Major Impacts of Untreated ADHD Across a Patient’s Lifespan

Interview published on Psych Congress Network

ADHD/ Attention Deficit Hyperactivity Disorder

What occurs if people with attention-deficit/hyperactivity disorder (ADHD) don’t receive the necessary treatment? And when patients seek medical attention, how may professionals more effectively test for ADHD? Timothy Wilens, MD, a professor of psychiatry at Harvard Medical School and co-director of the center for addiction medicine there, examines how untreated ADHD may manifest itself over the course of a patient’s life, beginning with behavioral and academic issues as children, progressing to substance abuse in adolescence, and culminating in interpersonal issues and difficulty keeping up at work in adulthood. Dr. Wilens also suggests methods and tools that physicians can use to guarantee they are correctly diagnosing ADHD when they encounter it.

The Video

Psych Congress Network: What are the major developmental impacts of untreated ADHD across a patient’s lifespan? How can clinicians better screen for the disorder?

Dr Wilens: I’m often asked what happens to ADHD over time, especially if you don’t treat it. And this is very important because when you’re thinking of treatment of ADHD, you also have to think about what happens if you don’t treat the disorder. Well, I can tell you that, very early, it starts with more behavioral disruption, and, by the way, self-esteem issues that persist. And as kids age, you’ll start to see more of the more classic school problems, academic issues, and even further, they start to have interpersonal problems. As they move through adolescence, you’ll start to see more injuries. They start smoking cigarettes. You start to see issues with substance use, misuse, even prescription stimulant misuse in some.

And then it increases as they move into adults. They carry all of that plus occupational problems—if they’re going to college, difficulties with college. If they’re going into trades, they have problems even getting through the coursework for the trades. If they’re in the military, difficulties with that. The interpersonal problems become, now, separations and sometimes divorces and it continues on and on.

How do you screen for ADHD? You can do it a number of ways. Most of the screening instruments we use are based on the Diagnostic and Statistic Manual, DSM, criteria for ADHD. There are, in kids, forms that you can download, and in adults, all you need to do is go to the World Health Organization and punch in ADHD and you’ll see a screener that you can use for the diagnosis of ADHD in adults. Most of the forms that you can get online are non-proprietary—they’re free. Others may charge. All of them, though, are helpful in helping you make a clinical diagnosis of ADHD.

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