Undiagnosed Attention Deficit Hyperactivity Disorder Research Articles

Prevalence of Undiagnosed Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in the Young Adult Population of the United Arab Emirates: A National Cross-Sectional Study

BackgroundAttention deficit hyperactivity disorder (ADHD), a globally prevalent behavioural disorder, remains underdiagnosed, particularly among adults. This issue is exacerbated in the Arab region due to stigma and insufficient healthcare facilities and professionals. Despite the United Arab Emirates (UAE) efforts to improve mental healthcare, shortcomings persist. No studies in the UAE currently assesses the appropriateness of the screening system for ADHD and other behavioural issues. Furthermore, prevalence rates of ADHD, particularly within the young adult population, are absent.AimTo estimate the prevalence of ADHD amongst young adults attending university in UAE and examine its relationship with gender and academic outcomes.MethodsA cross-sectional, correlational design was used. Young adults in their first year at university were recruited from different academic institutions across the UAE. The study utilized the Adult ADHD Self-Report Scale (ASRS) for data collection.ResultsA sample of 406 young adults, aged between 18 and 20 years of age were recruited. Approximately, 34.7% (n = 141) reported symptoms suggestive of probable ADHD. Significantly lower grade point average marks were observed in participants with ADHD symptoms (M = 3.15) compared to those without (M = 3.35). Females reported symptoms of probable ADHD at higher rates than males, indicating possibly a potential screening deficiency and a potential stigma consequence.ConclusionsThe study demonstrates a high prevalence of probable ADHD in young adults, particularly among females attending university in the United Arab Emirates. Implications for early screening, service provision, and greater professional health training on this disorder are required.

A Novel Intervention to Simultaneously Address the Dual Pathologies of Breathing Disorders During Sleep and Undiagnosed Attention Deficit Hyperactivity Disorder in School-Aged Children Ages 5–12

Purpose: To evaluate the improvement of ADHD related symptoms in school-aged children ages 5 to 12 in treatment with a monobloc appliance (MOA) for Sleep Disordered Breathing (SDB). Methods: A retrospective review of questionnaire scores of ADHD symptoms from school-aged children being treated with a MOA for SDB. Data was obtained from parent survey questionnaires of 40 school-aged children in three dental offices in treatment with an MOA for SDB showing symptoms of ADHD yet to be confirmed with a formal diagnosis between 2019 and 2021. ADHD symptom scores were ascertained by a parent survey questionnaire completed at the initial visit before MOA treatment, and 2 to 6 months, and 7+ months during MOA treatment. Results: At the 7+ month endpoint, 17 of the 28 (61%) children ages 5 to 12 saw at least a 1-point drop in the sum of their questionnaire scores indicating an improvement in ADHD symptoms after initiating treatment with an MOA. Although there was a reduction of the overall average symptom score from the initial visit to 2 to 6 months (M = 4.06, SD ± 1.55), a statistically significant improvement in ADHD symptoms occurred at the 7+ month endpoint (M = 15.29, SD ± 4.50) during MOA treatment. Conclusions: Treatment with an MOA may be highly effective in addressing the dual pathologies of SDB and ADHD in school-age children ages 5 to 12.

Could psychostimulant drug use among university students be related to ADHD symptoms? A preliminary study

We aimed to explore if psychostimulant use among student could be linked to attention deficit-hyperactivity disorder (ADHD) symptoms using a self-administered questionnaire sent by email to French students in 2021. Participants were asked about their psychostimulant use and the presence of ADHD symptoms using the Wender Utah Rating Scale and the Adult Self-Report Scale. Among the 4431 respondents, the prevalence of psychostimulant use was concerning and significantly associated with ADHD symptoms. This association could be related to undiagnosed ADHD or to psychobehavioral impairments induced by psychostimulant use underlining the need of ADHD screening and targeted prevention measures.

