Critical analysis of the concept of adult attention-deficit hyperactivity disorder

SummaryWe question whether adult attention-deficit hyperactivity disorder (ADHD) represents a discrete condition that is distinguishable from ordinary behaviour and other psychiatric disorders, and whether it is related to the childhood disorder, since adult and childhood ADHD are said to be characterised by a different range of symptoms. Although studies of stimulant drugs find marginal short-term effects, which can be explained by their known psychoactive properties, there is little evidence that there are any sustained long-term benefits of drug therapy. We suggest that adult ADHD represents one of the latest attempts to medicalise ordinary human difficulties, and that its popularity is partly dependent on marketing and the reinforcing effects of stimulants.

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Attention Deficit Hyperactivity Disorder

Overdiagnosis in Psychiatry ◽

10.1093/med/9780197504277.003.0008 ◽

2020 ◽

pp. 105-118

Author(s):

Joel Paris

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Side Effects ◽

Attention Deficit ◽

Driving Force ◽

Adult Adhd ◽

Stimulant Drugs ◽

Hyperactivity Disorder ◽

Dsm 5 ◽

History Of

Attention deficit hyperactivity disorder (ADHD), once considered fairly uncommon, is now being diagnosed at historically high levels. Moreover, because problems with attention are very common in the community, the frequency of the diagnosis in adults has exploded. Yet many adult patients who seem to have ADHD lack a childhood history of the disorder, as required by DSM-5. There is now evidence that adult ADHD frequently appears without such a history and may be an entirely different disorder. Moreover, many other diagnoses cause problems with attention, and stimulant drugs can increase focus in almost anyone. The driving force behind this diagnostic epidemic appears to be the wish to prescribe stimulants, even though these agents could have \ long-term side effects.

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The specificity of clinical characteristics in adults with attention-deficit/hyperactivity disorder: a comparison with patients with borderline personality disorder

European Psychiatry ◽

10.1016/j.eurpsy.2003.07.010 ◽

2004 ◽

Vol 19 (2) ◽

pp. 72-78 ◽

Cited By ~ 31

Author(s):

J.H. Dowson ◽

A. McLean ◽

E. Bazanis ◽

B. Toone ◽

S. Young ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Attention Deficit ◽

Adult Adhd ◽

Spatial Working Memory ◽

Borderline Personality ◽

Self Report ◽

Hyperactivity Disorder

AbstractCharacteristics of DSM-IV attention-deficit/hyperactivity disorder (ADHD) in adults can also be found as part of other psychiatric disorders. This study investigated the specificity of adult ADHD features in relation to patients with borderline personality disorder (BPD), a syndrome which shares some of its intrinsic features with ADHD and often co-occurs with ADHD. A group of 20 adult patients selected on the basis of a diagnosis of ADHD and 20 patients selected on the basis of a diagnosis of BPD were assessed by the self-report Attention Deficit Scales for Adults (ADSA). The two groups were matched for age, verbal IQ and gender. Of the nine ADSA scales, seven showed significant inter-group differences, in particular involving attention, organisation and persistence. The ‘Consistency/Long-Term’ scale, which mainly reflects impaired task and goal persistence, was the best discriminator between the groups. Furthermore, ratings on this scale correlated significantly with the error score of a computer-administered task of spatial working memory, the performance of which has been reported to be impaired in patients with ADHD. The results provide further validation for the ADSA scales and support a previous claim that ‘long-term consistencies’, i.e., related to task and goal persistence, is ‘the centrepiece behavioural issue’ for adults with ADHD.

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Attention Deficit Hyperactivity Disorder in Adults

Current Directions in Psychological Science ◽

10.1111/1467-8721.00055 ◽

2000 ◽

Vol 9 (1) ◽

pp. 33-36 ◽

Cited By ~ 42

Author(s):

Stephen V. Faraone

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Adult Adhd ◽

Clinical Problem ◽

Term Outcome ◽

Long Term Outcome ◽

Hyperactivity Disorder ◽

Psychological Science ◽

Theoretical Paradigms

The diagnosis of attention deficit hyperactivity disorder (ADHD) in adults has been a source of controversy, with some prominent researchers questioning its very existence and others suggesting it is an urgent clinical problem. This article reviews five domains of data addressing the validity of adult ADHD: clinical correlates, family history, treatment response, laboratory studies, and long-term outcome. It then shows how the debate over adult ADHD reflects a clash of theoretical paradigms and concludes by suggesting ways in which psychological science can collect the data needed to clarify the validity of adult ADHD.

