ADHD-A Lasting Disorder Needing Long-Term Treatment

In a symposium at the American Psychiatric Association Annual Meeting, Jeffrey H. Newcorn, MD, discussed ADHD and impulsivity from childhood to adulthood. Among the key points in the presentation titled ADHD and Impulsivity: Longitudinal Course, Comorbidity, and Impairments Related to Persistence Into Adulthood:

•ADHD is a highly prevalent disorder that persists across the lifespan in one form or other in the majority of affected individuals. Although the focus in adults is often on inattention and related cognitive impairments, there are often major impairments that result from persistent impulsivity symptoms

•The sequellae of untreated impulsivity can be profound, including problems in family and peer relationships, difficulty holding a job, and increased rates of automobile violations and accidents, substance abuse, and even criminality. There is also increased risk for a range of personality disorders, predominantly those in Cluster B. Treatment of ADHD can improve symptoms of inattention and impulsivity, and their sequellae

•Whether treatment can mitigate the long-term consequences and impairments related to ADHD remains an important research question. Findings from some studies indicate that early treatment mitigates some of the adverse, long-term consequences of ADHD; however, other findings suggest that the long-term outcome of ADHD may not be affected by treatment

•There is heightened risk for conditions attributable to impulsivity, such as personality disorders and pathological gambling

•Neurobiological models of ADHD and its treatment suggest a basis for the relationships across the various disorders of impulse control, and the possibility that treatment of ADHD might also mitigate symptoms of other co-occurring impulse control disorders

In this video, Dr Newcorn gives a brief synopsis on this growing area of study. Dr Newcorn is Associate Professor of Psychiatry and Pediatrics and Director of the Division of Child and Adolescent Psychiatry at Mount Sinai School of Medicine in New York.