Attention-Deficit/Hyperactivity Disorder: Diagnosis, Lifespan, Comorbidities, and Neurobiology
Abstract
In this report, we provide an evidence-based overview of attention-deficit/hyperactivity disorder (ADHD), including diagnosis, prevalence, developmental expression of symptoms, persistence, the heterogeneity of functional outcome, impairment in afflicted adults, psychiatric comorbidity, pathophysiology, genetics, psychosocial and biologic risk factors, and neurobiology. Attention-deficit/hyperactivity disorder is an early-onset, highly prevalent neurobehavioral disorder, with genetic, environmental, and biologic etiologies, that persists into adolescence and adulthood in a sizable majority of afflicted children of both sexes. It is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Comorbidity is a distinct clinical feature of both childhood and adult ADHD. Although its etiology remains unclear, emerging evidence documents its strong neurobiologic and genetic underpinnings. Despite the high diagnostic reliability and the robust evidence of the validity of ADHD, there are many underlying issues that remain to be resolved. These include establishing developmentally appropriate diagnostic criteria at older ages, further elaborating the impact of gender on symptom expression, and examining risk and protective factors in relationship to prevention or amelioration of ADHD as well as related functional impairments.
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Study limitations include that short treatment duration and assessment phases may underestimate TEAEs, exclusion of severe comorbid psychiatric conditions may under-represent psychiatric comorbidities, open-label dose-optimization limits interpretation, no measurements beyond 13 hours postdose were captured, and the population had uniformly high baseline severity, lacked inattentive type ADHD, and
“Consistent with laboratory school study designs, the short treatment duration and assessment phases may provide an underestimate of the number and severity of TEAEs typically seen with lengthier treatment of ADHD.”
From A 13-hour laboratory school study of lisdexamfetamine dimesylate in school-aged children with attention-deficit/hyperactivity disorder (2009) · cites this paper as [34]
ADHD has an estimated childhood prevalence of 4% to 7%.
“ADHD has an estimated childhood prevalence of 4% to 7% [9]”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [9]
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- Authors
- Spencer, T. J., Biederman, J., & Mick, E.
- Affiliations
- Massachusetts General Hospital (US)
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-05-28
- Volume
- 32
- Issue
- 6
- Pages
- 631-642
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- OpenAlex
- W2126551185
- Cited by
- 634
- References
- 78
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 17 · 2023: 19 · 2022: 17 · 2021: 32 · 2020: 35 · 2019: 37 · 2018: 27 · 2017: 33 · 2016: 48 · 2015: 52 · 2014: 41 · 2013: 51 · 2012: 38
- FWCI
- 25.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, ADHD diagnosis, ADHD prevalence, psychiatric comorbidity, neurobiology, risk factors, protective factors, functional disability, ADHD etiology
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Brain, Child, Humans, Prognosis, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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