Adults with ADHD may experience a range of functional impairments that are largely independent of associated comorbidities, reports a recent Danish study.
The aim of this naturalistic, cross-sectional study was to characterise the functional impairments associated with adult ADHD by evaluating the patient records of adults referred to and assessed by an adult ADHD clinic between 2010–2011 (n=155; 65% male; 60% aged ≥25 years).
The most frequent comorbidities included substance abuse disorders (26%), mood disorders (19%) and personality disorder (14%). Patient records showed that over half (51%) had primary/lower secondary school as their highest education level; with the majority of adults (65%) not self-supporting. Risk-taking/criminal behaviour was evident in many adults; 51% had been involved in violent crime; 53% in property crime; 16% had suspension of driving licence; 51% had exercised sexual behaviour with a high risk of catching a sexually transmitted disease and 37% with a high risk of unwanted pregnancy.
Key logistic regression results indicated that compared with adults without comorbidities, those with comorbidities, and personality disorder specifically, were significantly more likely to not be self-supporting (adj.* p<0.05 for both). In terms of risk-taking/criminal behaviour, those more likely to have committed violent crimes included males (vs females; adj. p<0.001) and adults with the ‘combined hyperactive-impulsive’ ADHD subtype† (vs adults with the ‘predominantly inattentive’ ADHD subtype; adj. p<0.05). Presence of comorbidities (including substance abuse disorder or personality disorder specifically) was associated with no significant increased risk for risk-taking/criminal behaviour.
Researchers concluded that functional impairments were evident in this Danish sample of adults with ADHD, although the study was limited by the small sample size and heterogeneous methods for diagnosing personality disorder. Of note, comorbidity, and personality disorder specifically, added a significant burden to occupational impairment, but did not significantly impact educational impairment or risk-taking behaviour. This emphasises the importance of focussing on the treatment of ADHD itself.
*Significant p-values adjusted for age and gender only reported.
†Predominantly hyperactive-impulsive was excluded due to low patient numbers.
Soendergaard HM, Thomsen PH, Pedersen P, et al. Education, occupation and risk-taking behaviour among adults with attention-deficit/hyperactivity disorder. Dan Med J 2015; 62: A5032.