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University Research on ADHD Issues

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Adult ADHD Often Undiagnosed by Primary Care Physicians

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About Adult ADHD

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A randomised controlled study of risperidone and olanzapine

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

University Research on ADHD Issues

A researcher has contacted ADDept as she is looking for families with children between the ages of  6 to17 years  with a diagnosis of Attention Deficit Hyperactivity Disorder who would be interested in taking part. She is offering to pay families £30:00

In the first instance please contact:

 

Kate Mowbray

Yorkshire Coordinator

ADDept Yorkshire ADHD & Learning Ability Support Group

               Registered Charity 1072 007

CONTACT:

Home:      01765 658 878

Mobile:     07719 439 522

E-mail:     kate.mowbray@btinternet.com

Website:  http://www.adhd-yorkshire.com

 

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Clinical Studies

Link to PubMed abstract

Journal of psychopharmacology (Oxford, England) 2008 Sep 18; In press

Chan H H, Chang C C, Chiang S S, Chen J J, Chen C C, Sun H H, Hwu H H, Lai M M

Department of General Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan; Graduate Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Abstract 

The objective of this study was to compare the effects of risperidone and olanzapine in schizophrenic patients with intolerant extrapyramidal side effects (EPS) on first generation antipsychotics. We conducted an 8-week, rater-blinded, flexible dose study. Seventy patients with schizophrenia, who met the DSM-IV research criteria of having neuroleptic-induced acute dystonia or parkinsonism, were randomly assigned to risperidone or olanzapine group. The primary outcome was a comparison of the incidence of concomitant anticholinergic drugs usage between the groups to manage their acute dystonia and parkinsonism. The average doses of risperidone and olanzapine from baseline to study end point were 1.8-3.5 mg/day and 7.7-11.7 mg/day, respectively. There were no significant differences in demographic data, severity of EPS or psychotic symptoms between the groups at baseline assessment. Patients taking risperidone had significantly higher incidence of using anticholinergic drugs to manage acute dystonia or parkinsonism overall during the study (OR = 5.17, 95%CI = 1.49-17.88, P = 0.013). There was no significant between-group difference in the changing of rating scales of EPS and psychotic symptoms. The results of our study favour olanzapine as a better choice in schizophrenic patients with intolerant EPS. Double-blinded, fixed dose and different ethnical study for EPS-intolerant schizophrenic patients is needed to confirm the results of our study.

 

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Adult ADHD Often Undiagnosed by

 

 

 Primary Care Physicians

 

 

New York University School of Medicine Survey Reveals

Inexperience and Lack of Training, Resources Cited as Barriers to Diagnosis


NEW YORK –Inadequate clinical training, inexperience and the lack of a well-validated screening tool are major barriers prohibiting primary care physicians from diagnosing ADHD in adults, according to a national survey released today by New York University School of Medicine. The survey also revealed that primary care physicians would take a more active role in treating adult ADHD if these issues were addressed.

 

ADHD affects nearly 8 million American adults and can lead to increased healthcare costs, higher divorce rates, unemployment and motor vehicle accidents. Yet, the vast majority of these patients remain undiagnosed, with only one quarter seeking medical help for impairment associated with ADHD. Even those patients who seek help often aren’t identified as having ADHD.

 

"The results tell us that we need to do a better job of supporting primary care physicians who are on the front lines of diagnosing adult ADHD," said Lenard Adler, M.D., Associate Professor of Clinical Psychiatry and Neurology at New York University School of Medicine. "This disorder causes significant problems for millions of adults and yet their doctors, including internists and general practitioners, often miss it."

 

A new symptom assessment tool, the Adult ADHD Self-Report Scale (ASRS), may assist physicians in evaluating symptoms of ADHD. Dr. Adler and other ADHD experts, in conjunction with the World Health Organization, developed the ASRS.

 

 

 


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Key Survey Findings

 

Nearly half (48 percent) of 400 primary care physicians surveyed said they do not feel confident in diagnosing ADHD in adults.

