Hostname: page-component-77c89778f8-m8s7h Total loading time: 0 Render date: 2024-07-18T08:30:52.372Z Has data issue: false hasContentIssue false

Adult ADHD: a controversial diagnosis?

Published online by Cambridge University Press:  13 June 2014

Aiveen Kirley
Affiliation:
Department of Psychiatry, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland
Michael Fitzgerald
Affiliation:
Department of Psychiatry, Trinity Centre for Health Sciences, St. James Hospital, Dublin 8, Ireland

Abstract

Attention deficit hyperactivity disorder (ADHD) is characterised by inattention, hyperactivity and impulsivity with onset in children before the age of seven years. ADHD is the most common disorder presenting to child guidance clinics and has been shown to be a well-validated diagnosis. Current estimates of prevalence range from 1%5%. The concept of adult ADHD as a clinical entity is an emerging but controversial area in psychiatry. While childhood ADHD is accepted as a reliable and valid diagnosis, the validity of adult ADHD as a disorder is unclear. This paper reviews the likely presenting features of adult ADHD and common comorbid disorders. Guidelines for assessment and management are discussed and the evidence for validity of the diagnosis is critically examined.

Type
Review
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Cantwell, DP. Attention deficit disorder: a review of the past 10 years. J Am Acad Child Adol Psychiatr 1996; 35(8): 978–87.CrossRefGoogle ScholarPubMed
2.Taylor, EA, Sandberg, ST. Hyperactive behaviour in English schoolchildren: a questionnaire survey. J Abn Psychol 1984; 12:143–56.CrossRefGoogle ScholarPubMed
3.Wilens, TE, Biederman, J, Spencer, TJ. Attention Deficit Hyperactivity Disorder Across the Lifespan. Ann Rev Med 2002, 53: 113–31.CrossRefGoogle ScholarPubMed
4.Klein, RG, Mannuzza, S. Long-term outcome of hyperactive children: a review. J Am Acad Child Adol Psychiatr 1991; 30: 383–87.CrossRefGoogle ScholarPubMed
5.Thorley, G. Review of follow-up and follow-back studies of childhood hyperactivity. Psychol Bull 1984; 96: 116–32.CrossRefGoogle ScholarPubMed
6.Biederman, J, Faraone, S, Milberger, Set al.Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study. J Am Acad Child Adol Psychiatr 1996; 35: 343–51.CrossRefGoogle ScholarPubMed
7.Fischer, M. Persistence of ADHD into adulthood: it depends on whom you ask. ADHD Rep 1997; 5: 810.Google Scholar
8.Trollor, J. 1999. Attention deficit hyperactivity disorder in adults: conceptual and clinical issues. Med J Aust 1999; 171: 421–25.CrossRefGoogle ScholarPubMed
9.Gittelman, R, Mannuzza, S, Shenker, R, Bonagura, N. Hyperactive boys almost grown up. I. Psychiatric status. Arch Gen Psychiatr 1985; 42: 937–47.CrossRefGoogle ScholarPubMed
10.Hart, E, Lahey, B, Loeber, R, Applegate, B, Frick, RJ. Developmental change in attention-deficit hyperactivity disorder in boys: a four-year longitudinal study. J Abnorm Child Psychol 1995; 23: 729–49.CrossRefGoogle Scholar
11.Anderson, JC, Williams, S, McGee, R, Silva, PA. DSM-III disorders in preadolescent children: prevalence in a large sample from the general population. Arch Gen Psychiatry 1987; 44: 6976.CrossRefGoogle Scholar
12.Bird, HR, Gould, MS, Staghezza, BM. Patterns of psychiatric comorbidity in a community sample of children aged 9 through 16 years. J Am Acad Child Adol Psychiatr 1993;32:361–68.CrossRefGoogle Scholar
13.Biederman, J, Newcorn, J, Sprich, S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatr 1991; 148: 564–77.Google ScholarPubMed
