Adult Psychiatric Clinic Research Articles

Evaluation of patients under the age of 18 who applied to an adult psychiatric policy clinic

Aims: The aim of this study is to evaluate the sociodemographic data and diagnoses of patients under the age of 18 who applied to an adult psychiatry clinic . Methods: 311 applicants under the age of 18 who applied to the adult psychiatry outpatient clinic of our hospital between January 2020 and December 2022 were included in the study. has been included . Sociodemographic data and diseases were evaluated retrospectively. Results: Of the 309 applicants in total, 194 ( 62.8 % ) were girls and 115 (37.2%) were boys. Considering the ages, 12.3 % of the applications were 15 years old and under, and 86.7% were over 15 years old. The psychiatric diagnosis rate was 84.5 % when both genders were evaluated . This rate was 86.5 % for girls and 82.6% for boys. Looking at the most common diagnoses in total; Diagnosis of anxiety disorders (21.7%), depressive disorder (21.7%), and activity and attention disorders (15.2%) were in the top 3 ranks . Conclusion: This study is important as it is the first study on adolescent patients admitted to an adult psychiatric service in our city. It is thought that these findings may guide interventions in the field of child and adolescent psychiatry.

Organization of French outpatient psychiatric clinics and delay to appointment

ObjectivesThe goals of the study were to obtain a glimpse of the several types of organization of outpatient psychiatric clinics, as well as an overview of delays between a request for and the first appointment. We also look at geographical variability of appointment scheduling delays and assess the impact of the number of new applications on delays. MethodsWe analyzed information collected from a phone survey conducted with the 103 adult outpatient psychiatric clinics of the French region Hauts-de-France. This survey had a one-week inclusion period in November 2022 and focused on the organization and delays before obtaining an appointment. ResultsThis study indicates that organizations seem to be homogeneous. Eighty-one outpatient psychiatric clinics (96.4%) receive with scheduled appointments. The initial evaluation by a nurse followed with a proposal for the organization of care seems to be the common practice. It also appears that primary psychiatric structures were capable of providing a response within a reasonable time frame in making a first appointment with a mental health professional. On the other hand, delays were much longer and heterogeneous for first appointments with psychiatrists and psychologists. ConclusionsThe organizations of the outpatient psychiatric clinics of the French region Hauts-de-France seem homogeneous. The evaluation by a nurse followed with a care proposal is the common practice. Primary psychiatric structures are able to provide a response within a reasonable time, with half the centers proposing an appointment with a nurse within 10.0 days.

Autism in adult psychiatric out-patients: self-reported suicidal ideation, suicide attempts and non-suicidal self-injury.

The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services. We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group. Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions on passive and active suicidality, evaluation of NSSI with the Functional Assessment of Self-Mutilation, and results of cognitive tests. One follow-up of medical records was made. In this sample of psychiatric out-patients identified as first having autism in adulthood, almost a third (31%) of patients reported suicidal ideation during the past month, 86% had lifetime suicidal ideation and 25% reported at least one suicide attempt. Factors associated with suicide attempts included hazardous or harmful alcohol use and/or drug-related problems, and severity of depression. A total of 44% reported NSSI. Factors associated with NSSI were female sex, history of suicidal plans and antisocial personality disorder. Substance or alcohol use were often overlooked, especially in women. Suicidal ideation, suicide attempts and NSSI were very common in adults with autism who were recently referred to an out-patient psychiatric service. Suicidal ideation and NSSI were more common than suicide attempts. Clinicians should always consider suicidal ideation and NSSI in adult psychiatric patients with autism.

Best practices for documentation of psychotropic drug-drug interactions in an adult psychiatric clinic.

