psychiatric Institute and Clinic; 1998.
78.Shaffer, D, Fisher, P, Dulcan, M, et al.The second version of the NIMH Diagnostic Interview Schedule for Children (DISC-2). J Am Acad Child Adolesc Psychiatry. 1996;35:865877.
79.Quinn, P, Wigal, S. Perceptions of girls and ADHD: results from a national survey. Med Gen Med. 2004;6:2.
80.Sharp, WS, Walter, J, Marsh, W, Ritchie, G, Hamburger, S, Castellanos, F. ADHD in girls: clinical comparability of a research sample. J Am Acad Child Adolesc Psychiatry. 1999;38:4047.
81.Biederman, J, Faraone, S, Milberger, S, et al.Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. J Am Acad Child Adolesc Psychiatry. 1999;38:966975.
82.Carlson, C, Tamm, L, Gaub, M. Gender differences in children with ADHD, ODD and co-occurring ADHD/ODD identified in a school population. J Am Acad Child Adolesc Psychiatry. 1997;36:17061714.
83.Gaub, M, Carlson, C. Gender differences in ADHD: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry. 1997;36:10361045.
84.Wigal, S, McGough, J, McCracken, J, et al.A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention deficit/hyperactivity disorder. J Atten Disord. 2005;9:275:289.
85.Arnold, L. Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD). Ann N Y Acad Sci. 2001;931:310341.
86.Wigal, S, Wigal, T, Kollins, S. Advances in methylphenidate drug delivery systems for ADHD therapy. Advances in ADHD. 2006;1:47.
87.Biederman, J, Monuteaux, M, Mick, E, et al.Young adult outcome of attention deficit hyperactivity disorder: a controlled 10 year follow-up study. Psychol Med. 2006;36:167179.
88.Kessler, RC, Adler, L, Barkle, R, et al.the prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163:716723.
89.Milstein, RB, Wilens, TE, Biederman, J, et al.Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD. J Atten Disord. 1997;2:159166.
90.McGough, JJ, Smalley, SL, McCracken, JT, et al.Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry. 2005;162:16211627.
91.Biederman, J, Faraone, SV, Spencer, T, et al.Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry. 2006;67:524540.
92.Faraone, SV, Sergeant, J, Gillberg, C, et al.The worldwide prevalence of ADHD: is it an American condition? World Psychiatry. 2003;163:716723.
93.Borland, BL, Heckman, HK. Hyperactive boys and their brothers: a 25-year follow-up study. Arch Gen Psychiatry. 1976;33:669675.
94.Morrison, JR. Childhood hyperactivity in an adult psychiatric population: social factors. J Clin Psychiatry. 1980;41:4043.
95.Wilens, TE, Biederman, J, Mick, E. Does ADHD affect the course of substance abuse? Findings from a sample of adults with and without ADHD. Am J Addict. 1998;7:156163.
96.Tarter, RE. Psychosocial history, minimal brain dysfunction and differential drinking patterns of male alcoholics. J Clin Psychol. 1982;38:867873.
97.Murphy, K, Barkley, RA. Attention deficit hyperactivity disorder adults comorbidities and adaptive impairments. Compr Psychiatry. 1996;37:393401.
98.Barkley, RA, Fischer, M, Fletcher, K, et al.Persistence of attention deficit hyperactivity disorder into adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol. 2002;111:279289.
99.Weiss, M, Murray, C. Assessment and management of attention-deficit hyperactivity disorder in adults. CMAJ. 2003;168:715722.
100.Barkley, RA. Major life activity and health outcomes associated with attention deficit/hyperactivity disorder. J Clin Psychiatry. 2002;63(Suppl 12):10–5.
101.Shekin, WO, Asarnow, RF, Hess, E, et al.A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Compr Psychiatry. 1990;31:416425.
102.Biederman, J, Faraone, SV, Spencer, T, et al.Patterns of psychiatric comoribidty, cognition, and psychosocial funcitioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150:17921798.
103.Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE. Lifetime prevalence and age-of-onset distributions fDSM-IV disorders in the national Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593602.
