Adults with add
Pro Research Analysisby 
Searched over 200M research papers
Understanding and Managing Attention Deficit Disorder (ADD) in Adults
Prevalence and Recognition of ADD in Adults
Attention Deficit Disorder (ADD), also known as Attention-Deficit/Hyperactivity Disorder (ADHD), is increasingly recognized as a legitimate and prevalent disorder among adults. Despite this, there remains a significant misunderstanding about its nature. ADD/ADHD is fundamentally a cognitive disorder characterized by impaired executive functions (EFs), which are crucial for self-management and executing daily tasks2. Studies indicate that a substantial proportion of children diagnosed with ADHD continue to exhibit symptoms into adulthood, with estimates ranging from one-third to one-half4.
Clinical Profile and Comorbidities
Adults with ADD often present with a complex clinical profile that includes a high prevalence of psychiatric comorbidities. For instance, a study on Canadian adults found that those with self-reported ADD/ADHD had significantly higher rates of major depressive disorder, bipolar disorders, generalized anxiety disorder, and substance use disorders compared to controls3. Similarly, another study reported that a majority of adults with ADHD had additional DSM-III-R diagnoses, including generalized anxiety disorder, alcohol abuse, drug abuse, dysthymic disorder, and cyclothymic disorder4.
Diagnostic Challenges and Misdiagnosis
Diagnosing ADD in adults can be challenging due to its overlap with other affective temperaments, such as cyclothymia. Misdiagnosis is common, and the use of amphetamines in treatment can sometimes exacerbate mood and anxiety symptoms in individuals with these temperaments9. Accurate diagnosis requires a thorough clinical assessment, often supported by self-rating scales and structured interviews10.
Treatment Approaches
Pharmacological Interventions
Pharmacological treatment for ADD in adults typically includes stimulants and antidepressants. Stimulants are well-supported by evidence and can benefit up to 60% of individuals with ADD10. However, the effectiveness of stimulant therapy alone can vary. For example, a study comparing venlafaxine (an antidepressant) with stimulant therapy found that venlafaxine monotherapy and combination therapy (stimulant plus antidepressant) were more effective in reducing both ADD and depressive symptoms compared to stimulant therapy alone6.
Non-Pharmacological Interventions
Non-pharmacological treatments, such as Dialectical Behavior Therapy Skills Training (DBT-ST), have also been explored. A feasibility trial in Latin America showed that DBT-ST had high attendance and completion rates, although it did not significantly outperform treatment as usual in reducing ADHD symptoms1. This suggests that while DBT-ST is feasible, its efficacy as an add-on treatment needs further investigation.
Conclusion
ADD in adults is a complex and often misunderstood disorder that requires careful diagnosis and a multifaceted treatment approach. The presence of significant psychiatric comorbidities and the potential for misdiagnosis highlight the need for comprehensive clinical assessments. Both pharmacological and non-pharmacological treatments can be effective, but their success may vary depending on individual patient profiles. Recognizing and addressing ADD in adults is crucial for improving their quality of life and overall functioning.
Sources and full results
Most relevant research papers on this topic
Feasibility trial of the dialectical behavior therapy skills training group as add-on treatment for adults with attention-deficit/hyperactivity disorder.
Dialectical Behavior Therapy Skills Training Group (DBT-ST) is a feasible add-on treatment for adult ADHD in Latin America, but shows no significantly higher improvement in symptoms compared to treatment as usual.
RCTADD/ADHD and impaired executive function in clinical practice
ADD/ADHD is a cognitive disorder characterized by impaired executive functions, involving chronic difficulties in executing various daily tasks, and can be effectively treated in clinical practice.
Highly CitedPrevalence and Correlates of Self-Reported ADD/ADHD in a Large National Sample of Canadian Adults
Self-reported ADD/ADHD is prevalent in Canadian adults and is associated with significant psychiatric comorbidity, with gender differences observed.
Observational Study
Rigorous JournalA clinical and demographic profile of a sample of adults with attention deficit hyperactivity disorder, residual state.
Adult ADHD is prevalent in the population, with most individuals having additional diagnoses, such as generalized anxiety disorder, alcohol abuse, drug abuse, dysthymic disorder, and cyclothymic disorder.
Observational StudyHighly CitedAttention deficit disorder ('minimal brain dysfunction') in adults. A replication study of diagnosis and drug treatment.
Pemoline is more effective than placebo for treating adult attention deficit disorder in patients with childhood hyperactivity.
RCTHighly CitedVenlafaxine versus stimulant therapy in patients with dual diagnosis ADD and depression
Venlafaxine monotherapy may be as effective as stimulant plus antidepressant therapy and superior to stimulant therapy alone in patients with comorbid MDD and ADD.
Observational StudyCerebrospinal fluid homovanillic acid and 5-hydroxyindoleacetic acid in adults with attention deficit disorder, residual type
Adults with attention deficit disorder, residual type, have lower levels of homovanillic acid, but nonresponding patients have higher levels than controls.
RCTApproach to attention deficit disorder in adults.
Attention deficit disorder in adults can be diagnosed and successfully treated with stimulants and adjunctive care, potentially affecting relationships, employment, and self-esteem.
Systematic ReviewAffective Temperaments Misdiagnosed as Adult Attention Deficit Disorder
Affective temperaments, particularly cyclothymia, are present in about half of adult ADD patients and may impact mood and cognition when treated with amphetamines.
Observational StudyAttention deficit disorder in adults. Management in primary care.
Primary care physicians should identify ADD in adults and initiate treatment or referral, with stimulants being effective and antidepressants showing mixed evidence of effectiveness.
Systematic Review