Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that for many years has been considered exclusively a childhood diagnosis. In recent decades, however, the professional community has increasingly focused on its persistence into adulthood, where ADHD manifestations often change but do not disappear. Adults with this diagnosis may experience chronic problems in working, academic, and personal life, while many of these difficulties remain undiagnosed or underestimated.

Current research suggests that ADHD significantly influences the subjective experience of quality of life (quality of life) and personal well-being (well-being). Difficulties with concentration, impulsivity, emotional dysregulation, and problems with organization can lead to frustration, lowered self-esteem, strained relationships, and limited use of free time. These factors together can create barriers to achieving personal happiness and satisfaction with life as a whole.

The aim of this study is to quantitatively explore how individual ADHD manifestations influence the quality of life of adult people in five key areas: work and education, leisure activities, self-love and self-esteem, intimate and family relationships, and social contacts. Our goal is to provide deeper insight into which life domains are most strongly impacted, and thereby contribute to better-targeted supportive interventions for this group of people.

Theoretical framework

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder traditionally associated primarily with childhood. However, in most cases ADHD manifestations persist into adulthood, even though their form and intensity change with age. While in children restlessness, impulsivity, and attention deficits primarily dominate in the school environment, in adults symptoms often appear as chronic disorganization, forgetfulness, inner restlessness, mood fluctuations, difficulties with self-regulation, and more. These manifestations can become obstacles to everyday functioning, while for many adults they are long misunderstood or incorrectly diagnosed.

Self-regulation is among the most affected areas in adults with ADHD. Insufficient ability to delay impulses, plan, persist in tasks, or regulate emotional reactions is expressed across daily situations. Disruption of these functions influences not only individual experience but also the quality of social and work relationships (Rosello et al., 2020).

Adulthood is a life period with significant responsibility—work performance, financial security, parenthood, maintaining partnerships, and social relationships. Individuals with ADHD face the same expectations as others, but their neurocognitive profile makes meeting these expectations difficult in many situations. Frequent delays, concentration problems, forgetting deadlines, or emotional impulsivity can create recurring conflicts and failures that directly threaten their inner well-being. This gap between the social expectation of “adult performance” and personal experience may lead to feelings of frustration, failure, and reduced self-worth, negatively affecting overall quality of life.

The World Health Organization (WHO, 2012) defines quality of life as an individual’s perception of one’s position in life in the context of culture and value systems, and in relation to one’s goals, expectations, and standards. It is a multidimensional concept that includes physical and mental health, interpersonal relationships, education, employment, material security, safety, freedom, recreation, and social connectedness.

Quality of life can be assessed in different ways, and there is no single agreed definition in the professional literature. In general, we can say that quality-of-life experts use two angles: quality of life as an assessment of life as a whole, and “engaged theories,” i.e., quality of life as assessment of individual domains (Teoli - Bhardwaj, 2023). The OECD Better Life Index offers a comprehensive perspective on quality of life in a social context: health, education, work, social ties, material conditions, environment, civic services, and justice (OECD, 2025).

Subjective well-being (SWB), as defined by Ed Diener, focuses on positive emotions, absence of negative feelings, and overall life satisfaction. Carol Ryff’s psychological well-being consists of six pillars: self-acceptance, quality relationships, autonomy, environmental mastery, purpose in life, and personal growth. Martin Seligman’s PERMA model adds dimensions of positive emotions, engagement, relationships, meaning, and accomplishment (Zhang et al., 2024).

Recent studies confirm that adults with ADHD face a marked reduction in quality of life even when diagnosed and treated. A study led by Adamis et al. (2024) showed that newly diagnosed adults had significantly lower scores in functioning and quality-of-life domains (measured with WFIRS, GAF, and AAQoL) compared with the general population. Likewise, a review by Kosheleff et al. (2023) confirms that ADHD symptoms in adults have a negative impact on overall life functioning, and this impact remains even despite pharmacological treatment. These findings emphasize that ADHD symptoms themselves constitute a significant burden that extends beyond comorbid disorders.