What It’s Like Being A Midwife With Attention Deficit Hyperactivity Disorder

Some women with attention deficit hyperactivity disorder (ADHD) may go their entire lives without receiving a diagnosis. This diagnosis gap exists in part because the disorder was once assumed to mostly afflict men but also because women typically exhibit less socially disruptive symptoms than men.1 Most ADHD clinic referrals for nearly a century were for young, hyperactive boys.2 The data characterising boys’ behaviours served as the foundation for early diagnostic standards. Since hyperactivity was demonstrated to be the hallmark, only rarely were young females diagnosed. The primary symptoms of inattention that most girls with ADHD encountered did not meet the diagnostic criteria, therefore ADHD was thought to be a typically male condition. The Nursing and Midwifery Council (NMC) recorded that 99.7% of midwives in the UK are women, while 3.7% of midwives have disclosed a disability.3 This could be suggestive of high numbers of UK midwives working and living with undiagnosed (therefore untreated) ADHD. This article explores the personal experience of being a midwife with ADHD with guidance on how colleagues can be supportive of each other.

Attention-deficit/hyperactivity disorder medication consumption in 64 countries and regions from 2015 to 2019: a longitudinal study

Timely recognition and appropriate treatment of attention-deficit/hyperactivity disorder (ADHD) are essential to enhance long-term outcomes of individuals with ADHD. This study aimed to evaluate the multinational trends and patterns of ADHD medication consumption. In this longitudinal trend study, we used pharmaceutical sales data of ADHD medication from the IQVIA-Multinational Integrated Data Analysis System between 2015 and 2019, covering 64 countries across the world. Consumption rates of ADHD medication were expressed as defined daily dose per 1000 child and adolescent inhabitants (aged 5-19) per day (DDD/TID). Linear mixed models were used to estimate the multinational, regional, and income level trend changes. The results showed that multinational ADHD medication consumption increased by+9.72% (95% confidence interval [CI],+6.25%,+13.31%) per year, from 1.19 DDD/TID in 2015 to 1.43 DDD/TID in 2019 across the 64 countries with marked differences between geographical locations. When stratified by countries' income levels, increases in ADHD medication consumption were observed in high-income countries but not in middle-income countries. In 2019, the pooled consumption rates of ADHD medication were 6.39 DDD/TID (95% CI, 4.63, 8.84) in high-income countries, 0.37 DDD/TID (95% CI, 0.23, 0.58) in upper-middle-income countries and 0.02 DDD/TID (95% CI, 0.01, 0.05) in lower-middle-income countries. Current ADHD prevalence estimates and rates of ADHD medication consumption in most middle-income countries are lower than the global epidemiological prevalence. It is therefore imperative to evaluate the potential barriers to diagnosis and treatment in these countries to minimise the risk of negative outcomes from undiagnosed and untreated ADHD. This project was funded by a grant from the Hong Kong Research Grants Council Collaborative Research Fund (project number C7009-19G).

Evidence-Based Assessment for Attention-Deficit/Hyperactivity Disorder.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals from all life stages, genders, and races/ethnicities. Accurate assessment of ADHD across different populations is essential as undiagnosed ADHD is associated with numerous costly negative public health outcomes and is complicated by high comorbidity and developmental change in symptoms over time. Predictive analysis suggests that best-practice evidence-based assessment of ADHD should include both ADHD-specific and broadband rating scales from multiple informants with consideration of IQ, academic achievement, and executive function when there are concerns about learning. For children under age 12, parent and teacher ratings should be averaged. For adolescents and adults, informant reports should be prioritized when self- and other-report are inconsistent. Future research should provide more stringent evaluation of the sensitivity of measures to treatment response and developmental change over time as well as further validate measures on historically understudied populations (i.e., adults, women, and racial/ethnic minorities).

Estimated prevalence study of attention-deficit/hyperactivity disorder among eastern province children in the Kingdom of Saudi Arabia.