Only 34 percent of primary care physicians report being "very knowledgeable" or "extremely knowledgeable" about adult ADHD compared with 92 percent who said the same for depression and 83 percent for generalized anxiety disorder (GAD).

Sixty-four percent of survey respondents indicated they received "not at all thorough" or "not very thorough" instruction in diagnosing and treating adult ADHD, compared with 13 percent who said the same for their training in depression.

Sixty-five percent of primary care physicians defer to a specialist when diagnosing adult ADHD compared with two percent for depression and three percent for GAD.

Eighty-five percent of primary care physicians surveyed said they would take a more active role in diagnosing and treating adult ADHD if they had an easy-to-use screening tool.
 

"Making quality, easy-to-use screening and symptom assessment tools available to physicians and the public will help adults with ADHD receive an accurate evaluation," added Dr. Adler. "These tools could go a long way to help increase confidence among primary care physicians in diagnosing adult ADHD."

Development of the ASRS was supported in part by an unrestricted educational grant from Eli Lilly and Company.



Survey Methodology


Four hundred physicians completed the survey from May 14, 2003 through May 28, 2003. New York University School of Medicine Institutional Board of Research Associates approved the final survey instrument. The survey was conducted by Harris Interactive® for New York University School of Medicine, with support from Eli Lilly and Company. Target physicians were in family practice, general practice or internal medicine and were recruited randomly from the American Medical Association master file. In order to qualify, physicians must have been practicing for at least two years and treating at least 30 patients per week with any combination of ADHD, bipolar disorder, depression, GAD or obsessive compulsive disorder. Recruitment for the survey was completed by mail, and the survey was conducted online.

 

 


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About Adult ADHD


 

Until the 1970s, ADHD was believed to be a childhood disorder that was outgrown. However, scientists now know that while hyperactivity may diminish, clinically significant inattentiveness and impulsivity can persist into adulthood. In adults, ADHD manifests itself through symptoms including inability to focus, disorganization and restlessness. Adults with ADHD have lower rates of professional employment, frequent job changes, lower self-esteem and poor social skills.

For more information about adult ADHD, visit

www.adultadd.com, www.medscape.com, www.webmd.com, www.chadd.org and www.add.org.

For complete survey results, please contact:

Leslie Forte, Chamberlain Communications Group at 212-884-0684 or lforte@chamberlainpr.com, or Nancy Wong, Harris Interactive at nwong@harrisinteractive.com.

 

About New York University
One of the world’s premier academic medical institutions for more than 155 years, NYU Medical Center continues to be a leader in patient care, physician education and scientific research. NYU Medical Center is internationally renowned for excellence in areas such as cardiovascular disease, pediatrics, skin care, neurosurgery, urology, cancer care, rehabilitation, plastic surgery, minimally invasive surgery, transplant surgery, infertility, women’s health and day surgery.

Dr. Adler has received research grants and educational grants, and has participated in consulting, advisory boards and speakers’ bureaus for: Eli Lilly and Company, Pfizer Inc., Novartis Pharmaceuticals Corp., Abbott Laboratories, McNeil Pharmaceutical, Johnson & Johnson, GlaxoSmithKline, Bristol-Myers Squibb Company and Merck & Co., Inc.

 

About Harris Interactive
Harris Interactive (www.harrisinteractive.com ) is a worldwide market research and consulting firm best known for The Harris Poll®, and for pioneering the Internet method to conduct scientifically accurate market research. Headquartered in Rochester, New York, U.S.A., Harris Interactive combines proprietary methodologies and technology with expertise in predictive, custom and strategic research. The Company conducts international research through wholly owned subsidiaries—London-based HI Europe (www.hieurope.com) and Tokyo-based Harris Interactive Japan—as well as through the Harris Interactive Global Network of local market- and opinion-research firms, and various U.S. offices. EOE M/F/D/V

Contact: Pamela McDonnell

Office of Public Affairs
NYU School of Medicine
Tel:       212-404-3555
Fax:      212-404-3570
E-mail:   Pamela.McDonnell@med.nyu.edu

 

 

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Kate Mowbray

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