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Adult ADHD: Introduction

Common questions in primary care

What is the prevalence of childhood versus adult attention-deficit/hyperactivity disorder (ADHD)?

ADHD is the most common neurobiological disorder in childhood. At least 60 per cent of this population continues into adulthood with impairing symptoms, leading to a possible prevalence rate for ADHD of 4.4 per cent among adults.  By adulthood, almost as many females present with this condition as males.

How did 4.4 per cent of the population suddenly have ADHD?

Until 1994, there were no diagnostic criteria for adult ADHD so clinicians, were forced to give another diagnosis to account for the clinical presentation.

What would it have been called if not ADHD?

The natural course of ADHD is to move toward anxiety and depression. Also consider ADHD in patients with bipolar II disorder, personality disorders, concurrent addictions to cannabis and cocaine, and generalized anxiety disorder.

Won't ADHD patients abuse their medications?

To the contrary, the medications have a protective role in preventing the patient from self-medicating.

Isn't ADHD just an excuse for bad habits and a lazy attitude?

ADHD is highly treatable. Providing treatment when symptoms are present will give patients an opportunity to live to their potential.

Doesn't everyone have some ADHD?

Anyone can have some of the symptoms of ADHD, but to meet the criteria for the diagnosis a number of symptoms must be present and they must be causing significant impairment.

The patient only wants the medication now and then. Is that possible?

Yes, while the medications should be seen as facilitating the non-drug agenda, some patients only need medications in situations of high attentional load.

My patient is not hyperactive. Could she still have ADHD?

We likely miss many of the patients who have only the inattentive symptoms of ADHD such as being shy or withdrawn, or being "daydreamers." As a general rule, patients who have only the inattentive symptoms are often female.

Isn't ADHD just a reflection of our Western lifestyle and the latest "fad" of the media?

ADHD is prevalent around the world and not just in Western countries. The existence of childhood ADHD has been well accepted for decades. Only since the late 1980s have outcome studies shown that the disorder continues into adulthood.

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Frequently asked questions

Clinical guidelines

Canadian ADHD practice guidelines (CADDRA, 2011)

Attention deficit hyperactivity disorder: diagnosis and management (NICE guideline CG72, 2008)