TEMPLATE DESIGN © Reasons for seeking psychiatric support among patients diagnosed with attention-deficit/ hyperactivity disorder in adulthood and differences from early diagnosed patients Nurdan Ünaldı¹*, Lütfi İlhan Yargıç² 1 Istanbul University, Faculty of Medicine, Departmant of Child and Adolescent Psychiatry, Istanbul 2 Istanbul University, Faculty of Medicine, Departmant of Psychiatry, Istanbul Objective Method 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. We utilized a questionnaire consisting of both open-ended and multiple choice questions, which was 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 evaluation. Participants were divided into two groups according to their age at which they were first clinically diagnosed with ADHD. The group of patients who were diagnosed at age 18 or later was named as adulthood diagnosed group while the others were accepted as childhood diagnosed group. These two groups were also compared according to comorbid psychiatric disorders, benefits from medications, 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 with 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. * Contact info: The comorbid psychiatric disorders are presented in Fig.2. Figure 2. Comorbid Psychiatric Diagnoses. There was no statistical difference between groups. The reasons for application to ADHD outpatient clinic are shown in Fig.1 Figure 1. Reasons for application to ADHD clinic. There was no statistical difference between groups. T test p< 0.05 In the childhood diagnosed group; hyperactivity, impulsivity and school failure were prominent, while in the adulthood diagnosed group depression was distinguished. In both groups inattention was the main reason for application to outpatient clinic. In the adulthood diagnosed group obsessive compulsive disorder and opponent defiant and conduct disorder were discernible, in the childhood diagnosed group high functional autism and borderline personality disorder showed differences compared to other comorbidities. In both groups major depressive disorder and anxiety disorder were the major disorders. The consequences of ADHD and benefits from medication are summarized in Table 2. Table 2. Consequences of ADHD and Benefits From Medication Table 1. Onset Age of Patient Complaints 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, the effects of the disorder may be discerned by some patients in older ages. The patients who are diagnosed with ADHD for the first time in adulthood show similar clinical features and symptom severity with the patients who are diagnosed earlier and they have comparable benefit from medical treatment. References 1. Alyanak FO, Yargic I, Oflaz S. Genel Psikiyatri Polikliniginde Eriskin Dikkat Eksikligi Hiperaktivite Bozuklugu Sıklıgı ve Dikkat Eksikligi-Hiperaktivite Bozukluguna Eslik Eden Diger Psikiyatrik Bozukluklar. Nöropsikiyatri Arsivi 2011; 48: Willoughby MT, Curran PJ, Costello EJ, Angold A. Implications of early versus late onset of attention-deficit/hyperactivity disorder symptoms. J Am Acad Child Adolesc Psychiatry. 2000; 39(12):