Greater Prevalence of ADHD Found in Adults Seeking Mental Health Services

The prevalence of attention-deficit/hyperactivity disorder (ADHD) identified in an outpatient sample of 492 adults seeking mental health treatment was nearly 10 times higher than the prevalence identified in epidemiological studies, according to a poster presented at the recent 2018 Annual Meeting of The American Professional Society of ADHD and Related Disorders (APSARD).

The authors, from the Penn State College of Medicine, wrote that the goal of the study was to examine the prevalence of ADHD in an adult outpatient setting and to examine the unique association between ADHD symptoms and functional impairment, controlling for co-occurring mental health concerns.

Despite the fact that approximately 4% of US adults are diagnosed with ADHD, there have been few studies of its prevalence and associated illness in clinical samples of adults seeking outpatient psychiatric care.

The sample was nearly 70% female and the mean age was 40; patients were starting mental health services. Researchers collected information on the total number of ADHD symptoms using the Adult ADHD Self-Report Scale (ASRS); the average score on the WHO Disability Assessment Schedule 2.0 for overall impairment; and co-occurring psychopathology on the DSM-5 Self-rated Level Cross-Cutting Symptom Measure.

Co-occurring psychopathology screening items included: depression, suicidality, mania, anxiety, sleep problems, and substance abuse. These scores were used as covariates.

ADHD symptoms contributed to the functional impairment of patients with a wide range of psychiatric symptoms. Age, depression, anxiety, substance abuse, mania, and sleep difficulty also explained a significant portion of variance in impairment, while gender and suicidality did not.

Using DSM-IV symptom count criteria (ie, 6+ inattention and/or hyperactivity/impulsivity symptoms), 40.85% of the sample met criteria for ADHD (110 inattentive, 24 hyperactive/impulsive, and 67 combined type). A total of 51.83% met DSM-5 symptom count criteria (125 inattentive presentation, 30 hyperactive/impulsive presentation, and 100 combined presentation).

The authors wrote that the results stress the need for further assessment of ADHD, including diagnostic interview and collateral rating, in standard mental health care for adults.

Reference

Babinski DE, Waxmonsky JG, Bixler EO, et al. Screening for ADHD and impairment in a general outpatient psychiatric sample of adults. Poster presented at the 2018 Annual Meeting of The American Professional Society of ADHD and Related Disorders; Washington, DC; January 12-14, 2018. Poster 32.