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ADHD in adults: diagnosing & treating this common problem

I only recently came across the important article "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD" published in the open access journal BMC Psychiatry last autumn.  I suspect that most mental health professionals working with adults are poor at recognising and treating Attention Deficit Hyperactivity Disorder (ADHD) - and I certainly include myself in this company! 

NICE guidelines: attention deficit hyperactivity disorder (ADHD) in children, young people & adults

Last month, NICE - the National Institute for Health and Clinical Excellence in England & Wales - issued a guideline on Attention Deficit Hyperactivity Disorder (ADHD).  In the associated press release they commented "ADHD is a common behavioural disorder in children and young people estimated to affect up to 3% of school-age children and young people in the UK, and about 2% of adults worldwide. It usually starts in early childhood and some people will continue to have ADHD as adults. Severe ADHD is sometimes known as ‘hyperkinetic disorder'. The symptoms of ADHD include: being inattentive (unable to concentrate for very long or finish a task); hyperactivity (fidgety and unable to sit still); and impulsive (speaking without thinking about the consequences). It is an extremely distressing disorder, affecting the person as well as their families and carers."

Handouts & questionnaires for sleep, ADHD & fatigue

Here are a collection of handouts, questionnaires and information sheets about sleep, ADHD, and fatigue.  The sleep handouts are mostly based on Colin Espie's excellent self-help book "Overcoming insomnia and sleep problems" and the intention is that the handouts would be used in conjunction with this book - see the bottom of the page for more details. 

Sleep diary and instructions - a key component of Espie's CBT programme is the use of this weekly diary form to both assess the sleep problem initially and then monitor progress.

Sleep diary, measuring progress - this is a form that can be helpful when measuring overall progress using information from the sleep diaries.

Sleep advice - fairly standard general advice about improving sleep. 

Sleep stimulus control - this and sleep restriction (see below) are probably both the most challenging and the most useful components of a CBT approach for insomnia.  

Sleep, ADHD & fatigue

“ Concerning all acts of initiative (and creation) there is one elementary truth, the ignorance of which kills countless ideas and splendid plans - that the moment one definitely commits oneself, then providence moves too ... Whatever you can do, or dream you can, begin it. Boldness has genius, magic and power in it. Begin it now! ” - Goethe

This section contains handouts, questionnaires and information sheets about sleep, ADHD, and fatigue.  The sleep handouts are mostly based on Colin Espie's excellent self-help book "Overcoming insomnia and sleep problems" and the intention is that the handouts would be used in conjunction with this book - see the bottom of the page for more details.  The Pittsburgh Sleep Quality Index is an alternative way of assessing severity of sleep problems and tracking progress - it is more convenient than assessment with a sleep diary but less accurate. 

Diagnosis of psychological disorders

“ When you were born, everyone was smiling but you were crying. Live such a life that when you depart, everyone is weeping but you are smiling. ” - Sa'di of Shiraz

Making a formal psychological diagnosis can be a mixed blessing. It has several potential advantages. If many of my symptoms can be accurately grouped under a specific psychological diagnosis, it may well help to understand what is happening, to clarify the likely time course of my symptoms, and to choose treatments that have the best chance of being effective. It's worth noting that often people suffer from more than one psychological disorder at the same time - this is called comorbidity and it is common.

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