A million adults with Asperger's or Adhd, diagnosis and treatment in only 1 out of 5

GRETA Thunberg, the activist against climate change, is turning 18 years old next year and will become she is an adult with Asperger's syndrome , an autism spectrum disorder, high-functioning that affects approximately 1% of the population and that can go a long in silence, arriving at the diagnosis much later than other forms of autism. Greta herself has discovered 13 years. Others, like the writer Susanna Tamaro, after the age of 40; for others still, we live together the whole life without knowing, but suffering of their own emotional difficulties of feeling different and unable to establish relationships with other people. The same happens to the person who has the disorder, attention deficit hyperactivity disorder, or Adhd: in Italy it is estimated that relates the 2% of the population, about a million adults, but is aware of less than one in 5. In all, between Asperger's and Adhd, are about 1.5 million people with the life 'uphill', but only 300 thousand can count on diagnosis and treatment.

And' the framework outlined today in Milan, on the occasion of the opening of the XXI national Congress of the Italian Society of Neuropsychopharmacology, in program until Friday, January 31. For the experts the first step is to quickly reach the correct diagnosis. This is possible - explain - through the collaboration between child neuropsychiatrists and psychiatrists, which, in fact, will embark on a national network for the promotion of research in the field and, in collaboration with associations of patients and relatives of patients, information campaigns national in order to spread the awareness of the need to deal with people with Adhd, Asperger's and other disorders of neurodevelopment during the whole of their existence, from childhood to adulthood.

The announcement will be given at the Congress in milan, and you will make your point about the possible strategies of treatment, indicating the 'red flags' that can signal a disorder of neurodevelopment and in adulthood. To recognize them is essential to avoid suffering and hardship. The social cost of these conditions is high: it is estimated that only in the United States for the only Adhd in adults oscillates between the 140 and the 260 billion dollars in health care costs and lost productivity. The presence of the disease, in addition, encourages the development of other disorders such as depression (40% of cases), anxiety disorders (35%) and substance abuse (10%).

"disorders of neurodevelopment occur, usually in childhood, often in conjunction with one another, with deficits that may affect your well-being even in adulthood because they promote the emergence of other mental illnesses, and impair social and occupational functioning," explains Claudio Mencacci, co-president of the Italian Society of Neuropsychopharmacology and director of the Department of Neuroscience and mental Health Asst Fatebenefratelli-Lot of Milan - Unfortunately, there are rare cases without a diagnosis until well over the age of 18: in the adult Adhd and Asperger's can be 'masked' by other psychopathological conditions that often appear precisely because the strategies of adaptation to the contexts it is often insufficient to a good functioning in work, in study, in relationships, in fact exposing the patient to the continuous stress and micro-traumas".

So, the reasoning of the expert, "in our Country it has been estimated, for example, that the peaks of Adhd are present in 25-30% of patients with addictions and eating disorders. The first step to get to the diagnosis is recognition of the 'bells allarmè disorders of neurodevelopment in the adult".

typical Signs of Adhd in the adult are, for example, "the disorganization and the inability to get priorities, plan, or focus on a task, lack of ability to manage his / her time or carry out the objectives, traits such as impulsivity, the low tolerance to the frustrations, the mood swings frequent, and the difficulty in managing stress ", lists Matteo Balestrieri, co-president of the Italian Society of Neuropsychopharmacology and director of the psychiatric Clinic of the healthcare university Central Friuli of Udine. "People with Asperger syndrome - continues - typically have poor social interaction skills, they are often closed in their own world and have difficulty communicating with others, have low self-esteem, limited interests, and sometimes obsessive, with a great need of routine fixed."

In both disorders, warns the specialist, "patients who come to adulthood without a diagnosis may not suspect their problem, but simply find it very laborious, the life and challenges of every day. For this reason many do not seek help and the diagnosis comes after having identified other diseases. 16% of patients with other mental disorders, has Adhd, not diagnosed". Unlike in children, adds Mencacci, "in adults, drugs are the first choice, although supported by the interventions of the cognitive, psychological and, eventually, the interventions of coaching".

For the Adhd, he continues, "the most widely used drug is methylphenidate, which, however, in our Country can be prescribed after the age of 18 only if you are already in treatment before the completion of the age: this greatly limits the use. In Italy the only approved drug for the adult with Adhd is atomoxetine, a drug that carries 60-70% of the patients in a remission of the disorder by acting mainly on the frontal cortex. Outside of their clinical indication can also be used inhibitors of the reuptake of serotonin and norepinephrine, clonidine, bupropion, modafinil, and so on, to evaluate, however, a case-by-case. And we are increasingly developing therapies digital that can support patients in the management of symptoms, such as App and software that help you to stay organised, to set goals and to reduce distractions."

Despite all the therapeutic possibilities, it is estimated that even today only about 10% of adults with Adhd is cured. "In adults with Asperger's - ends Crossbowmen - psychiatric comorbidity is very frequent: depression, anxiety, obsessive-compulsive disorder and bipolar disorder are common, and the drug therapy must often intervene on the other diseases, both on the typical symptoms of Asperger's. Irritability, and behavioral disorders can be managed with antipsychotics such as risperidone and aripiprazole, but there are no specific drugs to improve the emotional aspects: experimentation with many active substances, for example drugs that act on the vasopressin and seem to be able to improve the ability of empathy. Even for the Asperger's are at the studio therapies digital, aimed to facilitate the recognition of emotional states of others and to improve the effectiveness of psychological interventions, which remain important to allow patients a better social functioning".

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