Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-05-13T01:20:17.069Z Has data issue: false hasContentIssue false
  • English
  • Français

ADHD: Prevalence, Diagnosis, and Issues of Comorbidity

Published online by Cambridge University Press:  07 November 2014

Timothy E. Wilens
Timothy E. Wilens*
Affiliation:
Dr. Wilens is associate professor of psychiatry at, Harvard Medical Schooland director of substance abuse services at the Clinical and Research Program in Pediatric Psychopharmacology at Massachusetts General hospital in Boston
Get access Rights & Permissions [Opens in a new window]

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a lifelong condition that begins in childhood and continues with adult manifestations related to the core symptoms. Approximately 50% to 75% of children with ADHD continue to meet criteria for the disorder as adolescents and adults. Adults with the disorder increasingly present to primary care physicians, psychiatrists, and other practitioners for diagnosis and treatment. Understanding the diagnosis of ADHD in adults requires knowledge of age-dependent decline of symptoms over time. Retrospective recall of symptoms and impairment are valid methods of diagnosing the disorder. ADHD is also a brain disorder with a strong neurobiologic basis, complex etiology, and genetic component. Genetic and environmental vulnerabilities give rise to abnormalities in the brain and subsequent behavioral and cognitive deficits, which may produce the symptoms associated with ADHD. Magnetic resonance imaging studies of ADHD have provided evidence that abnormalities in the brain are caused by the disorder itself rather than treatment of the disorder. Psychiatric comorbidity is common among patients with ADHD and tends to complicate treatment. Acute and long-term use of long-acting stimulant formulations (methylphenidate and amphetamine compounds) have shown robust efficacy and tolerability consistent with the treatment response established in children with ADHD. Non-stimulant medications have demonstrated efficacy as well, and may be preferred in patients with tic and substance use disorders.

Type
Research Article
Information
CNS Spectrums , Volume 12 , Issue S6 , 2007 , pp. 1 - 5
Copyright
Copyright © Cambridge University Press 2007

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.Faraone, SV, Sergeant, J, Gillberg, C, et al.The worldwide prevalence of ADHD: is it an American condition? World Psychiatry. 2003;2:104–113.Google ScholarPubMed
2.Centers for Disease Control and Prevention (CDC). Mental Health in the United States. prevalence of diagnosis and medication treatment for attention-deficit/hyperactivity disorder-United States, 2003. MMWR Morb Mortal Wkly Rep. 2005; 54: 842–847.Google Scholar
3.Biederman, J, Monuteaux, M, Mick, E, et al.Young adult outcome of attention deficit hyperactivity disorder: a controlled 10 year follow-up study. Psychol Med. 2006;36:167–179.CrossRefGoogle ScholarPubMed
4.Kessler, RC, Adler, L, Barkley, R, et al.The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006;163:716–723.CrossRefGoogle ScholarPubMed
5.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
6.Biederman, J, Faraone, S, Mick, E. Age dependent decline of ADHD symptoms revisited: impact of remission definition and symptom subtype. Am J Psychiatry. 2000;157:816–817.CrossRefGoogle Scholar
7.Millstein, RB, Wilens, TE, Biederman, J, et al.Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD. J Atten Disord. 1997;2:159–166.CrossRefGoogle Scholar
8.Spencer, TJ, Adler, LA, McGough, JJ, et al.Efficacy and safety of dexmethylphenidate extended-release capsules in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2006; Nov 28; [Epub ahead of print].Google ScholarPubMed
9.Dulcan, M. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1997;36:85S–121S.CrossRefGoogle ScholarPubMed
10.Adler, L, Cohen, J. Diagnosis and evaluation of adults with attention-deficit/hyperactivity disorder. Psychiatr Clin North Am. 2004;27(2):187–201.CrossRefGoogle ScholarPubMed
11.Wilens, TE, Dodson, W. A clinical perspective of attention-deficit/hyperactivity disorder into adulthood. J Clin Psychiatry. 2004;65:1301–1313.CrossRefGoogle ScholarPubMed
12.Biederman, J, Faraone, SV, Spencer, T, et al.Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. J Clin Psychiatry. 2006;67:524–540.CrossRefGoogle ScholarPubMed
13.Barkley, R, Guvremont, D, Anastopoulos, A, et al.Driving-related risks and outcomes of attention deficit hyperactivity disorder in adolescents and young adults: a 3- to 5-year follow-up survey. Pediatrics. 1993;92:212–218.CrossRefGoogle Scholar
14.Cox, DJ, Merkel, RL, Kovatchev, B, et al.Effect of stimulant medication on driving performance of young adults with attention-deficit hyperactivity disorder: a preliminary double- blind placebo controlled trial. J Nerv Ment Dis. 2000;188:230–234.CrossRefGoogle ScholarPubMed
15.Barkley, RA, Murphy, KR, Kwasnik, D. Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder. Pediatrics. 1996;98:1089–1095.CrossRefGoogle Scholar
16.Murphy, K, Barkley, RA. Prevalence of DSM-IV symptoms of ADHD in adult licensed drivers: implications for clinical diagnosis. J Atten Disord. 1996;1:147–161.CrossRefGoogle Scholar
17.Cox, DJ, Merkel, L, Penberthy, JK, et al.Impact of methylphenidate delivery profiles on driving performance of adolescents with attention-deficit/hyperactivity disorder: a pilot study. J Am Acad Child Adolesc Psychiatry. 2004;43:269–275.CrossRefGoogle ScholarPubMed
18.Wilens, T, Faraone, S, Biederman, J, et al.Does stimulant therapy of ADHD beget later substance abuse: a metanalytic review of the literature. Pediatrics. 2003;11:179–185.CrossRefGoogle Scholar
19.Shekim, WO, Asarnow, RF, Hess, E, et al.A clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state. Compr Psychiatry. 1990; 31:416–425.CrossRefGoogle ScholarPubMed
20.Biederman, J, Faraone, SV, Spencer, T, et al.Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150:1792–1798.Google ScholarPubMed
21.McGough, JJ, Smalley, SL, McCracken, JT, et al.Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry. 2005;162:1621–1627.CrossRefGoogle ScholarPubMed
22.Alpert, J, Maddocks, A, Nierenberg, A, et al.Attention deficit hyperactivity disorder in childhood among adults with major depression. Psychiatry Res. 1996;62:213–219.CrossRefGoogle ScholarPubMed
23.Nierenberg, AA, Miyahara, S, Spencer, T, et al.Clinical and diagnostic implications of lifetime attention-deficit/hyperactivity disorder comorbidity in adults with bipolar disorder: data from the first 1000 STEP-BD participants. Biol Psychiatry. 2005;57:1467–1473.CrossRefGoogle ScholarPubMed
24.Fones, CS, Pollack, MH, Susswein, L, et al.History of childhood attention deficit hyperactivity disorder (ADHD) features among adults with panic disorder. J Affect Disord. 2000;58:99–106.CrossRefGoogle ScholarPubMed
25.Wilens, T. Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk and treatment issues. Psychiatr Clin North Am. 2004;27:283–301.CrossRefGoogle ScholarPubMed