Diagnostic Criteria May Be Missing ADHD in Many Adults

Adult ADDers who develop symptoms after childhood may be going undiagnosed, because the criteria used to identify the disorder were developed primarily with children in mind.

Friday December 1st - 10:22am

Many adults with ADHD may be going undiagnosed and untreated, a new study suggests, because the criteria used to identify the disorder were developed mainly with children in mind.

The criteria given in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) allow for a diagnosis of ADHD only if symptoms were present before the age of seven. But evidence is mounting that the disorder sometimes doesn’t produce symptoms until much later.

In the new study, researchers from SUNY Upstate Medical University in Syracuse, New York, and Harvard Medical School, in Boston, compared a group of 127 adults who had shown symptoms of ADHD before age seven to another 79 adults whose symptoms didn’t show up until later. In each group, the researchers looked for other strong indicators of ADHD, such as impairment in everyday activities, and a family history of the disorder.

It turned out that the adults whose symptoms had surfaced after age seven had all the same indicators as the other group — strong evidence that ADHD doesn’t always show up in early childhood. Eighty-three percent of the late-onset group had begun to exhibit symptoms by age 12.

The study was published in the October 2006 issue of The American Journal of Psychiatry.

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