In this study, quality of life of adults with ADHD is examined through the standardized diagnostic tool DIVA-5. We examine five life areas: work and education, free time and hobbies, self-love and self-esteem, relationships and family, and social contacts. These dimensions reflect key aspects of life satisfaction and connect professional quality-of-life concepts with the everyday reality of people living with ADHD. They allow us to examine not only performance and behavioral aspects but also the inner world of the person, their experience, self-evaluation, and interpersonal functioning.

Research framework

The research is quantitative in nature, specifically a non-experimental descriptive-correlational design.

The research problem is based on findings that adults with ADHD often face reduced quality of life. In professional literature, however, there is still no clear consensus on which specific life areas are most affected, and whether there is a relationship between symptom intensity and the extent of these disruptions.

The purpose of the study is to examine how ADHD symptoms affect adults’ subjectively perceived quality of life across different areas of everyday functioning, and to identify the domains of life that are most commonly and most strongly disrupted.

Research questions:

  1. Which life areas (work and education, relationship and/or family, social contacts, leisure time/hobbies, and self-esteem/self-image) are most frequently disrupted in adults with ADHD?
  2. Is there a relationship between the number of ADHD symptoms and the number of disrupted areas of life?
  3. Does the degree of quality-of-life disruption differ by gender or age?
  4. In which areas of disruption do women predominate, and in which do men predominate?

Hypotheses:

  • H1: ADHD manifestations most commonly disrupt quality of life in the area of work and education.
  • H2: There is a positive correlation between the number of ADHD symptoms and the number of disrupted quality-of-life areas.
  • H3: Women with ADHD report a higher number of disrupted quality-of-life areas than men.
  • H4: The respondents’ age influences the extent of ADHD’s impact on quality of life.

A total of 83 adults with diagnosed ADHD participated in the study. Eligibility criteria included adulthood (age over 18) and an official diagnosis of ADHD established by a psychiatrist or clinical psychologist. All respondents belonged to the combined subtype of ADHD, meaning they showed symptoms in both inattention and hyperactivity/impulsivity domains.

To collect data, we used the standardized tool DIVA-5 (Diagnostic Interview for ADHD in Adults, version 5) by Kooij, Francken, and Bron (2019). The research questionnaire had two parts: Assessment of ADHD symptoms in adulthood (in line with DSM-5), and a section examining the presence of disruption in five life areas: work and education, relationship and/or family, social contacts, leisure/hobbies, and self-esteem/self-image. Two language versions of the questionnaire were used: a Slovak version for respondents fluent in Slovak, and an English version for those who do not speak Slovak fluently but are fluent in English. Both language versions were officially translated and approved by the DIVA-5 tool authors and are available as valid versions directly on the official DIVA Foundation website.

Data were processed using quantitative statistical methods in SAS® Studio. Descriptive statistics were used to obtain an overview of basic data characteristics, such as frequencies, means, and percentages. To test dependencies between variable categories, the following validated statistical methods were used: ANOVA and Tukey comparison for H1, Pearson correlation and Cohen’s interpretation for H2, chi-square test, Fisher’s exact test, and Cramer’s V for H3, and chi-square test, Cramer’s V coefficient, and contingency coefficient for H4. Results

A total of 83 respondents participated in the study: 25 men and 58 women. In terms of age structure, 43 respondents (15 men and 28 women) were aged 18–30, 33 respondents (9 men and 24 women) were aged 31–45, and 3 respondents were in the 45–64 age group. In the senior age group (65+) there were 4 respondents (1 man and 3 women).

