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Review
. 2010 Sep 9;2(1):e9.
doi: 10.4081/mi.2010.e9. eCollection 2010 Jan 25.

ADHD-hyperactive/impulsive subtype in adults

Christopher Gibbins  1 , Margaret D Weiss  2 , David W Goodman  3 , Paul S Hodgkins  4 , Jeanne M Landgraf  5 , Stephen V Faraone  6
Affiliations
Review

ADHD-hyperactive/impulsive subtype in adults

Christopher Gibbins et al. Ment Illn. .

Abstract

This is the first study to evaluate ADHD-hyperactive/impulsive subtype in a large clinical sample of adults with ADHD. The Quality of Life, Effectiveness, Safety and Tolerability (QuEST) study included 725 adults who received clinician diagnoses of any ADHD subtype. Cross-sectional baseline data from 691 patients diagnosed with the hyperactive/impulsive (HI), inattentive (IA) and combined subtypes were used to compare the groups on the clinician administered ADHD-RS, clinical features and health-related quality of life. A consistent pattern of differences was found between the ADHD-I and combined subtypes, with the combined subtype being more likely to be diagnosed in childhood, more severe symptom severity and lower HRQL. Twenty-three patients out of the total sample of 691 patients (3%) received a clinician diagnosis of ADHD-hyperactive/impulsive subtype. Review of the ratings on the ADHD-RS-IV demonstrated, however, that this group had ratings of inattention comparable to the inattentive group. There were no significant differences found between the ADHD-HI and the other subtypes in symptom severity, functioning or quality of life. The hyperactive/impulsive subtype group identified by clinicians in this study was not significantly different from the rest of the sample. By contrast, significant differences were found between the inattentive and combined types. This suggests that in adults, hyperactivity declines and inattention remains significant, making the hyperactive/impulsive subtype as defined by childhood criteria a very rare condition and raising questions as to the validity of the HI subtype in adults.

Keywords: ADHD; adult; attention deficit; quality of life.; subtypes.

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Conflict of interest statement

Conflicts of interest: CG has no disclosures to make. MDW has received grant funding, honoraria, consultant fees, and travel expenses from Shire, Eli Lilly, Purdue Pharma and Janssen, and consultant fees from Abbott, Novartis and Takeda. She was one of the investigators on the QuEST trial from which these data were obtained. Shire provided unrestricted access to the complete trial dataset but no financial support. She receives royalties from the measure ASRI from Checkmate Plus. DWG has received grant funding, honoraria and consultant fees from Shire, McNeil, Lilly, Forest Labs, Wyeth Pharmaceuticals and Cephalon. PSH works for Shire and has stock in Shire. JML is the author of the AIM-A, which is the intellectual property of HealthActCHQ where she holds an executive position. SVF reports having received lecture fees and research funding from Pfizer, and consulting fees and research funding from Shire. The work for this study was funded by a fellowship granted to CG by the British Columbia Mental Health and Addictions Services of the Provincial Health Services Authority, and by a senior researcher award from the Provincial Health Services Authority to MDW.

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