How-To Guides

In this clinically referred adult ADHD sample, inattentive symptoms were the most commonly reported symptoms, with inattentive symptoms overall endorsed more often than hyperactive symptoms. The most commonly reported inattentive symptoms were being easily distracted, difficulty sustaining attention, and difficulty with sustained mental effort. The most commonly reported hyperactive symptoms were blurting out answers, interrupting or intruding, and fidgeting.

The combined subtype was the most common adult ADHD presentation in this study. Using current DSM-IV symptoms, 62% of adults had the combined subtype, 31% had the inattentive subtype, and 7% had the hyperactive/impulsive subtype. Overall, 93% had either the inattentive or combined subtype, supporting the prominence of inattention in adult ADHD.

Yes. Adults with the combined subtype had relatively more psychiatric comorbidity than those with the predominately inattentive subtype. In particular, adults with combined ADHD had significantly higher lifetime rates of conduct disorder, bipolar disorder, and psychosis compared with those with the inattentive subtype.

Psychiatric comorbidity was very common in this adult ADHD sample. Only 8% had no psychiatric comorbidity; 10% had 1 lifetime comorbid psychiatric disorder, 14% had 2, 15% had 3, and 53% had 4 or more psychiatric comorbidities.

ADHD-related impairment was substantial. When asked about past overall impairment directly related to ADHD symptoms, 40% reported severe impairment, 53% moderate impairment, and 7% mild impairment. For impairment within the past month, 22% reported severe impairment and 50% reported moderate impairment, while 26% reported mild impairment.

In this study, women and men were similar in core adult ADHD symptom presentation. There were no differences between sexes in the total number of endorsed inattentive or hyperactive/impulsive symptoms, although women were more likely to endorse the inattentive symptom of "loses things" (c72 = 7.5, P < .01).

Yes. Men had significantly higher lifetime rates of comorbid conduct disorder and alcohol abuse, while women had significantly higher rates of dysthymia, panic disorder, agoraphobia, simple phobia, and generalized anxiety disorder. The reported significance levels were P < .01 for conduct disorder and alcohol abuse in men, P < .05 for panic disorder in women, and P < .01 for agoraphobia, simple phobia, and generalized anxiety disorder in women.

Not in this sample. When the investigators split participants at the median age of 38 years, there were no differences in the total number or type of endorsed inattentive and hyperactive/impulsive symptoms between the age groups.

The study assessed 107 adults with current ADHD using structured diagnostic interviews, including the Structured Clinical Interview for DSM-IV and modules from the K-SADS-E. Diagnoses were reviewed by a blinded diagnostic committee and assigned for both lifetime and current time points, and DSM-IV symptoms were used to determine ADHD subtypes. Interrater reliability was high, with a median kappa of 0.98 across 500 assessments and a kappa of 0.88 for ADHD.

The authors noted several limitations. The sample was derived in part from clinically referred and nonreferred populations, so the findings may not generalize to all adults with ADHD. In addition, the study included adults who met 6 of 9 child-based ADHD diagnostic criteria, which may have selected a more severe group, and some symptom reporting relied on retrospective recall of past symptoms.