Clinical update: Recent advances in attention-deficit hyperactivity disorder

Abstract

Background: Attention-deficit hyperactivity disorder (ADHD) is a common and complex neurodevelopmental disorder that affects about 5% of children and 2.5% of adults and is associated with a wide range of negative impacts. In Australia, ADHD has traditionally been treated by paediatricians; however, it is increasingly seen within psychiatric settings, and we need to ensure that our training keeps us well prepared. Objectives: This session aims to present an update on recent advances in our understanding of ADHD and the evidence-based approaches to assessment and treatment across the lifespan. Findings: Recent studies have started to throw light onto the complex causal pathways to ADHD. We are starting to identify specific genetic markers (G) and risk factors and the importance of environmental factors (E) and G × E interactions are becoming clearer. Imaging and cognitive studies are increasingly demonstrating biological heterogeneity. While complicating our understanding of ADHD on one level, it also presents possible approaches to personalizing treatments. The recommendations of evidence-based ADHD guidelines are increasingly convergent regarding medication treatments for ADHD; however, questions remain about long-term effectiveness and safety and the efficacy of nonpharmacological approaches. It may be more helpful to think about what these approaches can add to medication treatments. ADHD has a significant impact on families and the parents of those with ADHD often require support. We will discuss each of these issues commenting on new evidence, clinical decision-making and translation into practice. Conclusions: ADHD is easy to treat but hard to treat well: this clinical update will provide options for optimizing outcomes.L6276974902019-05-21 <br />