Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness. Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated. Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated? Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.

ADHD Központ Budapest Budapest Hungary

Adult ADHD Service Barnet Enfield and Haringey NHS Mental Health Trust North London and Department of Psychiatry University of Cambridge; Adult ADHD Service Springwell Centre Barnet Hospital Barnet London England

Alexandru Obregia Clinical Hospital of Psychiatry Bucharest Romania

Antwerp University Boechout Belgium

Barnet Adult ADHD Service Barnet Enfield and Haringey NHS Mental Health Trust London; Barnet Adult ADHD Service Springwell Centre Barnet Hospital Barnet England

Cambridge Adult ADHD and ASD Clinic Cambridge England

Center for Neurodevelopmental Disorders at Karolinska Institutet CAP Research Center Stockholm Sweden

Central Institute of Mental Health Mannheim; University Medical Center Mainz Mainz Germany

Centrum Dobrej Terapii Cracow Poland

Child and Adolescent Psychiatry Department Robert Debré Hospital Paris France

Department of Child and adolescent Psychiatry Graduate School of Medicine Hokkaido University North 15 West 7 Kita ku Sapporo 060 8638 Japan

Department of Neurology and Psychiatry Sapienza University of Rome Rome; Department NSMOS Faculty of Medicine and Psychology University Sapienza of Rome Rome Italy

Department of Psychiatry Clinic for Neuropsychiatry Helsinki University Central Hospital HUS Finland

Department of Psychiatry Hospital Universitari Vall d'Hebron Barcelona Catalonia Spain; Psychiatric Genetics Unit Vall d'Hebron Research Institute Barcelona Catalonia Spain; Department of Psychiatry and Forensic Medicine Universitat Autònoma de Barcelona Barcelona Catalonia Spain

Department of Psychiatry Hospital Universitari Vall d'Hebron Barcelona; Biomedical Network Research Centre on Mental Health Barcelona; Department of Psychiatry and Legal Medicine Universitat Autònoma de Barcelona Barcelona Spain

Department of Psychiatry School of Medicine University of Oviedo Centro de Investigación Biomédica and Red de Salud Mental CIBERSAM Oviedo Spain

Department of Psychiatry Trinity College Dublin School of Medicine Dublin Republic of Ireland

Dept of Psychiatry University of Oviedo School of Medicine Psychiatry Oviedo Spain

DPC Naestved Ladby Naestved Region Sjaelland Denmark

Geha MHC Petach Tikva Israel

General Systems Division Centre for Addiction and Mental Health Dept Of Psychiatry University of Toronto Toronto Canada

Hasan Kalyoncu University Poyracık Sokak Istanbul Turkey

Helsinki University Central Hospital Department of Psychiatry HUS Finland

High Security Hospital CRP Les Marronniers Tournai Belgium

Hopitaux Pediatriques de Nice CHU Lenval Nice France

INS Institute of Neuroscience Florence Italy

Institute of Psychology Eotvos Lorand University Vadaskert Child Psychiatric Hospial and Outpatient Clinic Budapest Hungary

Istanbul Institute of Child and Adolescent Psychiatry Istanbul Turkey

Jagiellonian University Medical College Section of Affective Disorders Department of Psychiatry Krakow Poland

Klinikum Kassel Department of Psychiatry and Psychotherapy Kassel Germany

Lund University Clinical Sciences Lund Child and Adolescent Psychiatry Lund Sweden

Macedonian Academy of Sciences and Arts Skopje Republic of Macedonia

Mccabi Health Services Tel Aviv Israel

Medical University Vienna Department of Psychiatry and Psychotherapy Vienna Austria

National and Kapodistrian University of Athens Medical School Eginition Hospital Department of Psychiatry Athens Greece

National Institute of Mental Health Klecany Czech Republic; 3rd Faculty of Medicine Charles University Prague Czech Republic

Neuropsykologkonsult Taina Lehtonen Hjärup Sweden

Nova Medical School Universidade NOVA Lisboa Lisboa Portugal

Örebro Univerity School of Medical Sciences Campus USÖ Örebro Sweden

Oslo University Hospital Department of Rare Disorders NevSom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias Oslo Norway

Outpatient Clinic Ottobrunn Germany

Parenting and Special Education KU Leuven Leuven Belgium

Psychology Services Limited Croydon England

PsyQ Psycho Medical Programs Expertise Center Adult ADHD Carel Reinierszkade 197 2593 HR The Hague The Netherlands

PsyQ Psycho Medical Programs Expertise Center Adult ADHD Carel Reinierszkade 197 2593 HR The Hague The Netherlands; Amsterdam UMC LocationVUMc Dept of Psychiatry Amsterdam the Netherlands

Reinier van Arkel Mental Health Institute 's Hertogenbosch Netherlands

Semmelweis University Department of Psychiatry Budapest Hungary

SGDP Building Institute of Psychiatry Psychology and Neuroscience Kings' College London London England

St George Hospital University Medical Center Balamand University Faculty of Medicine Institute for Development Research Advocacy and Applied Care Department of Psychiatry and Clinical Psychology St George Hospital Achrafieh Beirut Lebanon

Stanford University Medical Center University of Florence INS Institute of Neuroscience Florence Italy

Stockholm Center for Eating Disorder R and D Unit Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

Thome Klinik und Poliklinik für Psychiatrie und Psychotherapie Universitatsmedizin Rostock Rostock Germany

Trinity College Blanchardstown Village Dublin Republic of Ireland

University College Dublin Dublin Republic of Ireland

University of Bonn Department of Psychiatry and Psychotherapy Bonn Germany

University of Huddersfield and South West Yorkshire Partnership NHS Manygates Clinic Wakefield England

University of Medicine and Pharmacy Carol Davila ; Child and adolescent Psychiatry Department Prof Dr Alex Obregia Psychiatry Hospital Bucharest Romania

University of Medicine and Pharmacy Carol Davila Child and adolescent Psychiatry Department Prof Dr Alex Obregia Psychiatry Hospital Bucharest Romania

University Psychiatric Center KU Leuven Kortenberg Belgium

Uppsala University Uppsala University Hospital Akademiska sjukhuset Uppsala Stockholm

Vieux Chemin de Cagnes à La Gaude la Gaude France

Visiting senior lecturer King's College London United Kingdom; Midland Regional Forensic Service Hamilton New Zealand

Wellmind Terveys Oy Oulu Finland

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