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Adult and Childhood ADHD Two Different Disorders?

1:45

A couple of recent studies are taking a new look at the differences in adult and childhood ADHD.

They suggest that adult ADHD is not just a continuation of childhood ADHD, but that the two are different disorders entirely.

In addition, the researchers say that adult-onset ADHD might actually be more common than childhood onset.

The two studies used similar methodology and showed fairly similar results.

The first study, conducted by a team at the Federal University of Rio Grande do Sul in Brazil, evaluated more than 5,000 individuals born in the city of Pelotas in 1993. Approximately 9 percent of them were diagnosed with childhood ADHD — a fairly average rate. Twelve percent of the subjects met criteria for ADHD in adulthood — significantly higher than the researchers expected — but there was very little overlap between the groups. In fact, only 12.6 percent of the adults with ADHD had shown diagnosable signs of the disorder in childhood.

The second study, which looked at 2,040 twins born in England and Wales from 1994-5, found that of 166 subjects who met the criteria for adult ADHD, more than half (67.5 percent) showed no symptoms of ADHD in childhood. Of the 247 individuals who had met the criteria for ADHD in childhood, less than 22 percent retained that diagnosis into adulthood.

These reports support findings from a third study from New Zealand, published in 2015. Researchers followed subjects from birth to age 38. Of the patients who showed signs of ADHD in adulthood in that study, 90 percent had demonstrated no signs of the disorder in childhood.

While the results from these studies suggests that the widely accepted definition of ADHD – a disorder that develops in childhood, is occasionally “outgrown” as the patient ages- may need to be reassessed.

However, not everyone is on board with the recent findings. Some experts suggest that the study’s authors may have simply missed symptoms of ADHD in childhood in cases where it didn’t seem to become apparent until adulthood.

“Because these concerns suggest that the UK, Brazil, and New Zealand studies may have underestimated the persistence of ADHD and overestimated the prevalence of adult-onset ADHD, it would be a mistake for practitioners to assume that most adults referred to them with ADHD symptoms will not have a history of ADHD in youth,” write Stephen Faraone, Ph.D., and Joseph Biederman, M.D., in an editorial cautioning the ADHD community to interpret the two most recent studies with a grain of salt. They called the findings “premature.”

In both of these studies and in previous research, adult ADHD has been linked to high levels of criminal behavior, substance abuse, traffic accidents and suicide attempts. These troubling correlations remained even after the authors adjusted for the existence of other psychiatric disorders — proving once again that whether it develops in childhood or adulthood, untreated ADHD is serious business.

Both of the studies challenge conventional beliefs that childhood onset ADHD is more likely to continue into adulthood. Many experts would like to see more research on this topic to verify these findings

The two studies were published in the July 2016 issue of JAMA Psychiatry.

Story source: Devon Frye, http://www.additudemag.com/adhdblogs/19/12040.html

Daily Dose

Fidget Spinners

1:30 to watch

Does your child have a fidget spinner?  Thank goodness school is coming to an end just as this craze is getting crazier! Not only are some schools banning fidget spinners altogether, there have recently been concerns over choking.  

 

While fidget spinners have warnings about choking hazards, 2 children have been hospitalized after ingesting and choking on parts of the spinner. Both of these children required surgery to remove the piece of the spinner that they had “accidentally swallowed”. Neither of these children were under the age of 3 years (the recommended age to avoid using a spinner). It seems that children of all ages put things in their mouths (fingernails, pencils, coins) and in several cases pieces of the spinner have fallen apart. 

 

I have recently noticed my patients playing with fidget spinners. Several little boys were fighting over their different colored fidget spinners just the other day, before their mom took them all away!  They were showing me how they “were supposed to help manage their attention and focus”…but they looked like a distraction to me and I can only imagine if 20 kids in one class have them…all “fidget spinning” at once.  Sounds like a few minutes of extra recess might be a better idea?

 

Fidget spinners have been around for some time, and were initially thought to be
a “stress relieving toy” which would help certain people focus.  But, there seems to be “ no research into the efficacy or safety of fidget spinners to help manage the symptoms of ADHD, anxiety or any other mental health conditions”, according to the director of the ADHD program at Duke University.  

 

While these may only be a craze for the rest of the school year they are inexpensive and easily purchased at multiple toy stores and on- line. Do not let children under the age of 3 years play with this toy!! For children ages 3-6 I would make sure to talk to them about choking dangers and never to put the toy in their mouths, and be supervised when playing.  For older children I would again make them aware of the choking issues and even show them x-rays of the toy lodged in the esophagus. This might be another “teaching moment” to NEVER put toys into your mouth (or coins or batteries….) because accidental ingestions do occur. Remind them to only play with them with their hands as some toys have been known to fall apart. 

 

I bet this craze may be short lived once school is out and summer activities provide even more diversion than a 3 pronged toy that turns into a blur when twirled on your finger!!  I am not investing in one.  

 

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