Undertreatment of ADHD in US Adults: An Unmet Need

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Illustration of person distracted
Results indicate there is an unmet need for better treatment to manage symptom burden in US adults with ADHD.
The following article is part of live conference coverage from the 2017 Psych Congress in New Orleans, Louisiana. Psychiatry Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in psychiatry, as well as presentations from the Congress. Visit Psychiatry Advisor’s conference section for continuous coverage live from Psych Congress 2017.

NEW ORLEANS — Results from a study presented at the at the 2017 US Psych Congress, held September 16-19 in New Orleans, Louisiana, showed that almost two-thirds of adults in the United States who self-reported attention deficit hyperactivity disorder (ADHD) were not pharmacologically treated, even though they were highly affected by their symptoms.

To examine the symptom burden of ADHD in a large, representative sample of US adults, Alexandra Khachatryan, MPH, from Shire, LLC in Lexington, Massachusetts, and colleagues contacted individuals who had completed the 2012 or 2013 National Health and Wellness Survey (NHWS) to participate in the current study. Eligible participants included adults 18 or older who either self-reported experiencing ADHD or attention deficit disorder (ADD) in the past 12 months or self-reported ADHD or ADD that was diagnosed by a physician. Participants opted in to the survey online. ADHD-like symptoms were screened using the Adult ADHD Self-Report Scale version 1.1 (ASRS-v1.1).

Of a total of 22,397 US adults who participated in the survey, 465 self-reported a diagnosis of ADHD. These patients were more likely to report comorbidities compared with patients who did not, including depression (58.1% vs 18.4%), anxiety (53.1% vs 16.0%), sleep difficulties (37.0% vs 14.0%), heartburn (21.5% vs 12.9%), panic disorder (20.4% vs 4.4%), posttraumatic stress disorder (PTSD)(18.3% vs 3.0%), and gastroesophogeal reflux disease (GERD) (13.8% vs 8.1%;P <.001 for each).

Individuals who self-reported an ADHD diagnosis were also more likely to screen positive for bipolar disorder (0.2% vs 0.0%, P =.02) and major depressive disorder (15.5% vs 5.6%, P <.001) on the Patient Health Questionnaire-9 (PHQ-9).

In patients who self-reported an ADHD diagnosis, 62.6% reported not currently using a prescription medication to treat it.

“Results indicate there is an unmet need for better treatment to manage symptom burden among US adults with ADHD,” the researchers wrote. “These findings underscore the importance of screening for symptoms with validated instruments, like the ASRS-v1.1, to aid proper diagnosis and optimal management of ADHD in adults.”

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In an interview with Psychiatry Advisor, Ms Khachatryan elaborated on these findings as well as a separate study focused on healthcare providers’ perspectives on diagnosing and treating adults with ADHD where she and her colleagues also looked at non-psych healthcare practices, including primary care practitioners, nurse practitioners, and family practices that treat adult ADHD to understand their confidence level with treating adult ADHD patients compared with psychiatrists.

“What we found was that non-psych specialists were not as confident and don’t always [have] the proper resources to screen, diagnose, and optimally treat adult ADHD patients,” she said. “I think we have a lot of work still ahead of us to make sure we’re recognizing adult ADHD, and that we’re properly leveraging the resources among our top [key opinion leaders] as well as other practitioners.” 

Visit Psychiatry Advisor’s conference section for continuous coverage live from Psych Congress 2017.


Adler LA, Faraone SV, Sarocco P, Atkins N, Khachatryan A. Symptom burden among self-reported ADHD in adults in the United States. Poster presented at: US Psych Congress; September 16-19, 2017; New Orleans, Louisiana.