Diagnostic Assessment & Treatment of Adult ADHD

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Methylphenidate (Mph)• Best studied (> 250 RCTs)• 50 years of clinical experience• Response: 70% children, 50-70% adults• Effect size .9• Better executive functioning• Safe, little side effects• Effective 20 min. after ingestion• Not addictive when used orally (but short acting can be when injected orsnored)• Inhibits reuptake of DA / NA• Short acting: too difficult to use due to frequent dosing need and lowcompliance; risk of abuse• Long acting best adviceFaraone 2003, Volkow ea 2002, Pietrzak 2006
Compliance in adults with ADHD?Using shortacting Mph• ADHD patiënts: chaotic and forgetful• Need to dose 6-8x/day ON TIME• Forget tablets, timer, batteries, water bottle and ...• No one is able to do this properly for a longer time• Efficacy low due to bad compliance• Medication wearing off generates rebound severaltimes a day, ´roller coaster´ in stead of stability• Patiënts stop short acting Mph: ‘medication is worsethan disorder´Kooij 2005
Page 2 and 3: Topics• Neurobiology of ADHD• P
Page 5 and 6: Neurobiology of ADHD• Highly heri
Page 8: Developmental trajectoriesof brainv
Page 11 and 12: The brain in ADHDcompared to contro
Page 13 and 14: Decrease of hyperactivityHyperactiv
Page 16 and 17: ADHD in DSM-IV• Attention-deficit
Page 18 and 19: ADHD and preferred jobs• Nightshi
Page 20 and 21: ADHD and drivingADHD is a danger on
Page 22 and 23: Comorbidity in ADHD?• Depression
Page 24 and 25: 12 month comorbidity with ADHDin ad
Page 26 and 27: ConclusionsEpidemiological study Ke
Page 28 and 29: Chance of addictionADHD vs controls
Page 30 and 31: ADHD and SUD• Medication treatmen
Page 32 and 33: Diagnostic Assessment• Screening
Page 34 and 35: NEW:DIVA 2.0Now available in Danish
Page 36 and 37: ADHD is a clinical diagnosis• Int
Page 38 and 39: Cutoff currentDSM-IV criteria in ad
Page 40 and 41: Treatment of ADHD andcomorbidity1.
Page 42 and 43: Available Methylphenidate (Mph)prep
Page 44 and 45: Place of medicationin treatment•
Page 48 and 49: Long Acting Mph in adults• More s
Page 50 and 51: Combination treatmentthe rule in ad
Page 52 and 53: Light therapy and ADHD5 days - 30 m
Page 54 and 55: Contra-indicationsfor coaching• C
Page 56 and 57: Coaching?• Active and practical q
Page 58 and 59: Planning of time• Problem• Purp
Page 60 and 61: Dealing with chaos at home• Probl
Page 62 and 63: Reorienting on work• Problem• P
Page 64 and 65: Dealing with feelings of loss• Pr
Page 66 and 67: Coaching in groups• Target group:
Page 68 and 69: ADHD and impairmentaccording to Saf
Page 70 and 71: Support groups• Danish patient or
Page 72 and 73: Set up Program Adult ADHDand Dutch
Page 74 and 75: Adult ADHD is new in psychiatryand
Page 76 and 77: 2002 - Start Program Adult ADHDat P
Page 78 and 79: April 200415 full time employees400
Page 80 and 81: Team Program Adult ADHD, 20091300 p
Page 82 and 83: What did this team do?• Develop s
Page 84 and 85: Diagnostic Assessment• 3 hour int
Page 86 and 87: Treatment Program Adult ADHDSix Tre
Page 88 and 89: Content Treatment PathsAll consist
Page 90 and 91: Adults want helpPsyQ, in the Hague
Page 93 and 94: Adult ADHDDiagnostic Assessment and
Page 95: European Network - UKAANSymposium,

Diagnostic Assessment & Treatment of Adult ADHD

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