Abstract
Attention deficit/hyperactivity disorder (ADHD) is the most prevalent childhood psychiatric condition. It frequently persists into adulthood and can have serious health and other adverse consequences. The majority of previous adult ADHD studies have focused on young adults so that relatively little is known about ADHD symptoms and their effects in mid and late life. In addition, effects of subclinical levels of attention deficit and hyperactivity have not been studied in detail. In this study we investigated ADHD symptoms and related impairment in a large population-based sample of middle-aged Australian adults (n = 2091; 47% male). Applying the WHO adult ADHD Self Report Screener (ASRS) we observed that 6.2% of participants had scores that were previously associated with ADHD diagnosis. No significant gender difference in the distribution of ASRS scores was observed. Multiple regression analyses indicated strong positive correlations between symptoms of ADHD and depression/anxiety and significant negative associations (p<0.01) with employment, financial stress, relationship quality, health and well-being measures in this age group. Importantly, associations were highly significant even when few ADHD symptoms were reported. Compared to the hyperactivity component, the inattention trait was particularly strongly associated and remained significant after controlling for depression/anxiety symptoms. Our study confirms previous findings and significantly adds to existing literature especially for an age-group that has not been well-studied. Our results suggest that ADHD symptoms continue to be associated with ill-health and functional impairment in mid-life and are, therefore, likely to be a major, previously unrecognized source of late-life morbidity with associated social and economic costs. Thus, there is a compelling need for better understanding and development of age-appropriate approaches to the diagnosis and treatment of ADHD in mid- to late-life.
Highlights
Attention Deficit/Hyperactivity Disorder (ADHD) is a treatable neuropsychiatric disorder characterized by inattention, excessive motor activity and impulsivity [1], which begins in childhood and can persist across the lifespan
We found no significant difference between males and females in either the continuous or categorical ADHD Self Report Screener (ASRS) measures (Table 2)
We present results for the four ASRS strata as a categorical classification of ADHD symptoms, as recommended by Kessler et al (2007) [35], to enable our results to be compared with clinical studies
Summary
Attention Deficit/Hyperactivity Disorder (ADHD) is a treatable neuropsychiatric disorder characterized by inattention, excessive motor activity and impulsivity [1], which begins in childhood and can persist across the lifespan. Most adults predominantly exhibit problems with inattention, which manifest as disorganization, forgetfulness, unreliability, and difficulty in planning, task completion, task shifting and time management [2,3] These symptoms adversely affect multiple life domains with serious negative impact on functioning in day-to-day life. Guldberg-Kjar and Johansson (2009) [32] studied self-rated ADHD symptoms in 65–80 year old Swedish adults and reported a prevalence rate of 3.3%, which is comparable to that in the younger age-groups. In this study we investigated the impact of self-reported ADHD symptoms on a range of measures of health, work, social life, relationship, well-being and anxiety/depression symptoms in a large population-based sample of middle-aged adults. These methods allowed us to provide a comprehensive view of the functional impairments experienced by middle-aged adults with inattention and hyperactivity symptoms that were not accounted for by co-occurring depression/anxiety symptoms
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