This paper is a consensus statement, not a new study, so there is no study sample. It was written and agreed by 63 experts who updated a 2010 statement. Its advice is about adults, though the research it sums up also covers children.
The authors describe ADHD as a heritable condition of brain development that starts in childhood and can last into old age. They state that it is underdiagnosed and undertreated in many European countries. In research they cite, ADHD was far more common in adult prisons than in the general population (26%).
The statement holds that adult diagnosis depends on what a person reports in a structured interview, ideally with input from others. It cannot rest on brain function tests alone. Trouble managing emotions and a wandering mind are common in adults with ADHD.
Treatment is described as having several parts. Education about ADHD comes first, then medicine and talking therapy or coaching. In the studies reviewed, medicines improved symptoms, and stimulants worked better than atomoxetine. One large brain scan analysis found small differences in children but no clear differences in adults.
The authors say a consensus statement is not a formal guideline and is provisional. They suggest that clinicians check heart rate, blood pressure, sleep and weight before and during treatment.
If ADHD is a concern for you, talk with a clinician about your own situation.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- One included study (cited in Kooij, 2018): ADHD among adult prisoners, from a meta-analysis of 42 studies in 15 countries, 26%.
- Reviewed studies (cited in Kooij, 2018): how much ADHD medicines improved symptoms, SMDs range from 0.4 to 0.7.
- Reviewed studies (cited in Kooij, 2018): how much atomoxetine improved symptoms, SMD: -0.33 to -0.40.
- ENIGMA mega-analysis (cited in Kooij, 2018): size of brain structure differences in children with ADHD, d = .10 to .15. What the terms mean:
- SMD The standardized mean difference, a measure of how far apart two groups ended up. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
- d A measure of how big a difference between two groups is. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
Source: J. J. Sandra Kooij, Denise Bijlenga, Luana Salerno, et al.. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry (2018). doi:10.1016/j.eurpsy.2018.11.001