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The episodes of hot temper, typified by frequent angry eruptions out of proportion to the precipitants, often “blow over” more quickly for the patient than for coworkers and family members.
Affective lability is characterized by brief, intense affective outbursts ranging from euphoria to despair to anger, and is experienced by the ADHD adult as being out of control.
Wender developed a set of ADHD criteria, referred to as the Utah criteria, that reflect the distinct features of the disorder in adults The diagnosis of ADHD in an adult requires a longstanding history of ADHD symptoms, dating back to at least age seven.
In the absence of treatment, such symptoms should have been consistently present without remission.
Hyperactivity, while a common feature among children, is likely to be less overt in adults.
The “on the go” drivenness seen in many ADHD children is replaced in adults with restlessness, difficulty relaxing and a feeling of being chronically “on edge.”1Deficits in sustained attention and concentration are likely to remain and may become more apparent in late adolescence and early adulthood as responsibilities increase.
Diagnostic and statistical manual of mental disorders. There is growing consensus that the central feature of ADHD is disinhibition.8 Patients are unable to stop themselves from immediately responding, and they have deficits in their capacity for monitoring their own behavior. While stimulants are a common treatment for adult patients with ADHD, antidepressants may also be effective. Diagnosis is further complicated by the overlap between the symptoms of adult ADHD and the symptoms of other common psychiatric conditions such as depression and substance abuse.Evaluation of adults with symptoms of ADHD requires weighing and integrating a range of data, including the patient's history, the patient's self-report of symptoms and mental status testing .A thorough history should include an emphasis on past school performance and conduct, previous and current psychiatric therapies, and reports of specific symptoms of inattention, distractibility and disorganization.
See related patient information handout on attention-deficit/hyperactivity disorder in adults, written by the authors of this article.