Studying mental disorders in children is significantly important due to the huge suffering of educational and psychosocial impairments in adult life. Attention-deficit/hyperactivity disorder (ADHD) is considered the most common mental disorder in children, especially in early school-aged children. It manifests in about 8%-12% of children in the world. In Saudi Arabia, it affects 4%-12% of children. The study aimed to count the number of undiagnosed ADHD cases and the associated risk factors in Eastern Province in Kingdom of Saudi Arabia (KSA). A cross-sectional study was performed among girls' and boys' children aged 6-10 years old in Eastern Province in KSA with a random selection of parents. Sample size is equal to 1658. The assessment was done by an online questionnaire filled it by parents using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria and Connor's scale of ADHD excluding any developmental or mental disorder at the beginning of the questionnaire. After excluding the participants who were diagnosed with behavioral and growth developmental disorder, the remaining 1430 have been screened for ADHD based on Connor's scale. 185 of a child out of 1430 were suggested to have ADHD, of which 10 out of them show the signs of ADHD, 76 of them have moderately severe ADHD, and 99 out of them have atypical or severe ADHD based on Connor's scale of ADHD. The study shows that there is a significant relationship between the positive screening of ADHD and gender males (71.35%), females (28.64%), family history (20.5%), nervous system diseases (4.32%), brain damage from trauma (9.72%), smoking habit of the mother (8.64%), smoking during pregnancy (3.78%), mother exposure to second-hand smoking (42.16%), child exposure to a toxic substance like lead during the early life (1.62%), and the preterm labor (15.13%). However, the study shows there is no significant relationship between the positive screening of ADHD with age, drinking alcohol, and central nervous system infection. The prevalence of undiagnosed ADHD is slightly high. Also, it has many causes of ADHD including gender, smoking, parental psychiatric disorders, and obstetric and pregnancy problems.

Prevalence of attention deficit hyperactivity disorder in an adult mental health service in the Republic of Ireland.

Attention Deficit Hyperactivity Disorder (ADHD) is well recognised in childhood. However, recognition that it commonly persists into adulthood is relatively recent. This study is the 2nd phase of a two-phase epidemiological investigation of the prevalence of adult ADHD in outpatients in Ireland. In phase-1, 634 participants were screened with Adult ADHD Self-Report Scale (ASRS) and Wender Utah Rating Scale (WURS). Those scoring positive in both scales have been invited to participate in the 2nd phase where the scales Conners' Adult ADHD Diagnostic Interview (CAADID), Mini International Neuropsychiatric Interview (MINI), and Global Assessment of Functioning (GAF) were administered, plus clinical evaluation based in DSM-5. 131 were eligible, 110 participated (84.0%). Using the CAADID (DSM-IV criteria) 71 were diagnosed with ADHD. Projecting to the total sample (N = 634) the prevalence was 13.25%, CI:95%:10.71-16.14. Converting the DSM-IV criteria to DSM-5, 89 had ADHD (prevalence:16.72%, CI: 13.9-19.86). Using clinical evaluation, 86 were diagnosed with ADHD (prevalence:16.09%, CI:13.31-19.18). Only 3 cases were diagnosed before with ADHD. Comorbidity was higher in those with ADHD, with the median number of additional diagnoses 2 (min 0 max 8, IQR 3) Also, they had significantly higher rates of depression and recurred depression. Agreement between DSM-IV and DSM-5 was high (rho = 0.90, p < .0001). High rates of undiagnosed ADHD were found to be present among AMHS attendees. Clinicians in AMHS need to be knowledgeable and alert to possible ADHD among their caseloads, and offer appropriate intervention. Interventions are urgently required to increase the detection and treatment of adult ADHD.

The Burden of Undiagnosed Adults With Attention-Deficit/Hyperactivity Disorder Symptoms in Japan: A Cross-Sectional Study.

BackgroundSymptoms experienced by adult patients with attention-deficit/hyperactivity disorder (ADHD) frequently result in functional impairment across academic/occupational functioning, daily life, and social functioning. A substantial proportion of undiagnosed and untreated ADHD has been suggested in Japan. This study aims to better understand the potential undiagnosed ADHD population in Japan by quantifying the burden associated with ADHD symptoms through a comparison of the prevalence of comorbidities, health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), and healthcare resource utilization (HRU) between undiagnosed potential ADHD respondents who were screened positive and negative using Adult ADHD Self-Report Scale (ASRS)-v1.1.MethodologyRespondents from Japan National Health and Wellness Survey 2016 who answered ASRS-v1.1 without an ADHD diagnosis were included. Respondents checking ≥4 items from ASRS-A and ≥9 from ASRS-A+B were classified as ASRS A+ (n = 309) and ASRS AB+ (n = 227), respectively. ASRS negative (n = 9,280) were respondents who were neither ASRS A+ nor ASRS AB+. Data on the presence of comorbidities, HRQoL, WPAI, and HRU were compared.ResultsASRS A+ and ASRS AB+ respondents reported higher coexistence of mental comorbidities (depression, generalized anxiety disorder, bipolar disorder, obsessive-compulsive disorder, etc.), sleep problems (insomnia, narcolepsy, sleep apnea, etc.), and physical comorbidities (non-alcoholic steatohepatitis, allergy, and asthma). They also reported greater WPAI and HRU and lower HRQoL than matched ASRS-negative respondents.ConclusionsA significantly higher burden was identified among undiagnosed adults with potential ADHD symptoms. Appropriate diagnosis may help those at risk or those who present with symptoms overlapping with ADHD.

