title: Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta-analysis.
abstract: Attention-deficit/hyperactivity disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder that continues into adulthood in up to half of diagnosed cases. In light of current evidence, factors associated with the course of the disorder remain unknown. We performed a systematic review of the literature searching for risk markers from childhood that predicted the persistence of ADHD into adulthood. We reviewed 26,168 abstracts and selected 72 for full-text review. We identified data from 16 studies, comprising 6 population-based retrospective samples and 10 clinical follow-ups. We performed meta-analyses of factors evaluated by at least three studies. Severity of ADHD (OR 2.33, 95 % CI = 1.6-3.39, p < 0.001), treatment for ADHD (OR 2.09, 95 % CI = 1.04-4.18, p = 0.037), comorbid conduct disorder (OR 1.85, 95 % CI = 1.06-3.24, p = 0.030), and comorbid major depressive disorder (OR 1.8, 95 % CI = 1.1-2.95, p = 0.019) emerged as predictors already presented in childhood for ADHD persistence into adulthood. Further, we suggest that cohort studies should be designed to clarify such an important question for research and clinical practice.
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
authors.forename: Arthur
authors.initials: A
authors.lastname: Caye
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
authors.forename: Alex V
authors.initials: AV
authors.lastname: Spadini
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
authors.forename: Rafael G
authors.initials: RG
authors.lastname: Karam
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
authors.forename: Eugenio H
authors.initials: EH
authors.lastname: Grevet
authors.affiliation: Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Diego L
authors.initials: DL
authors.lastname: Rovaris
authors.affiliation: Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Claiton H D
authors.initials: CH
authors.lastname: Bau
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.|National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Rohde
authors.affiliation: Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil. ckieling@ufrgs.br.
authors.forename: Christian
authors.initials: C
authors.lastname: Kieling
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D006801:Humans
keywords: ADHD; Adolescence; Course; Persistence; Prognosis; Risk factors