Download Free Medical Adults and Attention-Deficit Hyperactivity Disorder-Diagnostics Treatments Challenges PowerPoint Presentation

Adults and Attention-Deficit Hyperactivity Disorder-Diagnostics Treatments Challenges PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Neurology, which is titled "Adults and Attention-Deficit / Hyperactivity Disorder (ADHD): Diagnostics, Treatments, Challenges", to know about ADHD, diagnosing ADHD in adults, common treatments for ADHD, and challenges in working with adults who present with ADHD symptoms.

Tags : Neurology, Adults, Attention-Deficit, Hyperactivity Disorder, ADHD, Diagnostics, Treatments, Challenges

Published on : Aug 18, 2021 | Views : 1683 | Downloads : 8

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Adults and Attention-Deficit / Hyperactivity Disorder (ADHD): Diagnostics, Treatments, Challenges Edward Thomas Lewis III, M.D. Clinical Assistant Professor Attending Physician, Institute of Psychiatry Associate Director, Forensic Psychiatry Fellowship Medical University of South Carolina Department of Psychiatry and Behavioral Sciences Division of Community and Public Safety Psychiatry
Slide 2-

Acknowledgments & Disclosures Addiction Psychiatry background Not subspecialty trained in child and adolescent psychiatry No relevant financial disclosures
Slide 3-

Goals and Objectives Explore background information about ADHD Diagnosing ADHD in Adults Discuss common treatments for ADHD Understand challenges in working with adults who present with ADHD symptoms
Slide 4-

What is ADHD? Consistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning and/or development. Inattention Hyperactivity Impulsivity
Slide 5-

Inattention Wandering off task Lacking persistence Difficulty sustaining focus Disorganized Not due to defiance or lack of comprehension
Slide 6-

Hyperactivity Excessive motor activity Fidgeting Tapping Talkativeness Extreme restlessness (in adults) Frustrating peers due to elevated activity
Slide 7-

Impulsivity Hasty actions that occur in the moment Minimal forethought High potential for harm to the individual Social Intrusiveness Major Life Decisions
Slide 8-

ADHD: How Common? Global population surveys suggest ADHD occurs in about 5% of children and 2.5% of adults. More frequent in males than females 2:1 M:F in children 1.6:1 M:F in adults 50% of children with ADHD will experience attenuation of symptoms as they progress into adulthood
Slide 9-

Adult ADHD: How Common? 2.5 – 4.0% of the population Hyperactive / Impulsive presentation is more common in males Adults with ADHD have 4 – 9x higher prevalence of comorbid mental health diagnoses Bipolar Disorder Anxiety Disorders
Slide 10-

ADHD: Risk Factors Very low birth weight Smoking during pregnancy History of child abuse, neglect, multiple foster placements, neurotoxin, infection, or alcohol exposure in utero First degree biological relative with ADHD
Slide 11-

ADHD: Progression of Symptoms Begins in childhood Hyperactivity predominates in preschool-aged children Most often identified in elementary school Inattention is often predominant
Slide 12-

ADHD: Progression of Symptoms Hyperactivity may improve into adolescence and adulthood, but restlessness, inattention, poor planning, and impulsivity persist Substantial number of children with ADHD will remain relatively impaired into adulthood
Slide 13-

Negative Consequences of ADHD Reduced educational performance Social rejection Poorer occupational performance Higher probability of unemployment Interpersonal conflict More likely to be injured Traffic accidents Obesity Incarceration Conduct Disorder Substance Use Disorders
Slide 14-

Diagnosing Adult ADHD https://www.advancingadhd.com/diagnosis
Slide 15-

Diagnosing Adult ADHD https://www.advancingadhd.com/diagnosis
Slide 16-

Emotional Dysregulation (ED) Deficiency in executive or cognitive management of emotions Self-regulation of frustration, impatience, anger Emotional Impulsivity Mesolimbic Circuitry (“Bottom Up”) Deficient Emotional Self-Regulation Prefrontal Cortex (“Top Down”) Not in DSM-5 35-70% adults with ADHD experience ED
Slide 17-

Testing for ADHD: Behavior Rating Scales https://www.jaacap.org/article/S0890-8567(09)62182-1/fulltext
Slide 18-

Testing for ADHD: Behavior Rating Scales https://www.jaacap.org/article/S0890-8567(09)62182-1/fulltext
Slide 19-

