Adult Attention Deficit Hyperactivity Disorder Self Research Articles

Suicide risk with ASD traits or ADHD traits in non-clinical young adults

The impact of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) traits on suicidal thoughts and behaviors (STBs) remains inadequately explored. Hence, the present study aims to delve deeper into these intricate issues, contributing to a better understanding of these complex challenges among Chinese youth. The data of 90,882 participants was collected from 63 Chinese universities and colleges in Jilin, China. We aim to explore the risks of STBs on ASD, ADHD, and co-occurrence of ASD + ADHD by using the Autism Spectrum Quotient-10 items (AQ-10) and Adult ADHD Self Report Scale (ASRS). Propensity score matching (PSM) was implemented to balance demographical variables across the four groups. Binary logistic regression was then conducted to further analyze and compare suicide risk across the four groups, also accounting for sex differences. Suicide risks were significantly higher in the ADHD (OR = 1.24, p < 0.001) and ASD + ADHD(OR = 1.49, p < 0.001) traits group. However, there was no significant difference in suicide risk between the ASD traits group (OR = 1.00, p = 1.00) and the control group. The risk of suicide was significantly higher for females than for males across all four groups (p < 0.001). These results indicate the importance of screening for ASD + ADHD traits in young adults, especially females due to its higher risk of STBs. Further studies are warranted to delve deeper into this issue, emphasizing the necessity of formal diagnostic tests and directing focused attention toward addressing these complexities.

Sleep-related attentional bias does not associate with symptoms of ADHD in a sample of younger adults

Sleep-related attentional bias, wherein exaggerated attention is directed to sleep-related stimuli, has been proposed to be part of the cognitive processes that underpin the development and perpetuation of insomnia. Attention deficit hyperactivity disorder (ADHD) is commonly associated with clinically significant sleep disturbances, although the nature of the relationship between ADHD and sleep is not well understood. We hypothesised that ADHD symptoms would associate with greater attentional bias to sleep-related stimuli. We used an emotional Stroop task with sleep-related words to assess the presence of sleep attentional bias in a sample of 155 younger adults. ADHD symptoms and consistency with the presence of ADHD was assessed with the Adult ADHD Self Report Screener and insomnia symptoms and probability for the presence of insomnia disorder was assessed with the Sleep Condition Indicator. ADHD symptoms and consistency, and insomnia symptoms and probability for the presence of insomnia disorder, were not found to associate with sleep attentional bias scores. Sleep attentional bias also did not associate with chronotype or social jetlag, but habitual use of an alarm clock on work-free days associated with greater sleep attentional bias. As such, we did not find evidence to support the hypothesis that ADHD symptoms are associated with sleep attentional bias in a sample of healthy younger adults.

Internet delivered cognitive behavioral therapy for adults with ADHD - A randomized controlled trial

Evidence-based psychological interventions for adults with attention deficit hyperactivity disorder (ADHD) are seldom available in clinical settings. Medication is often offered as the sole treatment, with non-optimal effects for a majority of patients. The objective was to compare internet-based cognitive behavioral therapy (iCBT) to an active control treatment of internet-based applied relaxation training (iART), and to treatment as usual only (TAU) in adult outpatients with ADHD.One hundred and four patients, of which 67 % used ADHD medication, were randomized to 12 weeks of iCBT (n = 36), iART (n = 37), or TAU (n = 31). Primary outcome was change in the Adult ADHD Self Report Scale (ASRS) up to 3 (FU3) and 12 months (FU12) after treatment.ASRS improved more for iCBT (p < .01; Cohen's d = 0.42 at post-treatment and 0.67 at FU3) and iART (p < .01; Cohen's d = 0.57 at post-treatment and 0.66 at FU3) than for TAU. The effects sustained over 12 months for iCBT (p < .001) and iART (p < .001). No significant difference was found when comparing iCBT to iART (p = .53).Treatment responders reached 25 % for both treatments, which was superior to the 3 % responders in TAU (p < .05).iCBT and iART could both be promising add-ons to medication and increase availability to psychological treatment with sustained symptom reductions after one year.

