Influence of the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and comorbid disorders on functioning in adulthood

  1. Miranda Casas, Ana
  2. Berenguer Merelo, Carmen
  3. Colomer Diago, Carla
  4. Roselló Miranda, Rosa
Revista:
Psicothema

ISSN: 0214-9915

Any de publicació: 2014

Volum: 26

Número: 4

Pàgines: 471-476

Tipus: Article

Altres publicacions en: Psicothema

Resum

Background: ADHD is a chronic disorder that generally has a negative effect on socio-personal adaptation. The objectives of the current study were to examine the adaptive functioning in the daily lives of adults with ADHD compared to adults without the disorder and to test the influence of ADHD symptoms and comorbid problems on different areas of adaptive functioning. Method: Seventy-seven adults between 17 and 24 years old, 40 with a clinical diagnosis of combined-subtype ADHD in childhood and 37 controls, filled out the Weiss Functional Impairment Scale, the Weiss Symptom Record and Conners' Adult ADHD Rating Scale. Results: Significant differences were found between adults with and without ADHD in family and academic functioning. Moreover, the ADHD symptomatology as a whole predicted significant deficiencies in the family environment and self-concept, whereas inattention specifically predicted worse academic performance and life skills. The comorbidities mainly affected the family and risky activity domains (dangerous driving, illegal behaviors, substance misuse and sexually inappropriate behaviors). Conclusions: The results illustrate the importance of developing a multimodal approach to helping ADHD adults cope with associated comorbid disorders, offering them supportive coaching in organizing daily activities, and incorporating the family and/or partner in the treatment plan.