104.Wilens TE: Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk, and treatment issues. Psychiatr Clin North Am. 2004;27:283301.
105.Rush, CR, Higgins, ST, Vansickel, AR, Stoops, WW, Lile, JA, Glaser, PE. Methylphenidate increases cigarette smoking. Psychopharmacology (Berl). 2005;181:781789.
106.Wilens, TE, Faraone, SV, Biederman, J, Gunawardene, S. Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics. 2003;11:179185.
107.Sobanski, E. Pschiatric comorbidity in adults with attention-deficity/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci. 2006;256:2631.
108.Wender, PH, Reimherr, FW, Wood, D, Ward, M. A controlled study of methylphenidate in the treatment of attention deficit disorder, residual type, in adults. Am J Psychiatry. 1985:142:547552.
109.Markowitz, JS. Drug interactions with stimulant medications. Int Clin Psychopharmacol. 1999;14:118.
110.Greenhill, LL, Pliszka, S, Dulcan, MK, et al.Practice parameter for the use of stimulant mediaction in the treatment of children, adolescents and adults. J Am Acad Child Adolesc Psychiatry. 2002;41:26S49S.
111.Nierenberg, AA, Mihahara, S, Spencer, T, et al.Clinical and diagnostic implications of lifetime comorbidity of attention-deficit/hyperactivity disorder in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biol Psychiatry. 2005:57;14671473.
112.Brown, TE, McMullen, WJ. Attention deficit disorders and sleep/arousal disturbance. Ann NY Acad Sci. 2001;931:271286.
113.Kooj, JJS, Huub, AM, Middelkoop, AM, Van Gils, K, Buitelaar, JK. The effect of stimulants on nocturnal activity and sleep quality in adults with ADHD: an open-label case-control study. J Clin Psychiatry. 2001;62:952955.
114.Manuzza, S, Klein, RG, Bessler, A, Malloy, P, La Padula, M. Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. Arch Gen Psychiatry. 1993;50:565567.
115.Faraone, SV, Biederman, J, Doyle, A, et al.Neuropsychological Studies of Late Onset and Subthreshhold Diagnoses of Adult Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry. 2006;60:10811087.
116.Ward, MF, Wender, PH, Reimherr, FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150:885890.
117.Wender, PH. Attention-Deficit Hyperactivity Disorder in Adults. New York, NY: Oxford University Press; 1995.
118.Donnelly, C, Reimherr, F, Young, J. Differential diagnosis and treatment of adult ADHD and neighboring disorders. CNS Spectr. 2006;10(Suppl 11):116.
119.Wigal, T, Wigal, B, Steinhoff, K, et al.Establishing a clinical diagnosis of ADHD in adults: the QUEST method. Advances in ADHD. 2007. In press.
120.Safren, SA, Otto, MW, Sprich, S, Winett, CL, Wilens, TE, Biederman, J. Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behav Res Ther. 2005;43(7):831842.
121.Adler, LA, Spencer, TJ, Milton, DR, et al.Long-term, open-label study of the safety and efficacy of atomoxetine in adults with attention-deficit/hyperactivity disorder: an interim analysis. J Clin Psychiatry. 2005;66:294299.
122.Michelson, D, Adler, L, Spencer, T, et al.Atomoxetine in adults with ADHD: two randomized, placebo-controlled trials. Biol Psychiatry. 2003;53:112120.
123.Wilens, TE. Impact of ADHD and its treatment on substance abuse in adults. J Clin Psychiatry. 2004;65(Suppl 3);3845.
124.Allen, AJ, Kurlan, RM, Gilbert, DL, et al.Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology. 2005;65:19411949.
125.Nissen, SE. ADHD and cardiovascular risk. N Engl J Med. 2006;354:14451448.
126.Spencer, T, Biederman, J, Wilens, T, et al.A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57:456463.
127.Wender, EH. Managing stimulant medication for attention-deficit/hyperactivity disorder. Pediatr Rev. 2001;22:183189.
128.Dexmethylphenidate (Focalin) for ADHD. Med Lett. 2002;44:4546.
129.Graydanus, DE, Sloane, MA, Rappley, MD. Psychopharmacology of ADHD in adolescents. Adolesc Med. 2002;3:599624.

Related content

Powered by UNSILO

Special Considerations in Diagnosing and Treating Attention-Deficit/Hyperactivity Disorder

  • Sharon B. Wigal (a1) and Timothy L. Wigal (a2)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.