The DSM is the Diagnostic and Statistical Manual of the American Psychiatric Association - and it the manual used to diagnose psychiatric disorders - including ADD and ADHD.
The DSM criteria used to diagnose ADHD were developed with children as the focus. The criteria have been criticized in how poorly they help in the assessment and diagnosis of adult ADHD (or ADD).

Here is an article from the American Journal of Psychiatry which documents this issue in depth.

This article begins by summarizing the history of the diagnosis of ADHD.
It then criticizes the limitations of the diagnostic criteria for adults with ADHD.
One of the examples cited is the age of onset criteria - i.e. having to have symptoms before the age of 7 is often limiting. It is problematic, because it is often hard to establish this early history in an older adult. New research is showing that the age of onset is also too restrictive (this paper cites two new research papers which challenge this criterion).
Another criticism is that the description of impairment is done from the perspective of childhood ADHD and is not appropriate for the impairment that adults with ADHD experience.
Furthermore, the diagnostic threshold (i.e. 6 out of 9 symptoms) doesn’t reflect several lines of research which document that adults with fewer symptoms are still quite impaired from their ADHD.

The DSM-V is due out in 2011. Many researchers are working to improve the DSM criteria for adult ADD/ADHD. This is particulary needed because many doctors are not comfortable with the diagnosis of adult ADHD, and they need to have diagnostic criteria which will help them to diagnose this condition more easily. Also, new research has shown that 4.4% of american adults have ADD/ADHD. So there is a lot of need out there, and ‘new and improved’ DSM criteria are needed.

Please share your thoughts and comments below.

Dr. Kenny

Technorati Tags: Adult ADD, Adult ADHD, DSM, Diagnosis

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Eli Lilly - the makers of Strattera, are sponsoring a scholarship for Adults with ADD, called: “Focus on Your Possibilities”.

According to their website - the criteria for the scholarship include:

To apply for the Focus on Your Possibilities Scholarship, you must be:

* An adult age 25+ who has been diagnosed with and is currently undergoing any treatment for adult ADHD
* Currently attending or planning to attend an accredited public or private undergraduate or graduate school in the United States or would like to obtain your GED
* Going to enroll or already enrolled in a college, institute, university, or GED program on a full-time basis
* Willing to share your story with the media/public if selected as a Focus on Your Possibilities winner

If you are interested, please visit their site, and follow the steps to apply.

Dr. Kenny

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The New York Times put out a fantastic multimedia webpage this week - sharing people’s experiences with ADD/ADHD.
It’s called: Patient Voices: A.D.H.D.
There is a lot of great information there -
* to help parents to further understand their kids/teens
* For adults with ADD/ADHD to understand it better
* To further understand the role of medicine and other treatments

I suggest that you grab your favorite beverage, turn this on and listen for a while. You’ll learn a lot.

All the best,
Dr. Kenny

p.s. it is great to see such a high quality piece on ADHD in the mainstream media…

Technorati Tags: ADD, ADHD, Adult ADD, Adult ADHD, New York Times

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I am posting a message that ADD Coach Beverley Rohman forwarded to me to make sure that you know about the upcoming conference being put on by ADDA.
They want to encourage you to sign up right now - so they are giving you a discount if you register by May 16th. Here is the important information:

I’m writing today to tell you about the 2008 Adult Attention Deficit Disorder (ADDA) Conference this July 10-13 in Minneapolis

“Adult AD/HD: People, Purpose & Passion –
Pathways for Success”

This year’s conference features some of the most renown authorities in the world of AD/HD, including keynote presentations by:

* Sari Solden, MS, LMFT, on “A ‘Whole’ New View of Success – Aiming for Wholeness Instead of Perfection”
* Ned Hallowell, MD, on “Unwrapping the Gifts of the Mind”
* John Ratey, MD, on “The Spark for Success”

Other topics addressed in the many breakouts include:

• Family and Relationship Issues
• College Challenges and Success
• Workplace and Career Issues
• Medical Management and Treatment
• Science and Research
• Life Skills
• Non-AD/HD Spouses
• Time Management and Organization
• Women’s and Men’s Issues
• Coaching ………and much, much more!

