Attention-deficit/hyperactivity disorder (ADHD) is one of the most publicized, and controversial childhood disorders.

Now, doctors are realizing that ADHD doesn't always disappear when children enter puberty -- it is a persistent problem that can last a lifetime, although many adults don't realize they may be struggling with the condition.

"ADHD tends to be chronic," said Andrea M. Chronis, an assistant professor of psychology at the University of Maryland. "Most people diagnosed in childhood continue to have problems in adolescence and adulthood. About 60 percent of individuals who have problems as children continue to have problems in adulthood."

As a result, many psychologists are urging their colleagues to take a closer look at the parents of hyperactive and inattentive kids to see if Mom and Dad have similar symptoms. Often adults who have ADHD are diagnosed when they find out their children have the condition.

It's also known that symptoms continue into adulthood for more than 50 percent of children with ADHD, but few adults are identified or get appropriate treatment.

ADHD is estimated to affect as many as 7 percent of American children, as well as 2 percent to 4 percent adults.

But symptoms of ADHD often differ between the two age groups, Chronis said. "The adults aren't necessarily bouncing off the walls," she said. "But we see a lot of impulsive behaviors -- frivolous spending, impulsive driving." And difficulty focusing.

According to the Cleveland Clinic, common behaviors and problems of adult ADHD can include chronic lateness and forgetfulness; anxiety; low self-esteem; employment problems; difficulty controlling anger; substance abuse or addiction; poor organization skills; procrastination; difficulty concentrating when reading; and mood swings and depression.

The causes of the disorder remain unclear, but Chronis suspects genetics play a role. In a study last year, she and her colleagues found that parents of children with ADHD were 24 times more likely to show symptoms of the disorder themselves. That, in turn, can make it a challenge for them to help their own children cope with their ADHD.

"The parent might be forgetful in terms of taking the child to their doctor's appointment, and they may forget to administer the child's medication," Chronis said. Parents may also be unable to provide "structure and organization" for their kids.

Just as in children, stimulant drugs are a common treatment for ADHD in adults. It might seem counterintuitive to prescribe a stimulant to someone who's already overactive. In fact, the drugs work by boosting a person's ability to focus, explained William Frankenberger, professor of psychology and director of the Human Development Center at the University of Wisconsin at Eau Claire.

"They're performance enhancers," Frankenberger said. "You can do a boring task for a longer period of time and not make mistakes. You're more able to focus."

If the diagnosis is mild to moderate ADHD, stimulant medications such as methylphenidate or dextroamphetamine are often initially prescribed as part of the treatment plan. These drugs stimulate the parts of the brain responsible for organization and management, which have been shown to be less active in individuals with ADHD. They're effective in 70 percent to 80 percent of patients, Cleveland Clinic researchers report. The drugs may also improve ability to pay attention, concentrate and control impulses.

But some studies suggest the drugs only work in the short term in adults, Frankenberger said.

Alternatives to drugs include behavioral therapy, he said. "There are strategies people can learn to help themselves maintain their focus and be more efficient learners," Frankenberger said. While they require training and practice, "they can be very effective."

Reference Source 101
October 4, 2004

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