Attention deficit hyperactivity disorder (ADHD) and personality disorder (PD) can be found in the same patient. ADHD is characterized by poor attention span, hyperactivity, and impulsivity. There are actually 10 different personality disorders, including paranoid, schizoid, schizotypal, borderline, antisocial, narcissistic, histrionic, dependent, avoidant, and obsessive-compulsive personality disorder. Antisocial, borderline, and histrionic personality disorder are the disorders most commonly comorbid with ADHD.
Inattention
For ADHD, there are nine symptoms of inattention including forgetfulness, not listening when spoken to, not following through on tasks, losing things easily, distractibility, and not paying attention to details. Also included are problems paying attention in school, problems organizing tasks, and avoidance of tasks that require concentration. For the predominantly inattentive ADHD sufferer, at least six of the nine inattentive symptoms must be present for a positive diagnosis. For the combined type ADHD sufferer, at least six each of the inattentive and the hyperactivity-impulsivity symptoms must be present to qualify for a positive diagnosis.
Hyperactivity
In ADHD, there are six symptoms of hyperactivity including talking excessively, problems playing quietly, running around excessively, fidgeting with hands and feet, leaving seat often in the classroom or other environment, and acting as if driven by a motor. For the predominantly hyperactive-impulsive ADHD sufferer, at least six of the nine hyperactivity and impulsivity symptoms must be present for a positive diagnosis. For the combined type ADHD sufferer, at least six each of the inattentive and the hyperactivity-impulsivity symptoms must be present for a positive diagnosis.
Impulsivity
For ADHD, there are three symptoms of impulsivity, including problems waiting for their turn or standing in line, interrupting others, and answering questions before the question is finished. For the predominantly hyperactive-impulsive ADHD sufferer, at least six of the nine hyperactivity and impulsivity symptoms must be present for a positive diagnosis. For the combined type ADHD sufferer, at least six each of the inattentive and the hyperactivity-impulsivity symptoms must be present for a positive diagnosis.
Personality Disorder
Antisocial PD is characterized by the disregard of feelings and rights of others. As ADHD sufferers often have a hard time empathizing with others, being comorbid with antisocial PD may make these symptoms even more extreme.
Attention seeking, drama creation, and overtly sexual behavior characterize histrionic PD. ADHD patients suffer from hyperactivity, and thus their attention seeking behaviors, as well as promiscuity can be enhanced by having histrionic PD.
Borderline PD is characterized by unstable behavior, mood, self-image, and relationships. ADHD patients often have low self-esteem due to frustrations with school and relationships, and borderline PD can exacerbate these symptoms.
Narcissistic PD is characterized by grandiosity and feelings of self-importance. This PD is less often comorbid with ADHD because ADHD patients have low self-esteem.
Dependent PD is characterized by complete dependence on other people. This PD is less comorbid with ADHD because ADHD sufferers have difficulty following instructions and directions from others.
Avoidant PD is characterized by sensitivity to rejection and failure. As ADHD sufferers have low self-esteem, cannot follow through on tasks, and often fail in school and relationships, having avoidant PD clearly exacerbates these ADHD symptoms.
Obsessive-compulsive PD is characterized by inflexibility, organization, and over attention to detail. ADHD is not usually comorbid with this disorder due to ADHD sufferers being disorganized, distracted, and spontaneous.
References
- The Merck Manual: ADHD
- "Personality Disorders: A Practical Guide"; Carol W. Berman; 2009
