ADHD: Adult ADHD is overlooked and causes 50% higher mortality!

Around 6% of the World’s population suffers from ADHD, and as ADHD is a specific neurodevelopmental disorder, that we are born with and will die with, it is very important to get diagnosed and treated – regardless of your age and gender, since we now know that just having ADHD, on average shortens your life by 12.7 years and gives you a lifetime increased risk of an unnatural early death (mortality rate) which is 50% above what is normally seen in a population. So let’s get you screened for ADHD, right here, right now – in 9 questions …


DANSK RESUMÊ

Denne artikel handler om hvilke symptomer og ‘faresignaler’ man kan spotte ADHD hos voksne med og på. De 9 spørgsmål er nøje udvalgt af forskere på baggrund af langtidsstudier og ud fra 91 spørgsmål ialt, hvoraf man har fundet de 9 spørgsmål der giver den højeste grad af nøjagtighed ved screening for ADHD hos voksne. Du kan se mere om dette under referencerne til sidst i artiklen.


Introduction

As Dr. Barkley explains, in this video, the toughest part of being diagnosed as an adult, with ADHD, is the reconciliation with the past, your family and friends and with your self. Most of us who are diagnosed as adults, have felt the consequences of living 30-40 years with undiagnosed ADHD, like relationship problems, unemployment, substance abuse, crime, psychosocial problems and interpersonal problems.

What Barkley so eloquently states in this video, is that:

We also want the partners, the spouses, and the family members of the adult with ADHD, to learn about this disorder, to understand its neurobiological underpinning, in order to do, if only one thing, and that is to remove ADHD from the work realm of moral judgement because that is how most relatives and family members view this undiagnosed patient, as a character flaw, as a personality deficit and as a moral failing, you could be different if you really wanted to be, it\s merely a choice you’re making and we need relatives, partners and spouses to understand that this is no choice, this is this disorder, and in doing so, we hope to pull it under the realm of the medical and mental health sciences, and therefore under the realm of compassion and the willingness to assist the adult with ADHD as opposed to the realm of judgement

Dr. Barkley, Ph.D. (2009)

Screening for Adult ADHD

The core 9 questions that will help you know if you’ve got ADHD

These 9 questions have been scientifically selected, based on 91 questions in total, which Barkley et al. have asked their participants in their 27-year longitudinal study, where they have followed the participants from childhood and until age 25-30. This is a well-researched and evidence-based questionnaire which will give a more than 70% accurate quick assessment of your possible undiagnosed ADHD.

The more questions that you can answer ‘Yes’ to, the higher the likelihood of you having undiagnosed ADHD. An answer of ‘Yes’ should be when the question is relevant for your ‘often’ or ‘always’.

What do I do, if I screen positive for Adult ADHD?

Seek professional help. Ask your doctor for a referral for clinical evaluation, and bring along this questionnaire (print out this whole page, so the doctor can review the references as well).

What will my being diagnosed at age 35 do – anyways?

ADHD is a specific neurodevelopmental disorder, that is genetic (70%) or neurobiologic (30%) in its origin, and ADHD can only be present at birth, you are born with, and it is IMPOSSIBLE to develop ADHD at any later stage in life, due to its neurodevelopmental origin (in other words, you cannot get a developmental delay disorder, when you are already developed into an adult, right?).

While this might seem counterintuitive to some, being diagnosed as an adult will have huge implications for both your mental and physical health, as most (55-80%) have more than 2 other mental disorders alongside their ADHD (anxiety and depression is most seen), as well as a 15-25% risk of having comorbid Autism Spectrum Disorder (ASD) as well. There is a long list of physical disorders that go hand in hand with ADHD as well, more than 40% of all people who suffers from Obesity have undiagnosed ADHD, around 50% of all people who suffers from Substance Use Disorder have undiagnosed ADHD, 25% of people incarcerated suffers from undiagnosed ADHD, and if you have Diabetes Type-2, Hyperthyroidism, Asthma and Allergies, Skins problems, Dental problems, Gastrointestinal problems (Crohn’s, IBS etc.), and a long, long list of other diseases, as well.

OK, if get diagnosed, what then?

Well, for once, you will become member of OUR community, alongside millions of other adults with ADHD, who have already walked the path to a better quality of life, living with ADHD, both for themselves personally, but importantly also for their partner and family. ADHD interrupts all domain of functioning creating impairments in all areas of daily life, but especially in social relationships, such as marriages, in families and in the workplace.