Table 1 Number of respondents (Source: Author’s own processing)

In terms of the number of disrupted life areas (work and education, relationship and/or family, social contacts, leisure time/hobbies, and self-esteem/self-image), the distribution of ADHD effects was as follows: 5 disrupted life areas were confirmed for 23 respondents (8 men, 15 women), 4 disrupted life areas were reported by 25 respondents (6 men, 19 women), 3 disrupted areas by 19 respondents (6 men, 13 women), and 2 disrupted life areas were confirmed by 16 respondents (5 men, 11 women). Disruption of only one of the observed life areas was present in none of the respondents, because such a result would not meet the diagnostic criterion of DIVA-5, which we used, and the respondent would not have met the diagnosis confirmation criterion of this tool.

Graph 1 Distribution of respondents by number of disrupted areas (Source: Author’s own processing)

It was shown that, by frequency, the most commonly disrupted area was leisure time and hobbies, followed by the second most frequently disrupted area: self-love and self-image. In third place, work and education and relationship and family were aligned, and last by frequency was social contacts.

Graph 2 Frequency of disruptions in life areas (Source: Author’s own processing)

H1 was not confirmed. Differences between disruptions in individual areas were not demonstrated; that is, no area had a dominant position compared to the others in terms of disruption frequency. Results of ANOVA variance analysis (F = 1,71091; p = 0,146635) did not show statistical significance compared with the standard significance level (α = 0,05). No significant differences were also found when comparing disruptions in individual life areas using Tukey’s method.

A positive correlation between the number of ADHD symptoms and the number of disrupted areas was confirmed (r = 0,20166; p = 0,0675), and therefore H2 is supported. However, from Cohen’s interpretation, this is only a small correlation in the 0,1–0,3 range, indicating very limited practical significance of these results. According to these results, we can therefore state that the number of ADHD manifestations disrupts the quality of life of people with this diagnosis, because a correlation was confirmed—the more symptoms, the more life areas disrupted. However, the magnitude was not strong, so it would be appropriate to verify the correlation in terms of intensity (not frequency) of these manifestations in relation to the number of disrupted life areas: work and education, relationship and/or family, social contacts, leisure time/hobbies, and self-esteem/self-image.

Graph 3 Correlation between number of symptoms and number of disrupted areas (Source: Author’s own processing)

In comparing the number of disrupted areas between men and women, no statistically significant difference was also confirmed and H3 is rejected. Chi-square test results showed that differences between genders are not statistically significant (χ² = 0,7113; df = 3; p = 0,8705). Fisher’s exact test confirmed this conclusion (p = 0,8592). A Cramer’s V value of 0,093 also indicates a very weak association between gender and the number of disrupted quality-of-life areas.

Graph 4 Distribution of disrupted areas by gender (Source: Author’s own processing)

The largest part of respondents was the 18–30 age group, which reported disruptions in all areas of life (a total of up to 160 occurrences from a total of 304). They most commonly reported problems in free time and hobbies (35 occurrences) and in work and education (33 occurrences). Disruptions also appeared fairly often in the other three areas: specifically 32 occurrences for relationship and/or family, 31 occurrences for self-esteem/self-image, and 28 occurrences for social contacts. The second largest group was respondents aged 31–45 (122 occurrences). Again, the same problematic areas were identified: leisure time (29 occurrences), self-esteem/self-image, and work and education (24 occurrences). In the last two positions, respondents reported disruptions in relationship and/or family (21 occurrences) and social contacts (19 occurrences). Respondents aged 46–64 reported 10 disrupted occurrences, with disruption in relationship and/or family (3 occurrences) dominating in this group, and disruption being least frequent in social contacts (1 occurrence). The 65+ group also had a low number of disruptions (12 occurrences), most commonly reporting problems in social contacts and relationships/family (4 occurrences). More detailed graphical overviews of these data are presented below.

Table 2 Frequency of life-area disruptions by age (Source: Author’s own processing)

Graph 5 Life-area disruption by age (Source: Author’s own processing)

Hypothesis H4, that respondents’ age influences the extent of ADHD’s impact on quality of life, was not confirmed. The chi-square test showed that differences between age categories are not statistically significant (χ² = 7,22; df = 12; p = 0,614). A Cramer’s V value of 0,089 and a contingency coefficient of 0,15 indicate a very weak association between age and the number of disrupted quality-of-life areas. The respondents’ age therefore does not have a statistically significant impact on the number of disrupted quality-of-life areas.

