Adult ADHD and comorbid disorders: clinical implications of a dimensional approach

Summary & key facts

This paper reviews research and clinical guidance about adult ADHD and the other mental health problems it often appears with. It points out that about 2.5% of adults have ADHD and that it commonly co-occurs with mood problems, anxiety, substance use, and personality disorders. Because symptoms overlap, diagnosis and treatment can be tricky. The authors note family links and similar brain features between ADHD and these other conditions, and they say treating the most disabling problem first and using validated screening tools and focused questions can help. Early recognition and treatment might change a person’s longer-term mental health course.

Key facts:

• About 2.5% of adults in the general population are estimated to have ADHD.
• Adult ADHD often occurs alongside other psychiatric problems, most commonly mood disorders, anxiety disorders, substance use disorders, and personality disorders.
• Symptoms can overlap between ADHD and these other conditions, which makes diagnosis and treatment more difficult.
• The authors report strong family links and similar brain-related features between ADHD and many of its common comorbid conditions.
• Clinical guidelines generally recommend treating the condition that is causing the most impairment first when ADHD and other disorders coexist.
• Using validated assessment scales and a few focused clinical questions can help clinicians identify adults with ADHD who might benefit from evidence-based treatments.
• The paper suggests that early recognition and treatment of ADHD and its comorbidities has the potential to change the longer-term course of psychiatric problems, but this is described as a possibility rather than a certainty.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management.The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.

Topics

Attention Deficit Hyperactivity Disorder Functional Brain Connectivity Studies Neural and Behavioral Psychology Studies

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Anxiety Attention deficit hyperactivity disorder Clinical psychology Comorbidity Environmental health Medicine Mood Mood disorders Personality Personality disorders Population Psychiatry Psychology Social psychology

Conditions & symptoms

ADHD Anxiety Depression Substance abuse disorder Addiction or harmful habbits Anxiety or worry Difficulty focusing Sadness or low mood