Unrecognized Attention-Deficit/Hyperactivity Disorder in Adults Presenting with Other Psychiatric Disorders

CNS Spectrums ◽  
2008 ◽  
Vol 13 (11) ◽  
pp. 977-984 ◽  
Author(s):  
Russell A. Barkley ◽  
Thomas E. Brown
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Adhd Symptoms ◽  
Treatment Regimens ◽  
Text Revision ◽  
Hyperactivity Disorder ◽  
Poor Treatment ◽  
Comorbid Adhd

ABSTRACTMany adults with a diagnosed psychiatric disorder also have attention-deficit/hyperactivity disorder (ADHD). In many cases, comorbid ADHD is unrecognized and/or undertreated. Differential diagnosis of adult ADHD can be challenging because ADHD symptoms may overlap with other psychiatric disorders and patients may lack insight into their ADHD-related symptoms. Current ADHD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision may prevent appropriate diagnosis of many patients with significant ADHD symptoms. Adults may not be able to provide a history of onset of symptoms during childhood, and it may be difficult to confirm that ADHD symptoms are not better accounted for by other comorbid psychiatric conditions. Comorbid ADHD is most prevalent among patients with mood, anxiety, substance use, and impulse-control disorders. ADHD can negatively affect outcomes of other comorbid psychiatric disorders, and ADHD symptoms may compromise compliance with treatment regimens. Furthermore, unrecognized ADHD symptoms may be mistaken for poor treatment response in these comorbid disorders. In these individuals, ADHD pharmacotherapy seems to be as effective in reducing core ADHD symptoms, as it is in patients who have no comorbidity. Limited evidence further suggests that ADHD therapy may help to improve symptoms of certain psychiatric comorbidities, such as depression. Therefore, management of ADHD may help to stabilize daily functioning and facilitate a fuller recovery.

Treatment of Adult ADHD and Comorbid Depression

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S8) ◽  
pp. 14-16 ◽  
Author(s):  
Thomas J. Spencer
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Mood Disorders ◽  
Drug Administration ◽  
Attention Deficit ◽  
General Principle ◽  
Adult Adhd ◽  
Comorbid Depression ◽  
Hyperactivity Disorder ◽  
Comorbid Adhd

As a general principle, separate treatments are often needed for attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders. There are few treatments for mood disorders that also treat ADHD, and vice versa. This discussion will review the literature on agents that are effective for both disorders, or that may potentially be combined. Physicians must bear in mind that none of these agents is approved by the Food and Drug Administration for the treatment of comorbid ADHD and depression.

Attention-deficit/hyperactivity disorder (ADHD) in adults: Specific clinical and therapeutic issues

2015 ◽  
Vol 30 (S2) ◽  
pp. S27-S28
Author(s):  
B. Rolland ◽  
D. Da Fonseca ◽  
M. Fatseas ◽  
N. Simon
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Clinical Features ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Adhd Symptoms ◽  
Addiction Medicine ◽  
Global Functioning ◽  
Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) was initially considered as a childhood psychiatric disorder. However, longitudinal observations have revealed that ADHD symptoms may persist in adulthood among approximately 50% of the patients . Adult ADHD is associated with impaired social outcome and frequent comorbidities such as mood disorders, personality disorders, and substance use disorders [2,3]. Correctly identifying and treating ADHD can significantly improve the global functioning and cognition of adult subjects, and reduce the intensity and frequency of the comorbid states [2,3]. Nonetheless, the clinical features of adult ADHD are clearly different from the youth form [1,2], and ADHD symptoms are easily mixed up in adults with symptoms of the comorbid conditions [2,3]. These clinical intricacies can make the diagnosis of ADHD difficult in adults. Moreover, the management of methylphenidate in adult subjects is also associated with specific risks and pitfalls, such as abuse and tampering behaviors, and additional safety risks . Put together, it appears crucial to identify and treat ADHD in adults, but the clinical and therapeutic complexities of adult ADHD require improved expertise and caution from adult psychiatrists and addiction specialists. In this thematic session of the 2015 French Psychiatry Congress, three French leading experts of adult ADHD will address the aforementioned clinical and therapeutic issues of the adulthood form of this disorder. David Da Fonseca, professor of child psychiatry in Marseille, will disentangle the clinical features of adult ADHD from the typical symptoms observed in the youth form. Mélina FATSEAS, associate professor of psychiatry and addiction medicine in Bordeaux, will specifically focus on the many and complex relationships observed between adult ADHD and substance use disorders. Last, Nicolas Simon, professor of addiction medicine and psychopharmacology in Marseille, will synthesize what are the very risks and issues with prescribing methylphenidate in adults.

