Consider ADHD in adult nonpsychotic psychiatric outpatients
AT THE ECNP CONGRESS
Moreover, a major Swedish national registry study involving more than 25,000 patients with adult ADHD established that the disorder is associated with increased rates of criminality, and that during periods when patients were on ADHD medications, their risk of arrests and convictions was significantly reduced (N. Engl. J. Med. 2012;367:2006-14). But while this study drew extensive media attention, heralding a “treatment for criminality,” Dr. Thome cautioned that association in an observational study does not prove causality.
“Some people argue that because they can’t focus and are so impatient, people with adult ADHD are simply worse at hiding the crime and are much more easily caught by the police, and that during periods when they’re on medication they are more likely to be seeing a social worker or have other social support. That might be a partial explanation,” Dr. Thome said. “But my main point here is I want you to understand that you don’t need to be afraid of adult ADHD patients. They’re not more dangerous than others.”
With regard to treatment, he emphasized that a comprehensive plan for adult ADHD needs to address psychological, behavioral, and educational or occupational needs with a range of interventions.
“I want to make the point that psychologic therapy is at least as important as medication,” Dr. Thome said. “Pills don’t give you skills.”
The ADPSYC study was funded by Eli Lilly. Dr. Thome reported having received research grants and/or serving on advisory boards for Lilly and more than a dozen other companies.
