Dr Vladimir Maletic on Defining and Responding to Complex ADHD

In this video, Psych Congress Steering Committee member Vladimir Maletic, MD, MS, discusses the concept of complex attention/deficit-hyperactivity disorder (ADHD), how it is defined, and how clinicians should respond to it.

Dr Maletic is Clinical Professor of Psychiatry, University of South Carolina School of Medicine, Greenville. Complex ADHD is one of the topics he will address in "Trees or the Forest? Advances in Neurobiological Understanding of ADHD and Novel Treatments," which he is presenting at the 2021 Psych Congress Regionals meeting series.

Read the transcript:

Complex ADHD has emerged in treatment guidelines that have been composed by the Society for Developmental & Behavioral Pediatrics. They make several pertinent points. One of them is that ADHD is not a very simple diagnosis.

If the individual does not have sufficient expertise and experience in evaluating children and adolescents with ADHD, it may be a good idea to engage somebody who does have that kind of clinical background.

So, what are some defining features of complex ADHD?

• If a clinician either identifies or suspects presence of coexisting disorders, it would meet one of the criteria for complex ADHD, so either suspected or identified presence of a comorbid condition.

• It is associated with moderate to severe functional impairment, so greater degree of impairment.

• Inadequate response to treatment, that standard treatments have been tried and don't work very well.

• Lastly, atypical onset. It is ADHD that has onset before age 4 or after age 12.

In all these circumstances, again, unless clinician feels comfortable and has sufficient expertise to address these comorbidities and complexities, it may be a good idea to refer the patient to a specialist.

More with Dr. Maletic: 
The Relevance of Noncore Symptoms in Patients With ADHD
Recent Developments in Genetic Studies Examining ADHD

Test Your Knowledge: Defining Features of Complex ADHD