Differential Diagnosis of Adult Attention-deficit/hyperactivity Disorder: Treatment Options and Comorbidity Considerations

Attention-deficit/hyperactivity disorder (ADHD) in adults occurs at a prevalence rate that is higher than the prevalence of many major psychiatric disorders in adults. Thus, adult patients with ADHD often present with comorbid conditions, each of which alters the course of ADHD, overall treatment recommendations, and symptom response differently. Common ADHD comorbidities include major depressive disorder (MDD), bipolar disorder, and substance use disorders. Algorithms have been developed to aid clinicians in determining which presenting disorder to treat first, and additional studies have helped elucidate which pharmacologic and non-pharmacologic treatments best treat each comorbid disorder without worsening symptoms of another.