ADHD is underdiagnosed in the adult population, especially among women

Regarding attention deficit hyperactivity disorder (ADHD), it is not uncommon to come across erroneous assumptions, such as that it only appears in

, that it especially affects

and that it is

.

All of them are

by

, head of the Psychiatry Service of the Vall d'Hebron University Hospital (Barcelona) and principal investigator of the G-27 group of the Ciber de Salud Mental (CiberSAM).

This international reference expert

In ADHD he has participated with a presentation on adults at the XXV National Congress of Psychiatry, recently held in Santiago de Compostela.

"We need to debunk the idea that it's overdiagnosed. In fact, the scientific evidence shows us that it's actually underdiagnosed, especially among adults."

This has been commented to DM Josep Antoni Ramos Quiroga who alludes to a recent study that he has just published in

as the first signatory, where the prevalence and treatment of this disorder in Spain is analyzed.

Among the conclusions of the study, it stands out that "in Spain, only 0.1% of the general adult population has a diagnosis of ADHD, when epidemiological data put the disorder at 2-3%." This indicates a very significant underdiagnosis. ".

Four times more mortality

The implications are not trivial since ADHD is associated with higher mortality - "four times more, compared to that of the general population" - largely because without treatment these people may be at greater risk of accidents, drug use, suicide attempts and presenting cardiometabolic diseases.

According to the psychiatrist, "the genetic risk factors associated with ADHD are also related to a greater probability of

,

,

Y

.

We cannot make the mistake of thinking of ADHD as a minor disorder.

It is an alteration that is associated with other disorders;

adequate treatment allows us to carry out secondary prevention".

diagnostic suspicion

Isolated inattention or hyperactivity are to ADHD what sadness is to depression: traits and feelings that in themselves are not pathological, but when they interfere or prevent a person's life course they should be seen as an alarm sign.

In the consultation, the doctor of any other specialty can

that you are dealing with a patient with ADHD if you observe:

• - Obvious organizational problems.

• - Habitual tardiness.

• - Constantly interrupts the conversation and is always restless.

• - Exhibits poor adherence to treatments due to forgetfulness.

• - He often suffers accidents due to distractions.

• - Has a history of poor academic performance, and most likely (due to the high genetic risk) has a child with this diagnosis.

These traits, warns the specialist, may point to an undiagnosed disorder in adult patients.

Another of the premises qualified by Ramos Quiroga is that the disorder almost exclusively affects the male population.

"Women suffer

.

During childhood, perhaps due to certain biases, they are considered girls who are not interested or who do not perform or who have anxiety.

In general, they do not show marked symptoms of hyperactivity and do not bother as much, which prevents the disorder from being well detected.

It is not something unique to ADHD.

In other neurodevelopmental pathologies, such as autism spectrum disorder, it also occurs.

Perhaps more training is needed with this perspective."

In the study on the Spanish population, it is observed that more than 70% of the population with ADHD diagnosed in childhood are boys, while when they reach adulthood, half are women.

The

in adults they are stimulating treatments and in many cases, a cognitive-behavioral approach must also be associated, sums up the specialist for whom classifying the approach to mental illnesses in a

between pharmacotherapy and psychotherapy is a

.

"It depends on the pathology, one or the other will be more effective, but in the vast majority of cases, especially moderate-severe ones, it is necessary to combine both."

"Psychiatrists don't

we give pills

"

In his opinion, "the idea that psychiatrists

.

What we do is prescribe medications that, by the way, are sometimes administered intravenously, intranasally... We try to ensure that patients maintain a good quality of life.

In the specific case of ADHD,

.

It would be great to get a similar response in many oncological, cardiological or neurological diseases."

However, there is still a lot of room for improvement in different areas.

"We lack biomarkers that allow us to reach a diagnosis based on a simple analysis, although, in the case of ADHD, we have a high capacity to achieve it with great reliability."

In this regard, he recalls that "in Spain neither psychiatrists nor psychologists visit their patients in ten minutes. This idea that

does not correspond to reality.

The specialists

to the evaluation and follow-up of the patients".

The investigation is aimed at determining

that better explain "why the brain does not develop properly and if there are possibilities of making a

of this alteration in neurodevelopment".

In addition, each time, with the help of new devices, a better

patients digital.

At the Vall d'Hebron Research Institute (VHIR), the Ramos-Quiroga group is carrying out, together with King's College London, the ART-Carma study.

Within the vast project

, supported by funds from the European Union, which seeks to improve the treatment of

, these researchers analyze the risk factors associated with cardiovascular problems;

the best treatments for each of these individuals, and "through one-year follow-up with digital devices, we seek to obtain a better phenotyping in these adult patients."

diagnostic suspicion

Isolated inattention or hyperactivity are to ADHD what sadness is to depression: traits and feelings that in themselves are not pathological, but when they interfere or prevent a person's life course they should be seen as an alarm sign.

In the consultation, the doctor of any other specialty can

that he is dealing with a patient with ADHD if he observes obvious organizational problems;

habitual tardiness;

that he constantly interrupts the conversation and is always restless;

exhibits poor adherence to treatments due to forgetfulness;

he often suffers accidents due to distractions;

He has a history of poor academic performance, and most likely -due to the high genetic risk- he has a child with this diagnosis.

These traits, warns the specialist, may point to an undiagnosed disorder in adult patients.

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