Psychotropic drug-drug interactions (DDIs) contribute to adverse drug events, but many go undetected or unmanaged. Thorough documentation of potential DDIs can improve patient safety. The primary objective of this study is to determine the quality of and factors associated with documentation of DDIs in an adult psychiatric clinic run by postgraduate year 3 psychiatry residents (PGY3s). A list of high-alert psychotropic medications was identified by consulting primary literature on DDIs and clinic records. Charts of patients prescribed these medications by PGY3 residents from July 2021 to March 2022 were reviewed to detect potential DDIs and assess documentation. Chart documentation of DDIs was noted as none, partial, or complete. Chart review identified 146 DDIs among 129 patients. Among the 146 DDIs, 65% were not documented, 24% were partially documented, and 11% had complete documentation. The percentage of pharmacodynamic interactions documented was 68.6% with 35.3% of pharmacokinetic interactions documented. Factors associated with partial or complete documentation included diagnosis of psychotic disorder (p = .003), treatment with clozapine (p = .02), treatment with benzodiazepine-receptor agonist (p < .01), and assumption of care during July (p = .04). Factors associated with no documentation include diagnosis of "other (primarily impulse control disorder)" (p < .01) and taking an enzyme-inhibiting antidepressant (p < .01). Investigators propose best practices for psychotropic DDI documentation: (1) description and potential outcome of DDI, (2) monitoring and management, (3) Patient education on DDI, and (4) patient response to DDI education. Strategies to improve DDI documentation quality include targeted provider education, incentives, and electronic medical record "DDI smart phrases."

Evaluating the Risk of Suicide and Violence in Severe Mental Illness: A Feasibility Study of Two Risk Assessment Tools (OxMIS and OxMIV) in General Psychiatric Settings.

BackgroundTwo OxRisk risk assessment tools, the Oxford Mental Illness and Suicide (OxMIS) and the Oxford Mental Illness and Violence (OxMIV), were developed and validated using national linked registries in Sweden, to assess suicide and violence risk in individuals with severe mental illness (schizophrenia-spectrum disorders and bipolar disorders). In this study, we aim to examine the feasibility and acceptability of the tools in three different clinical services.MethodWe employed a two-step mixed-methods approach, by combining quantitative analyses of risk scores of 147 individual patients, and thematic analyses of qualitative data. First, 38 clinicians were asked to use OxMIS and OxMIV when conducting their routine risk assessments in patients with severe mental illness. The risk scores for each patient (which provide a probability of the outcome over 12 months) were then compared to the unstructured clinical risk assessment made by the treating clinician. Second, we carried out semi-structured interviews with the clinicians on the acceptability and utility of the tools. Thematic analysis was conducted on the qualitative data to identify common themes, in terms of the utility, accuracy, and acceptability of the tools. The investigations were undertaken in three general adult psychiatric clinics located in the cities of Barcelona and Sevilla (Spain), and Changsha (China).ResultsMedian risk probabilities over 12 months for OxMIS were 1.0% in the Spanish patient sample and 1.9% in the Chinese sample. For OxMIV, they were 0.7% (Spanish) and 0.8% (Chinese). In the thematic analysis, clinicians described the tools as easy to use, and thought that the risk score improved risk management. Potential additions to predictors were suggested, including family history and the patient's support network. Concordance rates of risk estimates between the tools and clinicians was high for violence (94.4%; 68/72) and moderate for suicide (50.0%; 36/72).ConclusionBoth OxMIS and OxMIV are feasible and practical in different general adult psychiatric settings. Clinicians interviewed found that both tools provide a useful structured approach to estimate the risk of suicide and violence. Risk scores from OxMIS and OxMIV can also be used to assist clinical decision-making for future management.

Prevalence of Autism Spectrum Disorders in Adult Outpatient Psychiatry.

Relatively little has been published about the prevalence of autism in adults with psychiatric disorders. In this study, all new patients referred to an adult psychiatric outpatient clinic in Sweden between November 2019 and October 2020 (n = 562) were screened for autism spectrum disorders using the Ritvo Autism and Asperger Diagnostic Scale Screen (RAADS-14). Out of the 304 (58%) responders, 197 who scored above the cut off (14) were invited to participate in an in-depth assessment. Twenty-six of the 48 that participated in the assessment met criteria for ASD and an additional eight had subthreshold ASD symptoms. We estimated the prevalence of ASD in this population to at least 18.9%, with another 5-10% having subthreshold symptoms.

Comparing the social networks of service users with long term mental health needs living in community with those in a general adult in-patient unit.

