ADHD Management: A Universal Consensus

According to High Authority of Health (HAS), between 3.5 and 5.6% of school children in France suffer from attention disorders, with or without hyperactivity, ADHD. These disorders are still often stigmatized, both by the general public and the medical community. Recently, the ADHD World Federation published a consensus, based on all existing scientific knowledge to date, and intended to harmonize worldwide care for children and adults affected.

Attention deficit disorder with or without hyperactivity, ADHD

The ADHD are usually diagnosed between 9 and 10 years of age, but they can be observed at different ages and persist in adults. In general, they are distinguished into three subsets:

  • Attention disorders, which represent about 47% of patients;
  • Hyperactivity or impulsiveness, which affects approximately 36% of patients;
  • Attention disorders with hyperactivity and impulsiveness, which affect approximately 17% of patients.

These attention disorders have only been described for a few years, and are still often poorly perceived, misunderstood, with children and their entourage often stigmatized. Educational problems are regularly put forward by the family circle to explain the behavior of the child. However, children, but also adults, affected by these disorders must live with a cognitive and social handicap that is sometimes severe, and quite often persistent. The diagnosis and management of these patients are revealed in this context, often heterogeneous from one territory to another and from one patient to another.

Diagnose as soon as possible

Bringing together all the knowledge acquired in robust studies on ADHD to develop a universal consensus on their management constitutes for patients and their families major progress in the recognition of their disorders, but also in the quality of their support and their care pathway. When the diagnosis is made late, the effectiveness of treatment may be reduced. For the diagnosis, the criteria used in the consensus are as follows:

  • Symptoms of inattention and/or hyperactivity and impulsivity;
  • The existence of these symptoms over a period of more than 6 months;
  • The appearance of symptoms or at least certain suggestive signs before the age of 12.

The diagnosis is made from the characteristic clinical signs, followed by a psychometric assessment, the objective of which is to assess the difficulties experienced by the patient on a daily basis and to look for other associated disorders, such as learning disabilities. (dys disorders) or impaired motor coordination.

Optimizing the management of ADHD

Once the diagnosis has been made, the consensus insists on the therapeutic solutions, which can be put in place and reveal a certain effectiveness:

  • Psychostimulant drugs, such as methylphenidate;
  • Non-stimulant drugs, such as atomoxetine (not available in France since 2012);
  • Cognitive-behavioral therapies;
  • Personalized psychotherapeutic support.

Medicines can relieve symptoms and limit the risk of certain complications, in particular suicidal behavior (link to file: https://www.sante-sur-le-net.com/ Maladies/psychiatrie/conduites-suicidaires/). Cognitive-behavioral therapies are interesting for improving daily life. Treatment must therefore be adapted to each patient. Nevertheless, the consensus reveals a flaw, the lack of specific drugs to treat ADHD. A better understanding of the biological and physiological mechanisms (environmental factors, genetic predisposition, etc.) involved in these disorders is necessary to develop new, more specific therapeutic approaches.

Estelle B., Doctor of Pharmacy

Sources

– ADHD: Towards a universal consensus. inserm.fr. Accessed September 7, 2022.
– Neurodevelopmental disorder / ADHD: Diagnosis and management of children and adolescents – Framework note. has-sante.fr. Accessed September 7, 2022.

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