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Study of needs and sevice use among young people with attention deficit hyperactivity disorder at transition from adolescence to young adulthood

Student thesis: Doctoral ThesisDoctor of Philosophy

Background
Although there is increasing evidence that Attention Deficit Hyperactivity Disorder (ADHD) frequently persists into adulthood and is associated with high levels of impairments and comorbid disorders, few studies have examined needs, health service use and healthcare transitions among adolescents and young adults with ADHD. There are currently limited adult services for those with ADHD and little is known about their needs and the correlates of health service use in this group once they leave child and adolescent health services. Moreover, little is known about how the needs of this group are currently being met by family and friends and formal services.
Aims
To investigate needs and other associates of health service use among those diagnosed with ADHD in childhood who are now at transition from adolescence to young adulthood and their experiences of healthcare transition (i.e. the process of moving from child to adult health services).
Methods
82 participants were drawn from a clinical sample (the IMAGE project, an international collaborative genetic study of ADHD) consisting of 154 participants aged 14-21 years with a childhood clinical diagnosis of combined type ADHD. Face-to-face interviews and questionnaires were used to assess needs, as well as demographic and health factors associated with health service use and experiences of healthcare transitions between April 2009 and February 2011.
Results
Although ADHD symptoms had diminished since participants were children, 73% still experienced ADHD symptoms severe enough to warrant diagnosis. Moreover, levels of impairments and psychiatric comorbidities were high with 90% of participants reporting significant impairments in at least one daily activity and 27% meeting cut off for a neurotic iii
disorder. A wide range of needs were also reported, for example in money management, safety to self, inappropriate behaviour and self-care. Most help in meeting needs was from family or friends rather than from formal services.
Service use was not associated with ADHD symptoms or other need and enabling factors but was related to age, with younger participants being more likely to be in contact with services. Only eight participants had experienced a transfer from child to adult services (10%) including one who had received a written transition plan during the transition process. In addition, both young people and parents reported difficulties in the process of moving from child to adult health services, for example, gaps in provision of information about adult services and the transition process and lack of co-ordination of transition.
Discussion
This study adds to the (currently scarce) evidence base about health service use and needs of adolescents and young adults with ADHD and will further the debate within public policy as to how services should be designed and implemented for this group. The importance of addressing the wide range of needs of this group is highlighted as is the discrepancy between help provided by families and services in meeting the needs of this group. The role of age in determining service use and the need for more support from services in regards to the transition from child to adult health services is also emphasised.
Original languageEnglish
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Award date2013

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