When diagnosed with ADHD, you will (most likely) be put on medication to reduce your symptoms of ADHD. Medication do not and cannot cure ADHD, but it can help you better manage your inattention (mostly Mind Wandering when an adult), hyperactivity (mostly within your thoughts when an adult), impulsivity (mostly Emotional Dysregulation when an adult). What medication does so beautifully, is that it gives you pause, between thoughts, feelings, emotions and ideas, so that you can reflect on the consequences of each future action BEFORE you have already acted upon the stimuli, without ane forethought.

So medication will give you the ability to better control and design your behavior, thus improving your social skills and internal reaction processes (anger, frustration, elation etc.)

OK, where can I get support when I get diagnosed as an adult?

There are national patient association across the world, and the biggest and best (in my opinion) is CHADD.org which is the American Patient Association for Children and Adults with ADHD. When I was diagnosed, in Los Angeles, back in 2012, CHADD and its forums was a great help for me to manage my transition into acceptance of my ADHD ad the limitations that it presented for my future life. At ADDspeaker.org, all the bloggers have been diagnosed as adults themselves, so if you browse our archives you will find articles written at various stages of e.g. my own journey from 2015 until now.


GET DIAGNOSED AND TREATED – AND INCREASE YOUR QUALITY OF LIFE!

Peter ‘ADDspeaker’ Vang (2019)


References

Key references

Attention-Deficit Hyperactivity Disorder, Fourth Edition: A Handbook for Diagnosis and Treatment, Russell A. Barkley, Ph.D. (2014) (Editor)

ADHD in Adults – What the Science Says, Barkley, Murphy, Fischer (2010)

Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., … Asherson, P. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34. https://doi.org/10.1016/j.eurpsy.2018.11.001

Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., … Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European Neuropsychopharmacology, 28(10), 1059–1088. https://doi.org/10.1016/j.euroneuro.2018.08.001

Faraone, S. V. (2018). The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neuroscience and Biobehavioral Reviews, 87, 255–270. https://doi.org/10.1016/j.neubiorev.2018.02.001

Barkley, R. A., & Fischer, M. (2018). Hyperactive Child Syndrome and Estimated Life Expectancy at Young Adult Follow-Up: The Role of ADHD Persistence and Other Potential Predictors. Journal of Attention Disorders, 108705471881616. https://doi.org/10.1177/1087054718816164

Additional references

Barkley, R. A. (2012). The Important Role of Executive Functioning and Self-Regulation in ADHD. Executive Functioning and Self-Regulation: Extended Phenotype, Synthesis, and Clinical Implications. Retrieved from http://www.russellbarkley.org/content/ADHD_EF_and_SR.pdf

Barkley, R. A., & Fischer, M. (2010). The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. Journal of the American Academy of Child and Adolescent Psychiatry, 49(5), 503–513.

Barkley, R. A., Knouse, L. E., & Murphy, K. R. (2011). Correspondence and Disparity in the Self- and Other Ratings of Current and Childhood ADHD Symptoms and Impairment in Adults With ADHD. Psychological Assessment, 23(2), 437–446. https://doi.org/10.1037/a0022172

Retz, W., Stieglitz, R. D., Corbisiero, S., Retz-Junginger, P., & Rösler, M. (2012). Emotional dysregulation in adult ADHD: What is the empirical evidence? Expert Review of Neurotherapeutics. https://doi.org/10.1586/ern.12.109

Young, S., González, R. A., Mutch, L., Mallet-Lambert, I., O’Rourke, L., Hickey, N., … Gudjonsson, G. H. (2016). Diagnostic accuracy of a brief screening tool for attention deficit hyperactivity disorder in UK prison inmates. Psychological Medicine, 46(7), 1449–1458. https://doi.org/10.1017/S0033291716000039

Lenzi, F., Cortese, S., Harris, J., & Masi, G. (2018). Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2017.08.010

Barkley, R. A., & Brown, T. E. (2008). Unrecognized attention-deficit/hyperactivity disorder in adults presenting with other psychiatric disorders. CNS Spectrums, 13(11), 977–984. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19037178

Barkley, R. A. (2010). Differential Diagnosis of Adults With ADHD. The Journal of Clinical Psychiatry, 71(07), e17. https://doi.org/10.4088/JCP.9066tx1c

Helfer, B., Cooper, R. E., Bozhilova, N., Maltezos, S., Kuntsi, J., & Asherson, P. (2019). The effects of emotional lability, mind wandering and sleep quality on ADHD symptom severity in adults with ADHD. European Psychiatry, 55, 45–51. https://doi.org/10.1016/j.eurpsy.2018.09.006

Barkley, R. A., & Fischer, M. (2011). Predicting impairment in major life activities and occupational functioning in hyperactive children as adults: Self-reported Executive Function (EF) deficits versus EF tests. Developmental Neuropsychology, 36(2), 137–161. https://doi.org/10.1080/87565641.2010.549877

