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Updated European Consensus Statement on diagnosis and treatment of adult ADHD
- J.J.S. Kooij, D. Bijlenga, L. Salerno, R. Jaeschke, I. Bitter, J. Balázs, J. Thome, G. Dom, S. Kasper, C. Nunes Filipe, S. Stes, P. Mohr, S. Leppämäki, M. Casas, J. Bobes, J.M. Mccarthy, V. Richarte, A. Kjems Philipsen, A. Pehlivanidis, A. Niemela, B. Styr, B. Semerci, B. Bolea-Alamanac, D. Edvinsson, D. Baeyens, D. Wynchank, E. Sobanski, A. Philipsen, F. McNicholas, H. Caci, I. Mihailescu, I. Manor, I. Dobrescu, T. Saito, J. Krause, J. Fayyad, J.A. Ramos-Quiroga, K. Foeken, F. Rad, M. Adamou, M. Ohlmeier, M. Fitzgerald, M. Gill, M. Lensing, N. Motavalli Mukaddes, P. Brudkiewicz, P. Gustafsson, P. Tani, P. Oswald, P.J. Carpentier, P. De Rossi, R. Delorme, S. Markovska Simoska, S. Pallanti, S. Young, S. Bejerot, T. Lehtonen, J. Kustow, U. Müller-Sedgwick, T. Hirvikoski, V. Pironti, Y. Ginsberg, Z. Félegyházy, M.P. Garcia-Portilla, P. Asherson
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- Journal:
- European Psychiatry / Volume 56 / Issue 1 / February 2019
- Published online by Cambridge University Press:
- 16 November 2018, pp. 14-34
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Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
The EPICA Dronning Maud Land deep drilling operation
- Frank Wilhelms, Heinrich Miller, Michael D. Gerasimoff, Cord Drücker, Andreas Frenzel, Diedrich Fritzsche, Hannes Grobe, Steffen Bo Hansen, Sverrir Æ. Hilmarsson, Georg Hoffmann, Kerstin Hörnby, Andrea Jaeschke, Steinunn S. Jakobsdóttir, Paul Juckschat, Achim Karsten, Lorenz Karsten, Patrik R. Kaufmann, Torbjörn Karlin, Eberhard Kohlberg, Guido Kleffel, Anja Lambrecht, Astrid Lambrecht, Gunther Lawer, Ivan Schärmeli, Jochen Schmitt, Simon G. Sheldon, Morimasa Takata, Marcus Trenke, Birthe Twarloh, Fernando Valero-Delgado, Dorothee Wilhelms-Dick
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- Journal:
- Annals of Glaciology / Volume 55 / Issue 68 / 2014
- Published online by Cambridge University Press:
- 26 July 2017, pp. 355-366
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We report on the EPICA Dronning Maud Land (East Antarctica) deep drilling operation. Starting with the scientific questions that led to the outline of the EPICA project, we introduce the setting of sister drillings at NorthGRIP and EPICA Dome C within the European ice-coring community. The progress of the drilling operation is described within the context of three parallel, deep-drilling operations, the problems that occurred and the solutions we developed. Modified procedures are described, such as the monitoring of penetration rate via cable weight rather than motor torque, and modifications to the system (e.g. closing the openings at the lower end of the outer barrel to reduce the risk of immersing the drill in highly concentrated chip suspension). Parameters of the drilling (e.g. core-break force, cutter pitch, chips balance, liquid level, core production rate and piece number) are discussed. We also review the operational mode, particularly in the context of achieved core length and piece length, which have to be optimized for drilling efficiency and core quality respectively. We conclude with recommendations addressing the design of the chip-collection openings and strictly limiting the cable-load drop with respect to the load at the start of the run.