ADHD usually starts early in life, typically between ages six and 12. Besides the core symptoms of hyperactivity, impulsivity, inattention and also emotional instability, many affected people suffer from other mental disorders that are found more frequently than expected by chance – so called comorbid disorders. The pattern of comorbid disorders however changes considerably over the life span. In childhood, oppositional defiant disorder (ODD) or conduct disorder (CD) are the most frequent comorbid disorders. However, ADHD can also occur together with autism spectrum disorders and learning disorders.
When people get older, ADHD may persist into adulthood and around two thirds of people continue to experience impairing symptoms. ODD and CD may develop further into antisocial personality disorder, and substance use disorders (for both legal substances like alcohol and illicit drugs such as cannabis or cocaine) may become a problematic comorbidity with respective overall health consequences. Most frequently however, adults with ADHD suffer from anxiety or mood disorders; up to 50% of people suffering from adult ADHD also experience at least once in their life an episode of major depression. Furthermore, overall mortality rate is increased due to higher risks of suicide and unintentional injuries.
About the Author
Prof. Andreas Reif, MD is head of the Department of Psychiatry, Psychosomatic Medicine and Psychotherapy of the University Hospital Frankfurt, Germany. His clinical and research interests comprise ADHD and mood disorder, with focus on mechanisms to enable new treatments. He coordinates the large EU consortium CoCA on comorbid conditions of ADHD.
Franke B, Michelini G, Asherson P, Banaschewski T, Bilbow A, Buitelaar JK, Cormand B, Faraone SV, Ginsberg Y, Haavik J, Kuntsi J, Larsson H, Lesch KP, Ramos-Quiroga JA, Réthelyi JM, Ribases M, Reif A. Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacol. 2018 Oct;28(10):1059-1088. doi: 10.1016/j.euroneuro.2018.08.001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379245/
Chen, Q., Hartman, C. A., Haavik, J., Harro, J., Klungsøyr, K., Hegvik, T. A., Wanders, R., Ottosen, C., Dalsgaard, S., Faraone, S. V., & Larsson, H. (2018). Common psychiatric and metabolic comorbidity of adult attention-deficit/hyperactivity disorder: A population-based cross-sectional study. PloS one, 13(9), e0204516. https://doi.org/10.1371/journal.pone.0204516 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157884/
Solberg, B. S., Halmøy, A., Engeland, A., Igland, J., Haavik, J., & Klungsøyr, K. (2018). Gender differences in psychiatric comorbidity: a population-based study of 40 000 adults with attention deficit hyperactivity disorder. Acta psychiatrica Scandinavica, 137(3), 176–186.