Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD
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OBJECTIVE: Despite the increasing presentation of attention-deficit/hyperactivity disorder (ADHD) in adults, many practitioners remain reluctant to assess individuals for ADHD, in part related to the relative lack of data on the presenting symptoms of ADHD in adulthood. Comorbidity among adults with ADHD is also of great interest due to the high rates of psychiatric comorbidity, which can lead to a more persistent ADHD among adults. METHOD: We assessed 107 adults with ADHD of both sexes (51% female; mean +/- SD of 37 +/- 10.4 years) using structured diagnostic interviews. Using DSM-IV symptoms, we determined DSM-IV subtypes. The study was conducted from 1998 to 2003. RESULTS: Inattentive symptoms were most frequently endorsed (> 90%) in adults with ADHD. Using current symptoms, 62% of adults had the combined subtype, 31% the inattentive only subtype, and 7% the hyperactive/impulsive only subtype. Adults with the combined subtype had relatively more psychiatric comorbidity compared to those with the predominately inattentive subtype. Women were similar to men in the presentation of ADHD. CONCLUSION: Adults with ADHD have prominent inattentive symptoms of ADHD, necessitating careful questioning of these symptoms when evaluating these individuals.
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Cross-sectional studies have found that ADHD-related symptoms have development-specific features, with motor restlessness, aggressive and disruptive behaviors commonly observed in preschoolers, and disorganized, impulsive, and inattentive symptoms more typically presented in adolescents and adults.
“Cross-sectional studies have found that ADHD-related symptoms have development-specific features, with motor restlessness, aggressive and disruptive behaviors commonly observed in preschoolers, disorganized, impulsive, and inattentive symptoms more typically presented in adolescents and adults (Wilens et al., 2009).”
From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Wilens et al., 2009
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Experimental — accuracy not yet measuredThe vast majority of people with ADHD, both child and adult, have a comorbid psychiatric disorder.
“The first challenge is related to the clinical complexity of the cases themselves; the vast majority of people with ADHD, both child and adult, have a comorbid psychiatric disorder [122-125].”
From Advances in understanding and treating ADHD (2011) · cites this paper as [122]
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- Authors
- Wilens, T. E., Biederman, J., Faraone, S. V., Martelon, M., Westerberg, D., & Spencer, T. J.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Corresponding author
- Wilens, Timothy E.
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2009-11-15
- Volume
- 70
- Issue
- 11
- Pages
- 1557-1562
- ISSN
- 0160-6689 (ISSN-L)
- PMC
- PMC2948439
- OpenAlex
- W1998594730
- Cited by
- 286
- References
- 36
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 18 · 2023: 19 · 2022: 15 · 2021: 17 · 2020: 23 · 2019: 18 · 2018: 12 · 2017: 17 · 2016: 21 · 2015: 13 · 2014: 28 · 2013: 13 · 2012: 16
- FWCI
- 7.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K24DA016264, R01DA012945)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- adult ADHD, ADHD subtypes, inattentive symptoms, psychiatric comorbidity, hyperactive-impulsive symptoms, gender differences, persistent ADHD
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Bipolar Disorder, Female, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Psychotic Disorders, Surveys and Questionnaires, Sex Factors, Comorbidity, Conduct Disorder, Diagnostic and Statistical Manual of Mental Disorders
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