Relationships are vital to recovery however, there is uncertainty whether users have different types of social networks in different mental health settings and how these networks may impact on users' wellbeing. To compare the social networks of people with long-term mental illness in the community with those of people in a general adult in-patient unit. A sample of general adult in-patients with enduring mental health problems, aged between 18 and 65, was compared with a similar sample attending a general adult psychiatric clinic. A cross-sectional survey collected demographic data and information about participants' social networks. Participants also completed the Short Warwick Edinburgh Mental Well-Being Scale to examine well-being and the Significant Others Scale to explore their social network support. The study recruited 53 participants (25 living in the community and 28 current in-patients) with 339 named as important members of their social networks. Both groups recorded low numbers in their social networks though the community sample had a significantly greater number of social contacts (7.4 vs. 5.4), more monthly contacts with members of their network and significantly higher levels of social media use. The in-patient group reported greater levels of emotional and practical support from their network. People with serious and enduring mental health problems living in the community had a significantly greater number of people in their social network than those who were in-patients while the in-patient group reported greater levels of emotional and practical support from their network. Recommendations for future work have been made.

Effects of khat use on response to antipsychotic medications in patients with newly diagnosed schizophrenia: a retrospective study

Khat contains the amphetamine-like cathinone, and can trigger onset of schizophrenia and exacerbate pre-existing psychosis. However, it remains unknown whether the use of khat complicates the outcome of schizophrenia treatment. We tested the hypothesis that patients with schizophrenia who are using khat will fail to respond to standard antipsychotic treatment. We retrospectively studied a consecutive series of patients who presented to an adult psychiatric clinic in Al-Amal Psychiatric Hospital in Jazan, Saudi Arabia, between January 1, 2013 and December 31, 2016. Patients with newly diagnosed schizophrenia on antipsychotic monotherapy (n = 1007, 817 men) were included and categorized into khat and non-khat users. A khat chewing index was developed to further categorize low, mild, moderate and heavy khat users. Antipsychotic medications were reviewed to determine their potential and the cause of substitution in association with khat use. There were 483 (48%) khat users. Olanzapine, haloperidol and aripiprazole were the most frequently used drugs (46.3%, 15.6% and 10%, respectively). The retention rate of the initial drug differed between the khat users and nonusers (53.8% and 78.4%, respectively). The proportion of moderate and heavy users (55% and 49%, respectively) who changed their initial drug was greater than that of low and mild users (35.6% and 44.7%, respectively). Lack of drug efficacy was the most appealing reason for switching the initial drug among moderate (51.7%) and heavy khat users (48.4%). Khat use hinders an individual's response to initial antipsychotic drug treatment for schizophrenia. Further studies are warranted to investigate the treatment decisions for this group of patients.

Improving Knowledge and Increasing Use of a Screening Tool in an Outpatient Psychiatric Clinic

Less than half of providers use screening tools to diagnose adult psychiatric patients. The bipolar population is specifically vulnerable to an inaccurate diagnosis. The goal of this project was to improve use of screening tools, specifically the HCL-32 in a rural adult psychiatric clinic. Following the end of the project, guidelines were analyzed to determine factors that could have improved the outcome. A pre-survey was administered to the 11 participating providers. Following the survey, a 10-minute educational session was given to each provider. Two months following the education, a post-survey was conducted. A chart review was completed to confirm post-survey results.

The functional impact of cognition in adults with autism spectrum disorders

Purpose and aim: The overall aim of this study was to examine the relationship between adaptive function and cognitive factors in young adults diagnosed with autism spectrum disorder (ASD) in adult age.Methods: The study included 30 adults (age 18-30) diagnosed with ASD in adulthood. All participants were clinically referred to an adult psychiatric clinic for assessment. Adaptive functioning was measured with Adaptive Behavior Assessment System – 2nd edition (parent version). Wechsler scales of intelligence and Delis-Kaplan Executive Function System were used to measure intelligence and executive function.Results: We found considerable adaptive functioning deficits regardless of Full Scale Intelligence Quotient (FSIQ) level. FSIQ, working memory and processing speed were positively associated with adaptive functioning. No associations were found between adaptive functioning and cognitive flexibility, inhibition, word generation or shifting. Regression analysis showed that working memory and processing speed predicted 23% of the variance in adaptive functioning in this group.Conclusions: The results suggest that cognitive dysfunction could be an important area for intervention to improve adaptive functioning in ASD.

