From Childhood Impairments to Delayed Diagnosis: A Series of Adult ADHD Cases

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neuro-developmental disorder typically characterized by, but not limited to, inattention, hyperactivity, and impulsivity. Persistence into adulthood is reported in at least half of those diagnosed in childhood with significant functional impairments in the form of inefficiency, distractibility, internal restlessness, and planning difficulties—often normalized or reframed as personality traits, anxiety, or low motivation. Academic, vocational & interpersonal functioning may be dependent on many factors and could be maintained by various positive psychosocial and intellectual scaffolds. But, transition to adolescence and adulthood, by its very nature, takes off some of these supports and increases expectations in performance—be it academic, interpersonal or occupational, affecting psychological wellbeing and might manifest as depression or anxiety. It is imperative to understand the process and evolution of current manifestations and to look for underlying deficits. In this case series, the authors demonstrate the psychiatric presentation of young adults with missed ADHD diagnosis during childhood and the clinical challenge of recognizing underlying impairments associated with ADHD.