Childhood Factors Affecting Persistence and Desistence of Attention-Deficit/Hyperactivity Disorder Symptoms in Adulthood: Results From the MTA.
To determine childhood factors that predict attention-deficit/hyperactivity disorder (ADHD) persistence and desistence in adulthood.



Regression analyses were used to determine associations between childhood factors and adult ADHD symptom persistence in 453 participants (mean age, 25 years) from the Multimodal Treatment Study of Children with ADHD (MTA). Childhood IQ, total number of comorbidities, child-perceived parenting practices, child-perceived parent-child relationships, parental mental health problems, marital problems of parents, household income levels, and parental education were assessed at a mean age of 8 years in all participants. Adult ADHD persistence was defined using DSM-5 symptom counts either with or without impairment, as well as mean ADHD symptom scores on the Conners' Adult ADHD Rating Scale (CAARS). Age, sex, MTA site, and childhood ADHD symptoms were covaried.



The most important childhood predictors of adult ADHD symptom persistence were initial ADHD symptom severity (odds ratio [OR] = 1.89, standard error [SE] = 0.28, p = .025), comorbidities (OR = 1.19, SE = 0.07, p = .018), and parental mental health problems (OR = 1.30, SE = 0.09, p = .003). Childhood IQ, socioeconomic status, parental education, and parent-child relationships showed no associations with adult ADHD symptom persistence.



Initial ADHD symptom severity, parental mental health, and childhood comorbidity affect persistence of ADHD symptoms into adulthood. Addressing these areas early may assist in reducing adult ADHD persistence and functioning problems.
Division of Child Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada; Interdisciplinary Centre Psychopathology and Emotion Regulation, University of Groningen, University Medical Centre Groningen, The Netherlands.
Arunima
A
Roy
Division of Child Psychiatry, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada. Electronic address: lily.hechtman@mcgill.ca.
Lily
L
Hechtman
Ohio State University, Nisonger Center, Columbus.
L Eugene
LE
Arnold
Florida International University, Miami.
Margaret H
MH
Sibley
University of Pittsburgh School of Medicine.
Brooke S G
BS
Molina
Child Development Center, School of Medicine, University of California, Irvine.
James M
JM
Swanson
Carleton University, Ottawa, Ontario.
Andrea L
AL
Howard
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000503:physiopathology*; D002648:Child; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D010290:Parents; D012720:Severity of Illness Index
IQ; adulthood; attention-deficit/hyperactivity disorder (ADHD); comorbidity; family