Subthreshold autism spectrum in bipolar disorder: Prevalence and clinical correlates

BackgroundWhile few previous studies highlighted a higher prevalence of autistic traits among adults with Bipolar Disorder (BD), little is known about their clinical significance in this population. Method143 subjects with BD were enrolled at the adult psychiatric inpatient clinic of the University of Pisa. Assessments included the SCID-5, the MOODS-SR, the AQ and the AdAS Spectrum. Results42.7% of the sample scored positively for significant levels of autistic traits. Subjects with high autistic traits showed a greater likelihood of a very early onset of BD, greater length of current in-hospital stay, significantly higher rates of anxiety disorders and lower rates of substance use disorders compared to patients with low autistic traits. They also show significantly greater depressive symptoms and suicidality across the lifetime. Suicidality was associated with the altered responsiveness to sensory input and inversely related to adherence to routine and inflexibility. ConclusionThe study is a first exploration of the clinical significance of autistic traits among BD patients. Our results highlight the clinical significance of autistic traits in patients with BD, supporting the usefulness of a dimensional approach to the autism spectrum.

Misdiagnosing medicalization: penal psychopathy and psychiatric practice

This article offers a critique and reconstruction of the concept of medicalization. Most researchers describe medicalization as the redefinition of social problems as medical concerns, and track its spread by the proliferation of disease language and diagnostic categories. Forensic psychiatry and disorders like psychopathy are often cited in these debates. I argue that focusing on discourse overlooks how medical language can justify or mask non-medical practices and outcomes, and lead researchers to identify medicalization where it has not occurred. Building on other critiques of medicalization and recent studies of medical and legal expertise, I propose an alternative conception based on conditions for the performance of medical practice and other forms of expert labor. I distinguish the participation or intervention of medical practitioners from the medicalization of expert practice and identify several institutional factors that facilitate the latter. I illustrate this approach using a critical historical case: the first adult penal psychiatric clinic in the United States, founded by the eminent psychopathologist Bernard Glueck at New York’s Sing Sing Prison in 1916. Glueck’s extensive writings reveal little evidence of medicalization: psychopaths were largely defined and diagnosed according to penal rather than medical criteria, and they received additional punishment rather than treatment. A review of recent research confirms that psychopathy remains primarily a penal rather than medical condition. I conclude that focusing studies of medicalization on practice rather than discourse clarifies the concept and avoids reifying the notion of a medicalized society.

Experiences of Change in Emotion Regulation Group Therapy. A Mixed-Methods Study of Six Patients.

Emotion Regulation Group Therapy (ERGT) is a treatment for non-suicidal self-injury (NSSI) that has recently been implemented in Sweden and evaluated in an open trial with 95 patients in 14 adult outpatient psychiatric clinics (Sahlin et al., 2017). The purpose of the present study was to explore in more detail six of these patients’ experiences of change in ERGT by means of a person-oriented mixed-methods design. Reliable change and clinical significance were calculated for each individual on measures of self-harm, depression, anxiety, stress, and emotion regulation. Semi-structured interviews were carried out, transcribed and analysed using thematic analysis. Both the quantitative and qualitative data on change suggested that the most consistent changes occurred on emotion regulation. The treatment sessions that were most appreciated were those that focused on emotion awareness and emotion regulation. The participants also expressed appreciation of what ERGT afforded in terms of belonging and sharing with others, and the sense of equality in the relationship to the therapist. Critical comments were expressed concerning some parts of the treatment, as for example not having access to an individual therapist. Among the limitations of the study are the small convenience sample, which does not allow for any generalizing conclusions, and that the interviews took place a considerable time (2-3 years) after the participation in ERGT.

Emotion regulation group therapy for deliberate self-harm: a multi-site evaluation in routine care using an uncontrolled open trial design

ObjectiveEmotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of...

Socio-demographic and clinic characterization in youth psychiatric outpatients: An observational study

IntroductionMost mental disorders begin during adolescence and early adulthood (18–24-years-old), highlighting the importance of understanding the onset and progression of mental disorders among youths. Although progress has been made, namely by creating youth mental health transition services, gaps continue to exist. Locally, our recently constituted young adults unit aimed to minimize discontinuities in care.Objectives/aimsTo characterize a population of young adult psychiatric outpatients, regarding socio-demographic and clinic variables.MethodsSocio-demographic and clinic characterization of young adult psychiatric outpatients observed during 1st January 2015–30th July 2016.ResultsTwo hundred and fifty-five outpatients were observed: 64.3% females and 35.7% males, average age 20.56-years-old (median 20). Most lived in urban areas (59.4%), with their parents (27.8%), were students (80.4%), attending secondary school (36.1%). A total of, 27.5% were referenced by an emergency department, and adjustment disorders (ICD-10 F43.2) were the most frequent diagnosis (21.6%). Regarding suicidal behaviours and self-harm, 9.8% did self-cutting. A vast majority did not have previous psychiatric hospitalizations–only 5.9% outpatients had at least one. In total, 39.8% were medicated with antidepressants (1/3 of which in association with other drugs), and about 38.8% received cognitive-behavioural interventions. About 2/3 of patients (66.3%) remained in care and only about 1/6 (15.7%) were discharged.ConclusionsOur typical youth psychiatric outpatient was of female gender, student, living with its parents. Adjustment disorders were the most frequent diagnosis, and antidepressants were the main psychopharmacologic option, often combined with other psychotropic drugs. In the future, psychotherapy interventions should be more widely available, namely group psychotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Self-stigma, self-esteem and self-efficacy of mentally ill

