Article updated in October 2026 – Dr Yavor Delchev, psychiatrist and addiction specialist.

1. What is ADHD?

ADHD is a neurodevelopmental disorder: it emerges in childhood, as the brain matures, and combines three dimensions to varying degrees.

• Inattention: difficulty sustaining attention on anything that is not stimulating, distractibility, forgetfulness, disorganisation, tasks started but not finished.
• Hyperactivity: a need to move, restlessness, impatience; in adulthood it often turns inward, as constant mental activity.
• Impulsivity: difficulty waiting or holding back a response or an urge; decisions made on the spur of the moment.

These difficulties do not reflect a lack of willpower or poor parenting. They reflect a different way of functioning in the brain networks that regulate attention, motivation and self-control.

Diagnostic criteria

According to the American Psychiatric Association’s reference classification (DSM-5-TR, 2022), a diagnosis requires:

• at least six symptoms of inattention and/or hyperactivity-impulsivity (five from age 17), present for at least six months;
• several symptoms present before age 12;
• symptoms present in at least two settings (home, school or work, social life…);
• clear interference with school, work or social functioning;
• symptoms that are not better explained by another condition.

There are three presentations: predominantly inattentive, predominantly hyperactive-impulsive, and combined. The presentation can change over a lifetime. In the World Health Organization’s classification (ICD-11), ADHD is coded 6A05.

2. How many people are affected?

• Children: about 5 to 8% of children worldwide, according to recent meta-analyses. In France, studies put the figure at 3.5 to 5.6% among 6–12-year-olds; the Enabee survey by Santé publique France (2022) found probable ADHD in 3.2% of 6–11-year-olds.
• Adults: about 2.5 to 3% of adults have ADHD that began in childhood, and nearly 7% have significant symptoms. In France, about 3% of adults are estimated to be affected.
• Persistence: up to two thirds of affected children still have impairing symptoms as adults. The course often fluctuates: in the large US MTA study, fewer than one child in ten had lastingly recovered by early adulthood.
• Women and men: in childhood, boys are diagnosed two to four times more often than girls; in adulthood the gap narrows considerably. Girls and women, who are more often inattentive, discreet and good at compensating, are diagnosed later (on average four years later in a large Swedish study) and are often first treated for anxiety, depression or a personality disorder.

The true frequency of ADHD has not increased in thirty years. What has grown is its recognition, and therefore the number of diagnoses.

3. What causes ADHD?

ADHD is one of the most heritable psychiatric conditions: twin studies put the genetic contribution at around 74%. There is no single “ADHD gene”, but a great many common genetic variants, each with a tiny effect. The largest genetic study to date identified 27 regions of the genome linked to the disorder; they involve genes active during early brain development, particularly in dopamine neurons, and are largely shared with other psychiatric conditions.

Environmental factors are associated with an increased risk: very preterm birth and very low birth weight, maternal obesity or high blood pressure during pregnancy, exposure to lead, and valproate taken during pregnancy. Smoking during pregnancy is also associated with ADHD, but this link is largely explained by shared family and genetic factors. An association does not prove a cause: for paracetamol (acetaminophen) during pregnancy, for example, comparisons between siblings no longer show any link.

Common misconceptions. Sugar does not cause ADHD: double-blind studies find no effect on behaviour. Food colourings have only a small effect, in a minority of children. Nor is ADHD the product of “bad” parenting, although the family environment influences how it is expressed.

4. What happens in the brain?

• Executive functions: on average, people with ADHD have more difficulty with inhibition, working memory, planning and vigilance. These difficulties vary widely from person to person and do not, on their own, explain the disorder.
• Reward and delay: there is a marked preference for immediate rewards, even smaller ones, over larger but delayed gains. This helps explain procrastination and the difficulty of getting started on unrewarding tasks.
• Dopamine and noradrenaline: brain imaging shows lower availability of certain dopamine markers in motivation circuits, linked to inattention. These are the systems that ADHD medications act on.
• Brain imaging: very slight differences in the volume of some deep brain structures have been described, mainly in children. They are far too small to be used for diagnosis: no brain scan can diagnose ADHD.

