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ADHD in Adults: a Challenging Diagnosis

Published online by Cambridge University Press:  15 April 2020

D. Durães ,
J. Gomes ,
R. Borralho  and
A. Paiva
D. Durães
Affiliation:
Mental Health and Psychiatry Department, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
J. Gomes
Affiliation:
Mental Health and Psychiatry Department, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
R. Borralho
Affiliation:
Mental Health and Psychiatry Department, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal
A. Paiva
Affiliation:
Mental Health and Psychiatry Department, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal

Abstract

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Introduction

Attention-deficit/hyperactivity disorder (ADHD) has been classically described as a children disorder until the late 1960s. However, research has shown that ADHD is not outgrown and young adults continue to experience problems and disability as they grow old. In addition, ADHD shares important features with Borderline personality disorder (BPD), such as impulsivity, emotional lability and dysregulation, which can make these disorders difficult to distinguish.

Objectives/Aims

This work aims to review ADHD’s definition, epidemiology, frequent psychiatric comorbidities, differential diagnosis – highlighting it’s similarities with BPD –, treatment, and outcome.

Methods

A review of relevant literature was conducted alongside online database research (PubMed and Medscape).

Results

ADHD is a neurodevelopmental disorder defined by persistent impairing levels of inattention, motor hyperactivity and impulsivity that exhibit a negative impact in functioning. It is estimated to affect 5% of children and 2.5% of adults. As the affected individual grows it is likely that the symptoms of hyperactivity will decrease, but the inattention, poor planning, and impulsivity tend to persist into adulthood, compromising social, academic, and occupational functioning.

It may be difficult to distinguish between ADHD and personality disorders, especially BPD. However, BPD has characteristic features like fear of abandonment, self-injury/suicidal behavior, extreme ambivalence, feelings of emptiness, and stress-related paranoia/severe dissociation, that are not present in ADHD.

Conclusions

Despite some similarities in clinical presentation in adolescents and young adults, PHDA and BPD differ substantially in their treatment, impairment in functioning, and outcome, making it crucial to establish a correct diagnosis which will enable proper treatment.

Type
Article: 1861
Information
European Psychiatry , Volume 30 , Issue S1: Abstracts of the 23rd European Congress of Psychiatry , March 2015 , pp. 1
Copyright
Copyright © European Psychiatric Association 2015
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