Presentation of Unrecognized Attention Deficit Hyperactivity Disorder in College Students

Mental health providers at university counseling and health centers should be alert to the possibility that college students with previously unrecognized attention deficit hyperactivity disorder (ADHD) may present for initial evaluation at their centers. This study was a systematic chart review of 42 students at an Upper Midwest university who were diagnosed with ADHD during calendar year 1993. Diagnoses were made by the treating psychiatrist, who reviewed records for presenting problems; recent associated problems; previous evaluations as a child, adolescent, or adult; and associated problems in childhood. Presenting problems included ADHD symptoms, mood symptoms, nonspecific learning disability, and academic underachievement. Associated problems were depressive disorders, anxiety disorders, drug and alcohol abuse or both, dependency, legal problems, learning disabilities, and eating disorders. Thirty-three percent had been evaluated for academic or behavior problems as children, and 36% had sought previous psychological care for non-ADHD symptoms as adults. Thirty-one percent were presenting at the university health center for their first evaluation. Childhood histories showed educational underachievement, learning disabilities, and behavior problems.