ADHD can begin in adulthood

23 May 2016

Interview with

Jessica Agnew-Blais, King’s College London

Do you struggle to concentrate on tasks, and frequently feel "unsettled"? If so, you might be one of the nearly 10% of the adult population with ADHD - attention deficit hyperactivity disorder. Previously we thought that this was mainly a childhood condition but now a new study, by King's College London's Jessica Agnew-Blais, suggests that a large number of individuals develop the condition in adulthood, despite not showing any signs of it as youngsters...

Jessica - We assessed people for ADHD in young adulthood, so age 18, and then we looked back at ADHD assessments done in childhood at ages 5, 7, 10 and 12 and we found that, actually, nearly 70% of people who had ADHD at 18 did not have ADHD at any of these childhood assessments.

Chris - Goodness! So that means those individuals did not receive a diagnosis when they were little, so are these new adult cases of ADHD?

Jessica - Right, exactly. And, even over and above that, not only did  they did not receive diagnosis but we actually asked their their mothers and their teachers about their ADHD symptoms in childhood, when they were 5, 7, 10, and 12, and it seems that these individuals did not have the disorder at any of these ages in childhood.

Chris - Do you think it's the same condition then?

Jessica - That's a very good question and is really one of the main questions that our study raises. I think a lot further research needs to be done to understand this better and to know whether this late onset ADHD as the same kind of causes as ADHD that begins in childhood and if would respond similarly to the same kind of treatments, for example.

Chris - Well, I'm thinking, obviously, when one is in the childhood time of one's life, it's a very different environment; very supportive, fewer risks, lower stress than when someone is a young adult who might be going off to university for the first time or in the workplace for the first time. So the demands on that individual and the support network can be quite different and so, is it possible they still had the same risk it was just disclosed at a different time in their life?

Jessica - Yes, that's exactly right. There's one thing that we considered in our study is that perhaps these individuals would have had ADHD in childhood, but they were in such supportive family environments that the disorder was not apparent until they left home later on. So, one thing I thing would be really interesting is to follow up these individuals later in life.  So, several years from now, are these people who had late onset ADHD and particular problems with ADHD when they were age 18, do they still have these problems once they've maybe adjusted a bit more to adult life?

Chris - Based on the numbers that you looked at with your twin study, what proportion of adults in the UK, or equivalent countries, might therefore have one of these adult diagnosis of ADHD?

Jessica - We found that, overall, there was about an 8% prevalence of adult ADHD at age 18 and that among these people nearly 70%, so 67.5%, did not have a childhood diagnosis of ADHD.

Chris - That's a lot of people, isn't it?

Jessica - Ahmm Ahmm.

Chris - What can we do about it?

Jessica - I think the first step is around recognition and so I think for clinicians especially, a lot of them are of the mindset and have been taught that if you were to have an ADHD diagnosis, you have to have it in childhood. So they may ask individuals parents about how they acted as children or they might even want to speak to someone's teachers to say, well were these problems with hyperactivity and inattention present in childhood? But here we found that for a lot of these people, they didn't really have particular problems with these symptoms when they were children so whether we really need to focus on looking back to that childhood period is not necessarily clear.

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