Late-Onset ADHD: Understanding the Evidence and Building Theoretical Frameworks
Arthur Caye1, Margaret H Sibley2, James M Swanson3
1Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Current Psychiatry Reports
|November 14, 2017
Summary
Attention-Deficit/Hyperactivity Disorder (ADHD) may present later in life, challenging traditional childhood onset definitions. Research indicates late-onset ADHD is a valid trajectory, though post-adolescent onset requires further study.
Area of Science:
- Neurodevelopmental Disorders
- Child and Adolescent Psychiatry
- Adult Psychiatry
Background:
- The conventional understanding of Attention-Deficit/Hyperactivity Disorder (ADHD) posits childhood onset.
- Recent birth-cohort studies challenge this, revealing many adults with ADHD lack a prior childhood diagnosis.
Purpose of the Study:
- To investigate the validity of late-onset Attention-Deficit/Hyperactivity Disorder (ADHD).
- To explore theoretical frameworks for understanding ADHD development across the lifespan.
Main Methods:
- Long-term follow-up data from the Multimodal Treatment study of ADHD (MTA) were analyzed.
- Evaluation of cases with late-onset ADHD symptoms to identify confounding factors.
Main Results:
- Most cases initially presenting as late-onset ADHD symptoms were attributable to other factors, excluding an ADHD diagnosis.
- Late onset (after age 12) was confirmed as a valid trajectory for ADHD symptoms in a subset of individuals.
Conclusions:
- Late-onset Attention-Deficit/Hyperactivity Disorder (ADHD) is a recognized diagnostic trajectory.
- The prevalence of ADHD with onset after adolescence remains an area for future research.
- The complex phenotype and restricted phenotype models offer frameworks for understanding ADHD's life-cycle trajectory.
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