MEDICAL DISCLAIMER

Information provided on this website is intended for your general knowledge and is not meant to be a substitute for professional medical advice and treatment. You should never disregard professional medical advice or delay in seeking an assessment or medical treatment because of something you may have read on this site. You should also not use the information on this web site or the information on links from this site to diagnose or treat ADHD and/or co-morbidities, in yourself or others, without consulting a qualified adult ADHD specialist.

Description by NHS Choices:

In adults, the symptoms of ADHD are more difficult to define than those in children and adolescents, which is largely due to a lack of research into the adult form of the condition. It is still uncertain whether or not ADHD can occur in adults without it first appearing during childhood, although it is known that symptoms of ADHD often persist from childhood into adolescence and adulthood. Any additional problems, or conditions, experienced by children with ADHD, such as depression, sleep problems and dyslexia, are also likely to carry on into adulthood.

By the age of 25, an estimated 15% of people diagnosed with childhood ADHD still have a full range of symptoms, and an estimated 65% still have symptoms which affect their daily lives.

There is no definitive list of adult ADHD symptoms, and experts agree that simply applying the childhood symptoms to adults would not work. This is because the way in which inattentiveness, hyperactivity, and impulsiveness affect adults, is very different ways from the way they affect children. For example, hyperactivity tends to decrease in adults, while inattentiveness tends to get worse as the pressure of adult life increases. Also, adult symptoms of ADHD tend to be far more subtle than childhood symptoms.

Below is a list of symptoms which may be used to recognise adult ADHD.

• carelessness and lack of attention to detail.
• continually starting new tasks before finishing old ones.
• poor organisational skills.
• inability to focus, or prioritise.
• continually losing, or misplacing, things.
• forgetfulness.
• restlessness and edginess.
• difficulty keeping quiet, and speaking out of turn.
• blurting responses, and poor social timing when talking to others.
• often interrupting others.
• mood swings.
• irritability and a quick temper.
• inability to deal with stress.
• extreme impatience.
• taking risks in activities, often with little, or no, regard for personal safety, or the safety of others.

As with ADHD in children and adolescents, ADHD in adults can appear alongside many related problems, or conditions. One of the most common conditions is depression. Any problems you may have had as a child are likely to persist into adulthood, which can make life extremely difficult. For example, you may have problems finding and keeping employment, as well as relationship, and social interaction problems. Some adults with ADHD may even become involved in drugs, or crime.

The above was taken from the NHS choices website (accessed 9/5/2017).

We have put a list of these symptoms into a leaflet which you can download here: Symptoms of ADHD in Adults

Description of Symptoms by The Royal College of Psychiatrists:

You find that:

• You may get easily distracted and find it hard to take notice of details, particularly with things you find boring.
• It’s hard to listen to other people – you may find yourself finishing their sentences for them or interrupting them, or just saying things at the wrong time.
• It’s hard to follow instructions.
• You find it hard to organise yourself and start a lot of things without ever finishing them.
• You find it hard to wait or when there’s nothing much going on – you fidget and can’t sit still.
• You are forgetful and tend to lose or misplace things.
• You easily get irritable, impatient or frustrated and lose your temper quickly.
• You feel restless or edgy, have difficulty turning your thoughts off, and find stress hard to handle.
• You tend to do things on the spur of the moment, without thinking, which gets you into trouble.

Psychiatrists diagnosing ADHD in adults need to be aware of the fact that people with this disorder often show decreased symptoms in a novel situation like a psychiatric evaluation. It is therefore important to base mental state evaluations on a typical week and a variety of normal situations.

Some symptoms of adult ADHD are similar to those of bipolar disorder, but ADHD tends to show a persisting trait of irritability and volatility, very different from the grandiose and euphoric symptoms of mania and the depression found in bipolar disorder.

The above was taken from The Royal College of Psychiatrists (accessed 9/5/2017)

Description of Symptoms by UK Adult ADHD Network (UKAAN)

ADHD can affect people in many different ways. Some of the most common complaints in adults are difficulties with organising daily activities and forgetfulness. People with ADHD often experience physical and mental over activity, so they may feel constantly restless, on the go all the time and complain of ceaseless unfocused mental activity; these symptoms may keep people with ADHD awake at night. Sustaining attention for any length of time can cause considerable difficulties and may lead to people with ADHD feeling exhausted or worn out by the effort. Mood instability and feelings of frustration are commonly reported, especially in situations where someone has to wait such as queuing at supermarkets.

While these types of symptoms are found in many people some of the time, they are severe, persistent over time and lead to impairments in people with ADHD. Impairment from ADHD can impact on an individual in several ways including: low self-esteem, distress from the symptoms of ADHD, impaired social interactions and relationships, behavioural problems, and the development of comorbid psychiatric symptoms, syndromes and disorders.