WITHDRAWN: Internet delivered cognitive behavioral therapy for adults with ADHD -A randomized controlled trial

Evidence-based psychological interventions for adults with attention deficit hyperactivity disorder (ADHD) are seldom available in clinical settings. Medication is often offered as the sole treatment, with non-optimal effects for a majority of patients. The objective was to compare internet-based cognitive behavioral therapy (ICBT) to an active control treatment of internet-based applied relaxation training (IART), and to treatment as usual only (TAU) in adult outpatients with ADHD. One hundred and four patients, of which 67 % used ADHD medication, were randomized to 12 weeks of ICBT (n = 36), IART (n = 37), or TAU (n = 31). Primary outcome was change in the Adult ADHD Self Report Scale (ASRS) up to 3 and 12 months after treatment. ASRS improved more for ICBT (t (93.8) = 3.2; p < .01) and IART (t (91.5) = 3.2; p < .01) than for TAU, with sustained effects over 12 months for ICBT (t (160.8) = −7.3; p < .001). No significant difference was found when comparing ICBT to IART (t (98.3) = 0.63; p = .53). Treatment responders reached 25 % for both treatments, which was superior to the 3 % responders in TAU (p < .05). ICBT could be a promising add-on to medication and increase availability to psychological treatment with sustained symptom reductions after one year. • Few patients with ADHD are offered cognitive behavioral therapy (CBT) after diagnosis • Guided self-help treatment through internet (iCBT) can increase access to CBT • This randomized controlled trial included 104 participants with verified ADHD • Positive effects on ADHD symptoms were found for both iCBT and internet-based Applied Relaxation compared to treatment as usual • The lower symptom levels were sustained after one year • iCBT can be a promising treatment for ADHD

The relationship between disease symptoms and restless legs syndrome in adult attention-deficit hyperactivity disorder without iron deficiency

BackgroundThis study aimed to investigate the frequency of restless legs syndrome (RLS) and the affecting factors in the attention-deficit hyperactivity disorder (ADHD) group without iron deficiency. Drug-naive ADHD patients were included in the study. Patients without iron deficiency filled out the adult ADHD Self Reporting Scale, the Wender Utah Rating Scale, the Beck Depression Inventory, and the Beck Anxiety Inventory. Scale scores were compared in ADHD patients with and without RLS. Univariate and multivariate binary logistic regression analyses were used to determine the risk factors associated with RLS.ResultsA total of 120 ADHD patients participated in the study; 53 were predominantly inattentive ADHD patients (ADHD-I), and 67 were ADHD combined type (ADHD-C). RLS incidence was found to be 31.6%. ADHD symptoms, anxiety, and depression were found to be significantly more severe in patients with ADHD accompanying RLS. Also, anxiety and the presence of ADHD predicted RLS.ConclusionsThe presence of ADHD and accompanying anxiety was effective on RLS, regardless of iron deficiency. RLS is a comorbidity that frequently accompanies ADHD, and its diagnosis and treatment should not be ignored. This is the first study to investigate the frequency of RLS and accompanying factors by excluding iron deficiency in the ADHD group.

Depression and other correlates of adult Attention Deficit Hyperactivity Disorder (ADHD) symptoms among Hungarian university students

IntroductionAttention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity. It is one of the most common disabilities in college populations and comorbidity with depression is frequently reported.ObjectivesThe aim of the study is to shed light on depression as comorbidity and other intrapersonal correlates of ADHD in young adults.MethodsParticipants were Hungarian university students (N=420; M=24.5, SD=5.0 years). Criteria of the ADHD group were based on the Adult ADHD Self Report Scale V1.1 (ASRS-V.1.1) screening tool. The participants filled in the Beck’s Depression Inventory, the Hyperfocus Scale, Flow State Scale, Academic Persistence Scale, Satisfaction With Life Scale, General Self-Efficacy Scale, and the Connor-Davidson Resilience Scale.ResultsWe found that in the group of students who had ADHD symptoms, depression score was significantly (p&lt;.001) higher (M=18.38, SD=5.87) than the control group’s scores (M=14.56, SD=4.45). Frequency of severe depression was 13.4% (moderate: 33.5%) while in the control group: 1.6% and 17.6% respectively. Participants reporting ADHD symptoms (N=164, 39%) also reported lower levels of resilience (M=23.40, SD=6.96), relative to their non-ADHD peers (M=27.69, SD=6.48). Significant differences were found in the areas of self-efficacy, depression, flow and hyperfocus as well, and ADHD symptoms contributed to lower level of life satisfaction (β=-0.24, p&lt;.001).ConclusionsOur findings suggest that university students reporting symptoms of ADHD may be assisted with strategies that are focused on increasing protective factors (i.e., resilience, self-efficacy, flow) to prevent depression and improve their life satisfaction and quality of life.DisclosureNo significant relationships.