Adult ADHD: Scales and Testing Role for Neuropsychological Testing Continuous Performance Test (CPT) World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS) Brown Attention-Deficit Disorder Scale (BADDS)
Slide 20-

Adult ADHD: ASRS Six question scale Designed for community samples Positive results require follow-up diagnostic assessment by trained a clinician Score of four or greater is positive
Slide 21-

Adult ADHD: ASRS https://www.hcp.med.harvard.edu/ncs/asrs.php
Slide 22-

Adult ADHD: ASRS https://www.hcp.med.harvard.edu/ncs/asrs.php
Slide 23-

Adult ADHD: BADDS 40-item screening instrument Designed for primary/preschool, school-age, adolescent, and adult populations Based on Thomas Brown’s model of cognitive impairment in ADHD
Slide 24-

Treating Adult ADHD: Pharmacotherapy Stimulant medications are front-line management National Comorbidity Survey Replication (NCS-R) FDA approved medications for Adult ADHD Extended release mixed amphetamine salts (Adderall XR) Lisdexamfetamine dimesylate (Vyvanse) Atomoxetine (Strattera) Bupropion (Wellbutrin)
Slide 25-

Treating Adult ADHD: Psychosocial Treatments CBT Negative Thoughts Perfectionism Over-estimation of one’s competence Comorbid Depression, Anxiety Organizational Skills Training Data for CBT in children vs. adults with ADHD http://namirockland.org/cbt.html
Slide 26-

Treating Adult ADHD: Substance Use Disorders (SUD)
Slide 27-

Neurobiology of Addiction https://www.google.com/search?q=hijacking+of+limbic+system&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj3t97R9IvfAhWoTd8KHckaCl0Q_AUIDigB&biw=1920&bih=934#imgrc=-V6hjWyv2C_tUM:&spf=1544123599719
Slide 28-

Neurobiology of Addiction: Hijacking of Limbic System https://www.google.com/search?q=hijacking+of+limbic+system&rls=com.microsoft:en-US:IE-Address&source=lnms&tbm=isch&sa=X&ved=0ahUKEwimnp_M-ovfAhVikuAKHbQlCaQQ_AUIDigB&biw=1920&bih=934#imgrc=UDv2lr0cOu8gXM:&spf=1544125201097
Slide 29-

Neurobiology of Addiction Wanting Liking Repeated use over time Needing
Slide 30-

Treating Adult ADHD: Substance Use Disorders (SUD) ADHD has a prevalence of 22% in adults with SUD More severe disease burden Higher comorbidity Dopamine System Reward Pathways Prefrontal Cortex Medication Management Strategies Psychotherapy Integrative CBT
Slide 31-

Treating Adult ADHD: Psychiatric Comorbidities Bipolar Disorder Anxiety Disorders Depressive Disorders
Slide 32-

References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. Faraone, S. V., & Antshel, K. M. (2008). Diagnosing and treating attention-deficit/hyperactivity disorder in adults. World psychiatry : official journal of the World Psychiatric Association (WPA), 7(3), 131–136. Giulio Perugi, Alessandro Pallucchini, Salvatore Rizzato, Vito Pinzone & Pietro De Rossi (2019) Current and emerging pharmacotherapy for the treatment of adult attention deficit hyperactivity disorder (ADHD), Expert Opinion on Pharmacotherapy, DOI: 10.1080/14656566.2019.1618270 Lopez PL, Torrente FM, Ciapponi A, Lischinsky AG, Cetkovich‐Bakmas M, Rojas JI, Romano M, Manes FF. Cognitive‐behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD010840. DOI: 10.1002/14651858.CD010840.pub2. Scrandis, Debra. Diagnosing and treating ADHD in adults. The Nurse Practitioner. 43(1):8–10, JANUARY 15, 2018 DOI: 10.1097/01.NPR.0000527741.90830.97. PMID: 29240618. Van der Burg, D., Crunelle, CL, Matthys, F, Van den Brink, W. diagnosis and treatment of patient with comorbid substance use disorder and adult attention-deficit and hyperactivity disorder: a review of recent publications. Curr Opin Psychiatry. 2019 Jul;32(4):300-306.
Slide 33-

Questions? Contact: Lewiset@musc.edu