Meeting abstract

https://doi.org/10.24869/spsih.2026.149

I Would Never Have Said It Was ADHD

Krešimir Radić ; Service for Mental Health and Addiction Prevention, Teaching Institute of Public Health „Dr. Andrija Štampar“, Mirogojska 11, 10000 Zagreb, Croatia *
Ivan Zečević ; Centre for Neuropsychology and Sleep Disorders, Vlaška ulica 64, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

ADHD is still often mistakenly understood as a
transient behavioral problem in childhood, although
contemporary research shows that it is a
neurodevelopmental disorder that often persists
into adulthood and can significantly impair educational,
occupational, social, and health functioning.
In addition, these patients frequently
develop additional comorbidities, including personality
disorders. Despite the relatively high
prevalence of ADHD in adults, especially in psychiatric
populations, it often remains unrecognized
and untreated. Difficulties with attention,
restlessness, impulsivity, emotional dysregulation,
insomnia, risk-taking behaviors, and executive
dysfunction are often attributed to other
mental disorders, personality traits, or comorbid
conditions. The aim of this presentation is to
show how unrecognized ADHD can act as a silent driver of chronicity, functional impairment, and
treatment resistance in psychiatric practice, particularly
in patients with addictions, depressive
disorders, chronic insomnia, traumatic experiences,
and emotional dysregulation. Three clinical
cases are presented in which ADHD was not recognized
during many years of psychiatric treatment.
In the first case, a patient with substance
use disorders and risky behaviors was treated for
addiction and borderline personality disorder,
while only subsequent screening through detailed
neuropsychological assessment confirmed ADHD
at a premorbid level. In the second case, longterm
treated depressive symptomatology in an
adult female patient was partially related to unrecognized
inattentive ADHD. In the third case,
chronic insomnia, restlessness, concentration difficulties,
and depressive mood in a patient with
a traumatic history masked persistent ADHD
with pronounced executive dysfunction, which
was further exacerbated by traumatic symptomatology.
The cases presented highlight the need
for detailed neuropsychological assessment in
complex clinical pictures and treatment-resistant
conditions. A key element is the assessment
of symptoms before the age of 12 on the basis
of collateral (heteroanamnestic) information,
visible in the neuropsychological profile and in
functional impairment across the life course, and
corroborated by others. Timely recognition and
treatment of ADHD can significantly improve
functioning and enhance treatment outcomes.

Keywords

ADHD; differential diagnosis; neuropsychological assessment; psychiatry

Hrčak ID:

352267

URI

https://hrcak.srce.hr/352267

Publication date:

15.6.2026.

Article data in other languages: croatian

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