Impact of the impairment criterion in the diagnosis of adult ADHD: 33-year follow-up study of boys with ADHD.
OBJECTIVE
To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12).


METHODS
Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. DSM-IV adult ADHD behaviors were systematically rated, and impairment resulting from symptoms was scored on a 5-point Likert-type scale.


RESULTS
Correlations between degree of impairment and number of behaviors were high (r's = .83 to .85, p < .001). The impairment criterion had no effect on classifying any participants as having, or not having, adult ADHD. All participants who reported experiencing 5 or more inattention or hyperactive-impulsive behaviors as "often" or "very often" in adulthood were significantly impaired by their symptoms.


CONCLUSIONS
Contrary to results reported in children, there was a strong relationship between number of ADHD symptoms and degree of impairment. However, for several reasons (discussed in the article), it should not be concluded that the impairment criterion is superfluous.
Mannuzza
Salvatore
S
New York University Child Study Center, 215 Lexington Avenue, Floor 13, New York, NY 10016, USA. sal.mannuzza@nyumc.org
Castellanos
Francisco X
FX
Roizen
Erica R
ER
Hutchison
Jesse A
JA
Lashua
Erin C
EC
Klein
Rachel G
RG
D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires