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(Adult ADHD)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 15 in the April 1-2, 2006 issue of The Mississauga News under the feature: Health & Wellness, Medical Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

We all probably know of at least one, but have met many such individuals. Do you know of someone who has trouble fitting it? They often speak first without thinking, are unable to sit still, and can be very disruptive in social situations. They tend to make mistakes for lack of concentration, have little regard for time, seem forgetful, easily distracted and frequently lose things. These are some of the characteristics that define Adult Attention Deficit-Hyperactivity Disorder (A-ADHD). The reason it is not a disease is that there is no known biochemical abnormality associated with this group of symptoms that can be tested for, nor does it lead to other health problems. A-ADHD is very difficult to diagnose as it relies on careful observation, close scrutiny and insight on the part of the patient. People who have various groupings of these characteristics can be further subdivided. As many as 5% of adults may exhibit some form of this disorder.

People with A-ADHD tend to interpret the rules of society in their own special way. They tend to be oblivious to the observations every one else makes. For this reason, it becomes difficult for them to fit into social situations. There are three key features of this disorder. First is inattention, whereby it is difficult to maintain concentration on a given task. Skipping from task to task while completing none is common and results in a great deal of frustration, because enormous time is spent on trivial tasks and major ones are left unfinished. Inattention means they cannot follow instructions, and tend to lose things or forget where they put them. The second feature is hyperactivity. This means being on the go with almost inexhaustible energy or continuous feeling of "being on the edge". These are the fidgety sitters who talk continuously and can be seen making inappropriate movements and gestures. The third feature is impulsivity manifested by blurting out statements or an inability to wait their turn whether it is at the supermarket, washroom or gas station. They interrupt and disrupt without realizing it. In adults, this is seen more as disinhibition, since they tend to realize it a little bit more than children. To be considered A-ADHD, the features must cause disruption in more than one sphere of their lives and be continually present for more than six months. A wrecked marriage and drifting from one job to another are common examples. Many psychiatrists believe that features of the disorder are present in childhood and continue into adulthood. Some adults diagnosed with the features appear to be underachievers, but it really depends on what you use as a measuring stick. Most A-ADHD sufferers have above average intelligence quotients.

To diagnose A-ADHD takes a great deal of time, insight and judgment. Rating scales and questionnaires have been developed to aid in this regard. The only reason to treat the disorder is to allow afflicted individuals to better function in society. A-ADHD seems to be genetically associated. If you are diagnosed, there is a much higher chance that a brother or sister also has these features. One of my favorite theories about the disorder suggests that ADHD is a genetic trait that was favored and naturally selected in "warrior" societies. It would certainly be advantageous to have armies full of energetic, intelligent, quick-moving, uninhibited and loud warriors. It is no secret that modern armies also attract these individuals. To keep such armies in control requires constant discipline, drilling and structure. Interestingly enough, these same disciplinary measures help children who exhibit ADHD to stay focused on their daily tasks. Sadly, some adults never accept the diagnosis and rarely recognize that they stand out. Others have discovered that alcohol and street drugs can modify symptoms and may end up becoming addicted by accident. This complicates the physician's ability to make a diagnosis.

Understanding A-ADHD is perhaps the key to recognizing and accepting it. We all have some aspects of the various features that I have described. If you have made it this far into this article, congratulations, you probably do not have A-ADHD. Almost 50% of adults who think they have the disorder do not meet the criteria.

Related resources:
Adult attention-deficit disorder from Wikipedia, the free encyclopedia. (Adult ADD, Adult ADHD, or AADD) is informal terminology commonly used to describe the neurological condition "attention-deficit hyperactivity disorder" (ADHD) when it occurs in adults. Prior to 1987, ADHD was formally known as ADD under the DSM-III issued in 1980. It has been estimated that about eight million adults have ADHD in the United States.
Attention Deficit Disorder (ADHD) Test. Jasper/Goldberg Adult ADD/ADHD Screening Quiz by Larry Jasper & Ivan Goldberg.
Adult ADHD: An overlooked problem by Randy Dotinga, HealthDay, from USA Today. ADHD is estimated to affect as many as 7% of American children, as well as 2% to 4% adults.
Attention-Deficit/Hyperactivity Disorder: ADHD in Adults from MedicineNet.
The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication by Ronald C. Kessler, et al. From American Journal of Psychiatry, April 2006. Despite growing interest in adult attention deficit hyperactivity disorder (ADHD), little is known about its prevalence or correlates.

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