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Objective: The purpose of this study was to determine the reasons for seeking psychiatric support among patients, who were diagnosed with attention-deficit/ hyperactivity disorder (ADHD) for the first time in adulthood and to compare them with adult ADHD patients, who had been diagnosed in childhood in terms of symptoms, functionality and comorbid psychiatric disorders.
Method: We utilized a questionnaire consisting of both open-ended and multiple-choice questions, which were filled in by the patients, who applied to the ADHD outpatient clinic at the Department of Psychiatry, Istanbul Faculty of Medicine. The questions inquired about age, education/job status, age during the first psychiatric application, application reasons and age of onset of the current complaints which are related to ADHD. The onset age of the current complaints related to ADHD were defined based on the patients' statement. This could be different from the clinician's point of evaluation. Participants were divided into two groups according to their age at which they were first clinically diagnosed to have ADHD. The group of patients who were diagnosed at age of 18 or later was named as adulthood diagnosed group while the others were classified as childhood diagnosed group. These two groups were also compared in terms of comorbid psychiatric disorders, pharmacotherapeutic outcomes, the effects of ADHD on Work/School Life and the impacts on Daily Life and Social Relationships.
Results: 35 patients (24 male and 11 female) participated to this study. 19 of them had been diagnosed to have ADHD during adulthood. The mean (m) age of all participants was 24.4 with a standard deviation (SD) of 9.2. The patients were also classified based on ADHD sub-type. In the adulthood diagnosed group, 13 patients had inattentive type and six of them had combined type, while in the childhood diagnosed group seven patients had inattentive type and nine of them had combined type. Half of the childhood diagnosed group stated that their complaints started before the age of seven and the other half reported an age of onset between ages of 8 and 15. In the adulthood-diagnosed group, eight of the 19 patients stated that their complaints started before the age of 7, five of them between the ages of 8 and 15 and the rest of them reported ages of 16 or later. The severity of the symptoms, comorbid disorders and subtype of ADHD were similar in adulthood diagnosed and childhood diagnosed patients. The consequences of ADHD and benefits from medication were similar in both groups but adulthood diagnosed patients expressed more depressive complaints.
Conclusion: Although ADHD symptoms appear in early life, some patients may discern the effects of the disorder in older ages. The patients who are diagnosed to have ADHD for the first time in adulthood shows similar clinical features and symptom severity in patients who are diagnosed earlier and they have comparable benefits out of medical treatment.