title: A prospective four-year follow-up study of children at risk for ADHD: psychiatric, neuropsychological, and psychosocial outcome.
abstract: BACKGROUND
  Attention-deficit hyperactivity disorder (ADHD) is a familial disorder that places the siblings of ADHD children at high risk for ADHD, conduct, mood, and anxiety disorders. Although the pattern of psychiatric risk has been well documented by prior family studies, neither the short- nor long-term outcome of these high-risk siblings has been prospectively examined.
  
  
  OBJECTIVE
  To document the 4-year psychiatric, psychosocial, and neuropsychological outcome of the siblings of children with ADHD.
  
  
  METHODS
  DSM-III-R structured diagnostic interviews and blind raters were used to conduct a 4-year follow-up of siblings from ADHD and control families. The siblings were also evaluated for cognitive, achievement, social, school, and family functioning.
  
  
  RESULTS
  At follow-up, significant elevations of behavioral, mood, and anxiety disorders were found among the siblings of ADHD children. The high-risk siblings had high rates of school failure and showed evidence of neuropsychological and psychosocial dysfunction. These impairments aggregated among the siblings who had ADHD.
  
  
  CONCLUSIONS
  The siblings of ADHD children are at high risk for clinically meaningful levels of psychopathology and functional impairment. In addition to supporting hypotheses about the familial transmission of ADHD, the results suggest that the high-risk siblings might be appropriate targets for primary preventive interventions.
authors.affiliation: Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Faraone
authors.forename: J
authors.initials: J
authors.lastname: Biederman
authors.forename: D
authors.initials: D
authors.lastname: Mennin
authors.forename: J
authors.initials: J
authors.lastname: Gershon
authors.forename: M T
authors.initials: MT
authors.lastname: Tsuang
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010552:Personality Assessment; D011446:Prospective Studies; D012307:Risk Factors; D012801:Sibling Relations; D012917:Social Adjustment; D012951:Socialization