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GP Vivasmental-health

GP Vivas · mental-health

ADHD in adults — structured viva

Structured oral on adult ADHD: defending the diagnosis against the overdiagnosis charge, quoting the first-line drug evidence, monitoring, and the misuse-versus-treatment paradox.

structured clinical oral2 min readVerification in progress

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
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Study tools

Target exams

RACGP CCEFRACGP oralsMRCGP SCA
Prompt
The examiner opens: 'Everyone seems to have ADHD now. Is this diagnosis real, and should GPs be medicating for it?' The viva branches through prevalence and overdiagnosis, assessment, pharmacotherapy evidence, monitoring, and the misuse paradox.

Stem

You are the GP. The examiner challenges both the diagnosis and its treatment. [23]

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You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the General Practice fellowship library.

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References18ShowHide
  1. [1]Sayal K, Prasad V, Daley D et al. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry, 2018.PMID 29033005
  2. [2]Cortese S, Adamo N, Del Giovane C et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry, 2018.PMID 30097390
  3. [3]Stuhec M, Lukić P, Locatelli I Efficacy, Acceptability, and Tolerability of Lisdexamfetamine, Mixed Amphetamine Salts, Methylphenidate, and Modafinil in the Treatment of Attention-Deficit Hyperactivity Disorder in Adults: A Systematic Review and Meta-analysis. Ann Pharmacother, 2019.PMID 30117329
  4. [5]Man KKC, Häge A, Banaschewski T et al. Long-term safety of methylphenidate in children and adolescents with ADHD: 2-year outcomes of the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study. Lancet Psychiatry, 2023.PMID 36958362
  5. [7]Olagunju AE, Ghoddusi F Attention-Deficit/Hyperactivity Disorder in Adults. Am Fam Physician, 2024.PMID 39172673
  6. [8]Popit S, Serod K, Locatelli I et al. Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis. Eur Psychiatry, 2024.PMID 39381949
  7. [9]Summit AG, Moseley MC, Chaku N et al. Prevalence of pharmacotherapy for attention-deficit/hyperactivity disorder and prescription stimulant misuse: A national study of US college students. Addiction, 2025.PMID 39552232
  8. [10]Chan M, Chan JJ, Wright JM Effect of amphetamines on blood pressure. Cochrane Database Syst Rev, 2025.PMID 40152309
  9. [11]Kothari A, Aparece JP, Del Toro Mijares R Cardiovascular Risk Associated with the Treatment of Attention-Deficit/Hyperactivity Disorder in Adults. Curr Cardiol Rep, 2025.PMID 40192901
  10. [12]Farhat LC, Lannes A, Del Giovane C et al. Comparative cardiovascular safety of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry, 2025.PMID 40203844
  11. [13]Forrest J, Chen W, Jagadheesan K Misuse and diversion of stimulant medications prescribed for the treatment of ADHD: a systematic review. Front Psychiatry, 2025.PMID 40698051
  12. [15]Johnson S, Lim E, Jacoby P et al. Prevalence of attention deficit hyperactivity disorder/hyperkinetic disorder of pediatric and adult populations in clinical settings: a systematic review, meta-analysis and meta-regression. Mol Psychiatry, 2026.PMID 40877470
  13. [16]Yavuzlar Civan H, Berkol TD ADHD Comorbidity in Women with Depression and Anxiety: Prevalence, Clinical Features and Hyperfocus Dynamics. Int J Psychiatry Med, 2026.PMID 40934870
  14. [17]Wynchank D, de Jong M, Kooij SJJS Practical tools for female-specific ADHD: The impact of hormonal fluctuations in clinical practice and from the literature. Eur Psychiatry, 2025.PMID 41115846
  15. [18]Gosling CJ, Garcia-Argibay M, De Prisco M et al. Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making. BMJ, 2025.PMID 41297970
  16. [20]Baweja R, Waschbusch DA, Padilla FM et al. Attention-Deficit/Hyperactivity Disorder Treatment Patterns and Association With Clinical Outcomes in Adolescents and Young Adults with Co-occurring Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Retrospective Analysis. J Am Acad Child Adolesc Psychiatry, 2025.PMID 41421461
  17. [23]Cortese S, Daley D, Hollis C et al. ADHD (over) diagnosis: fiction, fashion and failure. Br J Psychiatry, 2026.PMID 41787830
  18. [28]Nourredine M, Jurek L, Hamza T et al. Pharmacological interventions for ADHD: a systematic review and dose-effect network meta-analysis. Lancet Psychiatry, 2026.PMID 42134365
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