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What is UKAAN?
| The UK Adult ADHD Network (UKAAN) was established in March 2009 to provide support, education, research and training for mental health professionals working with adults with Attention Deficit Hyperactivity Disorder (ADHD). UKAAN was founded by a
group of experienced mental health specialists who run clinical services for adults with ADHD within the National Health Service. The Network was established in response to UK guidelines from the National Institute of Health and Clinical Excellence (NICE, 2008) and the British Association for Psychopharmacology (Nutt et al., 2007) which for the first time gave evidence based guidance on the need to diagnose and treat ADHD in adults as well as in children; and in response to the relative lack of training and support in this area for professionals working within adult mental health services.
What are the aims of UKAAN? The aim of UKAAN is to support clinicians in the development of clinical services for adults with ADHD. Further information on currently available services can be found on the Support Group page. Main aims include the following:
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What is ADHD?
ADHD is a clinical syndrome defined in the DSM-IV and ICD-10 (hyperkinetic disorder) by high levels of hyperactive, impulsive and inattentive behaviours beginning in early childhood, persistent over time, pervasive across situations and leading to clinically significant impairments. The disorder is common in the population with prevalence estimates in the UK around 3-4% (Ford, Goodman & Meltzer, 2003). Follow-up studies of ADHD in children find that the disorder frequently persists into adult life, with around 15% retaining the full diagnosis by the age of 25 years, and a further 50% in ‘partial remission’ with some of the symptoms persisting and leading to continued impairments in daily life. A recent review and meta-analysis estimated world prevalence of ADHD in adults to average 2.5% or higher (Simon, Czobor, Balint, et al, 2009), with around 1% expected to fall in the most severe group requiring immediate treatment.
What are the symptoms and impairments associated with ADHD in adults?
ADHD can affect people in many different ways. Some of the most common complaints in adults are difficulties with organising daily activities and forgetfulness. People with ADHD often experience physical and mental over activity, so they may feel constantly restless, on the go all the time and complain of ceaseless unfocused mental activity; these symptoms may keep people with ADHD awake at night. Sustaining attention for any length of time can cause considerable difficulties and may lead to people with ADHD feeling exhausted or worn out by the effort. Mood instability and feelings of frustration are commonly reported, especially in situations where someone has to wait such as queuing at supermarkets.
While these types of symptoms are found in many people some of the time, they are severe, persistent over time and lead to impairments in people with ADHD. Impairment from ADHD can impact on an individual in several ways including: low self-esteem, distress from the symptoms of ADHD, impaired social interactions and relationships, behavioural problems, and the development of comorbid psychiatric symptoms, syndromes and disorders.
In addition to the symptoms of ADHD comorbidities are common. These may be other neurodevelopmental disorders such as autism spectrum disorders and dyslexia, behavioural problems such as drug and alcohol abuse disorders, addiction and antisocial behaviour; and other common mental health problems such as anxiety and depression.
How is ADHD in adults treated?
If ADHD is suspected in adults the person should be referred to a specialist in adult mental health for a formal diagnosis and treatment plan. Treatments include both pharmacological treatments such as methylphenidate, dexamphetamine or atomoxetine; and psychological interventions such as psychoeducation and cognitive behavioural therapy targeted at the problems commonly associated with ADHD. Drug treatment for ADHD should always form part of a comprehensive treatment programme that addresses psychological, behavioural and educational or occupational needs. Children who have been diagnosed with ADHD should be offered treatment throughout the critical period from adolescence into adulthood so that complications of ADHD like substance abuse, antisocial behaviour, depression and anxiety can be prevented.
Ford, T., Goodman, R. & Meltzer, H. (2003) The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry, 42, 1203-1211.
Simon, V., Czobor, P., Balint, S., et al (2009) Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry, 194, 204-211.
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