Dr. Theresa Cerulli on the importance of standardizing ADHD care
1-minute summary: Dr Theresa Cerulli has been specialising in ADHD for 20 years. In this interview, Dr Cerulli reflects on how understanding of ADHD has grown within the specialist ADHD community, but that getting messages out to the general public remains challenging. It is Dr Cerulli’s hope that the ADHD Expert Consortium will help improve information dissemination to optimise and standardise care.
For over 20 years, Dr. Theresa Cerulli has been a noted expert in the field of ADHD treatment – a graduate of Tufts University, University of Massachusetts Medical School, Harvard Longwood Residency Program in Adult Psychiatry, and Harvard Fellowships in Medical Psychiatry and Neuropsychiatry. Dr. Cerulli has been at the forefront of improving the state of ADHD care for children, adolescents, and adults. In this interview, Dr. Cerulli provides her perspective on using QbTest, the state of ADHD care, and the importance of her work with the ADHD Expert Consortium.
Working with ADHD patients
My interest in ADHD goes back to my residency. I’ve been specializing in ADHD for 20 years, and in that time our level of understanding has changed tremendously. What hasn’t changed is the ability to pass along that information to others. If you’re a specialist then that research and knowledge is growing, but getting it out to the general public is more difficult. Keeping patients informed and aware of their treatment options is a high priority.
Improving understanding for practitioners
Even today, you’ll find medical curriculums don’t offer much in terms of didactics on ADHD. As a result, residents in training don’t have a strong handle on how to treat it. Generally only those who chose to continue on to child psychiatry fellowships receive some training in ADHD, at least in children and adolescent patients; unfortunately little to no training time is spent on adult ADHD. When it comes to treating ADHD in adults, few practitioners have a good understanding of the condition and are therefore spread thin.
On joining the consortium group
My goal for the consortium group is to understand how we can best disseminate the information we now have in order to optimize and standardize care. Many clinicians will ask for guidance on how to approach diagnosis, yet there currently isn’t a standardized approach. That’s a problem, and data can be part of the solution.
Coming from a medical model of treatment, I’ve always sought objective measurements for lab values. The lab doesn’t make the diagnosis, but it does inform the decisions you make based on objective data. That data focus is standard in other areas of medicine—psychiatry shouldn’t be an exception.
The social costs of untreated diagnoses
As noted in the consensus statement, there are higher mortality rates (accidents, suicides) for people with untreated ADHD, as well as a higher likelihood of substance abuse, unwanted pregnancies, and incarceration. Just under 1% of the population has schizophrenia, while the rate of bipolar disorder is around 2.8%. ADHD is far more prevalent (5-9% in children), and often comorbid with other psychiatric conditions. The socioeconomic impact of treating ADHD could be profound, but it’s about improving the standardization of care to get us there.