ADHD may become easier to diagnose in adults

From the LA Times:

Reporting from Honolulu — Attention deficit hyperactivity disorder has traditionally been considered to be a problem of children. But research over the last two decades shows the disorder often persists into adulthood and that adults can benefit from treatment of their symptoms.

Identifying older teens and adults with ADHD should become easier — and prevalence rates will increase — based on a proposal under consideration by the nation's psychiatrists, according to information reported Sunday at the annual meeting of the American Psychiatric Assn. here.

Psychiatrists are in the process of rewriting the essential textbook on mental illness — "Diagnostic and Statistical Manual of Mental Disorders" — for publication in 2013.

In the current DSM edition, ADHD is described as a disorder of children, but the same criteria are routinely applied to adults who seek help with what they perceive to be ADHD. The proposed changes of the new DSM — called DSM.5 — will describe what ADHD looks like in older teens and adults, said Dr. Steven Cuffe of the University of Florida.

For example, while children with ADHD may run around their classrooms and fail to complete their schoolwork, adults with the disorder are more likely to interrupt someone who is speaking and have problems meeting deadlines at work.

The hyperactivity seen in children tends to be reflected as restless feelings in adults. Impulsivity is more of an issue with children with the disorder, compared with adults, but problems with attention tend to persist from childhood into adulthood, Cuffe said.

Moreover, while the current diagnosis for ADHD requires the presence of at least six specific symptoms, the proposal for DSM-5 is to lower that threshold to four or more symptoms in adults.

The inclusion of information describing older teens and adults with the disorder will likely increase the prevalence of ADHD in the general population, Cuffe said. A few decades ago, ADHD was estimated to occur in about 3% to 5% of children. That figure is now 6% to 8%.

How many adults will end up with an official diagnosis of ADHD after DSM-5 goes into effect is unknown. But chances are the number is going up. Some doctors say they worry that the condition will become overdiagnosed.

"I think the prevalence in adolescents and adults who meet full criteria will definitely increase," Cuffe said.