title: Childhood predictors of adolescent and young adult outcome in ADHD.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, but it remains unclear which childhood factors predict future outcome.
  
  
  OBJECTIVE
  To identify childhood predictors of ADHD outcome using both dimensional and categorical approaches.
  
  
  METHODS
  116 adolescents and young adults with childhood ADHD were followed up on average 6.6 years later. ADHD outcome variables were interview-based parent-reported ADHD symptoms and impairment. Childhood predictors included parent- and teacher-rated ADHD symptoms and co-occurring behaviours; actigraph measures of activity level; socio-economic status (SES); and cognitive measures previously associated with ADHD.
  
  
  RESULTS
  Of the sample, 79% continued to meet clinical criteria of ADHD in adolescence and young adulthood. Higher parent-rated ADHD symptoms and movement intensity in childhood, but not teacher-rated symptoms, predicted ADHD symptoms at follow up. Co-occurring symptoms of oppositional behaviours, anxiety, social and emotional problems were also significant predictors, but these effects disappeared after controlling for ADHD symptoms. IQ and SES were significant predictors of both ADHD symptoms and impairment at follow up, but no other cognitive measures significantly predicted outcome.
  
  
  CONCLUSIONS
  SES and IQ emerge as potential moderators for the prognosis of ADHD. Childhood severity of ADHD symptoms, as measured by parent ratings and actigraph movement intensity, also predicts later ADHD outcome. These factors should be considered when identifying ADHD children at most risk of poor long-term outcomes and for the development of interventions to improve prognosis.
authors: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
authors: Celeste H M
authors: CH
authors: Cheung
authors: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors: Fruhling
authors: F
authors: Rijdijk
authors: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors: Gráinne
authors: G
authors: McLoughlin
authors: Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, USA.
authors: Stephen V
authors: SV
authors: Faraone
authors: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors: Philip
authors: P
authors: Asherson
authors: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. Electronic address: jonna.kuntsi@kcl.ac.uk.
authors: Jonna
authors: J
authors: Kuntsi
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D016015:Logistic Models; D008297:Male; D009068:Movement / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D055815:Young Adult
keywords: ADHD; Actigraph; IQ; Persistence; SES