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Adult-Onset ADHD: A Critical Analysis and Alternative Explanations

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Abstract

Attention deficit/hyperactivity disorder (ADHD) is characterized as a neurodevelopmental disorder. However, data from several recent studies suggest that there may be adults who meet current criteria for ADHD, yet did not experience symptoms until adulthood (i.e., “adult-onset ADHD”). This systematic review evaluated and synthesized the empirical evidence on adult-onset ADHD to answer the question: Is the extant literature strong enough to evaluate adult-onset ADHD? Nine studies met strict inclusion/exclusion criteria. Results suggest that the methodologies of the extant studies were not strong enough to evaluate adult-onset ADHD. Insufficient methodologies provide presently unclear information about the nature of late-onset symptoms. These symptoms seem to exist but their source could be (1) adult-emergent symptoms that were previously surpassed due to lower environmental demands/supportive facilitators, (2) mimics that were not properly assessed, or (3) childhood-onset symptoms that were not detected earlier due to failure to come to clinical attention. Future directions, clinical recommendations, and limitations of the literature and the current review are discussed.

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  1. Department of Psychology, Syracuse University, Syracuse, NY, 13244, USA

    Lea E. Taylor, Elizabeth A. Kaplan-Kahn, Rachel A. Lighthall & Kevin M. Antshel

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Kevin Antshel has received investigator-initiated research funding from Takeda Pharmaceutical company and serves as an Advisor to Arbor Pharmaceutical company. All other authors declare that they have no conflict of interest.

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Taylor, L.E., Kaplan-Kahn, E.A., Lighthall, R.A. et al. Adult-Onset ADHD: A Critical Analysis and Alternative Explanations. Child Psychiatry Hum Dev 53, 635–653 (2022). https://doi.org/10.1007/s10578-021-01159-w

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