How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

Abstract

The main aim of this study was to examine the age-dependent persistence of attention-deficit hyperactivity disorder (ADHD) in boys transitioning from adolescence into early adulthood attending to different definitions of persistence. We conducted a 10-year follow-up study (mean follow-up time=11 years) of 110 boys with ADHD and 105 non-ADHD controls. Both groups were 6-17 years of age at ascertainment. ADHD was considered persistent at follow-up if subjects met full or subthreshold (more than half of the symptoms required for a full diagnosis) Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV) diagnostic criteria, failed to attain functional remission (Global Assessment of Functioning, GAF score < or =60) or were receiving treatment for ADHD. While 65% of children with ADHD no longer met full DSM-IV criteria for ADHD at the 10-year follow-up, 78% of subjects met at least one of our definitions of persistence. Persistence as described above was associated with more psychiatric co-morbidity, more familiality with mood disorders and higher levels of educational and interpersonal impairments than controls. This 10-year longitudinal follow-up study shows that the majority of ADHD boys experience persistent symptoms and functional impairments into early adulthood. Persistence of ADHD is associated with greater psychiatric comorbidity, familiality and functional impairments.

Figure 1

Age-specific prevalence of persistence of ADHD at the 10-year follow-up by definition of persistence and symptom type (N=103). The prevalence of persistence varied considerably depending on the definition used. Persistence significantly decreased with age for ADHD and inattentive symptoms but not hyperactive/impulsive symptoms.