Attention-deficit hyperactivity disorder in adults: validity unknown1

Attention-deficit hyperactivity disorder (ADHD) is a commonly diagnosed childhood psychiatric disorder. Debate over its diagnostic validity, aetiology, presentation and treatment has extended from the clinical to the public domain. As children with ADHD diagnoses reach adulthood there is increasing interest in ‘adult ADHD’. Cohorts followed up show poorer outcomes as adults than do controls. Self-referred adults, sometimes relatives of children with ADHD, are also of interest regarding adult ADHD. Innovative work is being done examining issues of aetiology, treatment, outcomes and comorbidity in these groups, but heterogeneity among those diagnosed with ADHD and changes in classification systems and diagnostic criteria over time complicate comparison of research findings. The diagnostic validity of adult ADHD remains uncertain and needs further study. Morris Zwi is a consultant child and adolescent psychiatrist with South West London & St George’s Mental Health NHS Trust (Child and Family Consultation Centre, Richmond Royal, Kew Foot Road, Richmond, Surrey TW9 2TE, UK. E-mail: [email protected]). In addition to attention-deficit hyperactivity disorder, his special interests include evidencebased practice and the politics of health care. Ann York is a consultant and honorary senior lecturer in child and adolescent psychiatry at the Child and Family Consultation Centre, Richmond Royal, and at St George’s Hospital Medical School, London. Her special interests include neurodevelopmental disorders, depression, training and service design. 1. For an invited commentary on this article see Asherson (2004, this issue: pp. 257–259). For a related editorial see Green (2004, this issue: pp. 241–242).