Abstract
Attention-deficit hyperactivity disorder (ADHD) is a neurocognitive disorder characterized by symptoms of inattention, impulsivity and motor hyperactivity. The worldwide prevalence of ADHD, in the general adult population, has been estimated to be 2.8%. Patients with ADHD have a high incidence of comorbidity with other psychiatric disorders. Those with a psychiatric disorder as well as ADHD have more psychosocial difficulties than those without ADHD. Despite knowing that ADHD is often comorbid with other psychiatric diagnoses, there are currently no studies elucidating the prevalence of ADHD in the inpatient psychiatric population, nor is there significant information about its impact. The lack of research into this topic suggests more needs to be done in the field of adult ADHD, especially in the inpatient psychiatric population and with respect to impairment in patient function. Knowing the prevalence of ADHD and its impact on quality of life in adult inpatients will help lay the groundwork for effective screening and management. The purpose of this study was to understand the prevalence rates of ADHD among psychiatric acute care inpatients. Other objectives included comparing the quality of life and functioning between patients with a primary psychiatric diagnosis and ADHD (treated or untreated) versus those with a primary psychiatric diagnosis and no ADHD. Thirty-three (N = 31) psychiatric inpatients were screened using the Adult ADHD Self-Report Scale. Those that screened positive for ADHD received a full diagnostic assessment for ADHD. All patients completed the Weiss Functional Impairment Rating Scale (WFIRS) to assess level of functioning and a Clinical Global Impression of Severity/Improvement Scale (on admission and discharge). Demographic information was also obtained. Of the 31 patients analyzed, 12 had a diagnosis of ADHD (36.4%). The participants diagnosed with ADHD scored significantly higher on the WFIRS, suggesting decreased functioning compared to patients without comorbid ADHD. Patients with ADHD also scored significantly higher in the individual domains of this rating scale, suggesting impairment in family, work and social functioning as well as decreased life-skills, poor self-concept and increased risk-taking behavior. In this sample, the prevalence of ADHD is significantly higher among acute care psychiatric inpatients than in the general population. Patients with concomitant ADHD suffer more functional impairment than those without. These findings merit further investigation into the value of routine screening and patient-specific treatment of ADHD in this patient population.
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References
Adler L, Cohen J (2004) Diagnosis and evaluation of adults with attention-deficit/hyperactivity disorder. Psychiatr Clin North Am 27(2):187–201
Asherson P, Akehurst R, Kooij JJ et al (2012) Under diagnosis of adult ADHD: cultural influences and societal burden. J Atten Disord 16(5 Suppl):20S–38S
Babcock T, Ornstein CS (2009) Comorbidity and its impact in adult patients with attention-deficit/hyperactivity disorder: a primary care perspective. Postgrad Med 121(3):73–82
Barkley RA, DuPaul GJ, McMurray MB (1990) Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. J Consult Clin Psychol 58(6):775–789
Biederman J, Petty CR, Evans M et al (2010) How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Res 177(3):299–304
Canu WH, Hartung CM, Stevens AE, Lefler EK (2016) Psychometric properties of the weiss functional impairment rating scale: evidence for utility in research, assessment, and treatment of ADHD in emerging adults. J Atten Disord. https://doi.org/10.1177/1087054716661421
Castaneda R, Levy R, Hazzi C et al (2008) Treating adult attention deficit hyperactivity disorder in hospitalized psychiatric patients. Gen Hosp Psychiatry 30(6):572–577
Cox DJ, Madaan V, Cox BS (2011) Adult attention-deficit/hyperactivity disorder and driving: why and how to manage it. Curr Psychiatry Rep 13(5):345–350
Cumyn L, French L, Hechtman L (2009) Comorbidity in adults with attention-deficit hyperactivity disorder. Can J Psychiatry 54(10):673–683
Dawson EL, Shear PK, Howe SR, Adler CM, DelBello MP, Fleck DE, Strakowski SM (2014) Impulsivity predicts time to reach euthymia in adults with bipolar disorder. Bipolar Disord 16(8):846–856
Fayyad J, De Graaf R, Kessler R et al (2007) Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry 190:402–409
Fayyad J, Sampson NA, Hwang I et al (2017) The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord 9(1):47–65. https://doi.org/10.1007/s12402-016-0208-3 (Epub 2016 Nov 19)
Hechtman L (1999) Predictors of long-term outcome in children with attention-deficit/hyperactivity disorder. Pediatr Clin North Am 46(5):1039–1052
Kessler RC, Adler L, Ames M et al (2005a) The world health organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Psychol Med 35(2):245–256
Kessler RC, Adler LA, Barkley R et al (2005b) Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the national comorbidity survey replication. Biol Psychiatry 57(11):1442–1451
Kooij SJ, Bejerot S, Blackwell A et al (2010) European consensus statement on diagnosis and treatment of adult ADHD: the European network adult ADHD. BMC Psychiatry 3(10):67 (244X-10-67)
Kumar G, Faden J, Steer RA (2011) Screening for attention-deficit/hyperactivity disorder in adult inpatients with psychiatric disorders. Psychol Rep 108(3):815–824
Lichtenstein P, Halldner L, Zetterqvist J et al (2012) Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med 367(21):2006–2014
Marin A, Scott D, Groll DL (2013) Bipolar disorder comorbid with attention-deficit/hyperactivity disorder in adult inpatients with acute relapse. Prim Care Companion CNS Disord. https://doi.org/10.4088/PCC.12m01495 (Epub 2013 Jul 4)
Mohr P, Látalová K, Čeplová Z, Jelenová D, Stopková P, Mikoláš P, Czobor P, Bitter I (2014) Adult ADHD in a general psychiatric population. Poster session presented at: 27th European College of Neuropsychopharmacology (ECNP) congress. Berlin, 2014
Sharfstein SS (2009) Goals of inpatient treatment for psychiatric disorders. Annu Rev Med 60:393–403
Sobanski E, Bruggemann D, Alm B et al (2007) Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). Eur Arch Psychiatry Clin Neurosci 257(7):371–377
Turgay A, Goodman DW, Asherson P et al (2012) ADHD transition phase model working group. Lifespan persistence of ADHD: the life transition model and its application. J Clin Psychiatry 73(2):192–201
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Lines, K.L., Sadek, J. ADHD in acute care psychiatric inpatients. ADHD Atten Def Hyp Disord 10, 129–133 (2018). https://doi.org/10.1007/s12402-017-0243-8
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DOI: https://doi.org/10.1007/s12402-017-0243-8