Detection of comorbid PTSD among detained youths must be improved. PTSD is often missed because traumatic experiences are rarely included in standard screens or volunteered by patients. When planning treatment, clinicians must consider ramifications of comorbid PTSD.

Variation across Europe was observed in characteristics of caregivers and children/adolescents with ADHD, and treatment use. Even with medication, ADHD compromised or negatively impacted caregivers' work and children/adolescents' schoolwork, their social interactions and family relationships.

Objective: This study examined adult attention-deficit/hyperactivity disorder (ADHD) screening and management patterns among healthcare provider (HCP) subgroups. Methods: An online survey of US-based HCPs (neurologists, n = 200; nurse practitioners [NPs], n = 100; psychiatrists, n = 201; primary care physicians [PCPs], n = 201) was conducted from May to June 2017. The survey assessed issues relating to adult ADHD screening and management and HCP perceptions of factors influencing patient choice of pharmacotherapy. Participants were required to be experienced in diagnosing and/or treating ADHD in adults (≥5 patients/month for neurologists and NPs; ≥10 patients/ month for psychiatrists and PCPs). Results: Significantly greater percentages of psychiatrists than non-psychiatrists were confident in diagnosing ADHD (P < 0.001) and screened/evaluated for ADHD in patients with depression/anxiety disorders (P < 0.001). Significantly greater percentages of psychiatrists versus non-psychiatrists prescribed once-daily long-acting (LA) stimulants (71.6% vs 62.2%; P = 0.023) or short-acting (SA) stimulants more than once daily (40.3% vs 29.7%; P = 0.009) as first-line therapy. In contrast, a significantly greater percentage of non-psychiatrists than psychiatrists prescribed once-daily SA stimulants (32.9% vs 17.4%; P < 0.001). Psychiatrist and non-psychiatrist HCPs viewed insurance coverage/treatment costs (79.9%), perceived duration of effect (72.2%), and side effects (66.5%) as important factors to patients when choosing treatment. HCPs reported that the greatest mean ± SD percentages of patients changed their treatment regimen in the past 6 months because of perceptions of insufficient duration of effect (35.4% ± 22.1%) and lack of efficacy (30.3% ± 21.0%). Conclusion: Compared with psychiatrists, non-psychiatrists exhibited less confidence in diagnosing adult ADHD and experienced greater difficulty determining optimal treatment regimens.

Objective: To characterize impairments in daily life experienced by pharmacologically treated adults with attention-deficit/hyperactivity disorder (ADHD) versus adults without ADHD and to identify unmet needs in ADHD treatment from the perspective of adults with ADHD. Methods: Adults with ADHD taking prescription medication for ≥ 6 months and adults without ADHD agreed to participate in a cross-sectional online survey during December 2016. Participants with ADHD were stratified by their current ADHD medication: long-acting (LA) once daily, short-acting (SA) ≤ 2 times/d, and augmenters (AU; LA > 1 time/d, SA > 2 times/d, or LA plus SA). Results: A total of 616 adults with ADHD (SA: n = 166, LA: n = 201, AU: n = 249) and 200 adults without ADHD completed the survey. Even with treatment, adults with ADHD reported substantial impairments in their everyday life, particularly at home, at school/work, and in their social life and relationships. Participants with ADHD experienced impairments throughout the day, especially in the afternoon and evening. Signs or symptoms were reported when the ADHD medication was wearing off, resulting in negative effects (including school work, homework, work responsibilities, household responsibilities, emotional responses, mood, and relationships) on the daily life of adults with ADHD. Conclusions: Adults with ADHD, despite receiving medication, experienced impairments and challenges in many aspects of their daily life. Adults with ADHD described various unmet needs, especially those relating to the duration of treatment effect. When optimizing treatment for adults with ADHD, it is important that the treatment regimen is sufficient to meet the needs of the patient throughout the day.

ObjectivesTo examine treatment, comorbidity status and diagnosis among the French sample of the Caregiver Perspective of Pediatric ADHD (CAPPA) survey.MethodsCarers in 10 EU countries, including France, completed an Internet survey regarding ADHD diagnosis, treatment and comorbidities. Descriptive statistics were calculated for categorical [n (%)] and continuous variables [mean, standard deviation (SD), median, range].ResultsEU carers representing 3688 children/adolescents (6–17 years) with ADHD completed the survey; 486 were from France (median age 10 years, 84% male). Most (77%) French children/adolescents were currently receiving pharmacological treatment(s): 74% stimulant, 15% non-stimulant and 22% antipsychotic. Across countries, stimulant use ranged from 60% (Italy) to 93% (Germany/Netherlands), non-stimulant use from 1% (Germany) to 18% (Sweden) and antipsychotic use from 8% (Germany) to 46% (Italy). Many French children/adolescents received behaviour therapy (BT) after ADHD diagnosis (59%). Among those receiving BT, 52% began prior to starting medication. BT was often discontinued within 6 months (44%) or 6–12 (30%) months. 52% of carers reported ≥ 1 comorbidity; they reported the highest rates of conduct (24%), sleep (11%), eating (6%) and motor-coordination (6%) disorders, and the second-highest rates of anxiety (22%), learning difficulties (15%), oppositional defiant disorder (5%), bipolar disorder (4%) and epilepsy (2%). Time to diagnosis from first doctor's visit averaged 7 months (SD 11, median 3). 81% received a specialist referral. French carers reported the highest perceived difficulty (‘great deal’/’a lot’ of difficulty) obtaining a diagnosis (43%) and a specialist referral (53%).ConclusionsThis sample of French children/adolescents with ADHD had higher non-stimulant and antipsychotic use than most other countries and higher reports of certain comorbid conditions. Carers perceived greater difficulty in obtaining a diagnosis and seeing a specialist, although time to diagnosis was lower compared with a number of other countries.