title: A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders.
abstract: BACKGROUND
  Previous cross-sectional data showed that children and adolescents with attention-deficit hyperactivity disorder (ADHD) are at increased risk of comorbid conduct, mood, and anxiety disorders as well as impairments in cognitive, social, family, and school functioning. However, longitudinal data were needed to confirm these initial impressions.
  
  
  METHODS
  Using DSM-III-R structured diagnostic interviews and raters blinded as to diagnosis, we reexamined psychiatric diagnoses at 1- and 4-year follow-ups in children with ADHD and controls. In addition, subjects were evaluated for cognitive, achievement, social, school and family functioning.
  
  
  RESULTS
  Analyses of follow-up findings revealed significant differences between children with ADHD and controls in rates of behavioral, mood, and anxiety disorders, with these disorders increasing markedly from baseline to follow-up assessments. In addition, children with ADHD had significantly more impaired cognitive, family, school, and psychosocial functioning than did controls. Baseline diagnosis of conduct disorder predicted major depression and bipolar disorder at follow-up, and anxiety disorders at baseline predicted anxiety disorders at follow-up.
  
  
  CONCLUSIONS
  These results confirm and extend previous retrospective results indicating that children with ADHD are at high risk of developing a wide range of impairments affecting multiple domains of psychopathology such as cognition, interpersonal, school, and family functioning. These findings provide further support for the value of considering psychiatric comorbidity in both clinical assessment and research protocols involving children with ADHD.
authors.affiliation: Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, USA.
authors.forename: J
authors.initials: J
authors.lastname: Biederman
authors.forename: S
authors.initials: S
authors.lastname: Faraone
authors.forename: S
authors.initials: S
authors.lastname: Milberger
authors.forename: J
authors.initials: J
authors.lastname: Guite
authors.forename: E
authors.initials: E
authors.lastname: Mick
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.forename: D
authors.initials: D
authors.lastname: Mennin
authors.forename: A
authors.initials: A
authors.lastname: Marrs
authors.forename: C
authors.initials: C
authors.lastname: Ouellette
authors.forename: P
authors.initials: P
authors.lastname: Moore
authors.forename: T
authors.initials: T
authors.lastname: Spencer
authors.forename: D
authors.initials: D
authors.lastname: Norman
authors.forename: T
authors.initials: T
authors.lastname: Wilens
authors.forename: I
authors.initials: I
authors.lastname: Kraus
authors.forename: J
authors.initials: J
authors.lastname: Perrin
mesh_terms: D000124:Achievement; D000223:Adaptation, Psychological; D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment