Attention deficit hyperactivity disorder in adults: Epidemiology, pathogenesis, clinical features, course, assessment, and diagnosis
- Oscar Bukstein, MD
Oscar Bukstein, MD
- Clinical Professor of Psychiatry
- University of Texas Medical School at Houston, Baylor College of Medicine
Attention deficit hyperactivity disorder (ADHD), one of the most common neuropsychiatric disorders of childhood and adolescence, often persists into adulthood . Studies have found that a majority of people diagnosed with ADHD in childhood continue to meet criteria for the disorder as adults . More recent studies have found that a substantial proportion of those with adult ADHD did not have the condition in childhood. ADHD in adulthood is associated with significant impairment in occupational, academic, and social functioning.
Epidemiologic studies of adult ADHD have estimated the current prevalence to be 4.4 percent in the US and 3.4 percent internationally [1,3]; however, individual study results have varied widely. ADHD in adults is characterized by symptoms of inattention, impulsivity, and restlessness, resulting in functional impairment. Impairment in executive function is common. Emotional dysregulation is often seen in these patients.
This topic discusses the epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis of ADHD in adults. Pharmacotherapy and psychotherapy of adult ADHD are reviewed separately. ADHD in children and adolescents is reviewed separately. (See "Pharmacotherapy for adult attention deficit hyperactivity disorder" and "Psychotherapy for adult ADHD" and "Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis" and "Attention deficit hyperactivity disorder in children and adolescents: Epidemiology and pathogenesis" and "Attention deficit hyperactivity disorder in children and adolescents: Clinical features and diagnosis" and "Attention deficit hyperactivity disorder in children and adolescents: Treatment with medications" and "Pharmacology of drugs used to treat attention deficit hyperactivity disorder in children and adolescents".)
Epidemiologic studies of adult ADHD have estimated the current prevalence to be:
●4.4 percent among 18 to 44 year olds in US, National Comorbidity Survey Replication .
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- CLINICAL MANIFESTATIONS
- Executive dysfunction
- Hyperactivity (restlessness)
- Emotional dysregulation
- Other impairments, health and social problems
- Adult manifestations
- Rating scales
- - Conners’ adult ADHD rating scale (CAARS)
- - Adult ADHD self-report scale
- DSM-5 diagnostic criteria
- Diagnostic Interview for ADHD in adults
- Differential diagnosis
- SUMMARY AND RECOMMENDATIONS