Patterns of Adult ADHD and Comorbid Conditions

Recent research shows that ADHD in adults is often accompanied by comorbid psychiatric conditions including: mood and anxiety disorders, substance use disorders, and personality disorders. This is the case for about 60% of adults with ADHD. The  presence of these other conditions can often complicate the process of diagnosing and treating ADHD in an adult.

A large study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that women with ADHD are at an even greater risk for comorbid disorders that included autism spectrum disorder, oppositional defiant disorder, intellectual disability, personality disorders, schizophrenia, substance use disorders and suicidal behavior. The study investigated ADHD gender differences among 1,665,729 children born in Denmark from 1918 through 2013. The study took into such variables as birth characteristics, socioeconomic status, familial psychiatric history, and a diagnosis of ADHD and comorbid disorders.

The results showed that while all individuals with ADHD have significant risk for comorbid disorders, female individuals are a more vulnerable population. (This vulnerability is heightened by the fact that, since more boys than girls are diagnosed with ADHD, fewer clinical studies include large samples of females with ADHD.)

Other research has shown that the types of comorbid disorders tend to divide along gender lines. Men are three times more likely to have a substance-abuse disorder than women. Women, on the other hand, were more than twice as likely to have a personality disorder. Women were also slightly more likely to have a mood or anxiety disorder

One thing that most researchers and clinicians agree on is that early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of these psychiatric conditions later in life. The use of validated assessment scales and high-yield clinical questions are tools that can help identify adults with ADHD and provide a framework for treatment  strategies.

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