Publication of guidelines good news for adult sufferers of ADHD

IF YOU’RE an adult things are looking up.

The publication of South Africa’s first guidelines for adult attention deficit hyperactivity disorder (ADHD) means it should be easier to get the treatment you need – and persuade medical aids to pay for it.

The guidelines‚ published in the South African Journal of Psychiatry‚ with ADHD‚ have been compiled by psychiatrists Renata Schoeman and Rykie Liebenberg and include assessment procedures‚ drug options and a treatment plan for long-term health.

More than a million people between 20 and 50 are affected by adult ADHD‚ and Schoeman said despite the efficacy of treatment and the substantial costs of untreated ADHD‚ access to treatment was not a given.

“In South Africa‚ there is poor identification and treatment of common mental disorders at primary healthcare level and limited access to specialist resources with a service delivery and treatment gap of up to 75%‚” she said.

“Psychiatrists and patients do not have access to the medication resources available in established markets.

“More often than not‚ ADHD is not diagnosed or is misdiagnosed‚ and that can have a severe impact on the functioning of the patient and lead to costly medical aid or private out-ofpocket expenses.”

The guidelines outline the requirements for comprehensive specialist diagnostic assessment and diagnostic certainty before initiating drug treatment.

“Comprehensive assessment is not possible during the average 15minute general practitioner consult 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‚” said Schoeman.

“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 (like cognitive enhancement)‚ which artificially escalates the prevalence and costs of ADHD.”

This in turn forced medical schemes to manage their business risk by not covering ADHD as a chronic disorder‚ she said.

ADHD is characterised by severely impaired levels of inattention‚ hyperactivity and impulsivity.

To see the guidelines, http://www.sajp.org.za/index. visit