![]() ![]() The heritability of aADHD and cADHD appear to be very similar, although family studies indicate that there may be an increased familial liability for aADHD when compared with cADHD. 11 In addition, a third of ADHD’s heritability is due to a polygenic component, indicating many common variants with each having small effects. Only 10.9% of these individuals with aADHD received treatment for ADHD in the preceding 12 months.Īvailable evidence from family, twin, and adoption studies indicates that ADHD tends to run in families, with a high heritability rate of 74%. 11 aADHD was also associated with greater disability in both basic functioning (self-care, mobility, and cognition) and instrumental functioning (days out of role), productive role functioning and also on social role functioning). 10 The National Comorbidity Survey found that aADHD was significantly comorbid with mood disorders (OR = 2.7 to 7.5), anxiety disorders (OR = 1.5 to 5.5), substance use disorders (SUDs, OR = 1.5 to 7.9), and intermittent explosive disorder (OR = 3.7). 9 Most of these costs were incurred by adults ($105 billion to $194 billion) compared to children ($38 to $72 billion), and the largest cost category in this group was productivity and income losses of $87 billion to $138 billion.Īpproximately 80% of aADHD cases present with at least 1 lifetime psychiatric comorbidity. The overall national annual incremental costs of ADHD ranges from $143 to $266 billion. Individuals with aADHD are more likely to be unemployed and have a greater likelihood of being involved in criminal behaviors. They also have lower life expectancies and higher risk for death, including accidental deaths. ![]() Individuals with aADHD have greater rates of traffic violations and motor vehicle accidents, and higher rates of emergency room visits and hospital admissions. ![]() They also have significant educational difficulties with lower grades, greater rates of academic suspension and dropout rates, and are less likely to graduate than students without ADHD. These individuals are twice as likely to be divorced, when compared to age-matched controls. 8 Individuals with aADHD tend to have poor self-esteem and reduced quality of interpersonal and professional relationships. The authors also opined that the true prevalence rate of adult ADHD may be an underestimate, as some children with ADHD do not outgrow the disorder but outgrow the current diagnostic criteria ( Table 1).Īdult ADHD results in significant impairments in the individual’s personal, social, and professional life. This data is in contrast to cADHD, where boys had 3 to 10 times greater prevalence rates when compared to girls. 7 This study also found that the proportion of individuals with ADHD decreases with age, and the prevalence rates were equal among men and women. 5Ī meta-analysis by Simon et al, found the conservative pooled prevalence rate for adult ADHD (aADHD) to be 2.5%. A meta-analysis evaluating the risk markers that predicted the persistence of ADHD from childhood into adulthood found that the severity of ADHD (odds ratio (OR) = 2.33, P < 0.001), treatment for ADHD (OR = 2.09, P = 0.037), comorbid conduct disorder (OR = 1.85, P = 0.030), and comorbid major depressive disorder (OR = 1.8, P = 0.019) emerged as predictors for childhood ADHD persisting into adulthood. 5,6 It is postulated that there may be 2 distinct subtypes of aADHD: the first with childhood onset and the other with onset exclusively in adulthood. 4 Additionally, there is new evidence to suggest that adult ADHD (aADHD) is not just a continuation of childhood onset ADHD (cADHD), as many individuals do not have a history of this disorder in childhood. 3 Emerging evidence indicates that ADHD symptoms may persist into adulthood in approximately 15% to 65% of children with ADHD. The prevalence of ADHD in childhood is between 4% and 7%. 2 In this article we review various aspects of adult ADHD (aADHD) and suggest possible treatments. In addition, there is emerging evidence for the existence of a different variant of adult ADHD (aADHD) where ADHD symptoms emerge for the first time in young adulthood without any symptoms being noted in childhood. ![]() 1 There is growing evidence that symptoms of ADHD can persist into adulthood and can cause significant impairments in social, academic, and occupational functioning. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) classifies attention-deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. ![]()
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