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ADD IN THE NEWS |
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Adult ADHD Criteria May Need Revising |
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Thursday,
November 2, 2006 |
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Reuters Health
By David Douglas
NEW YORK (Reuters Health) - Attention deficit hyperactivity disorder
(ADHD) is routinely diagnosed and treated in children, but doing so
in adults may present problems, doctors warn in the American Journal
of Psychiatry.
This, they say, is chiefly due to criteria outlined in the American
Psychiatric Association's main reference work, the Diagnostic and
Statistical Manual of Mental Disorders -- Fourth Edition (DSM-IV),
which was published in 1994.
"When diagnosing ADHD in adults," lead investigator Dr. Stephen V.
Faraone told Reuters Health, "the current requirement that the
disorder begin prior to age 7 is too stringent. The next revision of
the diagnostic manual should consider raising this age-at-onset
requirement."
Faraone, of SUNY Upstate University, Syracuse, New York and
colleagues came to this conclusion after studying 127 adult subjects
with full ADHD who met all DSM-IV criteria for childhood onset. Also
involved were 79 comparable subjects who did not meet age-at-onset
criteria, 41 with borderline ADHD who did not meet full symptom
criteria and 123 controls who did not meet any ADHD criteria.
The team found that subjects with late-onset and full ADHD had
similar patterns of psychiatric comorbidity, functional impairment
and family history of ADHD. Most (83 percent) of those with
late-onset ADHD were originally diagnosed at younger than 12 years
of age. Borderline ADHD was milder and had a different pattern of
"familial transmission."
The results of this study, the researchers conclude, hint that
doctors "should not dismiss the diagnosis of ADHD in adults when the
onset occurs later than allowed by DSM-IV."
Dr. James J. McGough, co-author of an accompanying editorial pointed
out in remarks to Reuters Health, "these findings cast additional
doubt on the validity of the age-of-onset criterion."
However, McGough, of UCLA, added that they also "suggest that
current symptom thresholds have value in identifying more adults
with more severe disorders."
SOURCE: American Journal of Psychiatry, October 2006. |
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