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. Some others who no longer meet strict criteria still have significant residual ADHD traits.
  • 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.
  • DSM-5 also classifies ADHD into mild, moderate, and severe based on the severity of symptoms (1).

Epidemiology

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

Genetics
ADHD patients often have first-degree relatives with ADHD. Twin studies based on self-rated symptoms in adult population samples show moderate heritability estimates of 30–40%. Some genes have been correlated with ADHD, although not necessary or sufficient for diagnosis.

Risk Factors

History of childhood and adolescent ADHD diagnosis, particularly symptoms of hyperactivity and/or impulsivity, persisting into adulthood. 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

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TY - ELEC T1 - Attention Deficit/Hyperactivity Disorder, Adult ID - 117632 Y1 - 2019 PB - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/117632/all/Attention_Deficit_Hyperactivity_Disorder__Adult ER -