The way that the social stigma of mental illness is related with the self-stigma, which in turn affects self-esteem and self-efficacy of mental patients was investigated. A sample of 66 patients in the Adult Psychiatric Clinic of the Thessaloniki General Hospital "G. Papanikolaou" was participated in this descriptive association study, with cross-sectional comparisons. The sample comprised of patients who were hospitalized or visited the Clinic as out-patients during the period that the study was undertaken. A tool for measuring the basic demographic, social and clinical characteristics of the participants was designed and used. Additionally, the Self-Stigma of Mental Illness Scale, SSMIS, Rosenberg's Self-Esteem Scale, RSE and the General Self-Efficacy Sherer Scale, GSESH were used for measuring self-stigma, self-esteem and self-efficacy respectively. Results showed that self-esteem and self-efficacy were highly associated with each another. Self-esteem and self-efficacy co varied. Greater self-stigma was associated with lower self-esteem and selfefficacy confirming the power of this relationship which is connected with patients' psychological empowerment and acts as mediator between patients' self-categorization as "mentally ill" and their self-esteem and self-efficacy. Additionally, a mild negative association between self-esteem, self-efficacy and age was found while higher educational level was associated with greater selfefficacy. Greater self-stigma along with lower educational level were the most significant predictors of both self-esteem and self-efficacy of mental patients, as shown by regression analysis. Some of our results, such as the percentage of low self-esteem (30.3%), were different from previous relevant data (9.1-24%), probably due to differences in sample's cultural characteristics and composition, research tools used, and the degree of mentally ill patients' reaction to social stigma perception. Despite its methodological limitations, the present study showed that self-stigma contributes to low self-efficacy and self-esteem of the mentally ill. It is thus a fair objective on the one hand to reduce stigmatization for the benefit of patients, and secondly, to raise public awareness in order to minimize the overall stigmatization towards mental illness, which is the primary cause of self-stigma.

Intellectual developmental disorder in adult psychiatry: A 24-year register study

Background: Intellectual developmental disorder (IDD) may pre-dispose for mental health disorders. It is sometimes debated whether the needs of this group are adequately met in general psychiatry. However, little is known about patients with IDD in the psychiatric clinical setting—occurrence, clinical diagnoses, or service use.Aims: This study aimed to assess the number of adult patients diagnosed with IDD in a psychiatric clinic, their psychiatric diagnoses, and their use of psychiatric services.Methods: Individuals with registered IDD diagnoses were identified in a university hospital adult psychiatric clinic register comprising 67 384 patients.Results: IDD had been diagnosed in 0.6% of the patients. Psychotic disorders were the most common co-existing psychiatric diagnoses (25.5%). In 21.8% no psychiatric diagnosis other than IDD was registered. More than 50% had been inpatients; 21% had been compulsorily admitted. Patients with IDD had required a mean of five hospital beds per day.Conclusions: The percentage, 0.6%, of IDD diagnoses was lower than estimates of the prevalence of IDD in the general population. This may reflect a lower need for psychiatric care, barriers to access services, or diagnostic over-shadowing. One fifth of the patients in this study had no psychiatric diagnosis beside IDD, which may be due to diagnostic difficulties, or other problems (e.g. somatic or behavioural disorders) leading to psychiatric contact. Since patients with IDD use the equivalent of five inpatient beds every year, it is suggested that it may be worthwhile to consider specialized psychiatry with expertise in IDD, even though this group is small.