Alcohol and drug use disorders in adult attention-deficit/hyperactivity disorder: Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation.

BACKGROUNDHigh risk of alcohol and drug use disorders in people with attention-deficit/hyperactivity disorder (ADHD) calls for exploratory research of relationships with clinical features of ADHD.AIMTo estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation, in adults with ADHD.METHODSThis observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo, Norway (2014-2018). Five-hundred and fifty-eight eligible patients diagnosed with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria) agreed to participate. Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI). Dependence and abuse were merged into “use” disorder as in MINI version 7.0/DSM-5. Questions were related both to lifetime and the past 12-mo. ADHD severity was assessed by the Adult ADHD Self Report Scale (ASRS). Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately. Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale - Self Report.RESULTSThe 12-mo prevalence was 5.3% for alcohol use disorder and 13.7% for drug use disorder. The lifetime prevalence was 12.0% for alcohol use disorder and 27.7% for drug use disorder. Men had higher rates of both alcohol use disorder and drug use disorder compared to women. The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes. The drugs most participants reported having used were (in descending order): Amphetamine (19.1%), cannabis (17.1%), cocaine or ecstasy (7.4%), benzodiazepines (7.4%), and heroin or other opioids (2.9%). Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity. Lifetime alcohol use disorder, on the other hand, was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSIONPatients with ADHD have a high lifetime prevalence of drug use disorder, which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

Screening for Adult ADHD in Patients with Fibromyalgia Syndrome.

Fibromyalgia syndrome (FMS) is a common chronic pain disorder associated with altered activity of neurotransmitters involved in pain sensitivity such as dopamine, serotonin, and noradrenaline. FMS may significantly impact an individual's functioning due to the presence of chronic pain, fatigue, and cognitive impairment. Dyscognition may be more disabling than the chronic pain but is mostly under-recognized. This study aimed to assess the potential co-occurrence of FMS and adult attention deficit hyperactivity disorder (ADHD), a chronic neurodevelopmental disorder also associated with impaired cognition and dopaminergic function. In a cross-sectional observational study, 123 previously confirmed FMS patients were screened for adult ADHD using the World Health Organization Adult ADHD Self Report scale v1.1. The Revised Fibromyalgia Impact Questionnaire (FIQ-R) was used to assess the impact of FMS. Cognitive assessment was based on self-report in accordance with the 2011 modified American College of Rheumatology criteria and the FIQ-R, respectively. Of the 123 participants, 44.72% (N = 55) screened positive for adult ADHD. Participants with both FMS and a positive adult ADHD screening test scored higher on the FIQ-R score (64.74, SD = 17.66, vs 54.10, SD = 17.10). Self-reported cognitive impairment was rated higher in the combined group (odds ratio = 10.61, 95% confidence interval; 3.77-29.86, P < 0.01). These results indicate that the co-occurrence of adult ADHD in FMS may be highly prevalent and may also significantly impact the morbidity of FMS. Patients with FMS should be assessed for the presence of adult ADHD.