Screening for Attention-Deficit/Hyperactivity Disorder in Adult Inpatients with Psychiatric Disorders

2011 ◽  
Vol 108 (3) ◽  
pp. 815-824 ◽  
Author(s):  
Geetha Kumar ◽  
Justin Faden ◽  
Robert A. Steer
Keyword(s):  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Rating Scales ◽  
Male Adult ◽  
Hyperactivity Disorder ◽  
Dsm Iv ◽  
Assessment Measures ◽  
Comorbid Adhd ◽  
Symptom Criteria

The purpose was to assess the effectiveness of the adult ADHD Module from the MINI International Neuropsychiatrie Interview (MINI) and the Conners' Adult ADHD Rating Scales: Screening Version DSM-IV ADHD Symptoms Total Scale (CAARS-S:SV) in screening for attention-deficit/hyperactivity (ADHD) disorder in patients hospitalized for other psychiatric disorders. Assessment measures were administered to 55 (50%) female and 55 (50%) male adult (> 18 yr. old) inpatients. Only six (5%) of the 110 inpatients had been diagnosed with comorbid ADHD according to medical charts. In contrast, 55 (50%) patients met criteria for ADHD according to the MINI, and 39 (36%) patients met criteria on the CAARS-S:SV. The higher rates of prevalence for the MINI and the CAARS-S:SV were attributable to symptom criteria for ADHD being similar to those shared with comorbid disorders.

Incidence of Internet addiction in adult attention deficit hyperactivity disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S396-S397
Author(s):  
B. Tuzun Mutluer ◽  
T.G. Yener Orum ◽  
S. Sertcelik
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Internet Addiction ◽  
Attention Deficit ◽  
Internet Use ◽  
Adult Adhd ◽  
Rating Scale ◽  
Self Report ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Dsm Iv

ObjectiveIn this study, it was aimed to determine the internet use properties of Adult Attention Deficit Hyperactivity Disorder (ADHD) patients who were followed-up at Haydarpasa Numune Research and Training Hospital, Psychiatry Department; ADHD Outpatient Clinic.MethodThirty participants who were diagnosed with adult ADHD aged between 18–31 years rated their ADHD symptoms in childhood retrospectively, using Wender Utah Rating Scale. Patients rated current adult ADHD symptoms with the Adult ADHD DSM-IV-Based Diagnostic Screening and Rating Scale (DSRS) and severity of symptoms measured by Adult ADHD Self-Report Scale (ASRS). Internet addiction (IA) was assessed with Young's Internet Addiction Scale (IAS). It was determined that, none of 30 Adult ADHD patients have been diagnosed with IA.29 of patient have moderate internet use although 1 of patients have risky internet use. The results revealed that total ASRS score (P = 0.020), total Adult ADHD DSM-IV-Based DSRS score (P = 0.036) and the Attention Deficit related properties subscale total score (P = 0.042) were significantly correlated with the IAS total score. Subscale of the self-report scales including; failing to finish schoolworks, chores, or duties at workplace, difficulty of following through on instructions (P = 0.017), restiveness; impaired inhibitory performance (P = 0.017), feeling not confident (P = 0.017), difficulty of managing time (P = 0.047), failing to give close attention to details or making careless mistakes (P = 0.037) are closely relevant to IAS total score.ResultIn conclusion, clinical features, which are characteristic of Adult ADHD could have same shared etiology with IA. Furthermore, ADHD patients are more likely to have an IA diagnosis. However, it was thought that this result had to be supported with studies including larger samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Mediating Effects of Self-Esteem and Harm Avoidance on the Association between Social Anxiety Symptoms and Adult Attention Deficit Hyperactivity Disorder Symptom Severity in Turkish Inpatients with Alcohol Use Disorder

2021 ◽  
Author(s):  
Cuneyt Evren ◽  
Elvan Cicekci ◽  
Gokhan Umut ◽  
Bilge Evren ◽  
Kubra Durmus Cicek
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Social Anxiety ◽  
Attention Deficit ◽  
Symptom Severity ◽  
Alcohol Use Disorder ◽  
Adult Adhd ◽  
Self Esteem ◽  
Harm Avoidance ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder

