Childhood attention deficit hyperactivity disorder frequently persists into adulthood, bringing heightened risks of additional psychiatric issues and nearly five times the risk of suicide, US researchers say.
"Only 37.5 percent of the children we contacted as adults were free of these really worrisome outcomes," says William Barbaresi, MD, of Boston Children''s Hospital, lead investigator on the study.
"That''s a sobering statistic that speaks to the need to greatly improve the long-term treatment of children with ADHD and provide a mechanism for treating them as adults."
"This was a unique population based study of a large group of individuals with ADHD followed from childhood to adulthood," added Slavica Katusic, MD, lead Mayo Clinic investigator of the study.
The long-running study, begun when Barbaresi was at the Mayo Clinic and continued in collaboration with Mayo researchers, led by Katusic, followed all children in Rochester, Minn. who were born from 1976 through 1982, were still in Rochester at age 5 and whose families allowed access to their medical records.
That amounted to 5,718 children, including 367 who were diagnosed with ADHD; of this group; 232 participated in the follow-up study. About three-quarters had received ADHD treatment as children.
At follow-up, the researchers found:
29 percent of the children with ADHD still had ADHD as adults (ascertained through structured neuropsychiatric interviews).57 percent of children with ADHD had at least one other psychiatric disorder as adults, as compared with
35 percent of controls.
The most common were substance abuse/dependence, antisocial personality disorder, hypomanic episodes, generalized anxiety and major depression.
Of the children who still had ADHD as adults, 81 percent had at least one other psychiatric disorder, as compared with 47 percent of those who no longer had ADHD and 35 percent of controls.
7 of the 367 children with ADHD (1.9 percent) had died at the time of study recruitment, 3 of them from suicide. Of the 4,946 children without ADHD whose outcomes could be ascertained, only 37 children had died, 5 by suicide.
10 children with ADHD (2.7 percent) were incarcerated at the time of recruitment for the study.
Barbaresi advises parents of children with ADHD to ensure that their children are in high-quality treatment-and remain in treatment as they enter adolescence.
Children should also be assessed for learning disabilities and monitored for conditions associated with ADHD, including substance use, depression and anxiety.
The study has been published in the April 2013 issue of Pediatrics.