14.Beiderman, J, Faraone, SV, Spencer, Tet al.Patterns of psychiatric co-morbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatr 1993; 150(12): 1792–9.Google Scholar
15.Angold, A, Costello, EJ. Depressive comorbidity in children and adolescents: empirical, theoretical and methodological issues. Am J Psychiatr 1993; 150: 1779–91.Google ScholarPubMed
16.Biederman, J, Faraone, SV, Mick, Eet al.Attention deficit hyperactivity disorder and mania: an overlooked comorbidity? J Am Acad Child Adol Psychiatr 1996; 35: 9971008.CrossRefGoogle ScholarPubMed
17.Winokur, G, Coryell, W, Endicott, J, Akiskal, H. Further distinctions between manicdepressive illness (bipolar disorder) and primary depressive disorder (unipolar depression). Am J Psychiatr 1993; 150:1176–81.Google ScholarPubMed
18.Faraone, SV, Biederman, J, Wosniak, J, Mundy, E, Mennin, D, O'Donnell, D. Is comorbidity with ADHD a marker for juvenile onset mania? J Am Acad Child Adol Psychiatr 1997; 36: 1046–55.CrossRefGoogle ScholarPubMed
19.Wender, PH. Attention-Deficit Hyperactivity Disorder in Adults. The Psychiatric Clinics of North America 1998; 21 (4): 761–75.CrossRefGoogle ScholarPubMed
20.Swanson, JM, Sergeant, JA, Taylor, E, Sonuga-Barke, EJS, Jensen, PS, Cantwell, DP. Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet 1998: 351: 429–33.CrossRefGoogle ScholarPubMed
21.Millstein, RB, Wilens, TE, Biederman, Jet al.Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD. J Attent Dis 1997; 2:159–66.CrossRefGoogle Scholar
22.Faraone, SV, Biederman, J, Mick, Eet al.Family study of girls with attention deficit hyperactivity disorder. Am J Psychiatr 2000; 157:1077–83.CrossRefGoogle ScholarPubMed
23.Toone, BK, Van Der Linden, GJH. Attention deficit hyperactivity disorder or hyperkinetic disorder in adults. Br J Psychiatr 1997; 170: 489–91.CrossRefGoogle ScholarPubMed
24.Wender, PH. Attention-Deficit Hyperactivity Disorder in Adults. New York; Oxford University Press, 1995.Google Scholar
25.Brown, T. Brown Attention Deficit disorder Scales. San Antonio, TX: Psychol. Corp 1995.Google Scholar
26.Roy-Byrne, P, Scheele, L, Brinkley, Jet al.Adult attention deficit hyperactivity disorder: assessment guidelines based on clinical presentation to a specialty clinic. Compr Psychiatr 1997; 38:133–40.CrossRefGoogle ScholarPubMed
27.Wender, PH, Wolf, LE, Wasserstein, J. Adults with ADHD. An Overview. Ann NY Acad Sci 2001;931:116.CrossRefGoogle ScholarPubMed
28.Ward, MF, Wender, PH, Reimherr, FW. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am J Psychiatry 1993; 150: 885–90.Google ScholarPubMed
29.Goyette, CH, Conners, CK, Ulrich, RF. Normative data on Revised Conners Parent and Teacher Rating Scales. J Abnorm Child Psychol 1978; 6: 221–36.CrossRefGoogle ScholarPubMed
30.Barkley, RA, editor. Patient's Behaviour Checklist for ADHD Adults. Attention deficit hyperactivity disorders clinical workbook. New York: The Guildford Press, 1991: 43.Google Scholar
31.Barkley, RA, Grodzinsky, G, DuPaul, GJ. Frontal lobe functions in attention deficit disorder with and without hyperactivity: a review and research report. J Abnorm Child Psychol 1992; 20: 163–88.CrossRefGoogle ScholarPubMed
32.Barkley, R, Murphy, K, Kwasnik, D. Psychological adjustment and adaptive impairments in young adults with ADHD. J Att Disord 1996; 1:4154.CrossRefGoogle Scholar
33.Downey, K, Stelson, F, Pomerleau, O, Giordiani. Adult attention deficit hyperactivity disorder: Psychological test profiles in a clinical population. J Nerv Ment Dis 1997; 185: 32–8.CrossRefGoogle Scholar
