title: Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study.
abstract: OBJECTIVE
  We examined long-term outcomes of attention-deficit/hyperactivity disorder (ADHD) in a population-based sample of childhood ADHD cases and controls, prospectively assessed as adults.
  
  
  METHODS
  Adults with childhood ADHD and non-ADHD controls from the same birth cohort (N = 5718) were invited to participate in a prospective outcome study. Vital status was determined for birth cohort members. Standardized mortality ratios (SMRs) were constructed to compare overall and cause-specific mortality between childhood ADHD cases and controls. Incarceration status was determined for childhood ADHD cases. A standardized neuropsychiatric interview was administered.
  
  
  RESULTS
  Vital status for 367 childhood ADHD cases was determined: 7 (1.9%) were deceased, and 10 (2.7%) were currently incarcerated. The SMR for overall survival of childhood ADHD cases versus controls was 1.88 (95% confidence interval [CI], 0.83-4.26; P = .13) and for accidents only was 1.70 (95% CI, 0.49-5.97; P = .41). However, the cause-specific mortality for suicide only was significantly higher among ADHD cases (SMR, 4.83; 95% CI, 1.14-20.46; P = .032). Among the childhood ADHD cases participating in the prospective assessment (N = 232; mean age, 27.0 years), ADHD persisted into adulthood for 29.3% (95% CI, 23.5-35.2). Participating childhood ADHD cases were more likely than controls (N = 335; mean age, 28.6 years) to have ≥1 other psychiatric disorder (56.9% vs 34.9%; odds ratio, 2.6; 95% CI, 1.8-3.8; P < .01).
  
  
  CONCLUSIONS
  Childhood ADHD is a chronic health problem, with significant risk for mortality, persistence of ADHD, and long-term morbidity in adulthood.
authors: Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. william.barbaresi@childrens.harvard.edu
authors: William J
authors: WJ
authors: Barbaresi
authors: Robert C
authors: RC
authors: Colligan
authors: Amy L
authors: AL
authors: Weaver
authors: Robert G
authors: RG
authors: Voigt
authors: Jill M
authors: JM
authors: Killian
authors: Slavica K
authors: SK
authors: Katusic
mesh_terms: D000059:Accidents / Q000401:mortality; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000401:mortality / Q000523:psychology; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D011329:Prisoners / Q000706:statistics & numerical data; D011446:Prospective Studies; D013405:Suicide / Q000706:statistics & numerical data