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Services for adults with ADHD: work in progress: Commentary on … Specialist adult ADHD clinics in East Anglia

  • David Coghill (a1)
Summary

Magon and colleagues highlight a number of relative strengths and weaknesses very reminiscent of those we have seen over the years in the development of similar services for children and adolescents. It is clear that we all have a lot of work to do to improve our approach to the transition from child to adult services. There was clear evidence that adult services can adapt to manage ADHD, but there is also a clear need for increased upskilling of clinicians in the practical management of medication and other treatments. I disagree with Magon and colleagues about the role of primary care and believe that treatment initiation and ongoing monitoring should, for the time being, remain in secondary care and that, because of the volume of work that will come our way, this will need to become a core rather than specialist task. As with other aspects of psychiatric care, there is a clear role for specialist nurses in delivering a significant proportion of the core care.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to David Coghill (d.r.coghill@dundee.ac.uk)
Footnotes
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See pp. 136–40, this issue.

Declaration of interest

None.

Footnotes
References
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1 Magon, RK, Lateesh, B, McBreen, M, Müller, U. Specialist adult ADHD clinics in East Anglia: service evaluation and audit of NICE guideline compliance. Psychiatr Bull 2014; 38: in press.
2 Healthcare Improvement Scotland. Attention Deficit and Hyperkinetic Disorders: Services Over Scotland (Final Report). Healthcare Improvement Scotland, 2012.
3 Young, S, Murphy, CM, Coghill, D. Avoiding the ‘twilight zone’: recommendations for the transition of services from adolescence to adulthood for young people with ADHD. BMC Psychiatry 2011; 11: 174.
4 National Institute for Health and Clinical Excellence. Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults (CG72). NICE, 2008.
5 Asherson, P, Young, S, Adamou, M, Bolea, B, Coghill, D, Gudjonsson, GH, et al. Handbook for Attention Deficit Hyperactivity Disorder in Adults. Springer, 2013.
6 Bolea-Alamanac, B, Nutt, DJ, Adamou, M, Asherson, P, Bazire, S, Coghill, D, et al. Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2014; 28: 179203.
7 Molina, BSG, Hinshaw, SP, Swanson, JM, Arnold, LE, Vitiello, B, Jensen, PS, et al. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry 2009; 48: 484500.
8 Langley, K, Fowler, T, Ford, T, Thapar, AK, van den Bree, M, Harold, G, et al. Adolescent clinical outcomes for young people with attention-deficit hyperactivity disorder. Br J Psychiatry 2010; 196: 235–40.
9 Banaschewski, T, Buitelaar, J, Coghill, DR, Sergeant, JA, Sonuga-Barke, E, Zuddas, A, et al. The MTA at 8 (letter). J Am Acad Child Adolesc Psychiatry 2009; 48: 1120–2; author reply 3–4.
10 Coghill, D, Markarian, N, Seth, S. Effective management of attention-deficit/hyperactivity disorder (ADHD) through structured re-assessment: the Dundee ADHD Clinical Care Pathway. Child Adolesc Psychiatry Ment Health, in press.
11 NHS Quality Improvement Scotland. Attention Deficit and Hyperkinetic Disorders: Services Over Scotland. Report of the Implementation Review Exercise April 2008. NHS QIS, 2008 (http://www.healthcareimprovementscotland.org/our_work/mental_health/adhd_service_improvement/stage_2_implementation_review.aspx).
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
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Services for adults with ADHD: work in progress: Commentary on … Specialist adult ADHD clinics in East Anglia

  • David Coghill (a1)
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