34.McGuffin, P, Riley, B, Plomin, R. Toward behavioural genomics. Science 2001; 291: 1232–49.CrossRefGoogle Scholar
35.Faraone, SV, Biederman, J. Pathophysiology of ADHD. In: Davis, K, Charney, D, Coyle, JT, Nemeroff, C, eds. Psychopharmacology: The Fifth Generation of Progress-Version 2. New York: Lipponcott, Williams and Wilkens, 2002.Google Scholar
36.Kirley, A, Hawi, Z, Daly, Get al.Dopaminergic system genes in ADHD: Towards a Biological Hypothesis. Neuropsychopharmacology (in press).Google Scholar
37.Wilens, TE, Biederman, J, Spencer, TJ, Prince, J. Pharmacotherapy of adult attention deficit hyperactivity disorder: a review. J Clin Psychopharmacol 1995:15: 270–9.CrossRefGoogle ScholarPubMed
38.Fitzgerald, M. Psychopharmacological treatment of adolescent and adult attention deficit hyperactivity disorder. Ir J Psych Med 2001; 18(3): 93–8.CrossRefGoogle ScholarPubMed
39.Faraone, SV, Biederman, J, Spencer, Tet al.Attention-Deficit/Hyperactivity Disorder in Adults: An Overview. Biol Psychiatry 2000; 48: 920.CrossRefGoogle ScholarPubMed
40.Spencer, T, Biederman, J, Wilens, TE, Faraone, SV. Adults With Attention-Deficit/Hyperactivity Disorder: A Controversial Diagnosis. J Clin Psychiatry 1998; 59 [suppl 7]: 5968.Google ScholarPubMed
41.Spitzer, RL, Williams, JBW. Classification in psychiatry. In: Kaplan, HI, Sadock, BJ, eds. Comprehensive Textbook of Psychiatry. 4th ed. Baltimore, Md: Williams and Wilkins, 1985: 591613.Google Scholar
42.Spencer, T, Wilens, T, Biederman, J, Faraone, SV, Ablon, JS, Lapey, K. A double-blind, crossover comparison of methylphenidate and placebo in adults with childhood-onset attention-deficit hyperactivity disorder. Arch Gen Psychiatry 1995; 52: 434–43.CrossRefGoogle ScholarPubMed
43.Murphy, K, Barkley, R. Prevalence of DSM-IV symptoms of ADHD in adult licensed drivers: Implications for clinical diagnosis. J Att Disord 1996; 1: 147–61.CrossRefGoogle Scholar
44.Biederman, J, Faraone, SV, Spencer, T, Wilens, T, Mick, E, Lapey, KA. Gender differences in a sample of adults with attention deficit hyperactivity disorder. Psychiatry Res 1994; 53: 1329.CrossRefGoogle Scholar
45.Heiligenstein, E, Keeling, RP. Psychological and academic functioning in college students with attention deficit hyperactivity disorder. J Am Coll Health 1999; 47:181–5.CrossRefGoogle ScholarPubMed
46.Wilens, TE, Biederman, J, Spencer, TJet al.Controlled trial of high doses of pemoline for adults with attention-deficit/hyperactivity disorder. J Clin Psychopharmacol 1999; 19: 257–64.CrossRefGoogle ScholarPubMed
47.Levin, FR, Evans, SM, McDowell, DM, Kleber, HD. Methylphenidate treatment for cocaine abusers with adult attention-deficit/hyperactivity disorder: a pilot study. J Clin Psychiatry 1998; 59: 300–5.CrossRefGoogle ScholarPubMed
48.Faraone, S, Biederman, J. Is attention deficit hyperactivity disorder familial? Harvard Rev Psychiatry 1994; 1: 271–87.CrossRefGoogle ScholarPubMed
49.Biederman, J, Wilens, T, Mick, E, Milberger, S, Spencer, T, Faraone, S. Psychoactive substance use disorder in adults with attention deficit hyperactivity disorder: Effects of ADHD and psychiatric comorbidity. Am J Psychiatry 1995; 152: 1652–8.Google ScholarPubMed
50.Manshadi, M, Lippmann, S, O'Daniel, R, Blackman, A. Alcohol abuse and attention deficit disorder. J Clin Psychiatry 1983; 44: 379–80.Google ScholarPubMed
51.Fitzgerald, M. Adult attention deficit hyperactivity disorder. Ir J Psych Med 1998; 15(3): 82–3.CrossRefGoogle Scholar