ebook_ADHD2019

The World Federation of ADHD Guide 119 mental health professionals dealing with adults should have to screen for ADHD in the offspring if a positive ADHD diagnosis is made in an adult parent. ADHD ONLY OCCURS IN CHILDREN Three decades ago, there was a belief that ADHD was a childhood disorder and that biological modifications associated with puberty would make children outgrow the disorder. Investigations all around the world now demonstrate that ADHD can be detected in adolescents and adults and the prevalence rate in adul- thood is around 2.8%. 17 The clinical presentation might be different in adults compared to children with more prominent inattentive symptoms and deficits in executive functions deter- mining symptoms like procrastination. Impulsivity and emotional regulation pro- blems might be more important than hyperactivity. 18 This difference in clinical presentation in adults is now recognized in the diagnostic criteria for the disorder. The new version of the diagnostic system of the American Association of Psychia- try (DSM-5) 19 suggest that a lower threshold of inattentive and hyperactive/impul- sive symptoms for diagnosing ADHD is needed in adults than the one needed in children. Recent investigations have even demonstrated that ADHD might be present in older adults. A study in the Netherlands documented a prevalence rate of ADHD around 2.8% in older adults (60 years of age or older). 20 HOW ABOUT THE FUTURE? WILL MY CHILD ALWAYS HAVE ADHD? From an era where we believed that children would outgrow the disorder, we mo- ved to a time where ADHD was considered a “life sentence” for all. As usual, the true probably is not in any of the extremes. Although there is no consensus on the exact persistence rate of ADHD from childhood to adulthood, a significant group of children with ADHD will continue to present symptoms and impairments in adulthood. Some studies suggest a rate around 50%. 21 We know that the persisten- ce depends on how you define the disorder in adulthood (presence of full syndro- me, partial symptoms, or only impairment). Recent research suggests that persistence of the full ADHD syndrome in adul- thood depends on several factors like the severity of the symptoms in childhood, presence of co-occurring child mental disorders and parental mental disorders like depression. 21 That said, it is important to recognize that there is a significant proportion of children with ADHD that become adults without the disorder. This might be rela- ted to maturation of the brain areas involved in the disorder.