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Br J Psychiatry. 2018 Sep;213(3):526-534. doi: 10.1192/bjp.2018.97. Epub 2018 Jun 29.

Young adult mental health and functional outcomes among individuals with remitted, persistent and late-onset ADHD.

Author information

1
MRC Skills Development Fellow, Social, Genetic and Developmental Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UK.
2
Assistant Professor, Department of Psychiatry,University of São Paulo Medical School,Brazil.
3
Reader in Developmental Psychobioligy and Psychiatry, Consultant Child and Adolescent Psychiatrist, Social, Genetic and Developmental Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UK,Department of Child and Adolescent Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UKandNational and Specialist Child Traumatic Stress and Anxiety Clinic,South LondonandMaudsley NHS Foundation Trust,UK.
4
Postdoctoral Fellow, Social, Genetic and Developmental Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UKandDepartment of Psychology and Neuroscience,Duke University,USA.
5
Professor, Social, Genetic and Developmental Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UK,Department of Psychology and Neuroscience,Duke University,USAandDepartment of Psychiatry and Behavioral Sciences,Duke University Medical Center,USA.
6
Professor and ESRC Mental Health Leadership Fellow, Social, Genetic and Developmental Psychiatry,Institute of Psychiatry, Psychology and Neuroscience, King's College London,UK.

Abstract

BACKGROUND:

Attention-deficit hyperactivity disorder (ADHD) is associated with mental health problems and functional impairment across many domains. However, how the longitudinal course of ADHD affects later functioning remains unclear.AimsWe aimed to disentangle how ADHD developmental patterns are associated with young adult functioning.

METHOD:

The Environmental Risk (E-Risk) Longitudinal Twin Study is a population-based cohort of 2232 twins born in England and Wales in 1994-1995. We assessed ADHD in childhood at ages 5, 7, 10 and 12 years and in young adulthood at age 18 years. We examined three developmental patterns of ADHD from childhood to young adulthood - remitted, persistent and late-onset ADHD - and compared these groups with one another and with non-ADHD controls on functioning at age 18 years. We additionally tested whether group differences were attributable to childhood IQ, childhood conduct disorder or familial factors shared between twins.

RESULTS:

Compared with individuals without ADHD, those with remitted ADHD showed poorer physical health and socioeconomic outcomes in young adulthood. Individuals with persistent or late-onset ADHD showed poorer functioning across all domains, including mental health, substance misuse, psychosocial, physical health and socioeconomic outcomes. Overall, these associations were not explained by childhood IQ, childhood conduct disorder or shared familial factors.

CONCLUSIONS:

Long-term associations of childhood ADHD with adverse physical health and socioeconomic outcomes underscore the need for early intervention. Young adult ADHD showed stronger associations with poorer mental health, substance misuse and psychosocial outcomes, emphasising the importance of identifying and treating adults with ADHD.Declaration of interestNone.

KEYWORDS:

ADHD; longitudinal; outcomes

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