Check it out on www.add.org

There is a Mother’s Day special going on now.
FAX your registration in before May 16th and get the early bird rate of $299 for members/ $199 for students.
Write ‘Mother’s Day special’ on the FAX form. Or Register on line. All registrations up to May 16th will get the reduced rates.
[end of the ADDA notice]

I have heard rave reviews of this event, and I encourage you to come if you are interested.
I intend to be at the event - and I hope that if you come, you’ll come up and say hi.
And of course, if you are considering coming - act now to save some money on the discount that they’re offering.

All the best,
Dr. Kenny

Technorati Tags: ADD, ADHD, Adult ADD, Adult ADHD, ADDA

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People are becoming more aware of the fact that adults often have ADD/ADHD as well as kids. A recent US based study found that 4.4% of American adults have ADD/ADHD, and many aren’t aware of it.

Shire, the company which produces Adderall and Vyvanse, has developed an awareness campaign which will help adults to ’self screen’ for the disorder. They have called it the ‘RoADHD Trip’, as they will be traveling to different US cities.

This initiative is including volunteers from the Attention Deficit Disorder Association, who will help to answer questions for the estimated 20,000 adults who will complete a screening questionnaire during this campaign - to try to figure out if they have adult ADD/ADHD.

The news release which describes the program states that they will be going to the following cities:

The events will take in Atlanta, GA; Alpharetta, GA; Raleigh, NC;
Simpsonville, SC; Albany, NY; Nashville, TN; York, PA; Boston, MA; Chicago,
IL; Milwaukee, WI; Taylor, MI; Ionia, MI; and Columbus, OH.

I wanted to let you know that I strongly support this initiative. There are so many adults with ADD or ADHD who don’t know they have it, or they suspect that they do and can’t get the resources or help that they need.

As I write this, I am in a hotel room in San Francisco just before a conference begins. When I was clearing US customs (i.e. entering the US from Canada), the customs officer asked me where I was going. When I mentioned a conference, and ADHD, he actually asked me how he could learn more about it - because he thinks he has adult ADHD and he doesn’t know where to find answers. I took a few minutes to talk to him about it (though not too long - people were waiting to clear customs!).

This is one small example - but there are many more out there. I support this initiative - as we need to help to educate and advocate for people out there who have ADD and ADHD. And as people self screen for the disorder, the volunteers from ADDA will help to educate everyone about this disorder.

To find out more about this, you can visit Shire’s site: ADHD Support. And to see the schedule of their program, click here. To find out more about ADHD in adults, visit ADDA.

What if you can’t get to one of the tour’s sites?

If you suspect that you have adult ADD or ADHD, and you want to screen yourself for it, I suggest that you print this adult ADD screening questionnaire.

I suggest that you don’t read the questionnaire instructions, but rather go right to the questions and fill them out as best you can. (there are only 18 questions)

Then, go back and read the instructions on how to score it.

Whether you score highly or not (or even if you don’t even fill out this questionnaire), if you are concerned about adult ADD or ADHD, I strongly encourage you to talk to your primary care doctor about it and see if he or she can give you some help in finding the right local resources.

Please share your thoughts or comments below.

Dr. Kenny

Technorati Tags: ADHD, ADD, Vyvanse, Adderall, Adult ADD, Adult ADHD

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On April 24, 2008, the US Food and Drug Administration approved Lisdexamfetamine - known as Vyvanse - to be used for adult ADD and ADHD. Prior to this announcement, the medicine was just approved for use in children aged 6-12.

Although people often think of Attention Deficit Hyperactivity Disorder as just a disorder of childhood - it often carries on into adult life - and studies have shown that over 4% of US adults have ADD or ADHD.

