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(Technically called "Residual Type" -- sometimes called "Undifferentiated")
An important recent development is the recognition that ADD continues into the adult years in a significant percentage of cases. The symptoms can be very disruptive, but researchers are finding that ADD in adults is treatable. It is very important to locate adults with the condition, because they are probably not aware that they have a treatable condition.
To date, most cases have been found as a result of a child's evaluation. Since there is a hereditary component to many of these cases, we always ask if anyone else in the family has the same symptoms. Frequently, the answer is yes, and we proceed to evaluate the adult. Treatment is usually with Tofranil (imipramine) or Cylert. Drugs such as Ritalin or Dexedrine are very effective, but have other problems related to their use.
Making the Diagnosis
Some of the current research is being done by Paul Wender, M.D., Professor of Psychiatry and Director of Psychiatric Research at the University of Utah College of Medicine. The following is the "Modified Utah Criteria" for ADD, Residual Type.
In order to diagnose the condition as an adult disorder, the individual must fulfill criteria one and two, and two out of the remaining five items. Diagnosis is not made on the basis of a check list alone, but the presence of a positive preliminary screen makes it imperative to take the next step to evaluate the problem further.
--Persistent hyperactivity shown by restlessness; the inability to relax; being "always on the go."
--Attention problems as shown by easy distractibility,
inability to keep the mind on reading material, difficulty keeping the mind on the job, and forgetfulness.
--Mood Swings shift from normal to down, to mildly up. The moods usually last a few hours. When down, they describe feeling bored or discontent.
--Inability to complete tasks: the subject reports lack of organization in job, running the household, or doing school work. Tasks frequently not completed, disorganization in activities, problem solving, and organizing time.
--Explosive temper, easily provoked with short lived outbursts.
Impulsivity: decisions made hastily, without reflection, often to the disadvantage of the individual.
--Stress intolerance: subject cannot take ordinary stresses in stride and reacts excessively or inappropriately.
With this condition there are often associated features. These would include marital instability, academic and vocational success less than expected on the basis of intelligence and education, alcohol or drug abuse, and/or problems in interpersonal relationships.
As more is learned about the physiological causes of ADD in children and adults, new treatments will be developed. At this time the diagnosis is made by observation and a recognition of what we see. There are no laboratory tests to help us out, and it is therefore essential that we be aware of the condition, methods of diagnosis, and current treatments.
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