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David Baxter

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Adult ADHD Cannot Be Ignored
Tuesday, September 18, 2007

The concept of attention-deficit disorders as far more than the short-term symptoms of a caffeinated childhood is surprisingly new, but increasingly detailed surveys reveal the breadth of its influence to be more widespread than previous research implied. Many adults remain either unaware of or embarrassed by the possibility that ADHD - long represented in popular opinion by disobedient, distractible children - may account for some or most of their persistent functional and behavioral problems. They shouldn't be; treatment can be very simple and invaluable, for ADHD inhibits not only one's early academic performance but the general progression of one's path through adulthood and degrees of personal satisfaction with one's personal, professional and social lives.

Researchers have never insinuated that ADHD magically disappears with puberty, but the condition has only very recently been formally addressed as a problem extending into the adult population. It is not an insignificant one: a screening survey involving 3,200 Americans aged 18-44 estimated the overall rate of prevalence to be a considerable 4.4%. A larger, more expansive World Health Organization survey built on information submitted by more than 11,000 individuals in the Americas, Europe and the Middle East estimated the worldwide prevalence to be 3.4%. These numbers are almost certainly understated, because adults can only be considered for ADHD diagnoses if initial symptoms appeared before the age of 7, and the possibility that symptoms began to make their appearance at a later date or simply went unnoticed is considerable. Middle aged adults may have trouble remembering behavioral tics from such a young age.

Almost anyone can point to an acquaintance, co-worker or family member bearing more than one of the qualities symptomatic of adult ADHD. These individuals are easily forgetful, habitually "zone out" during various conversations, frequently arrive late to work or other events, are frequently considered "aloof and arrogant or tiresomely talkative," have trouble starting or finishing given tasks, and display an inability to clean up after themselves. Far from living in childlike oblivion, these individuals often maintain very high standards of self-evaluation and report a consistent frustration with their perceived inability to measure up.

The condition is, as we've noted, distressingly common, but it presents most often in a relatively narrow sociodemographic group: divorced white males whose current employment status is classified as "other," meaning they are either unemployed or disabled in some way. This finding reflects on commonly cited ADHD statistics noting that patients affected by the condition are considerably less likely to graduate from high school, earn a college diploma, enter high-skilled professions or retain the jobs they have, and remain married to their respective spouses. They also suffer from notably higher rates of incarceration as well as depression, anxiety and substance abuse disorders; when surveyed they generally report lower degrees of personal satisfaction in all aspects of their lives.

The surveys' overarching conclusion is that adult ADHD is far more influential than we know and that it goes almost exclusively untreated: many of those living with the condition have received treatment for other mental or substance abuse disorders but not for ADHD itself, as only 10% of those diagnosed receive any form of medication or therapy. Most importantly, the diagnostic requirements for ADHD "were developed with children in mind and offer only minimal guidance regarding diagnosis among adults," and all studies indicate that its symptoms "are more heterogeneous and subtle in adults than children." Research continues to demonstrate the obvious reality of adult ADHD, and the medical profession needs to respond in turn, fine-tuning its official definition to include the millions of adults around the world who would benefit greatly from appropriate treatments.
 

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