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Do food bioactives play a role in attention-deficit/ hyperactivity disorder?

Journal of Food Bioactives ◽

10.31665/jfb.2018.4160 ◽

2018 ◽

Vol 4 ◽

Cited By ~ 3

Author(s):

Klaus W. Lange

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Potential Role ◽

Omega 3 Fatty Acids ◽

Omega 3 ◽

Short Term ◽

Hyperactivity Disorder ◽

Common Diagnosis

Attention-deficit/hyperactivity disorder (ADHD) is a common diagnosis in children, which may persist into adulthood. Short-term benefits of pharmacological treatment have been shown, but concerns regarding long-term efficacy and safety have led to a search for alternative treatments. Nutrition may be an important factor in psychiatric disorders. At group level, food bioactives do not appear to play a significant pathogenetic or therapeutic role in ADHD. Benefits of treatment with omega-3 fatty acids, vitamins and minerals may be confined to individuals deficient in these micronutrients. Dietary patterns may be of greater importance than individual nutrients. However, both diet and consumption of certain nutrients may be precursors or consequences of ADHD. The controversy surrounding the clinical and pathogenetic heterogeneity of ADHD complicates the assessment of food bioactives. The identification of a potential role of food bioactives in ADHD is hindered by the ill-defined nature of the disorder and the lack of biological markers underpinning its validity. The therapeutic efficacy of food bioactives cannot be tested by evaluating their effect on the pathophysiology of ADHD but only by observing their effects on symptom severity.

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Attention-deficit hyperactivity disorder in adults

Advances in Psychiatric Treatment ◽

10.1192/apt.5.2.112 ◽

1999 ◽

Vol 5 (2) ◽

pp. 112-119 ◽

Cited By ~ 2

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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A Randomised, Double-Blind, Placebo-Controlled Trial of Dexamphetamine in Adults with Attention Deficit Hyperactivity Disorder

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.1999.00590.x ◽

1999 ◽

Vol 33 (4) ◽

pp. 494-502 ◽

Cited By ~ 47

Author(s):

Roger Paterson ◽

Charles Douglas ◽

Joachim Hallmayer ◽

Michael Hagan ◽

Zyron Krupenia

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Adult Adhd ◽

Brief Symptom Inventory ◽

Controlled Study ◽

Double Blind ◽

Double Blind Placebo ◽

Hyperactivity Disorder ◽

Dsm Iv

Objective: The aim of this paper is to determine the efficacy of dexamphetamine in adult attention deficit hyperactivity disorder (ADHD) in a naturalistic setting. Method: A randomised, double-blind, placebo-controlled study of dexamphetamine was conducted by two psychiatrists in private practice who saw a total of 68 consecutive referrals of patients thought to have ADHD by their referring general practitioners. Patients were admitted to the study if their current level of ADHD symptoms satisfied DSM-IV criteria (modified for use in adults), and were not currently comorbid for major mood disturbance or substance abuse. Response to medication was assessed by repeated administration of these modified DSM-IV criteria, self- and relatives' rating, as well as clinician rating using the Clinical Global Impressions Scale. More general outcome measures included the Brief Symptom Inventory and a patient satisfaction questionnaire. Medication side effects were recorded, including monitoring blood pressure and weight change. Urinalysis monitored concurrent substance usage and compliance. Results: Dexamphetamine had a significant therapeutic response exceeding the placebo response (p = 0.045). The response was similar in both genders and across the age range. It was detected by patients, their relatives and the two clinicians. The only significant side effect was weight loss. One patient on dexamphetamine discontinued the trial because of an event possibly related to the medication. Conclusions: In the short term, dexamphetamine appears to be efficacious in treating adult ADHD. As this is the first study in the literature, the result requires replication. Given that stimulant medication use in adult ADHD appears to be long-term, studies of long-term efficacy need to be carried out.

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