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Eur Child Adolesc Psychiatry. 2016 Sep;25(9):1007-17. doi: 10.1007/s00787-016-0820-y. Epub 2016 Feb 2.

A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.

Author information

1
Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. m.van.lieshout@vu.nl.
2
Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
3
Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
4
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
5
Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands.
6
Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
7
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, USA.
8
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
9
Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands.
10
Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands.

Abstract

There are very few studies on the long-term outcome of children and adolescents with ADHD-combined type in Europe. The objective of the present study is to assess the 6-year outcome (including pharmacological treatment) of a large cohort of participants with ADHD-combined type (N = 347, mean age 11.4 years) in late adolescence and early adulthood. At study entry and follow-up (mean age 17.4 years), participants were comprehensively assessed on ADHD and comorbid disorders by structured psychiatric interviews and multi-informant questionnaires. Overall functioning was assessed by the Children's Global Assessment Scale. The retention rate was 75.6 %. The majority of participants (86.5 %) persisted in a DSM-5 ADHD diagnosis, 8.4 % had a subthreshold diagnosis, and 5.1 % remitted from the disorder at follow-up. Comorbidities decreased strongly; oppositional defiant disorder: 58 > 31 %, conduct disorder: 19 > 7 %. At follow-up, mood- and anxiety disorders were virtually non-existent following strict criteria (1-3 %). Percentage of children having had pharmacological treatment at any time increased from 79 to 91 %. On the Children's Global Assessment Scale, 48.5 % of participants were still functionally impaired at follow-up. Parental ADHD, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline positively predicted current ADHD symptom severity (R (2) = 20.9 %). Younger baseline age, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline were positively associated with poorer overall functioning (R (2) = 17.8 %). Pharmacological treatment had no (beneficial) impact on either ADHD symptom severity or overall functioning. Results confirm that ADHD is largely persistent into late adolescence with severity and family history for the disorder as important risk factors.

KEYWORDS:

ADHD; Follow-up; Overall functioning; Persistence; Prediction; Symptom severity; Treatment

PMID:
26837866
PMCID:
PMC4990613
DOI:
10.1007/s00787-016-0820-y
[Indexed for MEDLINE]
Free PMC Article

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