Objective: The first objective of this research was to examine the association of the symptom severity of social anxiety with the adult attention deficit hyperactivity disorder (ADHD) symptom severity in Turkish patients with alcohol use disorder (AUD). The second objective was to examine if harm avoidance and self-esteem mediated this relationship. Method: This cross-sectional analysis was performed among 151 inpatients with AUD at the Bakirkoy/AMATEM, a treatment center for substance use disorder, in Istanbul. Patients were examined with the Liebowitz Social Anxiety Scale (LSAS), the Adult ADHD Self-Report Scale (ASRS), the Rosenberg Self-Esteem Scale (SES), and the temperament dimension of Harm Avoidance (HA). Using SPSS-20 software, the data was analyzed using Pearson correlations, multivariate analysis of covariance (MANCOVA), and multiple linear regressions. Results: The scales scores were mildly correlated with each other. The low self-esteem and high HA were related with the inattentive (IN) dimension of ADHD, whereas low self-esteem solely predicted hyperactivity/impulsivity (HI) dimension of ADHD in MANCOVA. In the linear regression analysis, the severity of social anxiety, particularly avoidance dimension, was associated with the symptom severity of ADHD. In the second step of the analysis, together with the avoidance dimension of social anxiety, self-esteem was associated with the symptom severity of ADHD. However, in the third step, after including HA as an independent variable in the analysis, the avoidance dimension of social anxiety was no longer associated with the severity of adult ADHD symptoms, whereas self-esteem together with HA (particularly “anticipatory worry and pessimism” [HA-1], and “asthenia and fatigability” [HA-4]) predicted. Conclusion: Findings of the present study shows that although the symptom severity of social anxiety is associated with the severity of ADHD symptoms among inpatients with AUD, among dimensions of social anxiety, the avoidance dimension plays a main role in this relationship. Also, while the self-esteem partially mediates this relationship, HA seems to have a full mediator effect on this relationship.

scholarly journals Pharmacotherapy for Comorbid Adult Attention-Deficit Hyperactivity Disorder and Stimulant Dependence: A Systematic Review

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Woon LS ◽  
Hazli Z ◽  
Gan LLY
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Small Sample ◽  
Retention Rates ◽  
Adhd Symptoms ◽  
Stimulant Use ◽  
Hyperactivity Disorder ◽  
Stimulant Medications ◽  
Stimulant Dependence

Comorbid adult attention-deficit hyperactivity disorder (ADHD) and stimulant dependence is widely recognized, but efficacy of pharmacotherapy in this patient population is not well established. We aimed to review whether pharmacotherapy is efficacious in reducing ADHD symptoms and stimulant use in comorbid adult ADHD and stimulant use disorder. English articles until June 2017 were systematically searched in electronic databases (MEDLINE and PsycINFO), an online clinical trials register (ClinicalTrial.gov), and through hand-search of article references. Randomized, double-blind, placebo-controlled trials that studied efficacy of pharmacotherapy in adults with comorbid ADHD and stimulant dependence were included. Two reviewers assessed studies for inclusion and extracted data; disagreements were resolved by consensus. Study outcomes included were changes in ADHD symptom severity, substance abstinence, treatment retention rates and safety. From the 1394 records identified, five trials (n=358) were included. Four studies involved methylphenidate; in another study extended-release mixed amphetamine were used. The comorbid stimulant was cocaine in three studies, and amphetamines in the rest. All were short-term studies involving predominantly young male adults conducted in outpatient settings. There is early promising but mixed evidence for therapeutic efficacy in improving ADHD symptoms. Stimulant medications did not worsen stimulant dependence or adverse effects of stimulant medications. Side effects were mild and tolerable. High attrition rates and small sample size limited the generalizability of findings. Current limited evidence suggests that stimulant treatment for comorbid adult ADHD and stimulant dependence is feasible. Welldesigned trials with adequate power are needed for more robust evidence on ADHD and stimulant use outcomes.

scholarly journals The Effect of Comorbid Attention-Deficit/Hyperactivity Disorder Symptoms on Face Memory in Children with Autism Spectrum Disorder: Insights from Transdiagnostic Profiles

2021 ◽  
Vol 11 (7) ◽  
pp. 859
Author(s):  
Qi Chen ◽  
Zengjian Wang ◽  
Bin Wan ◽  
Qingxin Chen ◽  
Kun Zhai ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Adhd Symptoms ◽  
Face Memory ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Lower Accuracy ◽  
Comorbid Adhd

Face memory impairments are common but heterogeneous in autism spectrum disorder (ASD), which may be influenced by co-occurrence with attention-deficit/hyperactivity disorder (ADHD). Here, we aimed to investigate the phenotype change of face memory in children with ASD comorbid ADHD symptoms, and discuss the potential role of executive function (EF). Ninety-eight children were analyzed in the present study, including ASD− (ASD-only, n = 24), ADHD (n = 23), ASD+ (with ADHD symptoms, n = 23) and neurotypical controls (NTC, n = 28). All participants completed two tests: face encoding and retrieving task and Wisconsin Card Sorting Test (WCST) for measuring face memory and EF, respectively. Results revealed that: compared with the NTC group, children with ASD− exhibited lower accuracy in both face encoding and retrieving, and participants with ASD+ showed lower accuracy only in the retrieving, whereas no differences were found among participants with ADHD. Moreover, in the ASD+ group, face encoding performance was correlated with response perseverative errors (RPE) and failure to maintain sets (FMS) of WCST; significantly, there were no group differences between ASD+ and NTC in these two indices. The transdiagnostic profiles indicated that comorbid ADHD symptoms could modulate the face encoding deficiency of ASD, which may be partially compensated by EF. Shared and distinct intervention strategies to improve social cognition are recommended for children undergoing treatment for each condition.

