The Shortage of Research on Adult ADHD

By Cathy Cassata

ADHD is often solely associated with children, and carries the false notion that kids “outgrow” the condition as they age. But ADHD is very much a part of many adults’ lives.

The American Professional Society of ADHD and Related Disorders (APSARD) estimates that 4.4% of U.S. adults — or about 11 million adults — live with ADHD.

“There are actually a lot more adults with ADHD than kids with ADHD simply because kids are only age 1-18 but adults with ADHD are 19-99. So in terms of the overall population, there are a lot more adults,” says Ari Tuckman, PsyD, psychologist and a former member of the board of directors of the non-profit Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

But many people aren’t aware of the prevalence of ADHD in adults. And just as that awareness lags, so does the amount of scientific research on adults with ADHD. Researchers point out that much less money is being spent on research on adult ADHD, compared to research on ADHD in children, or research done on other mental health conditions.

In one recent study in the Journal of Attention Disorders, researchers pointed out that as of January 2023, the National Institutes of Health (NIH) Reporter listed just under $5.5 million in active funding for adult ADHD research and over $42 million in funding for pediatric ADHD.

Additionally, the study authors noted that the NIH Reporter lists at least 10-fold greater support for depression research than ADHD research, even though there is only a slightly higher prevalence of depression.

“There is a glaring need to increase research on ADHD to inform best public health approaches to identifying and treating its variable presentations with optimal pharmacological and non-pharmacological interventions,” the authors wrote.

Why More Research is Needed

Stephen V. Faraone, PhD, president of the World Federation of ADHD, says that while a great deal of ADHD research has traditionally focused on children, the recognition that ADHD can persist into adulthood necessitates more extensive study in this area.

“Adults with ADHD face unique challenges in various domains, from the workplace to relationships to self-management, and it’s crucial to understand these issues to help adults manage ADHD more effectively,” Faraone says.

Furthermore, Faraone says, because many children with ADHD continue to have ADHD as adults, it’s crucial to have a strong understanding of the adult manifestation of ADHD so people can receive the best care and support possible.

“Understanding how ADHD presents and impacts adults differently can guide the development of more effective interventions and coping strategies tailored specifically for adults,” he says. It can also help us understand the comorbidities often associated with adult ADHD, like depression, anxiety, and substance use disorders, and how to address them.

Faraone says research can also contribute to identifying the most effective ways of applying existing treatments in adult settings, including modifications to behavioral therapy approaches and medication management.

Tuckman notes that ADHD is one of the few conditions in which diagnosis and treatment is studied in kids and teenagers first, then adults. This holds true for ADHD medications approved by the U.S. Food and Drug Administration. They are first approved for kids before they are approved for adults.

“We assume that everything (about these medications) approved for kids still applies for adults, but … the demands of being a kid are very different than the demands of being an adult,” says Tuckman. “Also, brain development is very different between a 10-year old and a 40-year old.”

For instance, if a 10-year old is distracted and forgetful, it’s developmentally appropriate that their parents or teachers help them keep track of homework and remember their shin guards for soccer.

“But when you’re 40, your parents hopefully aren’t involved and your spouse and boss don’t want to be,” Tuckman says.

Research can help explore and clarify the real-world differences ADHD has on children and adults and in turn shape supportive policies and accommodations in various settings, Faraone says.

For instance, to gauge the scope of ADHD in adults and improve the quality of care, the American Professional Society of ADHD and Related Disorders teamed up with CHADD and appointed a special committee to write the first-ever, authoritative guidelines for adult ADHD in the U.S. The group consists of international and national ADHD researchers and clinicians.

The group’s adult ADHD guidelines will be based on a critical review of scientific literature; the APSARD Adult ADHD Quality Measures initiative, which several years ago published metrics for assessing quality care for diagnosing and treating ADHD in adults; and the recommendations of a committee of nearly 300 ADHD experts, in collaboration with professional organizations.

The guidelines are expected to be available for primary care practitioners and mental health specialists near the end of this year.

“Some guidelines for adults with ADHD exist in Europe, but the U.S. does not have any kind of authoritative guidelines from any professional organization,” says Tuckman. “To create guidelines, you need a foundation of data that isn’t just anecdotal. Also, having official guidelines gives a certain marker in the development of the field.”

How to Get More Funding for Adult ADHD Research

Tuckman says the public, researchers, clinicians, policy makers, government agencies and private insurance companies need to better understand the impact of untreated and undertreated ADHD in adults. That increased understanding might bring more funding for research on adults ADHD, he says.

“For example, there was research that came out in 2019 that talked about the impact of ADHD on health outcomes and life expectancy,” Tuckman says. “(It found that) if you have ADHD, you’re more likely to have diabetes; that translates to healthcare dollars, which gains interest from (healthcare) funders,” says Tuckman.

While it might seem difficult to impact the problem on an individual level, people can make an impact by participating in existing studies. People interested in taking part in a research study can visit CHADD’s Find a Study informational page. People can also contact their local hospital or university research center and ask if there are any studies in need of participants.

“One of the challenges in research is finding enough subjects, finding the right subjects, finding a diverse set of subjects,” Tuckman says. “I am hopeful more research is coming in the long-term …. There is more and more interest in diagnosis and treatment and living with ADHD in adults than there ever has been.”

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