Trastorno por déficit de atención con hiperactividad en adultos: caracterización clínica y terapéutica

Abstract

To update the existing knowledge about attention deficit hyperactivity disorder (ADHD) in adults, with special interest given to aspects concerning epidemiology, diagnosis, progression and treatment. Acknowledging the fact that ADHD can persist into adulthood is a relatively recent development. Nevertheless, over the last few years evidence has been put forward to support the validity of its diagnosis in adults. The prevalence of ADHD in the general adult population is estimated to be around 4%. Over 50% of the children with the disorder will continue to have it as adults. The symptoms of ADHD can be different in adults, with less hyperactivity and a slight decrease in impulsiveness, but with the same symptoms of inattention. ADHD in adulthood is linked to serious economic, occupational, academic and familial repercussions, as well as to road accidents and to the presence of other psychiatric pathologies (such as drug addiction, personality disorders and depression). A number of different psychometric instruments are available in Spanish for evaluating ADHD in adults. The use of structured interviews, together with a systemized evaluation of possible comorbid disorders, makes it easier to reach a correct differential diagnostic. Pharmacological treatment in adults is essentially the same as that used with children, but weight-adjusted. Clinical trials have been carried out with psychostimulants and results show methylphenidate to be the most effective and the safest. Atomoxetine is the non-stimulating pharmaceutical that has been most widely studied in adults. Cognitive behavioural psychological treatments have proved to be effective in adults with ADHD.