Referències bibliogràfiques

  • American Psychiatric Association (2002). Manual diagnóstico y estadístico de los trastornos mentales DSM-IV-TR [Diagnostic and Statistical Manual of Mental Disorders]. Barcelona: Masson.
  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Arlington: American Psychiatric Publishing.
  • Barkley, R.A. (2008). Challenges in diagnosing adults with ADHD. Journal of Clinical Psychiatry, 69, e36.
  • Barkley, R.A., & Brown, T.E. (2008). Unrecognized attention-deficit/hyperactivity disorder in adults presenting with other psychiatric disorders. CNS Spectrums, 13, 977-984.
  • Biederman, J., Faraone, S., Spencer, T., Mick, E., Monuteaux, M., & Aleardi, M. (2006). Functional impairments in adults with selfreports of diagnosed ADHD: A controlled study of 1,001 adults in the community. Journal of Clinical Psychiatry, 67, 524-540.
  • Biederman, J., Petty, C.R., Dolan, C., Hughes, S., Mick, E., Monuteaux, M.C., & Faraone, S.V. (2008). The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: Findings from a controlled 10-year prospective longitudinal follow-up study. Psychological Medicine, 38, 1027-1036.
  • Booster, G.D., DuPaul, G.J., Eiraldi, R., & Power, T.J. (2012). Functional impairments in children with ADHD: Unique effects of age and comorbid status. Journal of Attention Disorders, 16(3), 179-189.
  • Cherkasova, M., Sulla, E.M., Dalena, K.L., Pondé, M.P., & Hechtman, L. (2013). Developmental course of attention deficit hyperactivity disorder and its predictors. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(1), 47-54.
  • Conners, C.K., Erhardt, D., & Sparrow, E. (1999). CAARS. Conners’ Adult ADHD Rating Scales. New York, NY: Multi-Health Systems.
  • Erhardt, D., Epstein, J.N., Conners, C.K., Parker, J.D.A., & Sitarenios, G. (1999). Self-ratings of ADHD symptoms in adults II: Reliability, validity, and diagnostic sensitivity. Journal of Attention Disorders, 3, 153-158.
  • Faraone, S.V., Biederman, J., & Mick, E. (2006). The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies. Psychological Medicine, 36, 159-165.
  • Fredriksen, M., Dahl, A.A., Martinsen, E.W., Klungsoyr, O., Faraone, S.V., & Peleikis, D.E. (in press). Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD. Attention Deficit Hyperactivity Disorder.
  • Gjervan, B., Torgersen, T., Nordahl, H.M., & Rasmussen, K. (2012). Functional impairment and occupational outcome in adults with ADHD. Journal of Attention Disorders, 16(7), 544-552.
  • Halmøy, A., Fasmer, O.B., Gillberg, C., & Haavik, J. (2009). Occupational outcome in adult ADHD: Impact of symptom profile, comorbid psychiatric problems, and treatment. A cross-sectional study of 414 clinically diagnosed adult ADHD patients. Journal of Attention Disorders, 13(2), 175-187.
  • Harpin, V.A. (2005). The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Archives of Disease in Childhood, 5, i2-i7.
  • Jacob, C., Gross-Lesch, S., Jans, T., Geissler, J., Reif, A., Dempfle, A., & Lesch, K.P. (in press). Internalizing and externalizing behavior in adult ADHD. Attention Deficit and Hyperactivity Disorders.
  • Klein, R., Mannuzza, S., Ramos Olazagasti, M., Roizen E., Hutchison, J., Erin, M., & Castellanos, X. (2012). Clinical and functional outcome of childhood ADHD 33 years later. Archives of General Psychiatry, 69(12), 1295-1303.
  • Kooij, S.J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugué, M., Carpentier, P.J., Asherson, P. (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry, 10, 67.
  • Kuntsi, J., Neale, B.M., Chen, W., Faraone, S.V., & Asherson, P. (2006). The IMAGE project: Methodological issues for the molecular genetic analysis of ADHD. Behavioural and Brain Functions, 2, 27.
  • López-Villalobos J.A., Serrano I., & Delgado (2004). Trastorno por déficit de atención con hiperactividad: comorbilidad con trastornos depresivos y de ansiedad [Attention deficit hyperactivity disorder: Comorbidity with depressive and anxiety disorders]. Psicothema, 16(3), 402-407.
  • Mannuzza, S., Castellanos, F.X., Roizen, E.R., Hutchison, J.A., Lashua, E.C., & Klein, R.G. (2011). Impact of the impairment criterion in the diagnosis of adult ADHD: 33-year follow-up study of boys with ADHD. Journal of Attention Disorders, 15(2), 122-129.
  • Miranda, A., Mercader, J., Fernández, M. I., & Colomer, C. (in press). Reading performance of young adults with ADHD diagnosed in childhood: Relations with executive functioning. Journal of Attention Disorders.
  • Polanczyk, G., de Lima, M.S., Horta, B.L., Biederman, J., & Rohde, L.A. (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American Journal of Psychiatry, 164(6), 942-948.
  • Ramos-Quiroga, J.A., Montoya, A., Kutzelnigg, A., Deberdt, W., & Sobanski, E. (2013). Attention deficit hyperactivity disorder in the European adult population: Prevalence, disease awareness, and treatment guidelines. Current Medical Research & Opinion, 29(9), 1-12.
  • Safren, S., Sprich, E., Cooper, C., Knous, L., & Lerner, J. (2010). Life impairments in adults with medication-treated ADHD. Journal of Attention Disorders, 13(5), 524-531.
  • Sarver, D.E., McCart, M.R., Sheidow, A.J., & Letourneau, E.J. (in press). ADHD and risky sexual behavior in adolescents: Conduct problems and substance use as mediators of risk. Journal of Child Psychology and Psychiatry.
  • Sciberras, E., Roos, L.E., & Efron, D. (2009). Review of prospective longitudinal studies of children with ADHD: Mental health, educational, and social outcomes. Current Attention Disorder Report, 1, 171-217.
  • Shifrin, J.G., Proctor, B.E., & Prevatt, F.F. (2010). Work performance differences between college students with and without ADHD. Journal of Attention Disorders, 13(5), 489-496.
  • Sobanski, E. (2006). Psychiatric comorbidity in adults with attention-deficit/hyperactivity disorder (ADHD). European Archives of Psychiatry and Clinical Neuroscience, 256 (Suppl), i26-31.
  • Sobanski, E., Brüggemann, D., Alm, B., Kern, S., Deschner, M., Schubert, T., Rietschel, M. (2007). Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). European Archives of Psychiatry and Clinical Neuroscience, 257, 371-377.
  • Sprich, S.E., Knouse, L., Cooper-Vince, C., Burbridge, J., & Safren, S.A. (2012). Description and demonstration of CBT for ADHD in adults. Cognitive and Behavioral Practice, 17(1), 1-17.
  • Steward, K.A., Tan, A., Delgaty, L., Gonzales, M.M., & Bunner, M. (in press). Self-awareness of executive functioning deficits in adolescents with ADHD. Journal of Attention Disorders.
  • Walker, S., Venter, A., van der Walt, A., & Esterhuyse, K. (2011). Prevalence of attention-deficit/hyperactivity disorder (ADHD) symptomatology and psychiatric co-morbidity among adolescents diagnosed with ADHD in childhood. The South African Journal of Psychiatry, 17(1), 24-28.
  • Wechsler, D. (1999). Escala de inteligencia de Wechsler para adultos-III [Wechsler Adult Intelligence Scale-Third edition (WAIS-III)]. Madrid, TEA.
  • Weiss, M.D. (2010). Diagnosis of childhood-onset conditions in adult psychiatry. Primary Psychiatry, 17, 21-28.
  • Weiss, M. (2008). Beyond core symptoms: Implications of effectiveness research for clinical practice. Paper presented at the American Academy of Child and Adolescent Psychiatry Annual Meeting.
  • Willcutt, E.G., Nigg, J.T., Pennington, B.F., Solanto, M.V., Rohde, L.A., Tannock, R., …, & Lahey, B.B. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991-1010.
  • Young, S., & Bramham, J. (2012). Cognitive-behavioural therapy for ADHD in adolescents and adults: A psychological guide to practice. UK: Wiley & Sons.
  • Zulauf, C.A., Sprich, S.E., Safren, S.A., & Wilens, T.E. (2014). The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Current Psychiatry Reports, 16, 436-445.