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10 Feb 2021

Fourneret P et al. Encephale 2020; Epub ahead of print

ADHD is a long-lasting disorder that can be a major risk factor to mental health in adulthood. Consequently, there is a need for adolescents and young adults to be able to have continual benefit from specialised therapeutic services. Therefore, monitoring and care transition in the 17–25 years age group is a crucial public health issue (Swift et al, 2014). However, in France, this transitional period for individuals with ADHD may be neglected and unprepared.

In France, some young adults with ADHD do not benefit from coordination, personalised and well-prepared transitional support from childhood to adulthood. As an example, the authors identified fewer than a dozen centres with specialised consultation for the management of adults with ADHD in the French metropolitan area. The result of this lack of transitional care for young adults with ADHD may lead many to drop out of treatment, which could lead to the initiation of unhealthy substance use (Montano and Young, 2012). Additionally, there is concern around the act of prohibiting sustained prescription of some psychostimulants to adults with ADHD in France and the inability to initiate ADHD medications for adults who were not diagnosed prior to age 18 years (Chappuy et al, 2020).

The authors described the urgency to better map the continued support of adolescents with ADHD and their families during the transition to adulthood. To enable this, services with fully trained, multidisciplinary teams are required (Chappuy et al, 2020; Young et al, 2016). Additionally, in order to improve transitional support, more awareness and training may be necessary for clinicians regarding the developmental and clinical manifestations of ADHD from childhood to adulthood. However, in France, this may be difficult due to the lack of academic training programmes.

The authors proposed that the transitional period for individuals with ADHD could be discussed and prepared for from the age of 15 years. In preparation of transition, the authors recommended that a shared space of trust could be utilised to facilitate dialogue between the paediatric team and the adult team, and to prepare the young adult and their family for the change in philosophy of care. Finally, the authors recommended that clinicians in France could be less hesitant in introducing digital intelligence via the development of specific and personalised applications, as this could strengthen the therapeutic alliance, self-management and adaptive strategies for older adolescents and young adults with ADHD (Sezgin et al, 2018).

Read more about improving transitional support for ADHD in France here

Chappuy M, Boulanger A, Nourredine M, et al. Disparate regulatory status of methylphenidate for adults with ADHD across Europe. Lancet Psychiatry 2020; 7: e1-e2.

Fourneret P, Zimmer L, Rolland B. How to improve in France ADHD transition support from childhood to adulthood. Encephale 2020; Epub ahead of print.

Montano CB, Young J. Discontinuity in the transition from pediatric to adult health care for patients with attention-deficit/hyperactivity disorder. Postgrad Med 2012; 124: 23-32.

Sezgin E, Weiler M, Weiler A, et al. Proposing an ecosystem of digital health solutions for teens with chronic conditions transitioning to self-management and independence: exploratory qualitative study. J Med Internet Res 2018; 20: e10285.

Swift KD, Sayal K, Hollis C. ADHD and transitions to adult mental health services: a scoping review. Child Care Health Dev 2014; 5: 175-186.

Young S, Adamou M, Asherson P, et al. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network. BMC Psychiatry 2016; 16: 301.

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