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Managing ADHD during Times of
Transition

Leaders in healthcare offer advice for helping patients manage their ADHD symptoms when they can’t control their circumstances.

Managing ADHD
during
Times of
Transition

Leaders in healthcare offer advice for helping patients manage their ADHD symptoms
when they can’t control their circumstances.

Dr. Rakesh Jain on supporting adult patients

NEW CHALLENGES, NEW ROUTINES

Times of transition can be challenging for adult patients' ADHD symptom management. They can interfere with coping strategies patients work to maintain, and can disrupt regular routines they've established over time.

When adult patients are challenged with unpredictable changes to their daily routines, it's important to continue to support patients with appropriate strategies that can help them adapt and manage their ADHD.1-6

Image of Dr. Rakesh Jain.
Ultimately, we must address individual patient needs, as there can be differences in how times of transition can impact their symptoms of ADHD.
Dr. Rakesh Jain

Dr. Jain is a paid consultant and investigator for Takeda.

Dr. Greg Mattingly on supporting pediatric patients

Support the caregiver, support the patient

Not only can times of transition interfere with pediatric patients' ADHD symptom management, but their caregivers may struggle to manage the increased demands newly placed on them as well.

Healthcare practitioners can work with pediatric patients and their caregivers to find alternative strategies that may help guide them in managing their ADHD symptoms.1,7-10

Image of Dr. Greg Mattingly.
I’ve really seen that frustration and sense of being overwhelmed bubbling up in a lot of patients in similar circumstances, especially when they’re not able to finish things.
Dr. Greg Mattingly

Dr. Mattingly is a paid consultant and investigator for Takeda.

Dr. Joel Young on PATIENT SUPPORT through telehealth

Finding value in telehealth

Telehealth can be a useful tool for patients and healthcare practitioners alike. It can help to maintain contact with ADHD patients, to periodically reassess their symptoms and how their ADHD is being managed, when in-person visits aren’t an option. It also offers the ability to see how patients live in their own homes, and provides a level of ease when bringing in perspectives of other family members.11-14

Image of Dr. Joel Young.
Being able to see our patients with ADHD in the context and comfort of their homes… adds an added dimension when thinking about their ADHD management.
Dr. Joel Young

Dr. Young is a paid consultant and investigator for Takeda.

ADHD SYMPTOMS AND DSM-5® DIAGNOSTIC CRITERIA FOR ADHD IN ADULTS AND CHILDREN1

ADHD is characterized as a persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development.

To be diagnosed with ADHD, individuals must meet the following criteria adapted from the DSM-5®:

  • 6 or more symptoms of inattention and/or hyperactivity/impulsivity must have persisted for at least 6 months to a degree that is inconsistent with developmental level, and that negatively impacts directly on social and academic/occupational activities. For older adolescents and adults (age 17 and older), at least 5 symptoms are required.
  • Several inattentive or hyperactive/impulsive symptoms were present before the age of 12 years.
  • Several inattentive or hyperactive/impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
  • Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, or withdrawal).

Diagnosis should be based on a complete history and evaluation of the patient.

  • Makes careless mistakes/lacks attention to detail
  • Lacks sustained attention
  • Poor listener
  • Fails to follow through on tasks and instructions
  • Exhibits poor organization
  • Avoids tasks requiring sustained mental effort
  • Loses things necessary for tasks/activities
  • Easily distracted (for older adolescents and adults may include unrelated thoughts)
  • Forgetful in daily activities
  • Fidgets with or taps hands or feet, squirms in seat
  • Leaves seat in situations when remaining seated is expected
  • Runs about or climbs inappropriately; older adolescents and adults may feel restless
  • Has difficulty engaging in leisure activities quietly
  • Is “on-the-go” acting as if “driven by a motor”
  • Talks excessively
  • Blurts out answers
  • Has difficulty waiting their turn
  • Interrupts or intrudes on others

*Symptoms must occur often

References

  1. American Psychiatric Association. Attention‐deficit/hyperactivity disorder. In: Diagnostic and
    Statistical Manual of Mental Disorders.
    5th ed. DSM-5® Arlington, VA: American Psychiatric Association;
    2013:59‐65.
  2. Canela C, Buadze A, Dube A, Eich D, Liebrenz M. Skills and compensation strategies in adult ADHD—a
    qualitative study. PLoS One. 2017;12(9):e0184964.
  3. Workplace Issues. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
    Accessed April 14, 2020. https://chadd.org/for-adults/workplace-issues/
  4. Managing adult ADHD. American Academy of Family Physicians (AAFP). Accessed April 14, 2020.
    https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_toolkit/adhd19-patient-handout.pdf.
  5. Pham AV. Understanding ADHD from a biopsychosocial‐cultural framework: a case
    study. Contemp Sch Psychol. 2015;19(1):54‐62.
  6. Salamanca LM. Biopsychosocial perspective of ADHD. Open J Epidemiol. 2014;4:1‐6.
  7. Eiraldi RB, Mautone JA, Power TJ. Strategies for implementing evidence‐based psychosocial
    interventions for children with attention‐deficit/hyperactivity disorder.  Child Adolesc Psychiatr Clin N
    Am
    . 2012;21(1):145‐159.
  8. ADHD and school - strategies to help with school success: a toolkit for parents of children with ADHD.
    Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Accessed April 14,
    2020. https://chadd.org/wp-content/uploads/2018/12/ADHD-School-Toolkit.pdf
  9. Langberg JM, Epstein JN, Graham AJ. Organizational‐skills interventions in the treatment of
    ADHD. Expert Rev Neurother. 2008;8(10):1549‐1561.
  10. Parenting a child with ADHD. Children and Adults with Attention-Deficit/Hyperactivity Disorder
    (CHADD). Accessed April 14, 2020. https://chadd.org/wp-content/uploads/2018/04/parenting2015.pdf
  11. What is telepsychiatry? American Psychiatric Association. Accessed June 2, 2020. https://www.psychiatry.org/patients-families/what-is-telepsychiatry
  12. Spencer T, Noyes E, Biederman J. Telemedicine in the management of ADHD: literature review of
    telemedicine in ADHD. J Atten Disord. 2020;24(1):3‐9.
  13. Telemental health: benefits and potential pitfalls. Children and Adults with Attention‐Deficit/Hyperactivity Disorder (CHADD). Accessed June 2, 2020. https://chadd.org/attention‐article/telemental‐health‐benefits‐and‐potential‐pitfalls/
  14. How to prepare for a video appointment with your mental health clinician. American Psychiatric
    Association. Accessed June 2, 2020. https://smiadviser.org/wp-content/uploads/2020/04/How-to-Prepare-for-a-Video-Appointment.pdf

DSM-5® is a registered trademark of the American Psychiatric Association. All rights reserved.