Discussion

Hypothesis no. 1, which assumed more pronounced representation of life disruption in ADHD in the area of work and education, was not confirmed. Approximately even disruption was present across all respondents for all life areas monitored according to DIVA-5. ADHD in adulthood has a very complex character, and it cannot be said that ADHD manifestations affect only one partial part of a person’s life. The results suggest that ADHD symptoms, especially in adulthood, have a very complex and holistic reach into the person’s entire life. This finding positively confirms that an adult occupies many social roles and carries a high degree of responsibility. A single symptom therefore does not necessarily predominantly disrupt only one part of life (as is often the case in children). In children and adolescents, the greatest emphasis on responsibility and error-free performance is in the school environment, where inattention and hyperactivity/impulsivity symptoms most commonly disrupt that domain (Kumar et al., 2020). The difference between the expectation in hypothesis no. 1 and our findings may also be due to the difference between subjective evaluation by respondents and the objective impact of ADHD manifestations on life. Joseph et al. (2018) examined the objective impacts of ADHD manifestations in adults on work performance and found that adults with ADHD have a 46% reduced work performance. Comparing these conclusions with our study’s findings, we can say that a person’s subjective well-being may not equal external expectations placed on an adult with ADHD. An individual may attach major importance to another sphere of life than work (for example, they may consider family most important), and therefore reduced work performance may have fewer consequences for their personal well-being than disruption in quality of life in the relationship and family area. Since our goal was to examine respondents’ subjective evaluation of quality of life, we consider our findings important primarily for helping professions. These insights could positively influence how to work with adults with ADHD—that is, to address the issue comprehensively (involving multiple professionals and specialists across different life areas disrupted by ADHD), rather than partially.

Hypothesis no. 2, which assumed a positive correlation between the number of ADHD symptoms and the number of disrupted areas, was confirmed. The correlation was weak but consistent. This result is consistent with existing professional literature. The study by López-Villalobos et al. (2019) also confirms a slight to moderately strong correlation between ADHD symptoms and all observed life dimensions. However, given the not-too-strong correlation, we find it important to focus attention on the intensity of ADHD manifestations. A symptom with high intensity may disrupt quality of life to a greater extent than more symptoms with mild intensity. The relationship between intensity and the number of disrupted areas may not be linear, and the results for hypothesis no. 2 therefore bring a new area of inquiry for researchers interested in this topic. Yet, the state of quality of life in adults is multifactorial, and as in the previous hypothesis, we recommend that interventions and support for personal well-being should be approached comprehensively.

The assumption of hypothesis no. 3, that women report a higher number of disrupted life areas than men, was also not confirmed. Men and women reported comparably similar numbers of disruptions in the five observed life areas. From a diagnostic perspective, underdiagnosis in women, or later diagnosis of ADHD compared to men, is well known (Brooten-Brooks, 2024). This difference may be explained by women’s ability to mask ADHD manifestations over a long period, or by developing functional coping mechanisms and compensatory strategies. Building one’s own functional tools for coping with inattention or hyperactivity/impulsivity may lead to better adaptation despite absent diagnosis. Regardless of diagnostic status in men and women, the universal relationship between gender and the impact on personal well-being was not confirmed in our results, nor in the results of international studies. A summary of five clinical studies in child and adolescent populations by Wehmeier et al. (2012) also confirmed poorer quality-of-life scores in studied persons, and in this case too no significant gender difference was shown. It appears that inattention, hyperactivity, and impulsivity do not have different impacts on quality of life depending on gender. ADHD brings with it various obstacles and problems; these difficulties affect men and women equally, without pronounced differences based on gender.

