Abstract
Background: The purpose of this article is to update the diagnostic assessment, therapeutic approach, and 12–18 month follow-up of patients added to the Italian Lombardy Attention Deficit Hyperactivity Disorder (ADHD) Register. Methods: Medical records of patients added to the Registry from 2011 to 2021 were analysed. Results: 4091 of 5934 patients met the criteria for a diagnosis of ADHD, and 20.3% of them presented a familiarity with the disorder. A total of 2879 children (70.4%) had at least one comorbidity disorder, in prevalence a learning disorder (39%). Nearly all (95.9%) received at least one psychological prescription, 17.9% of them almost one pharmacological treatment, and 15.6% a combination of both. Values of ≥5 of the Clinical Global Impression—Severity scale (CGI-S) are more commonly presented by patients with a pharmacological prescription than with a psychological treatment (p < 0.0001). A significant improvement was reported in half of the patients followed after 1 year, with Clinical Global Impression—Improvement scale (CGI-I) ≤ 3. In all, 233 of 4091 are 18-year-old patients. Conclusions: A ten-year systematic monitoring of models of care was a fruitful shared and collaborative initiative in order to promote significant improvement in clinical practice, providing effective and continuous quality of care. The unique experience reported here should spread.
Highlights
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 5.9% of children and persists into adulthood for two-thirds of them [1,2], with great impairments in academic achievement and work [3]
The peak age of diagnosis of ADHD is in primary school children aged
We explored if there was an improvement on their Clinical Global
Summary
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 5.9% of children and persists into adulthood for two-thirds of them [1,2], with great impairments in academic achievement and work [3]. According to the national and international guidelines [8,9], the diagnosis of ADHD is based on a careful and systematic assessment of a lifetime history of symptoms, childhood onset, and impairment in some contexts (schools, relationships, home) [10]. Psychiatric comorbidity is a clinically important factor that contributes to the persistence of ADHD in adulthood [11]. Results: 4091 of 5934 patients met the criteria for a diagnosis of ADHD, and 20.3% of them presented a familiarity with the disorder. Values of ≥5 of the Clinical Global Impression—Severity scale (CGI-S) are more commonly presented by patients with a pharmacological prescription than with a psychological treatment (p < 0.0001). A significant improvement was reported in half of the patients followed after 1 year, with Clinical Global Impression—Improvement scale (CGI-I) ≤ 3.
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