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 And not only can ADHD appear for the first time after childhood, but
the symptoms for adult-onset ADHD may be different from symptoms
experienced by kids, the researchers found.
“Although the nature of symptoms differs somewhat between children
and adults, all age groups show impairments in multiple domains –
school, family and friendships for kids and school, occupation,
marriage and driving for adults,” said Stephen Faraone, a psychiatry
researcher at SUNY Upstate Medical University in Syracuse, New York
and author of an editorial accompanying the two studies in JAMA
Psychiatry.
Faraone cautions, however, that some newly diagnosed adults might
have had undetected ADHD as children. Support from parents and
teachers or high intelligence, for example, might prevent ADHD
symptoms from emerging earlier in life.
It’s not clear whether study participants “were completely free of
psychopathology prior to adulthood,” Faraone said in an email.
One of the studies, from Brazil, tracked more than 5,200 people born
in 1993 until they were 18 or 19 years old.
At age 11, 393 kids, or 8.9 percent, had childhood ADHD. By the end
of the study, 492 participants, or 12.2 percent, met all the
criteria for young adult ADHD except the age of diagnosis.
Childhood ADHD was more prevalent among males, while adult ADHD was
more prevalent among females, the study also found.
Just 60 of the nearly 400 kids with ADHD still had symptoms at the
end of the study, and only 60 of the nearly 500 adults with ADHD had
been diagnosed as children.
“The main take-home message is that adult patients experiencing
significant and lasting symptoms of inattention, hyperactivity or
impulsivity that cause impairment should seek evaluation, even if
they began recently by their perception or if family members deny
their existence in childhood,” senior study author Dr. Luis Augusto
Rohde, a psychiatry researcher at Federal University of Rio Grande
Do Sul in Brazil said by email.
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The second study focused on 2,040 twins born in England and Wales in
1994 and 1995. During childhood, 247 of them met the diagnosis
criteria for ADHD. Of those, 54 still met the diagnosis criteria for
the disease at age 18.
Among 166 individuals with adult ADHD, roughly one third didn’t meet
the criteria for ADHD at any of four evaluations during childhood,
the study also found.
It’s possible some of these adults had undiagnosed ADHD as kids, but
symptoms may also look different in older people than they do in
children, said senior study author Louise Arseneault of King’s
College in London.
People with adult ADHD may have more inattentive symptoms like being
forgetful or having difficulty concentrating, whereas children with
ADHD may have more hyperactive symptoms, Arseneault said by email.
“And if adults do experience hyperactive symptoms, these symptoms
may manifest more as feelings of internal restlessness rather than
obvious hyperactive behavior like running or climbing around in
inappropriate situations,” she said.
SOURCES: http://bit.ly/1TrLfEz, http://bit.ly/1NHDoAL, and http://bit.ly/1Rak0qq
JAMA Psychiatry, online May 18, 2016.
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