Adults referred to a national ADHD clinic in Iceland: clinical characteristics and follow-up status

Abstract

Objective

Evaluate adults referred to a national ADHD clinic, by comparing those diagnosed with those who were not, and those who screened negative and to evaluate changes among those diagnosed at follow-up.

Method

Data obtained from 531 patients’ medical records (49.7% males). One hundred thirty-six screened negative, 395 positive and 305 met diagnostic criteria for ADHD. Eighty-three of them were contacted by phone at follow-up.

Results

ADHD diagnosis was associated with lower educational status and more concerns expressed by parents and teachers during childhood. Participants not diagnosed with ADHD more often met diagnostic criteria for dysthymia, agoraphobia and generalized anxiety, and were more likely to be diagnosed with two or more comorbid disorders. At follow-up, all reported a significant reduction of ADHD symptoms, irrespective of medication, but the medicated participants reported fewer symptoms of inattention and better functioning in daily life.

Conclusion

Adults referred to ADHD clinics may have multiple mental health problems, regardless of whether they receive ADHD diagnosis or not. This could have implications for differential diagnoses of ADHD in adults and emphasises the need to have appropriate treatment available for both groups. Psychoeducation about ADHD may be very helpful in decreasing anxiety and ADHD symptoms.

Keywords:

• Adult ADHD
• comorbid disorders
• medication
• follow-up
• functioning

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Bára Sif Ómarsdóttir

Bára Sif Ómarsdóttir received her BS degree in psychology at the University of Iceland in 2014 and Cand Psych degree (MSc) at the University of Reykjavík in 2017. She worked as a psychologist in the ADHD team at Landspítali – The National University Hospital in Iceland from 2017 to 2018. From 2018 she has worked at the Icelandic Centre for Treatment of Anxiety Disorders.

Sigurlín Hrund Kjartansdóttir

Halldóra Ólafsdóttir received her MD degree from University of Iceland 1976. She did her year of internship in Reykjavik hospitals, worked as a family physician in the countryside of Iceland and as a junior doctor in pediatiatrics before she began her training in psychiatry and neurology at Landspitali-The National University Hospital in Iceland in 1978. She had her formal residency training in psychiatry at Strong Memorial Hospital, Univ. of Rochester, New York 1980-1983 and thereafter did a clinical fellowship in psychiatry (psychotherapy and emergency psychiatry) at New England Medical. Center, Tufts Univ. Boston, Massachusetts, 1983-1985. American Board of Psychiatry.

Páll Magnússon

Jón Friðrik Sigurðsson received his PhD in Psychology at the Institute of Psychiatry, Psychology and Neuroscience at King’s College, London in 1998, MSc in Health Psychology at University of Stirling, Scotland in 1989, and BA in Psychology and Philosophy at the University of Iceland in 1976. He is presently a Professor of Psychology at the Department of Psychology, Reykjavik University (since 2007) and the Faculty of Medicine at the University of Iceland (since 2005). Between 2001 and 2013 he was the Head of Clinical Psychology Services at Landspitali-The National University Hospital of Iceland and between 1988 and 2001 he was a Prison Psychologist at the National Prison and Probation Administration in Iceland. He has been adviser to the Ministry of Welfare, the Althingi Ombudsman, and the Police and the Government Agency for Child Protection and been a member of a number of investigating committees in Iceland into ill treatment and sexual abuse of children in care homes.

Halldóra Ólafsdóttir

Páll Magnússon finished his Certificate of Clinical Psychology (D.E.S.S. de Psychologie Clinique) from the Université René Desartes, Sorbonne in 1977. He worked as a school psychologist in the southwestern school district in Iceland from 1977-1980. From 1980 until 2013 he was a psychologist in the Department of Child and Adolescent Psy chiatry of the National University Hospital, leading the specialized team for neurodevelopmental disorders and acting as the deputy head of child psychology. In 2013 he transferred to the Department of Adult Psychiatry as team leader og the newly established ADHD Team for Adults. Since 1983 he has intermittently taught courses in clinical child psychology in the University of Iceland and been a consultant to the State Diagnostic and Counseling Centre.

Jón Friðrik Sigurðsson

Sigurlín Hrund Kjartansdóttir has an expert licence in clinical psychology from 2015. She earned her BA degree in 2002 and Cand Psych degree (MSc) in 2005, both at the University of Iceland. She worked as a psychologist at Landspítali – The National University Hospital in Iceland from 2005 to 2018. During that time she worked in different settings within the hospital, alcohol and abuse, forensic settings and from 2016 to 2018 she was a team leader in the ADHD team. Presently, Sigurlín Hrund is the Head of Clinical Psychology Services at the Health Directorate of East Iceland, Health Centres and District Hospital.