Prevalence and correlates of adult attention-deficit hyperactivity disorder: Meta-analysis. British Journal of Psychiatry, 194(3), 204-211

Semmelweis University Budapest, Department of Psychiatry and Psychotherapy, Balassa u. 6, Budapest H-1083, Hungary.
The British journal of psychiatry: the journal of mental science (Impact Factor: 7.99). 04/2009; 194(3):204-11. DOI: 10.1192/bjp.bp.107.048827
Source: PubMed

ABSTRACT In spite of the growing literature about adult attention-deficit hyperactivity disorder (ADHD), relatively little is known about the prevalence and correlates of this disorder.
To estimate the prevalence of adult ADHD and to identify its demographic correlates using meta-regression analysis.
We used the MEDLINE, PsycLit and EMBASE databases as well as hand-searching to find relevant publications.
The pooled prevalence of adult ADHD was 2.5% (95% CI 2.1-3.1). Gender and mean age, interacting with each other, were significantly related to prevalence of ADHD. Meta-regression analysis indicated that the proportion of participants with ADHD decreased with age when men and women were equally represented in the sample.
Prevalence of ADHD in adults declines with age in the general population. We think, however, that the unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD.

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    • " disabilities . Another factor that may have confounded the outcome is gender ; our sample has more females than males . Meta - analytic reviews indicated that the prevalence rate of ADHD is higher in males than in females , and that there are gender differences in cognitive impairments , type of ADHD - comorbidities ( Gershon and Gershon , 2002 ; Simon et al . , 2009 ) , and lateralized brain functions ( Kret and De Gelder , 2012 ; Tomasi and Volkow , 2012 ; Herlitz and Lovén , 2013 ) . Although the CAARS scores are corrected for gender and the reaction time outcomes showed no difference between males and females , the present findings need a replication examining effects of gender in a sample with "
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    ABSTRACT: Many clinical studies reported a compromised brain lateralization in patients with Attention-Deficit/Hyperactivity Disorder (ADHD) without being conclusive about whether the deficit existed in the left or right hemisphere. It is well-recognized that studying ADHD dimensionally is more controlled for comorbid problems and medication effects, and provides more accurate assessment of the symptoms. Therefore, the present study applied the dimensional approach to test the relationship between brain lateralization and self-reported ADHD symptoms in a population sample. Eighty-five right-handed university students filled in the Conners’ Adult ADHD Rating Scales and performed a lateralization reaction time task. The task consists of two matching conditions: one condition requires nominal identification for letters tapping left hemisphere specialization (Letter Name-Identity condition) and the other one requires physical and visuospatial identification for shapes tapping right hemisphere specialization (Shape Physical-Identity condition). The letters or shapes to be matched are presented in left or right visual field of a fixation cross. For both task conditions, brain lateralization was indexed as the difference in mean reaction time between left and right visual field. Linear regression analyses, controlled for mood symptoms reported by a depression, anxiety and stress scale, showed no relationship between the variables. These findings from a population sample of adults do not support the dimensionality of lateralized information processing deficit in ADHD symptomatology. However, group comparison analyses showed that subjects with high level of inattention symptoms close to or above the clinical cut-off had a reduced right hemisphere processing in the Shape Physical-Identity condition.
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    • "The attention-deficit-hyperactivity disorder (ADHD) is one of the most frequently diagnosed psychiatric disorders in children with an estimated worldwide-pooled prevalence of about 5.3–8.7% [1] [2] [3], persisting through adolescence and adulthood with a prevalence of up to 5% [4] [5]. The core symptoms include increased inattention and/or hyperactivity and impulsivity as well as lack of emotional self-control and motivation. "
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    ADHD - New Directions in Diagnosis and Treatment, Edited by Jill M. Norvilitis, 09/2015: chapter 4: pages 55-83; InTech., ISBN: 978-953-51-2166-4
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    • "At least 35% of all childhood patients still meet full ADHD criteria in adulthood (American Psychiatric Association, 2000), and this percentage is much higher (78%) when partial remitted patients are included (Biederman et al., 2010). ADHD has an average prevalence of 2.5–4.9% in the adult population (Simon et al., 2009). The clinical phenotype of ADHD is characterized by persistent, ageinappropriate symptoms of inattention, and/or hyperactivity and impulsivity (American Psychiatric Association, 2000). "
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    ABSTRACT: Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA's comparing patients with persistent ADHD (N=133, 42% male, mean age 36) and healthy adults (N=132, 40% male, mean age 36). In addition, we tested which combination of variables provided the highest accuracy in predicting ADHD diagnosis. We also estimated for each individual the severity of neuropsychological dysfunctioning. Lastly, we investigated potential effects of stimulant medication and a history of comorbid major depressive disorder (MDD) on performance. Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding. However, effect sizes were small to moderate (range: 0.05-0.70) and 11% of patients did not show neuropsychological dysfunctioning. The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity). Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired. To conclude, while adults with ADHD as a group are impaired on several cognitive domains, the results confirm that adult ADHD is neuropsychologically heterogeneous. This provides a starting point to investigate individual differences in terms of impaired cognitive pathways. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.
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