The DOI matches its Crossref record; 91 of the 92 references it cites were found in a registry or an index.
Diagnostic Controversies in Adult Attention Deficit Hyperactivity Disorder
Abstract
OBJECTIVE: While it is increasingly recognized that attention deficit hyperactivity disorder (ADHD) persists into adulthood, there is no consensus on diagnostic criteria for adult ADHD. In this article the authors describe and contrast competing approaches for diagnosis of adult ADHD used in clinical and research practice. METHOD: The authors review the Wender Utah criteria, DSM criteria, and laboratory assessment strategies for adult ADHD. Advantages and disadvantages of each approach are described, and recommendations are made as a basis for clinical assessment and future research. RESULTS: Both the Wender Utah criteria and DSM-based approaches identify significantly impaired ADHD adults with neurocognitive, biological, and treatment response patterns similar to pediatric ADHD patients. The Wender Utah criteria established the need for retrospective childhood diagnosis and recognize developmental differences in adult symptom expression. The Wender Utah criteria fail to identify patients with predominantly inattentive symptoms, exclude some patients with significant comorbid psychopathology, and diverge significantly from the DSM conception of ADHD. The DSM criteria have never been validated in adults, do not include developmentally appropriate symptoms and thresholds for adults, and fail to identify some significantly impaired adults who are likely to benefit from treatment. There are insufficient scientific data to justify use of laboratory assessment measures, including neuropsychological tests and brain imaging, in diagnosing adult ADHD. CONCLUSIONS: Adult ADHD remains a clinical diagnosis. Clinicians should be flexible in application of the current ADHD criteria to adults. Additional research is required to validate adult diagnostic criteria.
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In the citing paper
“The Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association is a widely used approach for diagnosing adult ADHD and requires a childhood-onset [11,12].”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [11]
In the citing paper
“Compared with childhood ADHD, adult ADHD is relatively neglected in epidemiological studies, largely due to the absence of well-established and validated diagnostic criteria [6,11,12].”
From The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis (2021) · cites this paper as [11]
In the citing paper
“there is strong scientific consensus that it is extremely difficult to document childhood onset in adults with ADHD(3,50,51).”
From Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study (2015) · cites this paper as [51]
Citations
Cites
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Self-citationOppositional Defiant and Conduct Disorder: A Review of the Past 10 Years, Part I
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Cerebral Glucose Metabolism in Adults with Hyperactivity of Childhood Onset
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“Biederman and colleagues described a systematic DSMbased approach to diagnosis and demonstrated that adults identified with ADHD have patterns of impairment, comorbidity, and neurocognitive functioning similar to those of children with ADHD (47, 48).”
BackgroundDSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.11.1673 · Cited by 935
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Cited by
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Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder
Fayyad, J., De Graaf, R., Kessler, R., Alonso, J., Angermeyer, M., Demyttenaere, K., De Girolamo, G., Haro, J. M., Karam, E. G., Lara, C., et al. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.034389 · Cited by 1,321
Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021) · Journal of Global Health · doi:10.7189/jogh.11.04009 · Cited by 896
Moffitt, T. E., Houts, R., Asherson, P., Belsky, D. W., Corcoran, D. L., Hammerle, M., Harrington, H., Hogan, S., Meier, M. H., Polanczyk, G. V., et al. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.14101266 · Cited by 618
Epidemiology of attention-deficit/hyperactivity disorder across the lifespan
Polanczyk, G. V., & Rohde, L. A. (2007) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3281568d7a · Cited by 483
Barkley, R. A., & Fischer, M. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.01.019 · Cited by 479
Self-citation
Metadata
- Authors
- McGough, J. J., & Barkley, R. A.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Psychiatry
- Published
- 2004-11-01
- Volume
- 161
- Issue
- 11
- Pages
- 1948-1956
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2164720019
- Cited by
- 388
- References
- 92
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 10 · 2022: 5 · 2021: 4 · 2020: 10 · 2019: 8 · 2018: 7 · 2017: 11 · 2016: 22 · 2015: 18 · 2014: 25 · 2013: 14 · 2012: 37
- FWCI
- 13.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K23MH001966, MH 01966)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- adult ADHD, ADHD diagnosis, diagnostic criteria, DSM diagnostic criteria, laboratory evaluation, neuropsychological assessment, neuroimaging, comorbid psychopathology
- MeSH terms
- Adult, Age Factors, Attention Deficit Disorder with Hyperactivity, Child, Electroencephalography, Humans, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Tomography, Emission-Computed, Single-Photon, Diagnostic and Statistical Manual of Mental Disorders
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