Attention deficit hyperactivity disorder affects about 4% to 12% of children in the US. The condition continues into adulthood for approximately one-half of those diagnosed in childhood, resulting in an ADHD prevalence rate of 4.7% of the adult US population. The past 5 years have seen the rapid development of adult ADHD diagnostic tools, rating scales and treatment protocols.

In adults, as in children, the symptoms of ADHD include problems with attention such as forgetfulness, losing things, and organizational problems. Because the demands for planning increase with age, these difficulties become more prominent in adult life, resulting in other problems such as procrastination, overreacting to frustration, poor motivation, insomnia, and difficulty with time management. Adults are less obviously hyperactive than children. Their condition manifests more as being a workaholic, difficulty sitting through meetings, unwillingness to stand in line, and speeding while driving. Other manifestations may not involve motor behaviors but other aspects of functioning such as talking. Patients may complain that they talk too much, talk out of turn, or blurt out inappropriate responses uncontrollably. These behaviors can lead to social and occupational problems.

Many adults cope with their condition by manipulating their environment or work life. For example, someone who cannot sit in an office all day may seek employment in a job that requires he move from place to place, such as a real estate agent. While children with ADHD are often referred for help because their behavior is bothersome to others, adults often seek help for problems that impact their own well-being. Unique problems in treatment of adults include more difficulty implementing behavioral modification that uses rewards and consequences and difficulty obtaining objective feedback from their support environment regarding the effectiveness of their treatment. Another difference may the time of day during which adults experience the greatest degree of impairment. While children may suffer less at home than at school because they have more freedom, more supervision, and fewer demands on attention, adults may experience the opposite, having more freedom and mobility during the day and feeling the demands of attention more at home when they have the responsibilities of parenting and housework to deal with.

Treating adults with ADHD requires a step-wise approach. The first step is to give feedback to the patient regarding their ADHD behavior and to screen for other comorbid conditions such as anxiety or personality disorders. Next begin education explaining ADHD, symptoms and treatment goals. Medication trials should be used to determine the most effective medication treatment for the individual. ADHD is a common psychological adult disorder that is treatable. Practitioners should be aware of the differences in the manifestations and treatment of the disorder in adults versus children.

Reference: http://www.psychiatrist.com/supplenet/v65s03/v65s0306.pdf

[Return to Archive Index]

[PageTop]