Hypothesis no. 4 assumed a relationship between age and the extent of impact on the quality of life of adults with ADHD. On the basis of the results we also do not accept this hypothesis. The findings indicate that manifestations of inattention, hyperactivity, or impulsivity clearly disrupt an adult’s subjectively perceived well-being independently of age. Adamis et al. (2024) also confirm lifelong functional limitations due to ADHD symptoms. According to the authors, no relationship between age and enduring functional limitations caused by inattention, hyperactivity, and/or impulsivity was also found. Quality-of-life disruption was consistent across all age categories of the adult participants we observed (the differentiating factor being early diagnosis, not age). This conclusion confirms the classification of ADHD as a lifelong neurodevelopmental disorder (per DSM-5), which, when it persists into adulthood, does not change the number of symptoms or their severity, but changes their form. This means that while in a child inattention may appear as forgetting homework, in an adult it may manifest, for example, in forgetting important documents at work. For this reason, it is essential to support treatment and coping mechanisms to reduce as much as possible the impact of inattention, hyperactivity, and impulsivity on personal well-being, happiness, sense of fulfillment, and overall quality of life.

Ethics and research limitations

This research was conducted in accordance with ethical principles of research work. Absolute anonymity of participants was ensured, with no personally identifiable data collected, stored, or evaluated. All respondents provided informed consent based on transparent communication of study goals, purpose, and use. Participants were free to leave the study at any time without consequences. Emphasis was placed on respecting the dignity, autonomy, and voluntariness of each participant.

The study has several limitations that should be considered when interpreting the results. The first major limitation is the relatively small research sample, which is a consequence of the difficulty of reaching this specific population of adults with diagnosed ADHD. Despite efforts to achieve participant diversity, one cannot claim the sample is representative of the entire adult population with this diagnosis. Another limitation is the absence of qualitative methods, which could enable deeper understanding of the subjective experience of ADHD impacts.

The tool used in the research (DIVA-5) does provide an overview of functional disruption in the main life domains, but it does not provide a complete picture of subjective satisfaction, meaningfulness of life, or an individual’s emotional experience. The view on disruption intensity in each life area is also absent. Moreover, the study was conducted in a specific cultural and social context, which naturally limits its generalizability to other countries or cultural contexts. These limitations represent challenges for future research and also point to the need for further studies that combine quantitative and qualitative approaches and use larger, more diverse samples.

Conclusion

The aim of the work was achieved—we examined how ADHD symptoms affect the quality of life of an adult with this diagnosis from their own subjective perspective. The research confirmed a disruption of personal well-being, independent of age or gender, suggesting that ADHD impacts are universal. ADHD manifestations have a complex character and affect multiple life areas, so it is essential to work with them actively. The results of this study may be useful for professionals working with people with ADHD, providing a basis for designing interventions aimed at reducing negative consequences through social support, psychotherapy, increased awareness, development of compensatory strategies, and creating a safe and accepting environment. At the same time, they point to the need for accessible counselling and call for supporting individuals’ adaptation so that, despite their diagnosis, they can live full and satisfying lives.

Author: Mgr. Angelika Kreháková Katedra pedagogiky, Pedagogická fakulta, Univerzita Konštantína Filozofa v Nitre,

Mgr. Angelika Kreháková is a graduate of a five-year higher education program in andragogy with a specialization in social andragogy. She is professionally engaged in research and publications in the area of adult education and support for adults who are clients of helping professions. She is currently studying single-subject psychology at the University of Cyril and Methodius in Trnava and is undergoing a specialized rigorosum procedure focused on ADHD in adulthood at the Faculty of Education of the University of Constantine the Philosopher in Nitra. As part of continuing education, she is a graduate of an accredited innovative training program focused on art therapy and music therapy techniques in the practical work of educational and non-educational professionals and other helping professions at CHAT – Center for Creative Treatment through Art Therapy based in Košice.

