Presenting ADHD symptoms and subtypes in clinically referred adults with ADHD

Objective: Despite the increasing recognition of persistent ADHD into adulthood, there is a paucity of information available on its clinical presentation in adults. To this end, we evaluated ADHD symptoms in a large group of outpatient adults with ADHD attending to issues of psychiatric comorbidity, gender, and age. Methods: We assessed 149 clinically referred outpatient ADHD adults (mean age [±SD] of 37±11 years) using structured diagnostic interviews for psychopathology including current and childhood ADHD symptoms. Using DSM III-R symptoms, we determined DSM-IV subtypes by proxy. Results: Inattentive symptoms were most frequently endorsed in over 90% of ADHD adults. An assessment of current ADHD symptoms showed that 56% of adults had the combined ADHD subtype, 37% the inattentive only subtype, and 2% the hyperactive/impulsive subtype. Psychiatric comorbidity with ADHD was more prominent in adults with hyperactivity-impulsivity as part of their clinical picture. Whereas females had fewer childhood hyperactive-impulsive symptoms than males, there were no gender differences in their current ADHD presentation. Conclusion: Findings from the current study suggest that the vast majority of adults with ADHD present with prominent symptoms of inattention. Given that ADHD adults are presenting from multiple domains, clinicians should carefully query for the inattentive aspects of ADHD when evaluating these individuals.