Attention deficit/hyperactivity disorder in adults.

Attention deficit/hyperactivity disorder (ADHD), characterized by inattention, hyperactivity/impulsivity, or a combination of these, is being increasingly recognized in adults. Adult ADHD prevalence rates range from 1% to 4%. The pathophysiology of adult ADHD is likely multifactorial, including genetic, environmental, and neurobiological influences. Though ADHD diagnostic criteria per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) were developed based on child samples, the symptoms are believed to be similar in adults, with some developmental differences in symptom presentation. This article identifies common presenting complaints of adults who have ADHD and provides information useful for differential diagnosis of these patients. Specific strategies for pharmacological and nonpharmacological intervention are also presented.

Management of attention-deficit hyperactivity disorder in adults: focus on methylphenidate hydrochloride.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in young adults and causes significant psychosocial impairment and economic burden to society. Because of the paucity of long-term evidence and lack of national guidelines for diagnosis and management of adult ADHD, most of the data are based on experience derived from management of childhood ADHD. This article reviews the current evidence for the diagnosis and management of adult ADHD with special emphasis on the role of methylphenidate hydrochloride preparations in its treatment. Methylphenidate hydrochloride, a stimulant that acts through the dopaminergic and adrenergic pathways, has shown more than 75% efficacy in controlling the symptoms of adult ADHD. Although concern for diversion of the drug exists, recent data have shown benefits in preventing substance use disorders in patients with adult ADHD.

Wellness and Impairment Content in Schools of Medicine Curricula in the United States and Canada.

Medical students experience numerous stressors, ranging from academic demands to financial strain. These stressors contribute to medical students having a substantial incidence of psychological problems, substance abuse, and seeking of mental health treatment. Left untreated, these problems can result in dysfunctional habit development and subsequent professional impairment. Research has demonstrated the benefits of wellness-impairment educational programs in medical education, but it is unknown to what degree the topics of wellness and impairment are included in medical school curricula. To assess this, a 13-item survey instrument was sent to associate deans in 142 schools of allopathic medicine; 71 (50.0%) responded. The majority of respondents reported that physician impairment (95.8%) and wellness (77.5%) are addressed in their school of medicine curricula, although the degree to which these topics were included varied. Access to other health-promoting resources on campus was also assessed and is discussed. Results suggested that there is a disparity between primary and secondary prevention approaches on school of medicine campuses. Implications for curricula and directions for future research are discussed.