Thread by @rcpsych

It's day 4 #RCPsychIC - the first set of split sessions - and this thread will be concentrating on a clinical update on ADHD across the lifespan - Prof David Baldwin from @unisouthampton is chairing - we have a great set of speakers, this should be good.

@unisouthampton Our first speaker is @srcham whose talk is called 'Practical advice for assessing and understanding ADHD: diagnosis, comorbidities, and biological models'. #RCPsychIC

@unisouthampton @SrCham Current diagnostic criteria: DSM5 criteria says its characterised by inattention and hyperactivity-impulsivity - need at least 6 symptoms in one of these 2 domains, @srchamb tells #RCPsychIC

@unisouthampton @SrCham @srchamb ICD11 and DSM5 have subtle differences in diagnostic criteria - ICD is a little more relaxed but they are similar says @srchamb - here are the symptoms from DSM5 #RCPsychIC

@unisouthampton @SrCham @srchamb ADHD is more common than people think and is under diagnosed says @srchamb - it's more common in men than women, and how common it is varies across different parts of the world. #RCPsychIC

@unisouthampton @SrCham @srchamb Why does ADHD matter? It is expensive for the world's economy, and left untreated can lead to a host of problems @srchamb tells #RCPsychIC

@unisouthampton @SrCham @srchamb Before you diagnose with ADHD, consider other possibilities - perhaps symptoms cd be explained by thyroid disfunction, or a psych disorder eg substance use disorder, an impulse control condition - plenty of alternatives which might present similarly @srchamb #RCPsychIC

@unisouthampton @SrCham @srchamb There are diagnosis tools to validate ADHD - we don't want to prescribe stimulants for people who don't have ADHD says @srchamb #RCPsychIC

@unisouthampton @SrCham @srchamb Final thoughts from @srchamb - it frequently co-occurs with impulsive, compulsive and addictive disorders inc OCD and there are potential harms in inaccurate diagnosis of ADHD, as there are in overlooking ADHD #RCPsychIC

@unisouthampton @SrCham @srchamb Our next speaker is @Tamsin_J_Ford who will be addressing the question of how ADHD changes across the lifespan and how services cope, with reference to the CATCh-u$ project #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford Children of school age are more likely to be diagnosed with ADHD says @Tamsin_J_Ford - the proportion of young people diagnosed with ADHD in the UK has remained steady over the last 20 years. #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford There is a strong socio economic relationship with ADHD says @Tamsin_J_Ford - children who are being looked after or from deprived households are far more likely to be diagnosed with ADHD and other conditions #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford Now @Tamsin_J_Ford is talking about transition of young people with ADHD from CAMHS to adult services. The CATCh_u$ programme looked at what was happening with this, concerned the transition might not be working as well as it could #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford We discovered there was a big drop out and only one in 5 young adults with ADHD attended their first appointment having reached adulthood - it is a bit much to expect them to make their way there without support says @Tamsin_J_Ford #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford Young people thought of ADHD medication as helping them at school and they had not considered the longer term. We need to educate them, and explain though ADHD is unlikely to last forever, it is a long term condition + they will need support as adults @Tamsin_J_Ford #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford Our third speaker on ADHD is @CorteseSamuele whose talk is focused on evidence-based treatments for ADHD, including the BAP and NICE Guidelines #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele We start with the NICE guidelines for pre school children, and for school age and adolescents diagnosed with ADHD. @CorteseSamuele #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele And here are the BAP guidelines for school age children and adult, and for our American audience, the AAPs guidelines for 4-17 year olds. @CorteseSamuele #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele Now @CorteseSamuele is talking about the evidence underpinning all the guidelines about ADHD, and talks to #RCPsychIC through his own research published in the Lancet in 2018.

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele Different medication works for different age groups with ADHD - we found amphetamines were most effective for adults, and methylphenidate for children and adolescents says @CorteseSamuele #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele What about behavioural interventions for ADHD? There is evidence that they can be effective for some symptoms and this has been covered in a recent paper says @cortesesamuele #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele ADHD is picked up for boys far more than girls. Why? For one, a lot of early work abt ADHD was done on little boys so the study and desc of the syndrome is based on boys - is the criteria as suited for diagnosing girls as it cd be? @Tamsin_J_Ford #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele Would good performance at school rule out diagnosis of ADHD? Great question. "If someone is in a small structured school with 10 in the classroom and lots of support, their difficulties might not be unmasked." @Tamsin_J_Ford #RCPsychIC

@unisouthampton @SrCham @srchamb @Tamsin_J_Ford @CorteseSamuele And that's the end of our coverage of these talks on ADHD, which was attended by over 500 people - amazing for a split session. Thanks v much to our speakers, the chair and everyone who listened and asked questions. #RCPsychIC