Prevalence of ADHD in adult psychiatric outpatient clinics in Sligo/Leitrim Area, Ireland

Introduction The prevalence of ADHD in adult population has been estimated at 2.5%. Higher rates (23.9%) have been reported among adult mental health service (AMHS) users. Aims To estimate the prevalence of ADHD among adult MH users in west county Ireland. Methods All consecutive patients attending any of 5 Sligo/Leitrim AMHS were invited to participate. Participants completed the Adult ADHD Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS). Clinical notes were reviewed to identify those with preexisting ADHD diagnosis. Exclusion criteria applied were: age: less 18 or above 65, illiterate, non-English speaking patients. Results From 792 attending the clinics, n = 59 (47 aged above 65, 10 severe learning difficulties and 2 non-English speaking) were excluded. Ninety-three (11.7%) decline to participate, giving a total of n = 640 (87% eligible response rate). Mean age was 41.27 (SD: 12.8), and 336 (52.5%) were females. Three had diagnosis of ADHD. Two hundred and thirteen (33.8%) met criteria on the WURS for childhood onset ADHD and 238 (37.5%) participants met caseness on the ASRS. Applying more stringent criteria of scoring on both scales, suggested 125 (19.5%) with unrecognised ADHD. Conclusions While recall bias (WURS) and the possibility of overlapping symptoms with other major psychiatric disorders in adulthood need to be considered, the use of both screening reduces these confounders and suggests a very high rate of ADHD. Given the low number previously identified, this becomes a clinical priority, both to offset the negative trajectories associated with untreated ADHD, but also to effect optimal treatments in comorbid conditions.

Disclosure of Use and Abuse of Controlled Substances Among Psychiatric Outpatients.

Prescription drug abuse is a serious health concern and is considered a nationwide epidemic. Patients often fail or refuse to disclose the use of controlled substances, leaving prescribers and pharmacies unaware of the potential for harmful drug interactions and risk of overdose. Psychiatric patients are especially vulnerable to controlled substance misuse. To determine hazardous patterns of prescription drug use among psychiatric outpatients and to raise awareness about the importance of reviewing information provided by prescription drug monitoring programs (PDMPs). The medical records of 150 patients attending the Adult Outpatient Psychiatric Clinic at the Los Angeles County+University of Southern California (LAC+USC) Medical Center from July 2012 through May 2013 were reviewed. Patient activity reports were generated from California's PDMP. Nondisclosure of controlled substance use was identified by a discrepancy between patient reporting of prescriptions according to the medical records and PDMP reports. A "pattern suggestive of prescription drug abuse" was defined as having one or more of the following: within-class prescriptions from multiple providers and/or within-class early refills or within-class overlapping prescriptions picked up within 10 days of each other. Of the 150 patients, 113 were found in California's PDMP database. Of these 113 patients, 81 had obtained 111 prescriptions for controlled substances in the past 12 months. Of these 111 prescriptions, 52 (47%) were not disclosed to the primary psychiatrist, of which 14 (27%) revealed patterns consistent with prescription drug abuse. Reviewing PDMP databases before prescribing controlled substances should be considered a standard prescribing practice to prevent abuse, diversion, and adverse medical outcomes.

904 – Prevalence and co morbidity of adult ADHD in psychiatric outpatient admissions

In the present study, the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) in adult psychiatric outpatients was investigated. Moreover, co morbid psychiatric diagnoses in adults with ADHD were determined. Patients with and without co morbid ADHD were compared regarding axis I-II co morbidity and socio-demographic characteristics. The current study included 246 patients admitted for the first time to Numune Hospital psychiatric outpatient clinic in a four months period where they were evaluated for adult ADHD. Diagnosis of ADHD was made by evaluating symptoms of childhood via WURS scale, Turgay's adult ADD / ADHD evaluation scale. For the exact diagnosis DSM-IV criteria were applied to the patients who exceeded the cut of points of both above-mentioned scales. To assess the presence of psychiatric co morbidity a structured clinical interview (SCID-I and II) were applied. Socio demographic characteristics of patients were determined with a semi-structured form. In addition, to grade general psychopathology, Symptom Check List (SCL-90-R), Beck Depression Inventory (BDI) were given. Prevalence of ADHD in adult psychiatric clinic was 15.9%. Adults with ADHD usually referred due to co morbid psychiatric problems. It was determined that they had deficits in education and social functions. Substance abuse and suicide were among the most prevalent psychiatric problems. ADHD was common in adult psychiatric outpatients and axis I-II co morbidity was highly prevalent among these patients.