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. 2015 Mar:62:92-100.
doi: 10.1016/j.jpsychires.2015.01.011. Epub 2015 Jan 29.

Childhood predictors of adolescent and young adult outcome in ADHD

Celeste H M Cheung  1 , Fruhling Rijdijk  2 , Gráinne McLoughlin  2 , Stephen V Faraone  3 , Philip Asherson  2 , Jonna Kuntsi  4
Affiliations

Childhood predictors of adolescent and young adult outcome in ADHD

Celeste H M Cheung et al. J Psychiatr Res. 2015 Mar.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, but it remains unclear which childhood factors predict future outcome.

Aim: 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.

Keywords: ADHD; Actigraph; IQ; Persistence; SES.

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Figures

Figure 1
Figure 1. Standardised coefficients estimating the relative contribution of each variable on the canonical variates (T1/T2), where T1 reflects the linear combination of the childhood measures and T2 reflects the linear combination of the outcome measures. The relationship between the two canonical variates (T1 and T2) is represented by the canonical correlation
Significant paths (p<0.05) are indicated as solid lines and non-significant paths (p≥0.05) are indicated as dotted lines.
Figure 2
Figure 2. Mean standardised scores on childhood predictors for future ADHD outcome (persistent vs remittent)
See this image and copyright information in PMC

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