ADHD Subtypes
Evidence Based Answers
Which type of ADHD recovers the fastest?
Reviewed by Charles Li, MD
January 2, 2024
🌱
Hyperactive ADHD Recovers Fastest
Hyperactive ADHD, especially in children, is the least stable and shows the highest recovery rates, with most children shifting to other subtypes or no longer meeting ADHD criteria.
📉
Hyperactivity and Impulsivity Improve First
In children with ADHD, symptoms of hyperactivity and impulsivity are more likely to improve first compared to attention difficulties.
🔍
Hyperactive ADHD Rare in Adults
In adults, the hyperactive/impulsive subtype of ADHD is the least common, suggesting a significant decrease from childhood to adulthood.
Understanding ADHD Subtype Transitions in Children
One study highlighted that hyperactive ADHD is the most unstable form of the disorder in children. Astonishingly, over 90% of these young individuals no longer meet the same diagnostic criteria when reassessed in a follow-up study. This instability is a key indicator of the dynamic nature of ADHD in growing children.
A significant percentage of children with ADHD shift subtypes, with the highest shift in Hyperactive-Impulsive type.
Hyperactive ADHD not only shows the highest recovery rates but also the most frequent subtype shifts. This means that children initially diagnosed with hyperactive ADHD often transition to other ADHD subtypes or no longer fit the ADHD criteria at all.
Hyperactivity and Impulsivity: The Most Likely Symptoms to Improve
Interestingly, in a study of 128 boys, hyperactivity and impulsivity symptoms were found to be more likely to improve compared to difficulties with attention. This finding is significant as it suggests that the hyperactive and impulsive components of ADHD are more responsive to change, whether through natural development or therapeutic interventions.
A study of 128 boys found that hyperactivity and impulsivity symptoms of ADHD were more likely to get better compared to difficulties with attention.
The Stability of ADHD Subtypes Over Time
The stability of ADHD subtypes over a five-year period is relatively low to modest. It's reported to range from 11.1% to 35.3% for different subtypes. This lack of stability reinforces the notion that ADHD is not a static condition and can evolve over time, particularly during childhood and adolescence.
ADHD in Adults: Subtype Distribution
When looking at adults with ADHD, the combined subtype is the most common, followed by the inattentive subtype. The hyperactive/impulsive subtype, however, is least common among adults. This distribution aligns with the idea that hyperactive ADHD is indeed rare in adulthood, supporting the observation that this subtype is the least stable and most likely to change over time.
Combined subtype is most common, followed by inattentive only, and least common is hyperactive/impulsive only.
Risk Factors for Persistent ADHD
Severe symptoms of ADHD, along with the presence of other comorbid disorders like conduct disorder and major depression, are significant risk factors for the persistence of ADHD into adulthood. This underscores the complexity of ADHD as a condition influenced by a range of psychological factors.
A meta-analysis found that severe ADHD, ADHD treatment, conduct disorder, and major depressive disorder were all factors linked to someone having ADHD persisting into adulthood.
Parental Mental Health and Its Impact on ADHD Persistence
The mental health of parents, particularly maternal psychopathology, has been shown to predict the persistence of ADHD into adolescence and young adulthood. The total number of parental mental health problems also adds to the risk for ADHD persistence. This connection between parental and child mental health further illustrates the multifaceted nature of ADHD.
“
Parental mental health problems, and in particular maternal psychopathology has been shown to predict ADHD persistence in adolescence and young adulthood....Our results extend this literature by showing that the total number of parental psychopathologies affects adulthood ADHD - an increase in the number of parental mental health problems adds to the risk for persistence.
Key Takeaways
🔍
Importance of Proper ADHD Diagnosis
Accurate diagnosis of ADHD is crucial, as different subtypes, especially hyperactive ADHD, experience varied recovery rates and symptom changes.
💊
ADHD is Treatable
Regardless of the subtype, ADHD is treatable, and early intervention can lead to significant improvements, especially in hyperactive symptoms.
👶
Monitoring Hyperactive Symptoms in Children
For children with hyperactive ADHD, it's encouraging to know that hyperactive symptoms are often the first to improve.