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1/2025
vol. 4
abstract:
Guidelines/recommendations
Assessment and management of adults with ADHD. Guidelines of the Specialty Training Section of the Polish Psychiatric Association and a coalition of organizations for people with ADHD – update, 2025
Tomasz M. Gondek
1, 2, 3, 4
,
Filip Stramecki
1, 5, 6
,
Karolina Ziegart-Sadowska
7, 8
,
Kajetana Foryciarz
9, 10, 11
,
Patryk Główczyński
1, 12, 13
,
Anna Julia Krupa
1, 14, 15
,
Anna Karolina Malec
1, 17
,
Anna Szczegielniak
1, 4, 19
,
Anna Szczubiał-Kamińska
20
,
Anna Taracha-Mocarska
21
,
Agata Todzia-Kornaś
1, 3, 4, 24
- Sekcja Kształcenia Specjalizacyjnego Polskiego Towarzystwa Psychiatrycznego/Specialty Training Section of the Polish Psychiatric Association
- Instytut Studiów Społecznych, Uniwersytet Dolnośląski DSW, Wrocław/Institute of Social Studies, University of Lower Silesia, DSW, Wroclaw
- Sekcja Zaburzeń Neurorozwojowych w Ciągu Całego Życia (NDAL) Europejskiego Towarzystwa Psychiatrycznego/Neurodevelopmental Disorders Across the Lifespan (NDAL) Section, European Psychiatric Association
- Grupa Badawcza ADHD u Kobiet/Female ADHD Research Group
- Milickie Centrum Medyczne, Milicz/Milicz Medical Center, Milicz
- Światowa Federacja ADHD//World Federation of ADHD
- Akademia Różnorodności/Diversity Academy
- Klinika Terapii Poznawczo-Behawioralnej, Uniwersytet SWPS, Warszawa/Clinic of Cognitive-Behavioral Therapy, SWPS University, Warsaw
- Centrum Diagnostyczno-Lecznicze dr n. med. Kajetana Foryciarz, Warszawa/Diagnostic and Treatment Center of Dr. Kajetana Foryciarz, Warsaw
- Europejska Sieć ADHD Dorosłych/European Network Adult ADHD
- Polskie Towarzystwo Psychiatryczne/Polish Psychiatric Association
- Oddział Kliniczny Psychiatrii, Wielospecjalistyczny Szpital Powiatowy w Tarnowskich Górach/Clinical Department of Psychiatry, Multi-Specialty District
Hospital in Tarnowskie Gory
- Katedra Psychiatrii, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach/Department of Psychiatry, Faculty of Medical
Sciences in Zabrze, Medical University of Silesia in Katowice
- Zakład Zaburzeń Afektywnych, Collegium Medicum Uniwersytet Jagielloński, Kraków/Department of Affective Disorders, Collegium Medicum
of the Jagiellonian University, Krakow
- NZOZ Centrum Dobrej Terapii, Kraków/NZOZ, Center for Good Therapy, Krakow
- Katedra i Klinika Rehabilitacji Psychiatrycznej, Śląski Uniwersytet Medyczny w Katowicach/Department and Clinic of Psychiatric Rehabilitation,
Medical University of Silesia in Katowice
- Bytomskie Centrum Zdrowia Psychicznego, Bytom/Bytom Mental Health Center, Bytom
- Wielkopolskie Centrum Neuropsychiatryczne im. O. Bielawskiego w Kościanie/Greater Poland Neuropsychiatric Center named after O. Bielawski in Koscian
- Zakład Psychoprofilaktyki Katedry Psychiatrii, Wydział Nauk Medycznych w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach/Department
of Psychoprophylaxis, Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice
- Prywatna praktyka psychologiczna/Private psychological practice
- Oddział Psychiatryczny dla Dzieci i Młodzieży, Szpital Neuropsychiatryczny w Lublinie/Psychiatric Department for Children and Adolescents,
Neuropsychiatric Hospital in Lublin
- Wydział Psychologii we Wrocławiu, Uniwersytet SWPS/Faculty of Psychology in Wroclaw, SWPS University
- Praktyka prywatna „Psycholog na spektrum”/Private practice “Psychologist on the Spectrum”
- Klinika Psychiatrii, Stresu Bojowego i Psychotraumatologii, Wojskowy Instytut Medyczny – Państwowy Instytut Badawczy w Warszawie/Clinic
of Psychiatry, Combat Stress and Psychotraumatology, Military Institute of Medicine – National Research Institute in Warsaw
Personalized Psychiatry 2025; 4: e80-e115
Online publish date: 2025/09/15
PlumX metrics:
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental state, occurring in approximately 4% of adults. Screening is recommended in at-risk groups. Diagnosis relies on an in-depth clinical interview (≥ 90 min), assessing symptoms over the past 6 months (and earlier), onset before age 12, presence across at least two life domains, and clinically significant impairment. Neuropsychological tests, neuroimaging, or electroencephalography (EEG) are not routine but may assist when comorbidities are suspected. Information from relatives is valuable, yet lack of a parent report does not preclude diagnosis. Medication response is not a diagnostic criterion. Clinicians should consider compensatory strategies and sex-specific presentations, particularly in women. Therapeutic management is multi-directional. Psychoeducation is essential. Psychosocial interventions (CBT/DBT, coaching) improve functioning and can be used alone or in combination with pharmacotherapy, which is also the first-line treatment for adults with moderate to severe impairment. Preferred agents are long-acting stimulants (extended-release methylphenidate, lisdexamfetamine) while atomoxetine is an alternative in cases of contraindications or risk of prescription drug abuse. During treatment, blood pressure (BP), heart rate (HR), body weight, and sleep should be monitored. A cardiovascular history should be taken before treatment, and an electrocardiography (ECG) is recommended before starting treatment in individuals with cardiovascular risk factors. The most common side effects are increased BP and HR, insomnia, decreased appetite, and weight loss. Comorbidity is common, and generally the most severe disorder should be treated first. Treatment of ADHD reduces the risk of suicidal behavior, substance abuse, and traffic accidents.
keywords:
ADHD, guidelines, assessment, management, pharmacotherapy, comorbidity
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