5. ADHD in adults: what does it look like?

In adulthood, ADHD rarely shows up as visible restlessness. It tends to take the form of:

• inner restlessness, racing thoughts, difficulty settling down or relaxing; some people use alcohol or other substances to calm down or get to sleep;
• difficulty organising, prioritising and starting tasks: procrastination, chronic lateness, a poor sense of time;
• forgetfulness, lost objects, paperwork left undone;
• emotional dysregulation: low frustration tolerance, irritability, brief outbursts of anger, changeable mood;
• impulsivity in decisions, spending, driving or relationships;
• fluctuating attention, able to lock intensely onto whatever is exciting.

Many adults have built costly compensation strategies (over-investment, lists, working at night, relying on deadlines) that eventually wear out, especially at a life transition: higher education, a first job, the birth of a child. That is often when the first consultation takes place.

6. Associated conditions

ADHD in adults is rarely isolated: 60 to 80% of affected adults will have at least one other condition during their lifetime.

• Addictions: between one in five and one in four people treated for an addiction (alcohol, cannabis, cocaine, opioids) has ADHD, compared with about 3% of adults in the general population. Children with ADHD are nearly three times more likely to become dependent on tobacco, and about one in four people with gambling problems has ADHD. Substance use is often a form of self-medication: to calm down, sleep or concentrate. In February 2026, a national guide was published in France to improve the detection and treatment of ADHD in addiction services.
• Depression and anxiety: much more common than in the general population, they often mask ADHD, which is sometimes recognised only after several ineffective treatments.
• Bipolar disorder: about 8% of adults with ADHD also have bipolar disorder, and nearly one in six adults with bipolar disorder has ADHD; this combination calls for careful assessment.
• Sleep: late sleep onset, delayed sleep phase (very common), unrefreshing sleep.
• Autism: more than one in four autistic people has ADHD, and about one in five young people with ADHD has marked autistic traits.
• Other: learning disorders (dyslexia, dyscalculia…), borderline personality disorder, burnout.

7. Why ADHD should not be left untreated

Unrecognised and untreated, ADHD is not trivial:

• the risk of premature death is roughly doubled, mainly because of accidents;
• in the United Kingdom, the life expectancy of diagnosed adults is about 7 years shorter in men and nearly 9 years shorter in women; the authors attribute this gap to modifiable risk factors and unmet care needs;
• road accidents and injuries are more frequent;
• the risk of suicide is higher.

These figures are not inevitable. They make the case for early diagnosis and care, all the more so as large registry studies show that appropriate treatment markedly reduces several of these risks (see section 10).

8. How is ADHD diagnosed?

The diagnosis of ADHD is clinical. No blood test, brain scan, EEG or computerised test can establish it on its own. A neuropsychological assessment helps describe the cognitive profile, but it is not enough for a diagnosis. The assessment is based on:

• an in-depth interview tracing the history of the difficulties since childhood, ideally supported by school reports and the account of a parent or someone close;
• a structured diagnostic interview (the DIVA-5 in adults) and validated questionnaires;
• a search for associated conditions and differential diagnoses: anxiety, depression, bipolar disorder, sleep disorders, substance use, thyroid or hearing problems…;
• an assessment of the impact on the different areas of life.

In adults, the diagnosis is made by a trained doctor, in practice most often a psychiatrist. For children and adolescents, the French National Authority for Health (HAS) published detailed recommendations in September 2024; recommendations specific to adults are expected in 2026.

9. Assessment and follow-up with SuiVIP

At Cabinet T8, ADHD assessment and follow-up rely on SuiVIP, an online clinical follow-up platform that connects what patients record between consultations with the work done with their psychiatrist. Diagnosis and treatment decisions remain with the psychiatrist.