Despite the fact that Vyvanse has just received approval for use in adults - it has been used by some doctors previously, through ‘off label usage’ (see my previous article on this: Vyvanse in Adults).

The study which led to the approval included 414 adults, aged 18-55 years old. Over 4 weeks, they were tried on Vyvanse or placebo. Generally, the adults noted significant improvement within 1 week of starting the medicine. All doses used (i.e. 30 mg, 50 mg and 70 mg) were all found to be helpful.

The most common side effects experienced by the adults in the study with Vyvanse were: decreased appetite, difficulty falling asleep, and dry mouth.

To read more details about the study, please click here.

Does this mean that you should try Vyvanse if you are an adult with ADD or ADHD?

Not necessarily…
It just means that this is a good treatment option, and that the research has now been done to prove that it is effective for use in adults with ADD and ADHD.
It is best to talk to your doctor about your medication (and non-medication) treatment options.

As I have previously mentioned, as a doctor working in Canada, I have not been able to prescribe Vyvanse, because it has not yet come to Canada.
So, I have asked readers of this blog if Vyvanse works. To read over 275 responses, click here: Does Vyvanse Work?

Other Vyvanse articles on my blog:
Vyvanse Overview
Vyvanse Dose
No Addiction with Vyvanse

Please leave your thoughts or comments below.

Dr. Kenny

Technorati Tags: Vyvanse, ADD, ADHD

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Although it is accepted that fewer girls are diagnosed with ADD/ADHD than boys (in childhood) - the number is almost equal in adults. New research has demonstrated that women are in fact more impaired with their ADD than the men.

This study documented that women were more likely to have combined ADHD (i.e. inattention and hyperactivity), they were more likely to have emotional symptoms (depression and anxiety) with their ADD, and more sleep problems.

This research is very important - as women may need more support for their ADD than previously recognized.

An expert in this field is Sari Solden. She has written the respected book Women With Attention Deficit Disorder. I suggest you read this book if you want specific help for ADD in women.

Dr. Kenny

p.s. If you have particular issues which are specific to women with ADD, please share them below.

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Quite some time ago, I wrote an article on this blog about ADHD, pilots and ADHD medication. This is a tricky issue -because we all want pilots to be safe in the air, and I believe that people with ADHD can be outstanding pilots and should be allowed to take their medication and still fly! (Better than them not taking their medication or not pursuing the diagnosis to try to keep their pilot’s license!).

Just recently, a doctor emailed me, and let me know that he had created a whole web site about this issue.
It’s a great site and I recommend it.
Check it out -and please pass it along to anyone you know who has ADD and wants to fly.
Here it is: www.ADHDPilots.org/

Dr. Kenny

Technorati Tags: ADHD Medication, Pilots, Adult ADD

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A new study was just released which documents that Vyvanse works for Adults with ADD and ADHD.
Vyvanse (lisdexamfetamine) is a new medication for ADD and ADHD, which is currently approved for ADHD in children, aged 6-12.
Shire, the makers of Vyvanse, have applied to the FDA for approval for Vyvanse to be indicated in Adults.
This study documents that it works, and will hopefully help to make this medication more available to adults with ADD/ADHD.
To read more details of this new study, click here.

To read real life stories on whether Vyvanse works, visit this post on my blog - and be sure to scroll down (and please consider sharing your story!).

Dr. Kenny

Technorati Tags: Vyvanse, ADHD, Medication for ADHD

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As a child psychiatrist, I know that most teens with ADD or ADHD do their best school work while listening to their music.

I often have to convince parents and teachers to allow their ADD/ADHD kids and students the privelage of listening to music while they work.

Now, there is a study which has proven that this is the case. Well, it has actually proven that ‘white noise‘ in the background can increase the concentration for people with ADD or ADHD.

What is your experience?

Does white noise, or music help you to pay attention?

Please share your experiences by typing them into the comments box below.

Dr. Kenny

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