Recognising attention deficit hyperactivity disorder across the lifespan.

Attention deficit hyperactivity disorder(ADHD) is the most common neurodevelopmental disorder and is estimated to affect approximately 10% ofchildren and 5% of adults. It is associated with impaired functioning. Recognition and appropriate treatment can make a substantial difference. The aim of this article is to provide a framework for recognising ADHD and the ways that it can present at different stages of the lifespan. General practitioners have a vital role inidentifying people who may have undiagnosed ADHD. It is important totake a history targeted at eliciting problems in everyday functioning. People who are intellectually able may have developed coping strategies that mask their ADHD; in those with other psychiatric diagnoses, the underlying ADHD may be overlooked. Timely and effective treatment can make an enormous difference to the individual and to their family and peers and can reduce the likelihood of subsequent development of secondary mental health and social issues.

Cognitive enhancement drug use among resident physicians: Prevalence and motivations for use - results from a survey

Background: Non-medical use of prescription drugs for the enhancement of cognitive functioning has gained popularity in recent years, especially among young educated adults. To our knowledge, no previous study investigated this phenomenon among resident physicians.Objective: To analyze cognitive enhancement drugs use motivations and patterns among resident physicians.Methods: A survey and statistical analysis regarding the use of drugs traditionally prescribed for the treatment of Attention Deficit Hyperactivity Disorder: stimulants, amphetamines and modafinil.Participants: 1,453 residents who took their written residency exam in the summer of 2017. The response rate was 32.3%.Results: 28.1% of responders reported past use, with 73.67% of them reporting use without a related medical diagnosis. Almost half of the users (47.1%) acquired the drug with a prescription, but without a diagnosis of a related medical disorder. The first use was predominantly during residency (54.3%), with 45% reporting it as related to the residency exam.Factors found to positively impact non-medical use include: declaring undiagnosed Attention Deficit Hyperactivity Disorder, fear of failing the exam, a belief that more than 30% of other examinees take cognitive enhancements drugs, and a learning disability diagnosis. Self-reports of being a competitive person and being a parent, were negatively correlated with non-medical use.Conclusions: The use of drugs that are taken traditionally for the treatment of Attention Deficit Hyperactivity Disorder is common among resident physicians, both with and without related medical indication. Interestingly, factors associated with the fear of being “left behind” increase non-medical use and not the desire to succeed.

Pay Attention to Inattention: Exploring ADHD Symptoms in a Sample of Underachieving Gifted Students

Much has been written about the relationship of giftedness and attention-deficit/hyperactivity disorder (ADHD), as well as the relationship between ADHD and underachievement. The present study examined whether students who were identified as gifted underachievers were more likely to manifest symptoms of ADHD, as measured by the ADHD-IV. Over half of the gifted underachievers met the screening criteria for ADHD based on teacher reports, and almost 30% of the gifted underachievers met the screening criteria for ADHD based on parent reports. Most of these students had elevated scores on the inattention scale. The prevalence of inattention was over 2 times as high as the prevalence in the norming sample using the teacher rating scales and over 5 times as high as the prevalence in the norming sample using the parent rating scales. Although parents and teachers rated students similarly on the hyperactivity scale, teachers rated students as more inattentive than parents did. However, elevated parent ratings of inattention negatively predicted students’ self-regulation, goal valuation, and self-efficacy. Self-regulation was most strongly related to inattention. We cannot know whether the gifted underachievers with high inattention scores have undiagnosed ADHD. However, our results suggest that a substantial percentage of gifted underachievers exhibit attentional problems at home, and that these attentional problems are severe enough to merit further examination.

