Living with symptoms of attention deficit hyperactivity disorder in adulthood: a systematic review of qualitative evidence

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) relates to four dimensions of behavior: inattentiveness, restlessness, impulsiveness and hyperactivity. Symptoms affect multiple areas of daily life such as academic performance and social functioning. Despite the negative effects of ADHD, people diagnosed with ADHD do not necessarily regard themselves as being impaired. However, it is unclear how adults with ADHD experience and manage their symptoms.

OBJECTIVES: To identify and synthesize the best available evidence on how adults experience living with ADHD.

INCLUSION CRITERIA TYPES OF PARTICIPANTS: Adults with confirmed ADHD diagnosis.

PHENOMENA OF INTEREST: How adults with ADHD experience and manage the symptoms of ADHD and links between protective factors provided by relatives, friends, fellow students, mentors and colleagues.

TYPES OF STUDIES: Studies based on qualitative data, including, but not limited to, designs within phenomenology, grounded theory, content analysis or ethnography.

SEARCH STRATEGY: A three-step search strategy identified published and unpublished qualitative studies from 1990 to July 2015.

METHODOLOGICAL QUALITY: Studies meeting the inclusion criteria were independently assessed by two reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI).

DATA EXTRACTION: Data were extracted from 10 included studies using the JBI-QARI.

DATA SYNTHESIS: Qualitative research findings were synthesized using the JBI-QARI.

RESULTS: A total of 103 findings from 10 studies were aggregated into 16 categories that were meta-synthesized into four synthesized findings: "Adults are aware of being different from others and strive to be an integrated, accepted part of the community;" "Adults with ADHD are creative and inventive;" "Adults with ADHD develop coping strategies in striving for a healthy balance in life" and "For adults with ADHD, accomplishing and organizing tasks in everyday life is a challenge but it can also be rewarding."

CONCLUSION: Adults with ADHD have problems stemming from ADHD symptoms in relation to interacting in social relationships, academic functioning and being part of the community at the workplace and performing work tasks; they work harder to perform tasks and strive to be accepted and to be equal members of the community.Protective factors that support their ability to manage daily life with ADHD are personal strategies such as reminders and performing tasks within a given structure. Others close to them can assist by coaching, reminding them of appointments and so on. Superiors can assist by structuring the work tasks and setting up clear rules and limits for the tasks. Medication has proven to be very useful as it leads to less hyperactivity and enhances ability to stay focused and be more organized. Finally, insight into ADHD has a positive impact on the ability to manage the consequences of ADHD.Health professionals should, when advising adults with ADHD, fundamentally see them as persons who have a problem and not as problem persons, emphasize strategies adults themselves can apply such as structuring everyday tasks and informing them about positive effects and possible side effects of medication. Policy-makers could launch campaigns targeted at employers with information about the competencies adults with ADHD possess and how employers can benefit from these by structuring work tasks. When promoting employees with ADHD, it should be to positions with more advanced hands-on functions and not positions with administrative duties.