The initial assessment

After a first consultation, the patient completes validated questionnaires online, at their own pace:

• ADHD screening and severity: the WHO’s ASRS v1.1 (six screening questions, then the full 18-item version, which separates inattention and hyperactivity-impulsivity); the WSR-II (Weiss Symptom Record), which measures ADHD symptoms while also exploring frequently associated conditions (anxiety, mood, sleep, autism spectrum, learning, substance use…).
• Functional impairment: the WFIRS-S (Weiss Functional Impairment Rating Scale): family, work or studies, daily life, self-concept, social life, risky behaviour.
• Mood and anxiety: BDI-13 (Beck Depression Inventory, short form), GAD-7 (generalised anxiety), WHO-5 (WHO Well-Being Index).
• Sleep: PSQI (Pittsburgh Sleep Quality Index), ISI (Insomnia Severity Index).
• Burnout: MBI (Maslach Burnout Inventory), SIBM (brief burnout measure).
• Impulsivity and personality: BIS-11 (Barratt Impulsiveness Scale), BFI-10 (Big Five personality traits, short version).
• Substance use and addictions: screening for substance use and behavioural addictions.

In consultation, the psychiatrist then conducts the DIVA-5 structured diagnostic interview: the 18 DSM-5 symptoms are explored one by one, in adulthood and in childhood (ages 5–12), together with their impact in five areas of life. The psychiatrist then brings all the information together to confirm or rule out the diagnosis, specify the presentation and identify associated conditions. The patient receives a report and, if needed, a medical certificate (accommodations at school, university or work, disability application).

Follow-up

Once the diagnosis is made, the patient can regularly record how their symptoms and treatment are evolving between consultations. This allows the psychiatrist to follow symptoms over time and adjust care as closely as possible to the patient’s experience.

10. Treatment

Treatment of adult ADHD is multimodal. It begins with psychoeducation (understanding how one’s own mind works), combines environmental adjustments and psychological approaches and, when difficulties persist, medication. The European consensus and the UK guidelines (NICE) place medication at the heart of treatment when impairment is significant; in France, the HAS stresses that care relies first on non-drug measures, which may be combined with medication as a second step.

What medication can do

Stimulants are the most effective short-term treatments for ADHD symptoms. In adults, the largest meta-analysis to date (113 trials, nearly 15,000 participants, 2025) shows that only stimulants and atomoxetine improve symptoms as rated both by patients and by clinicians. The effect is real but moderate in size, and long-term trials remain scarce.

Large Swedish registry studies of nearly 150,000 people show that, in the two years following diagnosis, starting treatment is associated with a 21% reduction in all-cause mortality, as well as with fewer suicidal behaviours, less substance misuse, fewer road accidents and less crime.

Medications available in France (October 2026)

• Methylphenidate (Ritaline LP, Concerta LP, Medikinet and generics): the reference treatment. It has been licensed for adults in France since 2021–2022 and is 65% reimbursed. It is classified as a narcotic: secure prescription form, 28 days of treatment at most. The initial prescription, renewed every year, is reserved for psychiatrists, neurologists and paediatricians (in hospital, or in private practice since September 2021); in between, any doctor, including the GP, can renew the prescription.
• Lisdexamfetamine (Xurta): licensed since 2025 for adults and for children from age 6, available in pharmacies since September 2025, with the same prescribing rules. It is not reimbursed at present.
• Atomoxetine: a non-stimulant treatment, available only through a compassionate access programme and prescribed by a specialist; since Strattera is no longer manufactured, generics have taken over.
• Dexamfetamine (Tentin), recently launched, is restricted to ages 6–17. Guanfacine is not marketed in France.

Safety and monitoring

The most common side effects are reduced appetite, sleep problems, headaches and a slight increase in heart rate and blood pressure. A cardiovascular check is carried out before starting; blood pressure, pulse and weight are then monitored regularly. A large Swedish study found a slight increase in cardiovascular risk, mainly high blood pressure, with longer use: this justifies monitoring, particularly in people already at risk. At high doses, amphetamines carry a rare risk of a psychotic episode. Finally, these medicines must never be lent or shared.

