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Attention Deficit/Hyperactivity Disorder, Adult

Attention Deficit/Hyperactivity Disorder, Adult is a topic covered in the 5-Minute Clinical Consult.

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Basics

  • Adult attention deficit hyperactivity disorder (adult ADHD) is a psychiatric condition resulting in inattention and/or hyperactivity or impulsivity. It is typically associated with a combination of low self-esteem, dysfunctional or unstable social relationships, and impaired academic/job performance.
  • Adult ADHD has been shown to affect a significant portion of the adult population; 30–60% of patients diagnosed with ADHD as a child will continue to meet criteria as adults.
  • During transition from pediatric to adult care, poor control of high-risk behaviors during a hiatus of ADHD treatment can lead to increased morbidity.

Description

  • Symptoms include difficulty concentrating, impulsivity, and hyperactivity/overactivity. Impairment in executive functioning and emotional dysregulation are common features.
  • The three main types of ADHD are (i) hyperactivity-impulsivity predominant, (ii) inattentive predominant, and (iii) combined.

Epidemiology

Prevalence
ADHD affects approximately 4.4–5.2% of adults between 18 and 44 years of age (1).

Risk Factors

  • ADHD has a strong genetic component, with heritability of approximately 0.8, suggesting that genetic factors would account for about 65% of phenotypic variance (2).
  • Studies have shown that the risk of ADHD is increased among offsprings of mothers who smoked or had obesity and diabetes during pregnancy. Risk is also increased in those who had lead exposure in childhood. It is unknown whether these associations are causal (2).
  • Premature birth; very low birth weight; and extreme neglect, abuse, or social deprivation also increase the risk as do certain infections during pregnancy, at birth, and in early childhood.
  • ADHD is more commonly diagnosed among adult males than females, with an odds ratio of 1.6:1.0 (1); however, some studies have shown that this is due to the less overt symptoms in females.

Commonly Associated Conditions

  • Substance use and substance abuse disorders
  • Mood disorders
  • Anxiety disorders
  • Intellectual disabilities
  • Obsessive-compulsive disorder (OCD)
  • Tic disorders

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Citation

Stephens, Mark B., et al., editors. "Attention Deficit/Hyperactivity Disorder, Adult." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/2.1/Attention_Deficit_Hyperactivity_Disorder_Adult.
Attention Deficit/Hyperactivity Disorder, Adult. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/2.1/Attention_Deficit_Hyperactivity_Disorder_Adult. Accessed June 26, 2019.
Attention Deficit/Hyperactivity Disorder, Adult. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/2.1/Attention_Deficit_Hyperactivity_Disorder_Adult
Attention Deficit/Hyperactivity Disorder, Adult [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 26]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/2.1/Attention_Deficit_Hyperactivity_Disorder_Adult.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Attention Deficit/Hyperactivity Disorder, Adult ID - 117632 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/2.1/Attention_Deficit_Hyperactivity_Disorder_Adult PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -