OBJECTIVES: Awareness of adult ADHD is low. Even though guidelines have existed in Germany since 2003, diagnosis and treatment are not standardized and remain difficult in practice, often complicated by comorbidities. This analysis investigates prevalent psychiatric comorbidities and the applied pharmacotherapy of adult patients with ADHD diagnosed by general practitioners (GPs) or by neurologists/psychiatrics (NPs) in Germany in 2007. METHODS: A retrospective database analysis of adult patients aged 19-59 diagnosed with ADHD (ICD-10 code F90) was performed, using the IMS Disease Analyzer that contains electronic medical records of representative panels of German GPs and NPs, capturing drug prescription and diagnoses. RESULTS: Patients were identified through the records of NPs seeing 122,666 patients and GPs seeing 1.16 million patients, aged 19-59. NPs diagnosed ADHD in 851 adults (annual prevalence 0.69%, 60% male), of which 521 had at least one psychiatric co-diagnosis (33% mood disorders F30-39, 19% neurotic, stress-related and somatoform disorders F40-48). In 214 of 493 GPs' ADHD patients (annual prevalence 0.04%, 61% male), at least one psychiatric disorder was co-diagnosed (18% F30-39, 19% F40-48). A total of 48.8% of the NPs' patients (27.2% of the GPs') without a psychiatric comorbidity were treated with Methylphenidate (MPH) and 5.8% (0.4%) with MPH plus at least one antidepressant prescription. Treatment differed in patients with psychiatric comorbidities of which 22.1% (14.0%) received MPH, but 18.6% (9.8%) MPH plus at least one antidepressant. NPs treated other 186 (GPs 142) patients without diagnosed ADHD (F90) with MPH. CONCLUSIONS: Administrative prevalence of adult ADHD was low compared to data derived from literature and both prevalence and comorbidity profile differed in age, gender and specialist. The pharmacotherapy of GPs and NPs depended on prevalent comorbidities but did not show consistency according to guidelines. A further understanding of adult ADHD and its treatment opportunities is needed.