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. 2021 Jul;128(7):877-891.
doi: 10.1007/s00702-020-02281-0. Epub 2020 Dec 23.

Neuropsychological functioning of individuals at clinical evaluation of adult ADHD

Nana Guo  1 , Anselm B M Fuermaier  2 , Janneke Koerts  2 , Bernhard W Mueller  3   4 , Katerina Diers  3 , Aaron Mroß  3 , Christian Mette  5 , Lara Tucha  2   6 , Oliver Tucha  2   6
Affiliations

Neuropsychological functioning of individuals at clinical evaluation of adult ADHD

Nana Guo et al. J Neural Transm (Vienna). 2021 Jul.

Abstract

Objectives: Numerous studies showed that adults with attention deficit hyperactivity disorder (ADHD) suffer from impairments in a range of cognitive functions when compared to healthy controls. However, only little is known about the neuropsychological functions when compared to various clinical control groups and whether a distinct neuropsychological profile can be identified for adult ADHD.

Method: This retrospective study examined data of 199 outpatients referred for clinical evaluation of adult ADHD, allocated either to an ADHD group (n = 78) or to one of two clinical comparison groups, depending on whether they show indications (n = 71) or no indications (n = 50) for the presence of psychiatric disorders other than ADHD. All individuals performed a comprehensive neuropsychological test battery.

Results: Data analysis revealed impairments in a range of cognitive functions in a substantial number of patients of all three groups. However, profiles of neuropsychological impairments were similar between groups. Furthermore, significant small- to medium-sized correlations between basic and higher-order cognitive functions were revealed in the ADHD group and the clinical comparison group with indications for psychiatric disorders other than ADHD.

Conclusion: Neuropsychological impairments are prominent in psychiatric outpatients seeking a clinical evaluation of adult ADHD but are not specific for ADHD. It is concluded that neuropsychological test performance may have limited incremental value to support the psychiatric differential diagnosis. Furthermore, a clinical trajectory may need to take into account that deficits in a range of higher-order cognitive functions can be substantially explained by deficits in basic cognitive functions.

Keywords: Adult ADHD; Assessment; Cognition; Diagnosis; Neuropsychology.

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Figures

Fig. 1
Fig. 1
Percentage of individuals indicating impairment (percentile rank ≤ 16) in neuropsychological test performance and self-report. Impairment per function is defined if test performance is impaired in at least one test variable of this function; Dotted line indicates 16% of participants having impairment (i.e., baseline if impairment is defined as percentile rank ≤ 16); ADHD attention deficit hyperactivity disorder; CCG clinical comparison group; CCG-ND clinical comparison group-not diagnosed
Fig. 2
Fig. 2
Percentage of individuals showing impairment in neuropsychological functions, ranging from 0 (no impairment) to 10 (impairment in ten functions). ADHD attention deficit hyperactivity disorder; CCG clinical comparison group; CCG-ND clinical comparison group-not diagnosed
See this image and copyright information in PMC

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