Possible Link Between Attention-Deficit/Hyperactivity Disorder and Reproductive Complications

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Background: Initially conceptualized as a disorder of childhood, attention-deficit/hyperactivity disorder (ADHD) is now emerging as a chronic disorder that may present in adolescence and persist into adulthood. Failure to recognize this common disorder in childhood may lead to disabling comorbid symptoms and a poor long-term prognosis in adulthood. Young adults with undiagnosed ADHD experience significant psychiatric comorbidity, including high rates of drug dependency and lower levels of global functioning. The public health consequences of poor impulse control (e.g., delinquency, criminal activity, drug use, risky sexual behaviors, high-risk pregnancies) are emerging, and a link between ADHD and poverty seems highly probable.

Case Report: I explore the sexual behaviors, and their consequences, of a young adolescent female. Her reproductive complications led me to consider undiagnosed ADHD.

Conclusion: The long-term prognosis when ADHD is unrecognized and untreated in the adolescent is discouraging: maternal and perinatal morbidity may be anticipated and are biologically plausible. The actual assessment of risk in the setting of pregnancy and unrecognized ADHD remains largely unknown, and the benefits of timely diagnosis and appropriate treatment of ADHD during pregnancy have yet to be addressed. The following case presentation suggests an association between undiagnosed ADHD and reproductive complications.

Prim Care Companion J Clin Psychiatry 2002;4(3):104-108