The ADHD Symptom Infrequency Scale (ASIS): A novel measure designed to detect adult ADHD simulators.

The current project outlines the development of the Attention-Deficit/Hyperactivity Disorder (ADHD) Symptom Infrequency Scale (ASIS), a stand-alone measure designed to identify individuals feigning or exaggerating symptoms to receive a diagnosis of ADHD. Over the course of 3 studies, valid data was collected from 402 participants assigned to control, simulator, ADHD diagnosed, or possible undiagnosed ADHD groups. Group assignment was based on self-reported history of ADHD diagnosis including information about the credentials of diagnosing professional and methods used. The ASIS includes an Infrequency Scale (INF) designed to detect rarely reported symptoms of ADHD and several clinical scales designed to measure genuine symptoms. The final version of the ASIS demonstrated high internal consistency for the INF (α = .96) and the ADHD Total scales (α= .96). Convergent validity for the ADHD Total was established through a strong correlation with Barkley Adult ADHD Rating Scale-IV (r = .92). Initial validation of the INF yielded high discriminability between groups (d = 2.76; 95% confidence interval [2.17, 3.36]). The final INF scale demonstrated strong sensitivity (.79-.86) and excellent specificity (.89). Using our study's malingering base rate of 29%, positive and negative predictive values were strong (.71-.79 and .92-.93, respectively). Additional information is provided for a range of base rates. Current results suggest that the ASIS has potential as a reliable and valid measure of ADHD that is sensitive to malingering when compared to a sample of individuals self-reporting a history of ADHD diagnosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

SAT-266 A Retrospective Study Investigating the Association Between ADHD and Glycemic Control in Children and Adolescents with Type 1 Diabetes Mellitus

Background: Attention deficit hyperactivity disorder (ADHD) is a chronic neuropsychiatric disorder of childhood that often persists into adulthood. Common symptoms of ADHD include difficulty in sustaining attention, failure to give attention to detail, forgetfulness and avoiding tasks requiring mental effort, as well as lower executive functioning. Management of diabetes involves complex multistep tasks, requiring good cognitive and executive functioning. We hypothesized that patients with Type 1 diabetes mellitus (T1DM) who have a concurrent ADHD diagnosis, may encounter difficulty in managing their diabetes on a daily basis thereby leading to poor glycemic control. Objective: We compared average HbA1C values and number of diabetic ketoacidosis (DKA) episodes in patients between ages 6-25 years with T1DM with ADHD (case cohort) and T1DM without ADHD (control group). Methods: The study was designed as a retrospective review of data obtained from the electronic health record in our medical system. Cohort identification was performed through a combination of ICD 9/10 codes, problem list search and medication use. Results were grouped by age. Results: In the age range between 6-18 years, there were 334 controls and 25 cases. Between ages 18-25 years, there were 443 controls and 30 cases. There was an increased number of boys with ADHD in the age group 6-18 years (p=0.0035). There was no significant difference between the average HbA1C over a 2 year period between the two groups in either of the age ranges (p=0.6 and 0.8 respectively). There was no difference in the number of DKA episodes in either group. We did find a significant difference in the type of insurance coverage between the groups. The population with T1DM and ADHD had higher rates of commercial versus public insurance as compared to the control group with T1DM and no diagnosed ADHD in both age groups (p=0.004). Conclusions: The main limitation of the study is its retrospective nature and the possibility of undiagnosed ADHD symptoms in the control group. Diagnosis of ADHD in the Medicaid population with T1DM may be lower due to infrequent clinic visits, long waiting time for specialists or lack of resources and knowledge. Future studies could clarify whether screening for symptoms of inattention and school/work performance in this particular population may identify patients with ADHD who could benefit from therapeutic or medical intervention for the ADHD that could improve T1DM outcome. Funding: Pediatrics Research Grant, Center for Research Informatics.