Hyperfocusing as a dimension of adult attention deficit hyperactivity disorder

Patients with Attention Deficit Hyperactivity Disorder (ADHD) suffer not only from inability to focus but also from inability to shift attention for events that trigger their interests. This phenomenon is called “hyperfocusing”. Previous literature about hyperfocusing is scarce and relies mainly on case reports. The study aimed to investigate and compare the severity of hyperfocusing in adult ADHD with and without psycho-stimulant use. ADHD (DSM-IV-TR) patients either psycho-stimulant naive (n=53) or on psycho-stimulants (n=79) from two ADHD clinics were recruited. The control group (n=65) consisted of healthy university students. A socio-demographic form, the Beck Depression Inventory, the Wender-Utah Rating Scale, the Adult ADHD Self- Report Scale and the Hyperfocusing Scale were applied to the participants. There was no difference between total Hyperfocusing Scale and Adult ADHD Self- Report Scale scores of two patient groups, but both have higher scores than controls (p<0.001). Hyperfocusing is higher in adult ADHD and there was no difference between stimulant-naive patients or patients on stimulants. Hyperfocusing can be defined as a separate dimension of adult ADHD.

Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men.

Functional and mental health impairments that adults with attention-deficit/hyperactivity disorder (ADHD) experience may be exacerbated by regular substance use and co-morbidity with substance use disorders (SUD). This may be especially true during young adulthood, which represents a critical stage of life associated with increased substance use and associated problems. However, previous studies investigating the association between ADHD and substance use and SUD have demonstrated inconsistent results, probably due to methodological limitations (e.g., small and non-representative samples). Thus, the relationship of ADHD with substance use and related disorders remains unclear. The aim of the present study was to examine the association between ADHD and both the use of licit and illicit substances and the presence of SUD in a large, representative sample of young men. The sample included 5677 Swiss men (mean age 20 ± 1.23 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed using the adult ADHD Self Report Screener (ASRS). The association between ADHD and substance use and SUD was assessed for alcohol, nicotine, cannabis and other illicit drugs, while controlling for socio-demographic variables and co-morbid psychiatric disorders (i.e., major depression (MD) and anti-social personality disorder (ASPD)). Men with ADHD were more likely to report having used nicotine, cannabis and other illicit drugs at some time in their life, but not alcohol. ADHD was positively associated with early initiation of alcohol, nicotine and cannabis use, the risky use of these substances, and the presence of alcohol use disorders, and nicotine and cannabis dependence. Additionally, our analyses revealed that these patterns are also highly associated with ASPD. After adjusting for this disorder, the association between ADHD and licit and illicit substance use and the presence of SUDs was reduced, but remained significant. Our findings suggest that adult ADHD is significantly associated with a propensity to experiment with licit and illicit substances, especially at earlier ages, to exhibit risky substance use patterns, and to subsequently develop SUDs. Preventive strategies that include early intervention and addressing co-morbidity with ASPD may be crucial to reducing substance use and the development of pathological substance use patterns in young men affected by ADHD and, thus, helping to prevent further illness burden later in life.

Validation of the World Health Organization Adult ADHD Self-Report Scale for adolescents

Background: The World Health Organization Adult ADHD Self Report Scale (ASRS) is a widely used diagnostic tool for assessment of attention-deficit hyperactivity disorder (ADHD) symptoms in clinical psychiatry in Sweden. The ASRS consists of 18 questions, the first six of which can be used as a short screening version (ASRS-S). There is a version for adolescents—ASRS-Adolescent (ASRS-A)—and the corresponding screening version (ASRS-A-S), which has not been validated to date. Aim: The aim was to validate the ASRS-A and the ASRS-A-S for use in adolescent clinical populations. Methods: Adolescent psychiatric outpatients (n = 134, mean age 15 years, 40% boys) reported on the ASRS-A, and were interviewed with the Kiddie Schedule of Affective Disorders and Schizophrenia (K-SADS), a semi-structured interview, together with a parent. Results: Internal consistency was 0.79 for the ASRS-A-S and 0.92 for the ASRS-A (Cronbach's alpha). Internal consistency values were 0.79 and 0.87 for the inattention subscale, and 0.68 and 0.89 for the hyperactivity subscale, respectively. Concurrent validity values, measured with Spearman's correlation coefficient, between the total K-SADS ADHD symptom severity score and the sum of ASRS-A-S and ASRS-A total scores were 0.51 and 0.60, respectively. Psychometric properties of the ASRS-A-S and the ASRS-A were: sensitivity 74% and 79%; negative predictive value 81% and 84%; specificity 59% and 60%; and positive predictive value 49% and 51%, respectively. Both versions showed better properties for girls than for boys. Conclusion: Both the ASRS-A-S and the ASRS-A showed promising psychometric properties for use in adolescent clinical populations.

