Psychiatrist of Department Mental Health and Drug Abuse, AUSL-Modena, 41126 Modena, Italy.
Psychiatrist of Department Mental Health and Drug Abuse, AUSL-Bologna, 40131 Bologna, Italy.
Medicina (Kaunas). 2023 Feb 10;59(2):338. doi: 10.3390/medicina59020338.
ADHD is a neurodevelopmental disorder characterized by inattention and hyperactivity/impulsivity and can persist in adulthood. The aim of this study is to deepen knowledge about adult ADHD follow-up. This observational study consists of one retrospective part aimed at collecting records of children and adolescents treated for ADHD in the Children and Adolescent Mental Health Service (CAMHS) from 1995 to 2015 and, successively, at identifying their adult follow-up in Adult Mental Health Service (AMHS); the second part consists of ADHD scale administration, Diagnostic Interview for ADHD in Adults (DIVA 2-0) and Adult Self Rating Scale (ASRSv1.1), for the subjects currently being treated at AMHS who agreed to participate in the study. We observed that among the 55 patients treated at CAMHS between 1995 and 2015 for ADHD and subsequently at the AMHS, none presented a diagnosis of ADHD; instead, they were treated for Intellectual Dysfunction (33%), Borderline Personality Disorder (15%) and Anxiety Disorders (9%), and two individuals were also diagnosed with comorbid substance/alcohol abuse (4%). Of the 55 patients, only 25 (45%) were treated at AMHS during the study period. Though we asked for their informed consent to administer the questionnaires, we were able to test only seven patients. The ASRS-V1.1 score showed that 43% of patients reported symptoms of ADHD persistence in adulthood. For DIVA 2.0, 57% of individuals reported scores indicating the persistence of the ADHD inattention component, and 43% the persistence of both ADHD dimensions. : ADHD cannot be considered a disorder confined to childhood/adolescence but instead is a chronic and complex condition that can persist into adulthood. The very small size of our final sample may account for both the high ADHD dropout rate over the long follow-up period and the difficult transition from child to adult health care in ADHD treatment. Our investigation suggests the need for specific training in the diagnosis and treatment of adult ADHD and the implementation of transition protocols between minor and adult services to improve long-term treatments.
ADHD 是一种神经发育障碍,其特征为注意力不集中和多动/冲动,并可在成年期持续存在。本研究的目的是加深对成人 ADHD 随访的认识。这项观察性研究包括一个回顾性部分,旨在收集 1995 年至 2015 年在儿童和青少年心理健康服务(CAMHS)接受 ADHD 治疗的儿童和青少年的记录,并随后在成人心理健康服务(AMHS)中确定他们的成人随访情况;第二部分包括对目前在 AMHS 接受治疗并同意参与研究的患者进行 ADHD 量表评估、成人 ADHD 诊断访谈(DIVA 2-0)和成人自评量表(ASRSv1.1)。我们观察到,在 1995 年至 2015 年间在 CAMHS 接受 ADHD 治疗并随后在 AMHS 接受治疗的 55 名患者中,均未诊断出 ADHD;相反,他们被诊断为智力功能障碍(33%)、边缘型人格障碍(15%)和焦虑障碍(9%),还有两名患者也被诊断为合并物质/酒精滥用(4%)。在 55 名患者中,只有 25 名(45%)在研究期间在 AMHS 接受治疗。尽管我们要求他们同意进行问卷调查,但我们仅测试了 7 名患者。ASRS-V1.1 评分显示,43%的患者报告在成年期仍存在 ADHD 症状。对于 DIVA 2.0,57%的个体报告 ADHD 注意力不集中成分持续存在的分数,43%的个体报告 ADHD 两个维度均持续存在。结论:ADHD 不能被认为是一种仅限于儿童/青少年的疾病,而是一种慢性和复杂的疾病,可以持续到成年期。我们最终样本的规模非常小,这可能是 ADHD 患者在长期随访期间脱落率高的原因,也是 ADHD 治疗中从儿童保健向成人保健过渡困难的原因。我们的调查表明,需要在成人 ADHD 的诊断和治疗方面进行专门培训,并实施未成年人和成人服务之间的过渡方案,以改善长期治疗。