In addition to the symptoms of ADHD comorbidities are common. These may be other neurodevelopmental disorders such as autism spectrum disorders and dyslexia, behavioural problems such as drug and alcohol abuse disorders, addiction and antisocial behaviour; and other common mental health problems such as anxiety and depression.

The above was taken from UK Adult ADHD Network -UKAAN (accessed 9/5/2017)

Description of Symptoms on Diagnostic Interview for ADHD in Adults (DIVA) 2.0

The main requirements for the diagnosis are that the onset of ADHD symptoms occurred during childhood and that this was followed by a lifelong persistence of the characteristic symptoms to the time of the current evaluation. The symptoms need to be associated with significant clinical or psychosocial impairments that affect the individual in two or more life situations. Because ADHD in adults is a lifelong condition that starts in childhood, it is necessary to evaluate the symptoms, course and level of associated impairment in childhood, using a retrospective interview for childhood behaviours. Whenever possible the information should be gathered from the patient and supplemented by information from informants that knew the person as a child (usually parents or close relatives).

The DIVA only asks about the core symptoms of ADHD required to make the DSM-IV diagnosis of ADHD, and does not ask about other co-occurring psychiatric symptoms, syndromes or disorders. However comorbidity is commonly seen in both children and adults with ADHD, in around 75% of cases. For this reason, it is important to complete a general psychiatric assessment to enquire about commonly co-occurring symptoms, syndromes and disorders. The most common mental health problems that accompany ADHD include anxiety, depression, bipolar disorder, substance abuse disorders and addiction, sleep problems and personality disorders, and all these should be investigated. This is needed to understand the full range of symptoms experienced by the individual with ADHD; and also for the differential diagnosis, to exclude other major psychiatric disorders as the primary cause of ‘ADHD symptoms’ in adults.

Part 1: Symptoms of attention-deficit

• A1 Do you often fail to give close attention to detail, or do you make careless mistakes in your work or during other activities? And how was that during childhood?
• A2 Do you often find it difficult to sustain your attention on tasks? And how was that during childhood?
• A3 Does it often seem as though you are not listening when you are spoken to directly? And how was that during childhood?
• A4 Do you often fail to follow through on instructions and do you often fail to finish jobs or fail to meet obligations at work? And how was that during childhood (when doing schoolwork as opposed to when at work)?
• A5 Do you often find it difficult to organise tasks and activities? And how was that during childhood?
• A6 Do you often avoid (or do you have an aversion to, or are you unwilling to do) tasks which require sustained mental effort? And how was that during childhood?
• A7 Do you often lose things that are needed for tasks or activities? And how was that during childhood?
• A8 Are you often easily distracted by external stimuli? And how was that during childhood?
• A9 Are you often forgetful during daily activities? And how was that during childhood?

Part 2: Symptoms of hyperactivity-impulsivity

• H/I 1 Do you often move your hands or feet in a restless manner, or do you often fidget in your chair? And how was that during childhood?
• H/I 2 Do you often stand up in situations where the expectation is that you should remain in your seat? And how was that during childhood?
• H/I 3 Do you often feel restless? And how was that during childhood?
• H/I 4 Do you often find it difficult to engage in leisure activities quietly? And how was that during childhood?
• H/I 5 Are you often on the go or do you often act as if “driven by a motor”? And how was that during childhood?
• H/I 6 Do you often talk excessively? And how was that during childhood?
• H/I 7 Do you often give the answer before questions have been completed? And how was that during childhood?
• H/I 8 Do you often find it difficult to await your turn? And how was that during childhood?
• H/I 9 Do you often interrupt the activities of others, or intrude on others? And how was that during childhood?

The DIVA 2.0 is a publication of the DIVA Foundation, The Hague, The Netherlands, August 2010 and copies are also available in 18 other languages.

Other Adult ADHD Rating Scales

Rating scales are used to help evaluate mental health, social and  behavioural problems, including ADHD, anxiety, self-esteem, depression, and conduct problems.  Some scales describe symptoms only and not their developmental appropriateness or the level of impairment.  The diagnosis of ADHD should only be made after a full clinical and psychosocial evaluation, and never on the basis of rating scales alone.

Interpreting the results of scales can be a difficult task for non-experts so please do not use the following scales to diagnose yourself or others.  We have included the rating scales that are in the public domain them on this website for informational purposes only.  Also, their inclusion does not mean that we are recommending them.

1. Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist (this was developed in conjunction with the World Health Organization (WHO), and the Workgroup on Adult ADHD which included  Lenard Adler MD, Ronald C. Kessler PhD, & Thomas Spencer MD). The ASRS has 18 questions and a copy is available here.

2.  Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist: This is a 6 question screener which was developed later as a subset of WHO’s 18 question screener.  A copy is available here.

3.  Wender Utah Rating Scale for ADHD in Adults (may be used by adults as an aid for retroactively describing their own childhood behaviour); available here.

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Review date: 09/05/2017

Next review due: 10/05/2018