Adults with persistent ADHD: Gender and psychiatric comorbidities – a population-based longitudinal study

Abstract

Objective

To evaluate in adults the associations between persistent ADHD and comorbid psychiatric disorders and gender differences, among subjects from a population-based birth cohort.

Method

Subjects were recruited from a birth cohort of all children born during 1976–1982 who remained in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI-International Neuropsychiatric Interview) to assess current ADHD status and comorbid psychiatric disorders.

Results

Among the 232 with research-identified childhood ADHD, 68 (49 men and 19 women) had persistent adult ADHD. Compared to subjects without childhood ADHD, adults with persistent ADHD were significantly more likely to have any (81% vs. 35%, P < 0.001) as well as each of the specific psychiatric comorbidities. The associations retained significance when stratified by gender and there were no significant gender by ADHD interactions on psychiatric disorders except for dysthymia with which ADHD was more strongly associated in women than men. Among subjects with persistent ADHD, externalizing psychiatric disorders were more common in men (73%) and internalizing disorders were more common in women (53%).

Conclusion

Persistent ADHD is associated with an increased risk of comorbid psychiatric disorders in both adult men and women. Clinicians treating adults with persistent ADHD need to be aware of comorbid psychiatric disorders, especially externalizing disorders for men and internalizing disorders for women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.