Attention-deficit hyperactivity disorder.(WOMEN'S HEALTH ADVISER)

Up to 70% of children who have been diagnosed with attention-deficit hyperactivity disorder continue to experience symptoms into adulthood, and as a result, as many as 8 million adults are affected. That figure may come as a surprise to clinicians who still think of ADHD as a childhood disorder.

Studies suggest that only 20% of adults with ADHD are diagnosed and treated for the disorder. And there are a number of possible reasons for this treatment gap. First, the adult form of the illness was not recognized as a diagnostic entity until the late 1980s. Second, patients who were never diagnosed may have accepted their symptoms as personality flaws or developed ways to compensate. Finally, others are regulars in the psychiatrist's office and are being treated unsuccessfully for comorbid conditions such as depression or anxiety.

Diagnosis

Most adults diagnosed with ADHD are self-referred. One of the most frequent stimuli for seeking help is that their own child has been diagnosed with the disorder. A combination of hyperactivity and inattention forms the most common subtype of the disorder; 70% of adult patients manifest that combination. A largely inattentive subtype occurs in 25%, and about 5% show the hyperactive/impulsive subtype.

Adults with ADHD are likely to display poor tolerance for frustration, temper outbursts, lack of social judgment, inability to organize daily tasks, lack of motivation, procrastination, risk-taking, and low stimulation. They are poor listeners, tending to interrupt. They frequently misplace items or forget appointments.

Adults with ADHD are highly likely to have comorbid depression, anxiety, or bipolar disorder. If untreated, they also have an increased risk of substance abuse, which many researchers believe is an attempt to self-medicate.

Several screening tools are available to assess the likelihood of ADHD. One of these includes a six-question patient self-report that can be supplemented with a longer physician screen. The screening tool identifies individuals at risk for ADHD so that they can be evaluated by their doctors. It's important to use a screen designed for adults, with questions that pinpoint very specific areas of impairment an adult is likely to encounter. One such screen and a self-assessment tool ...