Doctors once thought that children who suffered from attention deficit hyperactivity disorder (ADHD) would outgrow the condition once they reached adulthood. It's now clear, however, that most of these children continue to experience ADHD-related difficulties later in life.
"About two-thirds of children with ADHD go on to be adults with ADHD,'' said Lenard Adler, director of the Adult ADHD Program at New York University School of Medicine. According to recent estimates, nearly 4% of U.S. adults have the disorder.
Research shows, however, that only about one in five adults with ADHD is properly diagnosed and treated. One reason the diagnosis of ADHD often is missed in adults: Many doctors are uncomfortable making it. "There's a lack of understanding and training about adult ADHD among healthcare providers," Adler said.
In a recent survey of primary-care physicians, only 35% reported feeling comfortable diagnosing and treating adult patients with ADHD, although their comfort levels with other conditions that affect mental function, including depression (92%) and anxiety (85%), were much higher.
Also, the diagnosis of ADHD is not always clear-cut, particularly in adults. There are no objective measures, such as blood tests or X-rays, on which to base this diagnosis. Instead, doctors must rely on subjective criteria such as what patients say they're feeling and experiencing.
Adults with ADHD may complain of difficulty managing their day-to-day responsibilities, such as paying bills or completing household tasks; they might report feeling stressed because they're unable to finish work or tasks; or they could experience overwhelming feelings of frustration because they are simply unable to organize themselves. Some report difficulties managing time efficiently, or complain that they are easily distracted.
Since most adults experience similar problems at one time or another, it often is difficult for physicians to differentiate people with actual ADHD from those who don't have it. "It's really a question of degree," says Jeanette Wasserstein, assistant clinical professor of psychiatry at Mount Sinai School of Medicine in New York. To justify a diagnosis of adult ADHD, the symptoms must cause actual impairment at work, at home or in social settings. Symptoms must also be more or less continuous from childhood. (Even if a patient was not actually diagnosed with ADHD as a child, some symptoms must have been present then.)
