A crossroad in ADHD – adult-onset ADHD

Abstract

IntroductionAttention-deficit/hyperactivity disorder (ADHD) is a common disorder characterized by inattention or hyperactivity–impulsivity, or both. For a long time, ADHD was thought of as a disorder of children which would sometimes persist into adulthood. DSM 5 uses as a criterion that several symptoms have to be present prior to age 12 years.ObjectivesTo discuss the findings of 3 recent cohorts that show the onset of ADHD in adulthood.MethodsA review of selected articles of interest using PubMed database.Results3 large, longitudinal, population studies from Brazil, New Zealand (NZ) and the United Kingdom (UK) show that we are at a crossroads in our understanding of ADHD. In each study, the prevalence of adult-onset ADHD (Brazil, 10.3%; UK, 5.5%; and NZ, 2.7%) was much larger than the prevalence of childhood-onset adult ADHD (UK, 2.6%; Brazil, 1.5%; and NZ, 0.3%). They all propose different conclusions that would result in a paradigmatic shift in ADHD: in Brazil, that child and adult ADHD are “distinct syndromes”; in the UK, “that adult ADHD is more complex than a straightforward continuation of the childhood disorder” and in NZ, that adult ADHD is “not a neurodevelopmental disorder”. Faraone et al., in an editorial in JAMA Psychiatry, propose that these findings might correlate to subthreshold child ADHD before it emerges as adolescent- or adult-onset ADHD.ConclusionsIt's an exciting time in ADHD research. These new data work as an incentive to study adult-onset ADHD and how it emerges. Future research will shape our understanding of adult ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.