Adult-Onset ADHD: A Critical Analysis and Alternative Explanations

Taylor, Lea; Kaplan‐Kahn, Elizabeth A.; Lighthall, Rachel A; Antshel, Kevin M.

doi:10.1007/s10578-021-01159-w

Cited by 29 publications

(17 citation statements)

References 78 publications

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“…Cases of adult-onset ADHD symptoms were mainly those diagnosed with substance use and other mental disorders (Sibley et al, 2018). Thus extant data are insufficient to confirm an adult-onset ADHD although sporadic cases may exist (Asherson & Agnew-Blais, 2019; Taylor et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics

Adamis

Flynn

Wrigley³

et al. 2022

J Atten Disord

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Objective: Systematic review and meta-analysis to estimate the pooled prevalence of ADHD in adult attendees of outpatient mental health clinics and to investigate factors influencing prevalence rates. Methods: The following were extracted: demographics, design of the study (screening only or two-phase), scales/criteria for diagnosis of ADHD, number of ADHD, and non-ADHD participants. Results: The pooled prevalence of ADHD from screening studies ( n = 9) was 26.7%, (95% CI [17.2–37.4]), ADHD = 1727, No ADHD = 3,578. From studies employing a two-stage design ( n = 5), prevalence was 14.61%, CI [10.39–19.41], ADHD = 561, No ADHD = 3,578. Age and gender did not have any significant effect on the estimated prevalence. By contrast exclusion of psychotic disorders lowers prevalence. The screening scale used also influence prevalence rates. Conclusion: Meta-analysis shows high rates of adult ADHD among psychiatric outpatient clinics. Applying DSM-5 criteria increased prevalence rates. More methodologically robust studies, using two-stage design, need to be conducted to help assist in service planning.

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Section: Discussionmentioning

confidence: 99%

ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics

Adamis

Flynn

Wrigley³

et al. 2022

J Atten Disord

View full text Add to dashboard Cite

show abstract

“…For a long time it has been debated if ADHD may also be developed in adulthood, with no previous symptoms in childhood (“adult‐onset ADHD”; (Castellanos, 2015)). However, a recent review argues that symptoms in adults indeed exist but that their source would be either symptoms that were previously surpassed, were not properly assessed before, or not detected earlier (Taylor et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Effects of a single‐dose methylphenidate challenge on resting‐state functional connectivity in stimulant‐treatment naive children and adults with ADHD

Kaiser

Broeder

Cohen

et al. 2022

Human Brain Mapping

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Prior studies suggest that methylphenidate, the primary pharmacological treatment for attention‐deficit/hyperactivity disorder (ADHD), alters functional brain connectivity. As the neurotransmitter systems targeted by methylphenidate undergo significant alterations throughout development, the effects of methylphenidate on functional connectivity may also be modulated by age. Therefore, we assessed the effects of a single methylphenidate challenge on brain network connectivity in stimulant‐treatment naïve children and adults with ADHD. We obtained resting‐state functional MRI from 50 boys (10–12 years of age) and 49 men (23–40 years of age) with ADHD (DSM IV, all subtypes), before and after an oral challenge with 0.5 mg/kg methylphenidate; and from 11 boys and 12 men as typically developing controls. Connectivity strength (CS), eigenvector centrality (EC), and betweenness centrality (BC) were calculated for the striatum, thalamus, dorsal anterior cingulate cortex (dACC), and prefrontal cortex (PFC). In line with our hypotheses, we found that methylphenidate decreased measures of connectivity and centrality in the striatum and thalamus in children with ADHD, but increased the same metrics in adults with ADHD. Surprisingly, we found no major effects of methylphenidate in the dACC and PFC in either children or adults. Interestingly, pre‐methylphenidate, participants with ADHD showed aberrant connectivity and centrality compared to controls predominantly in frontal regions. Our findings demonstrate that methylphenidate's effects on connectivity of subcortical regions are age‐dependent in stimulant‐treatment naïve participants with ADHD, likely due to ongoing maturation of dopamine and noradrenaline systems. These findings highlight the importance for future studies to take a developmental perspective when studying the effects of methylphenidate treatment.

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“…For a long time it has been debated if ADHD may also be developed in adulthood, with no previous symptoms in childhood (“adult-onset ADHD”; [68]). However, a recent review argues that symptoms in adults indeed exist but that their source would be either symptoms that were previously surpassed, were not properly assessed before, or not detected earlier [69].…”

Section: Discussionmentioning

confidence: 99%

Effects of a single-dose methylphenidate challenge on resting-state functional connectivity in stimulant-treatment naive children and adults with ADHD

Kaiser

Broeder

Cohen

et al. 2022

Preprint

View full text Add to dashboard Cite

Prior studies suggest that methylphenidate, the primary pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD), alters functional brain connectivity. As the neurotransmitter systems targeted by methylphenidate undergo significant alterations throughout development, the effects of methylphenidate on functional connectivity may also be modulated by age. Therefore, we assessed the effects of a single methylphenidate challenge on brain network connectivity in stimulant-treatment naïve children and adults with ADHD. We obtained resting-state functional MRI from 50 boys (10-12 years of age) and 49 men (23-40 years of age) with ADHD (DSM IV, all subtypes), before and after an oral challenge with 0.5 mg/kg methylphenidate; and from 11 boys and 12 men as typically-developing controls. Connectivity strength (CS), eigenvector centrality (EC), and betweenness centrality (BC) were calculated for the striatum, thalamus, dorsal anterior cingulate cortex (dACC), and prefrontal cortex (PFC). In line with our hypotheses, we found that methylphenidate decreased measures of connectivity and centrality in the striatum and thalamus in children with ADHD, but increased the same metrics in adults with ADHD. Surprisingly, we found no major effects of methylphenidate in the dACC and PFC in either children or adults. Interestingly, pre-methylphenidate, participants with ADHD showed aberrant connectivity and centrality compared to controls predominantly in frontal regions. Our findings demonstrate that methylphenidate’s effects on connectivity of subcortical regions are age-dependent in stimulant-treatment naïve ADHD patients, likely due to ongoing maturation of dopamine and noradrenaline systems. These findings highlight the importance for future studies to take a developmental perspective when studying the effects of methylphenidate treatment.

show abstract

Adult-Onset ADHD: A Critical Analysis and Alternative Explanations

Cited by 29 publications

References 78 publications

ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics

ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics

Effects of a single‐dose methylphenidate challenge on resting‐state functional connectivity in stimulant‐treatment naive children and adults with ADHD

Effects of a single-dose methylphenidate challenge on resting-state functional connectivity in stimulant-treatment naive children and adults with ADHD

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