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


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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    • "It is therefore not clear the extent to which these findings will generalise to more complex patients, of both genders, showing features of both ADHD and BD. ADHD is considered to reflect the extreme and impairing tail of a dimensional trait and symptoms commonly may also occur at sub-diagnostic levels (Hudziak et al., 1999; Simon et al., 2009). This means that BD patients are expected to display some ADHD traits as part of a normal population distribution. "
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    ABSTRACT: Objective: Overlapping symptoms can make the diagnostic differentiation of attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) challenging in adults using current clinical assessments. This study sought to determine if current clinical measures delineate ADHD from BD in adults, comparing relative levels of ADHD, BD and emotional lability (EL) symptoms. Methods: Sixty adult women with ADHD, BD or controls were compared on self-report and interview measures for ADHD symptoms, mania, depression, EL, and impairment. Results: ADHD interview measures and self-ratings of ADHD symptoms best discriminated between ADHD and BD. Self-report measures of EL and depression showed non-specific enhancement in both clinical groups. BD-specific items may distinguish BD from ADHD if a retrospective time-frame is adopted. Conclusions: Using measures which capture specific symptoms of ADHD and chronicity/episodicity of symptoms facilitates the delineation of ADHD from BD in adult women.
    Full-text · Article · Mar 2016 · Journal of Affective Disorders
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    • "This is noteworthy, as the prevalence of ADHD in this sample was just more than 30%. Given that the population prevalence of ADHD in adults is estimated at below 10% (Simon, Czobor, Bálint, Mészáros, & Bitter, 2009), our results suggest that a score above 65 on any of the CAARS scales has, at best, a 22% chance of correctly identifying a true case of ADHD, and a 25% chance at cut scores above 70 with a 22%-15% false positive rate depending on the t score employed. These findings are consistent with many recent studies (e.g.,Harrison et al., 2013), which show that individuals who experience high levels of anxiety , depression, or stress frequently endorse a high number of symptoms on ADHD self-report scales even when they have no previous history of ADHD symptoms. "
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    ABSTRACT: Objective: Clinicians frequently rely upon the results of self-report rating scales when making the diagnosis of ADHD; however, little research exists regarding the ability of self-report measures to accurately differentiate ADHD from other disorders. Method: This present study investigated the ability of the Conners' Adult ADHD Rating Scale (CAARS) to discriminate between 249 postsecondary students with carefully diagnosed ADHD and 507 clinical controls. Results: The overall discriminant validity of the CAARS was 69%, and it had an unacceptably high false positive and false negative rate. At lower prevalence rates, a high score on the CAARS has only a 22% chance of accurately identifying individuals with ADHD. Conclusion: Although the CAARS is an adequate screening measure, it should not be the main method by which a diagnosis is made, as it frequently misidentifies individuals with other psychological complaints as having ADHD. Implications for clinical practice are discussed.
    Full-text · Article · Jan 2016 · Journal of Attention Disorders
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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.
    Full-text · Article · Sep 2015 · Frontiers in Psychology
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