scholarly journals Can the MMPI Predict Adult ADHD? An Approach Using Machine Learning Methods

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 976
Author(s):  
Sunhae Kim ◽  
Hyekyung Lee ◽  
Kounseok Lee
Keyword(s):  
Machine Learning ◽  
Attention Deficit Hyperactivity Disorder ◽  
Random Forest ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Minnesota Multiphasic Personality Inventory ◽  
Self Report ◽  
Adhd Symptoms ◽  
Linear Discriminant ◽  
Hyperactivity Disorder

(1) Background: Adult attention-deficit/hyperactivity disorder (ADHD) symptoms cause various social difficulties due to attention deficit and impulsivity. In addition, in contrast to ADHD in childhood, ADHD in adulthood is difficult to diagnose due to mixed psychopathologies. This study aimed to determine whether it is possible to predict ADHD symptoms in adults using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) with machine learning (ML) techniques; (2) Methods: Data collected from 5726 college students were analyzed. The MMPI-2-Restructured Form (MMPI-2-RF) was used, and ADHD symptoms in adults were evaluated using the Attention-Deficit/Hyperactivity Disorder Self-Report Scale (ASRS). For statistical analysis, three ML algorithms were used, i.e., K-nearest neighbors (KNN), linear discriminant analysis (LDA), and random forest, with the ASRS evaluation result as the dependent variable and the 50 MMPI-2-RF scales as predictors; (3) Results: When the KNN, LDA, and random forest techniques were applied, the accuracy was 93.1%, 91.2%, and 93.6%, respectively, and the area under the curve (AUC) was 0.722, 0.806, and 0.790, respectively. The AUC of the LDA method was the largest, with an excellent level of diagnostic accuracy; (4) Conclusions: ML using the MMPI-2 in a large group could provide reliable accuracy in screening for adult ADHD.

Malingered Attention Deficit/Hyperactivity Disorder on the Conners’ Adult ADHD Rating Scales: Do Reasons for Malingering Matter?

2017 ◽  
Vol 36 (6) ◽  
pp. 552-561 ◽  
Author(s):  
Carolyn Cook ◽  
Melissa T. Buelow ◽  
Esther Lee ◽  
Ashley Howell ◽  
Brittni Morgan ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Rating Scales ◽  
Adhd Group ◽  
Adhd Symptoms ◽  
Extra Time ◽  
Hyperactivity Disorder ◽  
The Impact ◽  
Adhd Rating Scales

Malingering is a significant assessment concern in adults undergoing evaluations for attention deficit/hyperactivity disorder (ADHD) and may occur for a number of reasons, including access to medication and/or accommodations. Therefore, it is important to investigate ways to determine accuracy of self-reported ADHD symptoms. The present study used a simulation design to examine the impact of reasons for malingering on the Conners’ Adult ADHD Rating Scales (CAARS) Symptom subscales and the CAARS infrequency index (CII). Participants ( N = 157) were randomly assigned to one of three conditions: best effort, malingering for stimulant medication, or malingering for extra time accommodations. The three groups were compared with 34 individuals reporting previous diagnosis of ADHD. Results showed that individuals in both malingering groups scored higher than controls on all CAARS subscales and CII. Individuals in the medication malingering group, but not the extra time malingering group, scored higher than the ADHD group on CII and several CAARS subscales whose content overtly reflects ADHD symptomatology. Findings emphasize the influence of malingering on self-reported ADHD symptoms and the need to assess for malingering in ADHD evaluation. Results also suggest that reason for malingering might differentially affect self-report of ADHD symptoms.

scholarly journals Attention-deficit hyperactivity disorder in adults

1999 ◽  
Vol 5 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Brian Toone ◽  
Maria Clarke ◽  
Susan Young
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Support Group ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Psychiatric Comorbidity ◽  
Hyperkinetic Disorder ◽  
Adhd Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder are well-established diagnoses in children, with estimates of prevalence in pre-adolescent children from 3 to 5%. Until recently ADHD was not thought to persist beyond adolescence, but results from long-term prospective outcome studies indicate that 30–70% of children with ADHD exhibit some symptoms as adults. Recognition of this disorder is important as the persistence of ADHD symptoms has been shown to be associated with academic and occupational failure and high rates of psychiatric comorbidity. With the establishment of a UK support group (LADDER) and increasing media attention highlighting this problem it is likely that there will be an increased demand for psychiatric assessment of adult ADHD in the next few years.

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