List of bibliographic references

ADAMIS, D. – WEST, S. – SINGH, J. – HANLEY, L. et al. 2024. Functional impairment and quality of life in newly diagnosed adults attending a tertiary ADHD clinic in Ireland. In Irish Journal of Medical Science, 2024, 193(5), p. 2433–2441 [online]. [cited 2025-06-22]. Available at: https://pubmed.ncbi.nlm.nih.gov/38755511/.

AMERICAN PSYCHIATRIC ASSOCIATION. 2013. Diagnostic and Statistical Manual of Mental Disorders (5th ed.) – DSM-5. [online]. [cited 2025-08-21]. Available at: https://archive.org/details/APA-DSM-5.

BROOTEN-BROOKS, M. C. 2024. Untreated ADHD in Adults. Verywell Health, updated 12 July 2024 [online]. [cited 2025-08-21]. Available at: https://www.verywellhealth.com/untreated-adhd-in-adults-5213475.

JOSEPH, A. – KOSMAS, E. CH. – PATEL, CH. – DOLL, H. – ASHERSON, P. 2018. Health-Related Quality of Life and Work Productivity of Adults With ADHD: A U.K. Web-Based Cross-Sectional Survey. In Journal of Attention Disorders, 2018, 23(13), p. 1610–1623 [online]. [cited 2025-08-19]. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6732822/.

KOOIJ, J.J.S. – FRANCKEN, M.H. – BRON, I. T. 2019. Diva-5.0 – Diagnostic Interview for ADHD in adults. Netherlands: Diva Founfation. 2019. 20 s.

KOSHELEFF, A. R. – MASON, O. – JAIN, R. – KOCH, J. – RUBIN, J. 2023. Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment. In Journal of Attention Disorders, 2023, 27(7), p. 669–697 [online]. [cited 2025-06-14]. Available at: https://pubmed.ncbi.nlm.nih.gov/36876491/.

KUMAR, K. - SHARMA, R. - MEHRA, A. - SAINI, L. - SHAH, R. 2020. Quality of life, adjustment, and associative comorbid conditions in children diagnosed with attention deficit hyperactivity disorder: A comparative study [online]. In Psychiatry Journal, 2020, 29(1): 123–129 [cited 2025-08-14]. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7989465/.

ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT (OECD). 2025. OECD Better Life Index [online]. [cited 2025-05-23]. Available at: https://www.oecd.org/en/data/tools/oecd-better-life-index.html.

ROSELLO, B. – BERENGUER, C. – RAGA, M. J. – BAIXAULI, I. – MIRANDA, A. 2020. Executive functions, effortful control, and emotional lability in adults with ADHD [online]. In Journal of Affective Disorders, ISSN 0165-1781, 2020, vol. 293. ISSN 0165-1781 [cited 2025-06-03]. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0165178119324345.

TEOLI, D. - BHARDWAJ, A. 2023. Quality of Life. In StatPearls [online]. Treasure Island (FL): StatPearls Publishing, [cited 2025-07-02]. Available at: https://www.ncbi.nlm.nih.gov/books/NBK536962.

WEHMEIER, P. M. - SCHACHT, A. - ESCOBAR, R. - HERVÁS, A. - DICKSON, R. 2012. Health-related quality of life in ADHD: a pooled analysis of gender differences in five atomoxetine trials. In Attention Deficit and Hyperactivity Disorders, 2012, vol. 4, no. 1, p. 25–35 [online]. [cited 2025-08-14]. Available at: https://pubmed.ncbi.nlm.nih.gov/22271466/.

WORLD HEALTH ORGANIZATION. 2012. WHOQOL – Measuring Quality of Life [online]. [cited 2025-08-01]. Available at: https://www.who.int/tools/whoqol.

ZHANG, W. - BALLOO, K. - HOSEIN, A. - MEDLAND, E. et al. 2024. A scoping review of well-being measures: conceptualisation and scales for overall well-being. In BMC Psychology, 2024, vol. 12, Article 585 [online]. [cited 2025-07-11]. Available at: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-024-02074-0.