Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study.
BACKGROUND
Our objective was to estimate the lifetime prevalence of psychopathology in a sample of youth with and without attention deficit hyperactivity disorder (ADHD) through young adulthood using contemporaneous diagnostic and analytic techniques.


METHODS
We conducted a case-control, 10-year prospective study of ADHD youth. At baseline, we assessed consecutively referred male, Caucasian children with (n=140) and without (n=120) DSM-III-R ADHD, aged 6-18 years, ascertained from psychiatric and pediatric sources to allow for generalizability of results. At the 10-year follow-up, 112 (80%) and 105 (88%) of the ADHD and control children, respectively, were reassessed (mean age 22 years). We created the following categories of psychiatric disorders: Major Psychopathology (mood disorders and psychosis), Anxiety Disorders, Antisocial Disorders (conduct, oppositional-defiant, and antisocial personality disorder), Developmental Disorders (elimination, language, and tics disorder), and Substance Dependence Disorders (alcohol, drug, and nicotine dependence), as measured by blinded structured diagnostic interview.


RESULTS
The lifetime prevalence for all categories of psychopathology were significantly greater in ADHD young adults compared to controls, with hazard ratios and 95% confidence intervals of 6.1 (3.5-10.7), 2.2 (1.5-3.2), 5.9 (3.9-8.8), 2.5 (1.7-3.6), and 2.0 (1.3-3.0), respectively, for the categories described above.


CONCLUSIONS
By their young adult years, ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial, addictive, mood and anxiety disorders. These prospective findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies.
Biederman
Joseph
J
Pediatric Psychopharmacology Unit of the Psychiatry Department, Massachusetts General Hospital, Boston, MA 02114, USA. jbiederman@partners.org
Monuteaux
Michael C
MC
Mick
Eric
E
Spencer
Thomas
T
Wilens
Timothy E
TE
Silva
Julie M
JM
Snyder
Lindsey E
LE
Faraone
Stephen V
SV
D000293:Adolescent; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000523:psychology; D009069:Movement Disorders / Q000175:diagnosis / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D013997:Time Factors