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Life Span Studies of ADHD—Conceptual Challenges and Predictors of Persistence and Outcome

  • Attention-Deficit Disorder (A Rostain, Section Editor)
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Abstract

There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.

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Authors and Affiliations

  1. ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Arthur Caye & Luis Augusto Rohde

  2. Department of Pediatrics, University of California, Irvine, CA, USA

    James Swanson

  3. MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK

    Anita Thapar

  4. Department of Psychiatry and Behavioral Health at the Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA

    Margaret Sibley

  5. MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Louise Arseneault

  6. Department of Psychiatry, McGill University, Montreal, Quebec, Canada

    Lily Hechtman

  7. Department of Psychiatry, Nisonger Center, Ohio State University, Columbus, OH, USA

    L. Eugene Arnold

  8. Department of Psychology, University of Copenhagen, Copenhagen, Denmark

    Janni Niclasen

  9. Centre for Collaborative Health, Aarhus University, Aarhus, Denmark

    Janni Niclasen

  10. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA

    Terrie Moffitt

  11. National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil

    Luis Augusto Rohde

  12. Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clinicas de Porto Alegre, 4o andar, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil

    Luis Augusto Rohde

Authors
  1. Arthur Caye
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  2. James Swanson
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  3. Anita Thapar
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  4. Margaret Sibley
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  5. Louise Arseneault
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  6. Lily Hechtman
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  7. L. Eugene Arnold
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  8. Janni Niclasen
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  9. Terrie Moffitt
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  10. Luis Augusto Rohde
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Corresponding author

Correspondence to Luis Augusto Rohde.

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Conflict of Interest

Arthur Caye, Anita Thapar, Margaret Sibley, Louise Arseneault, Janni Niclasen, and Terrie Moffitt declare that they have no conflict of interest.

James Swanson reported receiving research support, advisory board membership, speaker’s bureau membership, and/or consulting for Alza, Richwood, Shire, Celgene, Novartis, Celltech, Gliatech, Cephalon, Watson, CIBA, UCB, Janssen-Cilag, McNeil, and Eli-Lilly.

Lily Hechtman has been on advisory boards and a speaker for Shire, Jannsen, Ironshore, and Purdue Pharma. She has also received research funds from Purdue.

L. Eugene Arnold has received research funding from Curemark, Forest, Lilly, Neuropharm, Novartis, Noven, Shire, Supernus, and YoungLiving (as well as NIH and Autism Speaks); has consulted with Gowlings, Neuropharm, Organon, Pfizer, Sigma Tau, Shire, Tris Pharma, and Waypoint; been on advisory boards for Arbor, Ironshore, Novartis, Noven, Otsuka, Pfizer, Roche, Seaside Therapeutics, Sigma Tau, and Shire; and received travel support from Noven.

Luis Augusto Rohde was on the speakers’ bureau/advisory board and/or acted as consultant for Eli-Lilly, Janssen-Cilag, Novartis, and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. He also received travel awards for taking part in the 2014 APA meeting and 2015 WFADHD meeting from Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Attention-Deficit Disorder

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Caye, A., Swanson, J., Thapar, A. et al. Life Span Studies of ADHD—Conceptual Challenges and Predictors of Persistence and Outcome. Curr Psychiatry Rep 18, 111 (2016). https://doi.org/10.1007/s11920-016-0750-x

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  • DOI: https://doi.org/10.1007/s11920-016-0750-x

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