Assessing Adult ADHD: A Conversation With Jeffrey Newcorn, MD

TALKING WITH TITANS OF PSYCHOPHARMACOLOGY

At the 2025 American Psychiatric Association (APA) Annual Meeting, Psychiatric Times' Editor in Chief, John J. Miller, MD, sat down with leaders in psychopharmacology to discuss the topics they find most important.

Jeffrey Newcorn, MD, has special expertise in the areas of attention-deficit/hyperactivity disorder (ADHD), aggression, descriptive psychopathology of child and adolescent disorders, and child and adolescent psychopharmacology. Miller and Newcorn sat down to discuss identifying ADHD in adult patients.

"It really has evolved, from the 90s especially," shared Newcorn. "Now, more people are coming for treatment as adults than children. There are important differences in the people who first present later in life."

Approximately 15.5 million US adults (6.0%) have a current ADHD diagnosis based on self-report.¹

Differences in treatment of ADHD in adults vs children include:

• Adults come in for treatment because they want to be there, whereas children may be brought by concerned parents or caregivers.
• Adults almost always come in for impairments related to attention and executive function, whereas children come in for behavioral issues.
• In children, you often see more boys than girls report ADHD symptoms, whereas adults have comparable sex ratios.

"Understanding what the main problems are that you are trying to make better should lead you to what you are going to prioritize in treatment," said Newcorn.

In terms of areas of concern, Newcorn believes clinicians should monitor areas of functioning, medical history, comorbid conditions (like obesity and cardiovascular risk), and substance use (and misuse of stimulants). The misuse of stimulants is more frequently a problem in late adolescence or early adulthood. Structured therapies may be effective in treating adolescents and young adults with ADHD and substance use disorder.²

Dr Newcorn is professor of psychiatry and pediatrics, and director of the Division of ADHD and Learning Disorders at Icahn School of Medicine at Mount Sinai. He is also the director of Pediatric Psychopharmacology for the Mount Sinai Health System, and supervising psychiatrist in the Student Trainee Mental Health Program at Mount Sinai.

Dr Miller is Medical Director, Brain Health, Exeter, New Hampshire; Editor in Chief,Psychiatric Times; Voluntary Consulting Psychiatrist at Seacoast Mental Health Center, Exeter/Portsmouth, NH; Consulting Psychiatrist, Insight Meditation Society, Barre, Massachusetts.

References

1. Staley BS, Robinson LR, Claussen AH, et al. Attention-deficit/hyperactivity disorder diagnosis, treatment, and telehealth use in adults — National Center for Health Statistics Rapid Surveys System, United States, October–November 2023. MMWR Morb Mortal Wkly Rep. 2024;73(40):890-895.

2. Zulauf CA, Sprich SE, Safren SA, Wilens TE. The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders. Curr Psychiatry Rep. 2014;16(3):436.