Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD

J Clin Psychiatry. 2009 Nov;70(11):1557-62. doi: 10.4088/JCP.08m04785pur.


Objective: Despite the increasing presentation of attention-deficit/hyperactivity disorder (ADHD) in adults, many practitioners remain reluctant to assess individuals for ADHD, in part related to the relative lack of data on the presenting symptoms of ADHD in adulthood. Comorbidity among adults with ADHD is also of great interest due to the high rates of psychiatric comorbidity, which can lead to a more persistent ADHD among adults.

Method: We assessed 107 adults with ADHD of both sexes (51% female; mean +/- SD of 37 +/- 10.4 years) using structured diagnostic interviews. Using DSM-IV symptoms, we determined DSM-IV subtypes. The study was conducted from 1998 to 2003.

Results: Inattentive symptoms were most frequently endorsed (> 90%) in adults with ADHD. Using current symptoms, 62% of adults had the combined subtype, 31% the inattentive only subtype, and 7% the hyperactive/impulsive only subtype. Adults with the combined subtype had relatively more psychiatric comorbidity compared to those with the predominately inattentive subtype. Women were similar to men in the presentation of ADHD.

Conclusion: Adults with ADHD have prominent inattentive symptoms of ADHD, necessitating careful questioning of these symptoms when evaluating these individuals.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Attention Deficit Disorder with Hyperactivity / classification
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology
  • Comorbidity
  • Conduct Disorder / diagnosis
  • Conduct Disorder / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / etiology
  • Sex Factors
  • Surveys and Questionnaires