NPs and PAs who treat patients with mental health conditions must know and communicate to patients current ADHD data as there is much confusion surrounding the condition. Do you know the five prevalent myths below and how to debunk them with the latest research?
Myth #1: ADHD is a Disorder of Childhood
Long-term studies show that ADHD is a lifespan disorder. About 50%-80% of individuals who have ADHD in childhood continue to have it in adolescence (Owens et al. 2015). Up to 50% will continue to have it in adulthood (ADHDAwarnessMonth Coalition 2019). Though some with ADHD during childhood experience a reduction in their ADHD impairments as they grow older, others continue to struggle or may even experience more significant problems related to ADHD in adulthood. Recent research has shown that some people with ADHD function well during childhood and do not manifest any significant symptoms until adolescence or later, when greater challenges to executive function are encountered (Brown 2018).
Myth #2: ADHD is Over-Diagnosed and/or Over-Medicated
Although it’s been estimated that six percent of the adult population has ADHD, the majority of those adults remain undiagnosed, and only one in four of them seek treatment (ADHDAwarnessMonth Coalition 2019). Without help, adults with ADHD are highly vulnerable to depression, anxiety, and substance abuse. They often experience career difficulties, legal and financial problems, and troubled personal relationships. Even among children, recent studies show that the vast majority (nine out of 10) had been diagnosed by practitioners using best practice guidelines (Visser et al. 2015). Possible explanations for increased diagnostic rates include improved awareness about ADHD among healthcare professionals and parents, more screenings by HCPs, decreased stigma, availability of better treatment options, and more cases arising from suspected environmental causes. As for the over-medicating myth, most evidence from research studies suggest that levels of treating ADHD with medication are either appropriate or that ADHD is undertreated (Adler 2017, CHADD).
Myth #3: Patients with High IQ or Success Are Unlikely to Have ADHD
Studies have shown that children and adults with extremely high-IQ can suffer impairments of ADHD, which significantly interfere with their ability to use their strong cognitive skills consistently and effectively in many situations faced in daily life (Brown 2018, Frye 2018). Clinical observations indicate that high-IQ individuals with ADHD often face lengthy delays before they obtain a correct diagnosis and appropriate treatment. This is due largely to uninformed teachers, clinicians, and patients who assume that high IQ precludes ADHD (Brown 2018.) Some are surprised to learn that many well-known, high-achieving individuals have ADHD, including top executives such as David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s. Other well-known, high achieving people with ADHD include Terry Bradshaw (quarterback, Super Bowl winner and NFL commentator), Adam Levine (singer and TV show personality), Lisa Ling (renowned journalist diagnosed at age 40), Simone Biles (Olympic gold medal winning gymnast), Karina Smirnoff (professional dancer), James Carville (political strategist), and Michael Phelps (swimmer with 14 Olympic gold medals).
Myth #4: Females Have Lower Rates and Less Severe ADHD
Females are just as likely to have ADHD as males, and gender makes no difference in the symptoms caused by the disorder. However, because this myth persists, males are more likely to be diagnosed than females (ADHDAwarnessMonth Coalition 2019).
Myth #5: Only Psychiatrists Diagnose and Prescribe Medications for Adult ADHD
Nurse Practitioners (NPs) with a specialty in psychiatry can evaluate, diagnose, and treat adults with ADHD (and other mental conditions), and, if trained, children as well. Psychiatric NPs can prescribe medication and provide counseling as they are trained in psychotherapy and psychological theories. Studies have shown that patients of psychiatric NPs are very satisfied with their care. In a recent qualitative study, evidence showed that psychiatric mental health nurse practitioners (PMHNPs) often took the lead in prescribing medications, with minimal or no supervision from a psychiatrist (Phoenix 2016). In addition to NPs and psychiatrists, other medical professionals that can diagnose and prescribe medications for Adult ADHD include neurologists and physician assistants (PAs) under the supervision of a physician.
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