By J. Timothy Bricker
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Extra resources for Adults with Childhood Illnesses: Considerations for Practice (Health, Medicine and Human Development)
Example text
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning. E. , mood disorder, anxiety disorder, dissociative disorder, or personality disorder) Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type if Criterion A2 is met but Criterion A1 is not met for the past 6 months poor self-regulation of emotion; increased incidents of medical difficulties; and greater proneness to accidents are associated with ADHD (7).
In a naturalistic study of adults with ADHD that included retrospective chart reviews, cognitive therapy resulted in significant improvements of symptoms of ADHD, anxiety, depression, and overall functioning (58). In addition, a pilot study of group-administered treatment based on the principles of cognitive–behavioral treatment for Borderline Personality Disorder (59) that was tailored to adults with ADHD resulted in a reduction in ADHD symptoms and depressive symptoms, and an increase in general health status (60).
There are unique considerations when using these medications with adults. For instance, the effect on cardiovascular functioning of psychostimulants may be of greater concern than it is for children and adolescents. Adults may also require higher doses of psychostimulants than young patients (48). In addition, the abuse potential of the psychostimulants may preclude their use in adults who have a substance use disorder. If a patient has a comorbid substance use disorder it may be more effective to refer that patient to substance abuse treatment before initiating medication for ADHD.