Background
Diagnosing attention-deficit/hyperactivity disorder (ADHD) in adults is difficult
when the diagnostician cannot establish an onset prior to the DSM-IV criterion of
age 7 or if the number of symptoms recalled does not achieve the DSM-IV threshold
for diagnosis. Because neuropsychological deficits are associated with ADHD, we addressed
the validity of the DSM-IV age at onset and symptom threshold criteria by using neuropsychological
test scores as external validators.
Methods
We compared four groups of adults: 1) full ADHD subjects met all DSM-IV criteria for
childhood-onset ADHD; 2) late-onset ADHD subjects met all criteria except the age
at onset criterion; 3) subthreshold ADHD subjects did not meet full symptom criteria;
and 4) non-ADHD subjects did not meet any of the above criteria.
Results
Late-onset and full ADHD subjects had similar patterns of neuropsychological dysfunction.
By comparison, subthreshold ADHD subjects showed few neuropsychological differences
with non-ADHD subjects.
Conclusions
Our results showing similar neuropsychological underpinning in subjects with late-onset
ADHD suggest that the DSM-IV age at onset criterion may be too stringent. Our data
also suggest that ADHD subjects who failed to ever meet the DSM-IV threshold for diagnosis
have a milder form of the disorder.
Key Words
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Article info
Publication history
Published online: July 28, 2006
Accepted:
March 14,
2006
Received in revised form:
March 9,
2006
Received:
September 6,
2005
Identification
Copyright
© 2006 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