Bijlenga, D., Vroege, J. A., Stammen, A. J. M., Breuk, M., Boonstra, A. M., van der Rhee, K., & Kooij, J. J. S. (2018). Prevalence of sexual dysfunctions and other sexual disorders in adults with attention-deficit/hyperactivity disorder compared to the general population. ADHD Attention Deficit and Hyperactivity Disorders, 10(1), 87–96. https://doi.org/10.1007/s12402-017-0237-6

Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: Clinical implications of a dimensional approach. BMC Psychiatry. https://doi.org/10.1186/s12888-017-1463-3

Pettersson, R., Söderström, S., & Nilsson, K. W. (2018). Diagnosing ADHD in Adults: An Examination of the Discriminative Validity of Neuropsychological Tests and Diagnostic Assessment Instruments. Journal of Attention Disorders, 22(11), 1019–1031. https://doi.org/10.1177/1087054715618788

Moukhtarian, T. R., Cooper, R. E., Vassos, E., Moran, P., & Asherson, P. (2017). Effects of stimulants and atomoxetine on emotional lability in adults: A systematic review and meta-analysis. European Psychiatry. https://doi.org/10.1016/j.eurpsy.2017.05.021

Barkley, R. A., & Murphy, K. R. (2010). Impairment in occupational functioning and adult ADHD: The predictive utility of executive function (EF) ratings versus EF tests. Archives of Clinical Neuropsychology, 25(3), 157–173. https://doi.org/10.1093/arclin/acq014

Fuermaier, A. B. M., Hüpen, P., De Vries, S. M., Müller, M., Kok, F. M., Koerts, J., … Tucha, O. (2018). Perception in attention deficit hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders. https://doi.org/10.1007/s12402-017-0230-0

Lebowitz, M. S. (2016). Stigmatization of ADHD: A Developmental Review. Journal of Attention Disorders, 20(3), 199–205. https://doi.org/10.1177/1087054712475211

Young, S., Sedgwick, O., Fridman, M., Gudjonsson, G., Hodgkins, P., Lantigua, M., & González, R. A. (2015). Co-morbid psychiatric disorders among incarcerated ADHD populations: A meta-analysis. Psychological Medicine, 45(12), 2499–2510. https://doi.org/10.1017/S0033291715000598

Tsai, F. J., Tseng, W. L., Yang, L. K., & Gau, S. S. F. (2019). Psychiatric comorbid patterns in adults with attention-deficit hyperactivity disorder: Treatment effect and subtypes. PLoS ONE, 14(2), e0211873. https://doi.org/10.1371/journal.pone.0211873

Mutch, L., Gudjonsson, G. H., Young, S., Malet-Lambert, I., Xenitidis, K., Wolff, K., & González, R. A. (2017). Substance and Alcohol Misuse, Drug Pathways, and Offending Behaviors in Association With ADHD in Prison Inmates. Journal of Attention Disorders, 108705471668853. https://doi.org/10.1177/1087054716688532

Cândido, R. C. F., Golder, S., Menezes de Padua, C. A., Perini, E., & Junqueira, D. R. (2018). Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, 2018(4). https://doi.org/10.1002/14651858.CD013011

Magnin, E., & Maurs, C. (2017). Attention-deficit/hyperactivity disorder during adulthood. Revue Neurologique. https://doi.org/10.1016/j.neurol.2017.07.008

Polanczyk, G. V., Willcutt, E. G., Salum, G. A., Kieling, C., & Rohde, L. A. (2014). ADHD prevalence estimates across three decades: An updated systematic review and meta-regression analysis. International Journal of Epidemiology, 43(2), 434–442. https://doi.org/10.1093/ije/dyt261

Petrovic, P., & Castellanos, F. X. (2016). Top-Down Dysregulation—From ADHD to Emotional Instability. Frontiers in Behavioral Neuroscience, 10. https://doi.org/10.3389/fnbeh.2016.00070

Coogan, A. N., Schenk, M., Palm, D., Uzoni, A., Grube, J., Tsang, A. H., … Faltraco, F. (2019). Impact of adult attention deficit hyperactivity disorder and medication status on sleep/wake behavior and molecular circadian rhythms. Neuropsychopharmacology. https://doi.org/10.1038/s41386-019-0327-6

Barbaresi, W. J., Colligan, R. C., Weaver, A. L., Voigt, R. G., Killian, J. M., & Katusic, S. K. (2013). Mortality, ADHD, and Psychosocial Adversity in Adults With Childhood ADHD: A Prospective Study. Pediatrics, 131(4), 637–644. https://doi.org/10.1542/peds.2012-2354