The burdened life of adults with ADHD: Impairment beyond comorbidity

Abstract

Since approximately 70% of adult patients with attention-deficit/hyperactivity disorder (ADHD) have at least one comorbid disorder, rating of impairment specifically attributable to ADHD is a hard task. Despite the evidence linking environmental adversities with negative outcomes in ADHD, life events measures have not been used to rate the disorder impairment. The present study tested for the first time the hypothesis that increased ADHD severity is associated with an increase in negative recent life events, independently of comorbidity status. The psychiatric diagnoses of 211 adult ADHD outpatients were based on DSM-IV criteria assessed through structured interviews (K-SADS-E for ADHD and ODD, MINI for ASPD and SCID-IV-R for other comorbidities). ADHD severity was evaluated with the Swanson, Nolan and Pelham rating scale (SNAP-IV) and recent life events with the Life Experience Survey. Higher SNAP-IV inattention and hyperactivity scores, female gender, lower socioeconomic status and the presence of comorbid mood disorders were associated with negative life events. Poisson regression models with adjustment for possible confounders confirmed the effect of inattention and hyperactivity severity on negative life events. Our results suggest that the negative life events experienced by these patients are associated to the severity of ADHD independently from comorbid psychiatric disorders.

Impairments, Diagnosis and Treatments Associated with Attention-Deficit/Hyperactivity Disorder (ADHD) in UK Adults: Results from the Lifetime Impairment Survey

“…In contrast, cross-sectional studies of ADHD find a high frequency of other diagnoses and co-occurring symptom groups that make important additional contributions to impairment (Kessler et al, 2006;Kooij et al, 2010;Skirrow, Hosang, Farmer, & Asherson, 2012). Approximately 70% of adult patients with ADHD have at least one comorbid disorder (Garcia et al, 2012). These patients have an increased risk of emotional lability, generalized anxiety disorder, post-traumatic stress disorder, specific phobias and personality disorders that contribute to significantly lower psychological health scores (Bernardi et al, 2012;O'Callaghan & Sharma, 2012).…”

Gender differences in adults with attention-deficit/hyperactivity disorder: A narrative review

“…Garcia et al (2012) asked participants to rate their affective responses to life events, whereas Friedrichs, Igl, Larsson, and Larsson (2012) asked participants only to endorse whether they had experienced various negative life events (e.g., "Have you sometimes during the last 12 months been on sick-leave with a medical certificate?"). Only Garcia et al found an effect of gender: women with ADHD subjectively reported a greater impact of negative life events than men with ADHD, whereas Friedrichs et al found no gender difference in the more objective rate of events.…”

Preventive Interventions for ADHD: A Neurodevelopmental Perspective

“…In addition to the "core symptoms" of inattention, impulsiveness, and hyperactivity that define the disorder, a substantial portion of individuals diagnosed with ADHD present with an array of neurocognitive deficits, psychiatric comorbidities, and social and emotional difficulties [2,3]. As a result of persisting impairments across an array of behavioral domains, long-term outcome for many, if not most, children with ADHD is far from optimal [4].…”