ADHD and addiction: treating protects

An addiction is not a contraindication to treating ADHD; on the contrary, leaving ADHD untreated often keeps substance use going. In adults without an addiction, stimulants do not increase the risk of developing one, and at population level, treatment is associated with less substance misuse. In people who also have an addiction, treatment should be supervised by a specialist: higher doses are sometimes needed, and some trials show a benefit on substance use itself, particularly in stimulant addictions (cocaine, amphetamines), although results remain mixed.

Non-drug approaches

• Psychoeducation: understanding ADHD, for oneself and for one’s family, improves knowledge and eases relationships. It is the recommended first step.
• Cognitive behavioural therapy (CBT): it works on organisation, planning, time management, procrastination and emotional regulation. In adults already on medication who still had symptoms, a 12-session programme more than doubled the response rate (53% vs 23%), with benefits maintained at one year.
• Mindfulness: in adults, modest benefits, with still-limited evidence; the HAS does not recommend it for children.
• Physical activity: good for health, sleep and mood; its specific effect on symptoms remains uncertain.
• Coaching: practical help that many people value, but it has not been evaluated in controlled studies.
• Digital tools: apps and online programmes bring a modest but real benefit and extend therapy between sessions.
• Adjustments: a quiet work environment, written instructions, breaking tasks down, extra time in exams…

What has not proven effective. Neurofeedback brings no significant benefit when outcomes are assessed blind. Omega-3 supplements have not shown any effect on symptoms. Elimination diets are not recommended. In children, the HAS also advises against computerised cognitive training, psychoanalytically inspired therapies, kinesiology, osteopathy and acupuncture.

11. Rights and accommodations in France

• Education: extra time (“tiers-temps”) and other exam accommodations; a personalised support plan (PAP) or a personalised schooling project (PPS), depending on needs.
• Work: recognition as a disabled worker (RQTH), applied for through the MDPH (the departmental disability office), gives access to workplace adjustments. In the most severe situations, the adult disability allowance (AAH) or the disability compensation benefit (PCH), which since 2023 includes an “autonomy support” component open to neurodevelopmental disorders, may be considered.
• Care pathway: France’s national strategy for neurodevelopmental disorders 2023–2027 provides for a dedicated ADHD care pathway, the opening of ADHD resource centres from autumn 2026, and training for community doctors in diagnosis.
• Associations: HyperSupers – TDAH France supports people with ADHD and their families.

12. When to seek help

It is worth seeking an assessment if difficulties with attention, organisation or impulsivity present since childhood are now weighing on your studies, work, relationships or health. Online self-report questionnaires, such as the WHO’s ASRS, can point you in the right direction but do not replace a clinical assessment. Talk to your GP or see a psychiatrist; bring your old school reports if you can and, if possible, come with someone who knew you as a child.

References

Definition, criteria and overviews

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Prevalence and course

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Causes

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Brain function

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Adult ADHD and associated conditions

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Risks

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Medication: efficacy, benefits and safety

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ADHD and addiction

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Non-drug approaches

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Guidelines and French context

57. National Institute for Health and Care Excellence (NICE). Attention deficit hyperactivity disorder: diagnosis and management (NG87). 2018, mis à jour 2019. nice.org.uk
58. Haute Autorité de santé. Trouble du neurodéveloppement/TDAH : diagnostic et interventions thérapeutiques auprès des enfants et adolescents. Recommandation de bonne pratique ; 2024. has-sante.fr
59. Haute Autorité de santé. Trouble du neurodéveloppement/TDAH : repérage, diagnostic et prise en charge des adultes. Note de cadrage ; 2021. has-sante.fr
60. Haute Autorité de santé, Commission de la transparence. Xurta (lisdexamfétamine) : avis du 8 octobre 2025. has-sante.fr
61. ANSM. Méthylphénidate : modification des conditions de prescription et de délivrance. Septembre 2021. meddispar.fr
62. ANSM. Psychostimulants (dossier thématique, mis à jour en 2026). ansm.sante.fr
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