Dr Georgina Brown, Clinical Governance lead for the service, discusses how ADHD evolves as we progress from childhood to adulthood.
Challenging misconceptions about ADHD
It’s long been the subject of debate and in fact, a belief that ADHD was solely a childhood condition, and this inaccuracy meant many adults remained undiagnosed for years until research(but mainly public opinion) caught up.
Insights from the European Council of Neuropsychopharmacology
I recently attended the 36th Annual Congress of the European Council of Neuropsychopharmacology and presented at the Colloquium,’ A modernised concept of ADHD’, an update on how the UK healthcare system manages ADHD in children and adults and what the options are currently for treatment.
This progressed onto a discussion on three landmark papers relating to the dynamic course of ADHD across the lifespan and the implications this has on how we care for our patients.
A Closer Look at Remission in Adulthood
Existing studies estimate that childhood ADHD remits by adulthood in approximately 50% of cases, however, this statement has always failed to consider longitudinal patterns of how ADHD symptoms are expressed.
Sibley et al (2022) 1 investigated the extent to which children with ADHD symptoms recover from their symptoms and also the variability in their patterns of remission in adulthood.
The researchers studied 558 children with ADHD, tracking them from 2 to 16 years post-diagnosis. They discovered that around 30% of these children experienced complete relief from ADHD symptoms at some point. However, surprisingly, 60% of those who experienced relief then had a reoccurrence of their ADHD symptoms after this initial relief period. Only a small percentage, 9.1% to be exact, showed a continuous recovery, while the majority (63.8%) had periods where their ADHD symptoms improved and then returned over time.
The researchers emphasise the intricate nature of individual experiences with ADHD. Their objective was to accentuate that even when simplifying these experiences, substantial variations persist. The diversity of neurodiversity.
This prompts significant inquiries regarding the essence of ADHD, considering the possibility that it may manifest as a fluctuating condition for certain people.
From a clinical standpoint, recognising these shifting patterns and individual manifestations reinforces the need for continual support and highlights the dynamic nature of ADHD. It is important that all specialist services keep up to date with research and adapt our care and management in line with best clinical practice
ADHD is some ways still presents as an enigma; there are aspects of ADHD that are still not fully understood, especially regarding its precise causes, underlying mechanisms, and the ways it manifests in different individuals.
The Clinical Perspective
From a clinical standpoint, recognising these shifting patterns and individual manifestations reinforces the need for continual support and highlights the dynamic nature of ADHD. It is important that all specialist services keep up to date with research and adapt our care and management in line with best clinical practice
ADHD is some ways still presents as an enigma; there are aspects of ADHD that are still not fully understood, especially regarding its precise causes, underlying mechanisms, and the ways it manifests in different individuals.
Sources:
- Sibley, M. H., Arnold, L. E., Swanson, J. M., Hechtman, L. T., Kennedy, T. M., Owens, E., … Rohde, L. A. (2022). Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD. The American Journal of Psychiatry, 179(2), 142-151. view research >>>
