Is adult attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ?

Psychol Med. 2009 Aug;39(8):1325-35. doi: 10.1017/S0033291708004959. Epub 2008 Dec 24.

Abstract

Background: Because the diagnosis of attention deficit hyperactivity disorder (ADHD) in higher education settings is rapidly becoming a contentious issue, particularly among patients with high IQs, we sought to assess the validity of diagnosing ADHD in high-IQ adults and to further characterize the clinical features associated with their ADHD.

Method: We operationalized high IQ as having a full-scale IQ120. We identified 53 adults with a high IQ who did not have ADHD and 64 adults with a high IQ who met diagnostic criteria for ADHD. Groups did not differ on IQ, socio-economic status or gender.

Results: High-IQ adults with ADHD reported a lower quality of life, had poorer familial and occupational functioning, and had more functional impairments, including more speeding tickets, accidents and arrests. Major depressive disorder, obsessive-compulsive disorder and generalized anxiety disorder diagnoses were higher in high-IQ adults with ADHD. All other psychiatric co-morbidities, including antisocial personality disorder and substance abuse, did not differ between the two high-IQ groups. ADHD was more prevalent in first-degree relatives of adults with ADHD relative to controls.

Conclusions: Our data suggest that adults with ADHD and a high IQ display patterns of functional impairments, familiality and psychiatric co-morbidities that parallel those found in the average-IQ adult ADHD population.

MeSH terms

  • Achievement
  • Adolescent
  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / genetics
  • Anxiety Disorders / psychology
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / genetics
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / genetics
  • Depressive Disorder, Major / psychology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Genetic Predisposition to Disease / psychology
  • Humans
  • Intelligence*
  • Interview, Psychological
  • Learning Disabilities / diagnosis
  • Learning Disabilities / epidemiology
  • Learning Disabilities / genetics
  • Learning Disabilities / psychology
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / genetics
  • Obsessive-Compulsive Disorder / psychology
  • Quality of Life / psychology
  • Reproducibility of Results
  • Social Adjustment
  • Young Adult