Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- onset prior to age 12 years
- past or present academic dysfunction
- present or past occupational dysfunction
- familial and relationship dysfunction
- drug and alcohol use disorders
- thrill-seeking behavior
- driving accidents
- unable to pay attention to details resulting in "careless" mistakes at work, school, etc.
- has difficulty maintaining attention in tasks
- seems not to listen when being spoken to
- does not follow instructions and does not finish duties and assigned tasks (not due to misunderstanding or oppositional behavior)
- has organizational difficulties
- avoids, dislikes, or is reluctant to engage in tasks that require maintaining mental effort
- frequently loses things needed for tasks or activities
- frequently forgetful in daily activities
- fidgets often with hands or feet and moves in seat
- frequently leaves situations, rises from chair when remaining seated is expected
- often feels restless
- has difficulty engaging in leisure activities quietly
- often "on the go," acting as if "driven by a motor"
- often talks excessively
- often interrupts with answers before questions have been completed
- often has difficulty waiting for his/her turn (e.g., while waiting in line)
- often interrupts or intrudes on others (e.g., interrupting conversations)
- increased criminal justice system involvement
- distracted easily by surroundings and external stimuli
Otros factores de diagnóstico
- mild mood symptoms (dysphoria, mood lability, irritability, boredom)
- anxiety
- difficulty with peer interactions
- low self-esteem
- working memory (i.e., short-term memory) impairment
- processing speed impairment (i.e., the rate at which information is dealt with)
Factores de riesgo
- family history of ADHD
- male sex
- low birth weight
- psychosocial adversity
- obstetric complications in pregnancy or labor
- lead exposure
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- Conners Adult ADHD Rating Scale
- Brown Attention Deficit Disorder Scale
- World Health Organization Adult ADHD Self-Report Scale
- Wender Utah Rating Scale
- Diagnostic Interview for ADHD in adults, third edition (DIVA 5)
- neuropsychologic testing
Pruebas diagnósticas que deben considerarse
- urine drug screen
- electroencephalogram
- brain imaging (CT or MRI)
- polysomnography
- computer-based program
Algoritmo de tratamiento
ADHD without concomitant mood, anxiety, or substance use disorder
ADHD with concomitant substance use disorder
ADHD with depression (with or without prominent anxiety)
ADHD with bipolar disorder
ADHD with anxiety disorder alone
Colaboradores
Autores
Marios Adamou, MD, MSc, LL.M, MA, MBA, PhD, FRCPsych, FFOM
Consultant Psychiatrist
South West Yorkshire NHS Partnership Foundation Trust
University of Huddersfield
Huddersfield
UK
Divulgaciones
None to declare.
Agradecimientos
Professor Marios Adamou would like to gratefully acknowledge Dr Bridget Craddock, Dr S. Nassir Ghaemi, and Dr Elizabeth A. Whitham, the previous contributors to this topic.
Divulgaciones
BC declares that she has no competing interests. SNG has received research grants from Pfizer, served on the speakers' bureaus of Astra Zeneca and Pfizer, and received honoraria from Bristol Myers Squibb. Neither SNG nor his family hold equity positions in pharmaceutical corporations. EAW declares that she has no competing interests.
Revisores por pares
Gianni Faedda, MD
Lucio Bini Mood Disorders Center
New York
NY
Divulgaciones
GF has been reimbursed by Astra Zeneca, the manufacturer of Seroquel, for attending several conferences.
David W. Goodman, MD
Assistant Professor
Department of Psychiatry and Behavioral Sciences
Johns Hopkins School of Medicine
Baltimore
MD
Divulgaciones
DWG has received research grants from Shire Pharmaceuticals. DWG has received speaking fees from Neuroscience Education Institute, Temple University, American Professional Society of ADHD and Related Disorders, Medscape, and WebMD. DWG has been a paid consultant to American Physician Institute for Advanced Professional Studies, Prescriber's Letter, Consumer Reports, Thomson Reuters, GuidePoint Global, Shire Pharmaceuticals, McNeil Pediatrics, Cephalon, Teva Pharmaceuticals, Lundbeck, Otsuka Pharmaceuticals, and Novartis.
Diferenciales
- Depression in adults
- Bipolar disorder in adults
- Borderline personality disorder
Más DiferencialesGuías de práctica clínica
- Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR)
- World Federation of ADHD International consensus statement
Más Guías de práctica clínicaFolletos para el paciente
ADHD: what is it?
Coping strategies for teenagers and adults with ADHD
Más Folletos para el paciente- Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad