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Children with ADHD at risk in adulthood

Those who have childhood attention-deficit/hyperactivity disorder are at increased risk for long-term morbidity, persistence of attention-deficit/hyperactivity disorder and mortality, according to study results.

William J. Barbaresi, MD, of the Boston Children’s Hospital, and colleagues conducted a prospective study of 567 adults, 232 of whom had childhood ADHD and 335 non-ADHD controls.

Researchers found that 29.3% of childhood ADHD cases met criteria for adult ADHD (95% CI, 23.5-35.2). The rates among males (29.3%; 95% CI, 22.4-36.6) and females (29.2%; 95% CI, 18.2-40.3) were similar.

Participants who had childhood ADHD also were more likely than those in the control group to have one or more comorbid psychiatric disorders besides persistent ADHD (56.9% vs. 34.9%; OR=2.6; 95% CI, 1.8-3.8). Researchers found that the most common disorders included: alcohol dependence/abuse (26.3%), antisocial personality disorder (16.8%), other substance dependence/abuse (16.4%), current or history of hypomanic episode (15.1%), generalized anxiety disorder (14.2%) and current major depressive episode (12.9%).

Researchers also said adults with persistent ADHD were more likely to have one or more comorbid disorders vs. those whose ADHD did not persist (80.9% vs. 47%; OR=4.8; 95% CI, 2.4-9.5).

Among the participants who had childhood ADHD, 23.7% had persistent ADHD with one or more comorbid psychiatric disorders; 5.6% had persistent ADHD only; 33.2% had one or more comorbid psychiatric disorders; and 37.5% were free of adverse outcomes.

“These findings have important implications for the effectiveness of care provided to children with ADHD and the system of care to meet the needs of individuals with ADHD across the lifespan,” Barbaresi and colleagues wrote. “It is concerning that only a minority of children with ADHD reaches adulthood without suffering serious adverse outcomes, suggesting that the care of childhood ADHD is far from optimal.”

Disclosure: The researchers report no relevant financial disclosures.