Are subjects with criteria for adult attention-deficit/ hyperactivity disorder doing worse after bariatric surgery? A case-control study.

There is an increasing awareness of the strong associations between obesity and adult attention- deficit/hyperactivity disorder (ADHD), with high rates of ADHD (26-61%) in patients seeking weight loss. To determine the frequency of ADHD in a bariatric surgery (BS) sample and investigate whether there were any differences among clinical, analytical and psychological parameters in individuals with criteria for ADHD. Sixty patients (78.3% female, age 46.3±9.8, months since BS 46.28±18.1) who underwent BS, with a minimum follow-up of 18 months, were evaluated cross-sectionally. Initial and current BMI, eating patterns, comorbidity, socio-demographic and biochemical parameters were recorded. For the screening of ADHD, ADHD self rating scale-v1.1 was administered. Nineteen individuals (31.6%) had a positive screening for ADHD. This group had higher levels of HDL-cholesterol (62.8±17.3 mg/dl vs 53.5±9.9 mg/dl; p=0.011) and Apo-A (177.7±28.4 mg/dl vs 154.9±34.7 mg/ dl; p=0.015), and an increased consumption of lipids (42.2±7.1% vs 36.7±8.3%; p=0.019). Subjects with ADHD symptoms had more difficulties in following visits after BS (52.6% vs 24.3%; p= 0.011).We could not find any differences in achieved BMI, depressive symptoms or quality of life. Patients who met criteria for ADHD face significant difficulties with compliance in follow-up, but we could not find differences in major clinical outcomes. Surprisingly, these patients could have a protective lipid profile.

Prevalence of and Associated Factors for Adult Attention Deficit Hyperactivity Disorder in Young Swiss Men

ObjectiveThe present study aimed to measure the prevalence of adult attention deficit hyperactivity disorder (ADHD) in a large, representative sample of young Swiss men and to assess factors associated with this disorder.MethodsOur sample consisted of 5656 Swiss men (mean age 20 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed with the World Health Organization (WHO) adult ADHD Self Report Screener (ASRS). Logistic regression analyses were conducted to assess the association between ADHD and several socio-demographic, clinical and familial factors.ResultsThe prevalence of ADHD was 4.0%, being higher in older and French-speaking conscripts. A higher prevalence also was identified among men whose mothers had completed primary or high school/university and those with a family history of alcohol or psychiatric problems. Additionally, adults with ADHD demonstrated impairment in their professional life, as well as considerable mental health impairment.ConclusionOur results demonstrate that ADHD is common among young Swiss men. The impairments in function and mental health we observed highlight the need for further support and interventions to reduce burden in affected individuals. Interventions that incorporate the whole family also seem crucial.

EPA-1298 - Attention deficit hyperactivity disorder in adults and substance use disorder

The attention deficit hyperactivity disorder (ADHD) is one of the most common diagnosis in child psychiatry, and persists so often in adulthood. The symptoms of ADHD are very different in adults, with less hiperactivity and a slight decrease in impulsiveness and there's a high rate of comorbidity, such as drug addiction, anxiety and personality disorders, so diagnosing ADHD in patients with substance use disorder is a complicated process in which a screening tool may be useful, for example, the ‘Adult ADHD Self- Report Scale’ (ASRS v1.1), proposed by the WHO. The use of structured interviews, together with a systemised evaluation of possible comorbid disorders, makes it easier to reach a correct differential diagnostic. So, it presents a special interest given to aspects concerning epidemiology, diagnosis, progression and treatment. We want to know more about the relationship between the presence of symptoms consistent with ADHD in patients who are receiving ambulatory treatment for abuse/dependence cocaine in the Addictive Behavior Unit of Albacete and their sociodemographic characteristics, so we will realized an observational, descriptive and cross-sectional study during a period of one month, using the ‘Adult ADHD Self- Report Scale’ (ASRS v1.1). The conclusion will be focused on the importance of screening for ADHD symptoms in patients with a diagnosis of substance disorders and propose interventions believed helpful in improving management of ADHD and outcome.

