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(PSYCHIATRIC TIMES)- Inattention and hyperactivity/ impulsivity are the defining features of attention-deficit/hyperactivity disorder (ADHD) in both children and adults; however, several core symptoms (eg, hyperactivity) mollify over time in adults. This has led to some diagnostic confusion and possibly underdiagnosis. Significant functional impairment in educational, marital, interpersonal, and occupational realms and in motor vehicle operation is common among adults with ADHD. Moreover, the disorder is associated with comorbid mood, anxiety, and substance use disorders. The same pharmacological agents that are effective in children and adolescents with ADHD (stimulants and atomoxetine) are also effective in adults. A psychosocial treatment component, such as cognitive-behavioral therapy, is generally recommended in addition to pharmacotherapy.

In the past 15 years, there has been an increasing awareness of the syndromal persistence of attention-deficit/ hyperactivity disorder (ADHD) into adulthood. Once considered only a childhood disorder, ADHD has become increasingly recognized as a valid psychiatric disorder in adults.1-3 Proponents of ADHD as a valid adult diagnosis do not suggest that ADHD arises de novo in adulthood. Rather, adult ADHD is considered the natural continuation of childhood ADHD, albeit with a different topographical expression of symptoms. The focus of this article is to discuss what is known about ADHD in adults, with a particular emphasis on diagnosis and treatment strategies.

Comparisons with Pediatric ADHD

Prevalence and symptoms. In children, the prevalence of ADHD is typically cited as between 3% and 5% of the general population while in adults, studies suggest that the prevalence is about 4%.4,5 This is not surprising given that longitudinal research indicates that the majority (50% to 70%) of children with ADHD continue to show impairing symptoms as they age.6

ADHD research in children and adults indicates that inattention and hyperactivity/impulsivity are the defining features of the disorder. For example, in a family study of ADHD, more than two-thirds of nonreferred adult relatives of children with ADHD reported current ADHD symptoms at levels comparable to those in pediatric participants with ADHD.7 These data suggest that inattentive and hyperactive/impulsive symptoms are the defining features of ADHD in both clinically referred and nonreferred adults.8-13

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