Attention-deficit/hyperactivity disorder (ADHD) is an impairing but usually treatable condition. Popular culture propagates the myth that ADHD recedes with age; this is not the case. Although it is common, <20% of adults with ADHD are diagnosed or treated. Adults with ADHD show significant comorbidities with depressive disorders, anxiety disorders, substance use, oppositional defiant disorder, personality disorders, sleep problems, and learning disabilities. However, symptoms that result from ADHD, such as mood symptoms or lability, are often mistaken for comorbid disorders. Comorbidity with ADHD impacts treatment compliance, treatment response, and patient insight. Insufficient data on the interaction between ADHD and comorbidities impedes proper diagnosis and treatment. Better clinical tools for assessing these conditions are needed. Food and Drug Administration-approved pharmacologic treatments for adult ADHD include stimulants, dexmethylphenidate, and the nonstimulant atomoxetine. Effect sizes of approved medicines at approved doses are half those seen in children. Adults may also need longer duration of medication effects than children. Short-acting stimulants are likely to result in poorer adherence and have a higher risk for diversion or abuse. Risk of abuse is a major concern; stimulant treatments are controlled substances, and children with ADHD show increased risk of substance abuse. Psychosocial interventions may be beneficial in treating both ADHD and comorbidities.

In this expert roundtable supplement, Margaret Weiss, MD, PhD, presents a comprehensive overview of complications surrounding differential diagnosis in adults with ADHD. Next, Mark A. Stein, PhD, reviews evaluation, comorbidity, and development of a treatment plan in this population. Finally, Jeffrey H. Newcorn, MD, provides a discussion on the pharmacologic options available for adults with ADHD, considering dosages specific to adults and common comorbidities.

The presentation of attention-deficit/hyperactivity disorder (ADHD) in adolescence is often complex, but clinicians will attest multiple and complex comorbid conditions in adolescence are by no means unusual. Given that this is often the typical presentation, this article will describe a case to illustrate the multiple pathways to treatment of an adolescent with myriad distinct but interacting issues. Although all clinicians attempt to practice evidence-based medicine, the evidence is often limited to circumscribed disorders, and management and sequencing of treatment of adolescents with a combination of different conditions has not be adequately researched.

Sex differences in executive speech tasks, favoring women, have been noted in behavioral studies and functional imaging studies. In the present study, the clustering and switching components of semantic and phonemic verbal fluency tests were examined in 40 healthy men and 40 healthy women. Possible sex differences in the influence of cognitive factors such as speed of information processing, word knowledge, and/or verbal long-term memory on these verbal fluency factors were also assessed. The results showed that women switched more often between categories in the phonemic fluency test, whereas men showed a trend toward a larger cluster size leading to a smaller total number of words generated. Additionally, higher performance on the Digit Symbol test was associated with better performance on the semantic and phonemic verbal fluency test in men, whereas in women, better memory performance was associated with better performance on these verbal fluency tests. Our data indicate that men and women are using different processing strategies for phonemic verbal fluency tests to optimize verbal fluency task performance. In the current study, women adopted a more successful strategy of balancing clustering and switching in the phonemic fluency task. (JINS, 2006, 12, 502–509.)

The oxidation of prereacted Pt films on (100)-oriented n-GaAs substrates was studied in the temperature range between 550 and 750°C using Auger electron spectroscopy and Xe+ ion profiling. The GaPt/PtAs2/GaAs structure formed during annealing in hydrogen was oxidized using a mixture of water vapor and hydrogen. The GaPt phase can be oxidized completely, whereas the inner PtAs2 and GaAs interfaces are left unoxidized. The oxidation of the platinum-gallium phase is self limited by the diffusion of the Ga through the gallium oxide overlayer. The oxide can be etched off to leave a structure consisting only of platinum-arsenide on the GaAs substrate.