Prevalence of Adult Attention Deficit Hyperactivity Disorder and its Correlates among Recently Diagnosed Young Adult Males with HIV

A majority of children with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) from early childhood continue to demonstrate notable ADHD symptoms throughout life. ADHD-associated impulsivity, in adults, has been found to be a predictor of unstable interpersonal relationships and high risk sexual behavior. This study was undertaken to determine the prevalence of adult ADHD in recently diagnosed young male HIV patients. 100 young adult males who were diagnosed with HIV less than a year ago were recruited after an informed consent and were administered the following questionnaires-socio-demographic questionnaire with details of HIV diagnosis, HIV High Risk Behavior Questionnaire (HRBS) to measure High risk sexual behaviors, MINI neuropsychiatric Interview 6.0 to rule out psychiatric co-morbidities, Mini Mental State Examination (MMSE) to rule out major cognitive impairment, Adult ADHD Self Report scale (ASRS) v1.1 to screen for ADHD in adulthood. ADHD-rating scale was administered to parent/ informant to screen for childhood ADHD. Statistical analyses were done using SPSS v 17.0. The prevalence of Adult ADHD in our sample was 20%. 94% of subjects were on Highly Active Anti-Retroviral Therapy (HAART). Adherence to HAART was comparatively lesser in the ADHD group which was statistically significant (p=0.014). Substance use was significantly more in the ADHD group (p=0.03). People with ADHD had significantly higher High Risk sexual behavior than those without ADHD (p<0.001). Hence, these findings suggest that ADHD may contribute to high risk sexual behavior and thereby also the risk of contracting HIV. Future research on a larger population will provide more conclusive evidence. For now, health promotion and specific protection with greater emphasis in this vulnerable population of adult ADHD would be warranted in preventing HIV.

Cross-sectional study of self-reported ADHD symptoms and psychological comorbidity among college students in Chandigarh, India.

Background:Existence of attention deficit hyperactivity disorder (ADHD) in adults is scantily researched in India. There is dearth of information on prevalence of ADHD in college students worldwide. Further, fewer studies in the past have evaluated the impact of ADHD on the psychological well-being of college students.Aims:To study the prevalence of ADHD among college students and psychological problems related to ADHD.Design:Cross-sectional study.Subjects and Methods:A total of 237 students were recruited from various medical, engineering, and commerce and arts colleges of Chandigarh, India. They were administered the Adult ADHD Self Report Scale v1.1(ASRS) and the Wender Utah Rating Scale (WURS) to diagnose adult ADHD. To assess comorbidities; General Health Questionnaire-12 (GHQ); Zung Depression Rating Scale (ZDRS); Rosenberg's Self-Esteem Scale (RSES);and questions on emotional stability, social problems, and substance use (alcohol, tobacco, and cannabis) were administered on all participants.Results:A total of 13 students (5.48%) fulfilled the criteria for adult ADHD. These students experienced significantly higher emotional instability and low self-esteem than those without ADHD (N = 224). The occurrence of psychological problems, depression, social problems, and substance abuse was comparable in students with and without ADHD.Conclusions:ADHD is prevalent among the college students studying in the most competitive institutes as well. Students with ADHD experience higher emotional instability and poor self-esteem than others. It has little effect on their psychological well-being and social adjustment. Prompt detection and management of ADHD in college students may help them deal with these problems effectively.

