Summary
This guideline provides an overview of the recommended Adult ADHD assessment steps, differentials to be considered and options for treatment according to the best available evidence based guidelines.
Adult ADHD is a chronic, costly and debilitating disorder – if untreated. Recognition of adult ADHD as a chronic disorder which needs chronic treatment is crucial.
A comprehensive diagnostic assessment and diagnostic certainty prior to initiating drug treatment are crucial. This is not possible during the average 15-min general practitioner consultation, and it is therefore strongly advised that the diagnosis of adult ADHD and treatment initiation should be made by a psychiatrist well versed in the complexities of ADHD and the comorbidity thereof. Raising the diagnostic bar for adult ADHD will also prevent the scripting of medication for patients who use the medication for reasons other than the treatment of ADHD (e.g. cognitive enhancement) which artificially escalates the prevalence and costs of ADHD.
Once a proper treatment plan has been established, and a patient is contained within a multi-disciplinary and multimodal (psychosocial intervention and an optimal medication regime) basket of care, follow-up can take place on primary healthcare level – leading to further cost savings to schemes and reducing pressure on resources (manpower and financial) at specialist level.19 Ongoing treatment (which includes compliance to treatment) is crucial in preventing complications and long-term costs.
Click here for the ADHD Treatment Armamentarium in South Africa
Schoeman R, Liebenberg R. The South African Society of Psychiatrists/Psychiatry Management Group Management Guidelines for Adult Attention-Deficit/ Hyperactivity Disorder. S Afr J Psychiat. 2017;23(0), a1060. https://doi.org/10.4102/sajpsychiatry.v23i0.1060 - An Update on the ADHD Treatment Armamentarium in South Africa., Prof Renata Schoeman
South African Journal of Psychiatry; The South African Society of Psychiatrists/Psychiatry Management Group the Management Guidelines for Adult Attention-Deficit/ Hyperactivity Disorder, 28 April 2017_An Update on the ADHD Treatment Armamentarium in South Africa, 2023