Attention‐deficit/hyperactivity disorder ( ADHD ) in adults: evidence base, uncertainties and controversies

作者：Samuele Cortese, Mark A. Bellgrove, Isabell Brikell, Barbara Franke, D. Wayne Goodman, Catharina A. Hartman, Henrik Larsson, Frances R. Levin, Edoardo G. Ostinelli, Valeria Parlatini, Josep Antoni Ramos‐Quiroga, Margaret H. Sibley, Anneka Tomlinson, Timothy E. Wilens, Ian Chi Kei Wong, Nina Hovén, J. M. Didier, Christoph U. Correll, Luís Augusto Rohde, Stephen V. Faraone · 发表于：World Psychiatry · 年份：2025 · DOI：10.1002/wps.21374 · 被引用次数：46 · 研究领域：Attention Deficit Hyperactivity Disorder、Functional Brain Connectivity Studies、Neural and Behavioral Psychology Studies

Attention-deficit/hyperactivity disorder (ADHD) was once thought to be solely a childhood condition. Now it is well established that it can persist into adulthood, with an estimated worldwide prevalence of around 2.5%. Additionally, up to 70% of individuals with childhood-onset ADHD continue to experience impairing symptoms as adults, even if they no longer meet the criteria for a formal diagnosis. The validity of adult ADHD initially faced strong criticism. Today, empirical research supports its descriptive validity (identifying characteristic signs and symptoms), predictive validity (concerning specific outcomes, courses, and responses to treatment), and concurrent validity (evidence related to its underlying causes and biological mechanisms). Despite this progress, unresolved questions and ongoing debates about adult ADHD persist. This paper summarizes current empirical evidence, alongside uncertainties and controversies, regarding the definition, epidemiology, diagnosis, etiology, neurobiology, and management of ADHD in adults. Crucially, we also include perspectives from individuals with lived experience of this condition, highlighting their views on unmet needs and priorities for improving care. Key uncertainties and controversies on adult ADHD include: a) the possibility of late-onset ADHD; b) the significance of emotional dysregulation as a core symptom; c) the definition and characterization of functional impairment; d) the persistence of comorbid psychiatric and som...