Adult Attention Deficit Hyperactivity Disorder (ADHD): public health implications

In 2008 NICE guidance recommended the identification and treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults. Previously, diagnosis and treatment of this condition had mainly been confined to children and young people. Dr Tamsin Newlove-Delgado and Professor Ken Stein from University of Exeter explain why adult ADHD is important and what the implications are for health improvement, commissioning and providing evidence based services Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, with symptoms of inattention, hyperactivity and impulsivity causing significant impairment in functioning. The diagnostic criteria for ADHD currently require that symptoms must have been present before the age of seven years, and be apparent in more than one setting. There is no single cause; instead the condition appears to result from a complex interaction of genetic and environmental factors.1 ADHD is estimated to affect 3-5% of children of school age in the UK.1,2 Does ADHD exist in adults? Few studies have followed up young people with ADHD beyond the age of 25. A meta-analysis of data from follow-up studies suggested that although the rate of persistence of ADHD meeting the full diagnostic criteria at age 25 was only 15%, the persistence of symptoms was much higher at around 40-60%.3 Therefore, although the prevalence of ADHD certainly declines with age, a significant proportion of adults have still been found to be affected. ADHD in adults remains the subject of some debate, given the high rate of co-morbidities and the difficulty in distinguishing normal symptoms from pathological ones. However, in 2008 the National Institute for Health and Clinical Excellence (NICE) reviewed the evidence on adult ADHD, recommending recognition of the condition and establishment of services for assessment and management, with stimulant medication as the first-line treatment for adults with either moderate or severe levels of impairment.2 How many adults might suffer with ADHD? A meta-analysis of world literature produced a pooled prevalence estimate of 2.5%.4 The UK 2007 Adult Psychiatric Morbidity Survey5 used the six item Adult ADHD Self Report Scale (ASRS) to screen the sample for ADHD symptoms. Using this scale 8.2% of adults scored four or more, which was considered to warrant clinical assessment, and 0.6% scored all six, indicating a high likelihood of a positive diagnosis. NICE have estimated the number of men with ADHD at over 300,000 in England, and the number of women at over 80,000,6 indicating that there is a considerable population likely to be affected. Impact of adult ADHD Higher risk of other psychiatric disorders Adults with ADHD are at increased risk for other psychiatric disorders. Over a lifetime, it is estimated that over threequarters of those with ADHD will have a psychiatric co-morbidity;7 with depression and anxiety being most common. Substance misuse and smoking Substance misuse affects up to half of adults with ADHD.7 A significant proportion of those in contact with substance misuse services also have ADHD symptoms. High rates of smoking (up to 40%) in ADHD8 may be explained by genetic influences or self-medication with nicotine: the condition is also linked with earlier initiation of smoking and difficulty in quitting.9 Accidents Studies have reported that adolescents and adults with ADHD are more likely to be involved in road traffic collisions, to be stopped for speeding, and to report losses of concentration and control whilst driving.10 Similarly, both children and adults with ADHD appear to have more accidents and injuries in general, possibly due to impulsivity and risktaking behaviours.11 Educational and occupational underachievement Adults with ADHD experience higher job turnover and more periods of unemployment. A recent European study found they were twice as likely to be unemployed. …

A Population-Based Study of Attention Deficit/Hyperactivity Disorder Symptoms and Associated Impairment in Middle-Aged Adults

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.

P01-362 - The associated risks among ADHD children and adolescent with internet addition in Taiwan

ObjectionThis study aimed to evaluate various associated risks between internet addiction (IA) and Attention deficit/Hyperactivity disorder (ADHD) children and adolescents by comparing ADHD group with and without IA problem.Method78 ADHD children and their parents were performed designed general demographic questionnaire and standardized measurement including Chen IA Scale (CIAS), Swanson, Nolan, and Pelham, Version IV ADHD questionnaire (SNAP-IV), Child Behavior Checklist (CBCL), Adult ADHD self Rating Scale (ASRS), Symptom Check List (SCL-90) and were then divided into ADHD with IA or without IA group according to IA cutting point. Various associated risks included the BMI value, general demographic data, subtype, comorbidity, childhood common behavior problem, parental ADHD diagnosis, parental symptom, nail biting, and media exposure problem.ResultsADHD youth with IA problem was highly associated with overweight and playing computer game more than one hour. Stepwise logistic regression revealed that father of these ADHD children in this group were significantly younger, and children self having withdrawn tendency.ConclusionFather's younger age, overweight and withdrawal tendency on ADHD youth is risks associated with internet addiction problem and the presence of playing computer game more than one hour on ADHD child is at greater risk for developing internet addiction.