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Presenting ADHD Symptoms, Subtypes, and Comorbid Disorders in Clinically Referred Adults With ADHD [CME]

J Clin Psychiatry 2009;70(11):1557-1562
10.4088/JCP.08m04785pur

Objective: Despite the increasing presentation of attention-deficit/hyperactivity disorder (ADHD) in adults, many practitioners remain reluctant to assess individuals for ADHD, in part related to the relative lack of data on the presenting symptoms of ADHD in adulthood. Comorbidity among adults with ADHD is also of great interest due to the high rates of psychiatric comorbidity, which can lead to a more persistent ADHD among adults.

Method: We assessed 107 adults with ADHD of both sexes (51% female; mean ± SD of 37 ± 10.4 years) using structured diagnostic interviews. Using DSM-IV symptoms, we determined DSM-IV subtypes. The study was conducted from 1998 to 2003.

Results: Inattentive symptoms were most frequently endorsed (> 90%) in adults with ADHD. Using current symptoms, 62% of adults had the combined subtype, 31% the inattentive only subtype, and 7% the hyperactive/impulsive only subtype. Adults with the combined subtype had relatively more psychiatric comorbidity compared to those with the predominately inattentive subtype. Women were similar to men in the presentation of ADHD.

Conclusion: Adults with ADHD have prominent inattentive symptoms of ADHD, necessitating careful questioning of these symptoms when evaluating these individuals.


Submitted: October 3, 2008; accepted January 9, 2009.

Corresponding author: Timothy E. Wilens, MD, Pediatric Psychopharmacology Unit, Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA 02114 (twilens@partners.org).