Psychological Medicine



Original Article

Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study


JOSEPH BIEDERMAN a1c1, MICHAEL C. MONUTEAUX a1, ERIC MICK a1, THOMAS SPENCER a1, TIMOTHY E. WILENS a1, JULIE M. SILVA a1, LINDSEY E. SNYDER a1 and STEPHEN V. FARAONE a2
a1 Pediatric Psychopharmacology Unit of the Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
a2 Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA

Article author query
biederman j   [PubMed][Google Scholar] 
monuteaux mc   [PubMed][Google Scholar] 
mick e   [PubMed][Google Scholar] 
spencer t   [PubMed][Google Scholar] 
wilens te   [PubMed][Google Scholar] 
silva jm   [PubMed][Google Scholar] 
snyder le   [PubMed][Google Scholar] 
faraone sv   [PubMed][Google Scholar] 

Abstract

Background. Our objective was to estimate the lifetime prevalence of psychopathology in a sample of youth with and without attention deficit hyperactivity disorder (ADHD) through young adulthood using contemporaneous diagnostic and analytic techniques.

Method. We conducted a case-control, 10-year prospective study of ADHD youth. At baseline, we assessed consecutively referred male, Caucasian children with (n=140) and without (n=120) DSM-III-R ADHD, aged 6–18 years, ascertained from psychiatric and pediatric sources to allow for generalizability of results. At the 10-year follow-up, 112 (80%) and 105 (88%) of the ADHD and control children, respectively, were reassessed (mean age 22 years). We created the following categories of psychiatric disorders: Major Psychopathology (mood disorders and psychosis), Anxiety Disorders, Antisocial Disorders (conduct, oppositional-defiant, and antisocial personality disorder), Developmental Disorders (elimination, language, and tics disorder), and Substance Dependence Disorders (alcohol, drug, and nicotine dependence), as measured by blinded structured diagnostic interview.

Results. The lifetime prevalence for all categories of psychopathology were significantly greater in ADHD young adults compared to controls, with hazard ratios and 95% confidence intervals of 6·1 (3·5–10·7), 2·2 (1·5–3·2), 5·9 (3·9–8·8), 2·5 (1·7–3·6), and 2·0 (1·3–3·0), respectively, for the categories described above.

Conclusions. By their young adult years, ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial, addictive, mood and anxiety disorders. These prospective findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies.

(Published Online January 18 2006)


Correspondence:
c1 Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, YAW-6A-6900, 32 Fruit Street, Boston, MA 02114, USA. (Email: jbiederman@partners.org)


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