A Juvenile Sex Offender with Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder manifesting in early life. These children are more vulnerable to sexual abuse as victims and offenders. This is a case report of a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending.Case report: According to the 14-year-old accused, he has engaged  in  penetrative  anal  intercourse  with  another schoolmate. that similar past incidents had involved a teenage malerelative and insertion of foreign bodies to his anus repeatedly by him. On assessment the accused had features of inattention, such as difficulty in sustaining attention, failing to finish work and features of impulsivity, such as difficulty waiting for his turn and intruding on others. He was diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental disorders (DSM 5) clinical criteria which were supported by the Sinhalese adaptation of the Swanson, Nolan and Pelham questionnaire. The assessment of the non-verbal intelligence was in the normal range, but his school performance was far below the average.Discussion:  Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour. It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour. Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.

Attention-Deficit Hyperactivity Disorder: Clinical Considerations for Women.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by hyperactivity, impulsivity, and/or inattention. Women with ADHD represent a particularly vulnerable group, given their increased risk for psychosocial and parenting difficulties. Women's health care clinicians should expect to encounter women with diagnosed and undiagnosed ADHD that may or may not be treated. Pharmacologic intervention, namely, prescription stimulants, is an important consideration for pregnant and breastfeeding women with ADHD, especially because the US Food and Drug Administration has determined that there is not enough information to confirm either harm or lack of harm to the developing fetus following exposure to these drugs. Due to the increase in use of prescription stimulants without a prescription, clinicians are also likely to encounter women misusing stimulants for a variety of reasons. This article provides an overview of ADHD diagnosis, outlines effective treatment options, and offers insight into the importance for clinicians to consider prescription stimulant misuse. Guidance concerning treatment of ADHD during pregnancy and lactation is reviewed.

Treatment Controversies in Adult ADHD.

Treatment Controversies in Adult ADHD.

In Response to: Poisonings with Suicidal Intent Aged 0-21 Years Reported to Poison Centers 2003-12.

To the Editor: It was with great interest that we read the paper by Sheikh et al. that attempted to use Poison Control Center (PCC) data to explore the clinical features of self-poisonings with suicidal intent in children. Understanding the features of youth-attempted suicide by poisoning is necessary to effectively identify and treat those patients at highest risk for serious outcomes. The study was able to characterize several clinical features of the 52.2% of subjects in the 15–18 year old age group. We question why the authors performed a subgroup analysis on children <10 years of age, since this group represented <1% of the study patients. It seems that an in-depth analysis of the 15–18 year old age group would have yielded a more useful conclusion. As clinicians, we view the most clinically significant population as those who attempted and ultimately completed suicide. The data provided to readers in this regard were incomplete. Details regarding the exact age, substance ingested and details surrounding the cause of death would be useful in determining risk factors of the population and how the substance may have contributed to mortality. Given the relatively small number of deaths, this information could have easily been provided for a more complete assessment. Finally, the authors conclude that undiagnosed attention deficit hyperactivity disorder (ADHD) predisposes pediatric patients to self-harming behaviors. This conclusion is completed unsupported by any data. No information about medical history is mentioned and readers cannot assume that patients that overdosed on ADHD medications did so because they had the diagnosis themselves. Medications may be from siblings, friends or any other number of possibilities. Furthermore ADHD medications have a variety of clinical applications outside of treatment for ADHD. This study was further hindered by the inherent limitations of analyzing PCC data. We suggest that it could have been strengthened by focusing on the group that is at highest risk, providing past medical history and prescribed medications, and focusing on mortality as a more significant outcome. Providing readers with this information would have strengthened the conclusions and enabled further interpretation of the data.

Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment.

Attention-deficit/hyperactivity disorder (ADHD) is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type) are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful.

Recognizing and Treating Attention-Deficit/Hyperactivity Disorder in College Students

Traditionally diagnosed in children, attention-deficit/hyperactivity disorder (ADHD) is now regarded as a life span condition. The academic difficulties experienced by children and adolescents with ADHD have been observed to continue into young adulthood. Treatment outcome studies demonstrate that behavioral and pharmacotherapeutic interventions can be beneficial in improving ADHD symptoms such as inattention, and so facilitate academic performance in young adults with ADHD. This review discusses how ADHD leads to academic underperformance, the warning signs of undiagnosed ADHD, and the potential impact interventions can have on adult academic impairment.