Background
Although it is known that childhood attention-deficit/hyperactivity disorder (ADHD)
often persists into adulthood, childhood predictors of this persistence have not been
widely studied.
Methods
Childhood history of ADHD and adult ADHD were assessed in 10 countries in the World
Health Organization World Mental Health Surveys. Logistic regression analysis was
used to study associations of retrospectively reported childhood risk factors with
adult persistence among the 629 adult respondents with childhood ADHD. Risk factors
included age; sex; childhood ADHD symptom profiles, severity, and treatment; comorbid
child/adolescent DSM-IV disorders; childhood family adversities; and child/adolescent
exposure to traumatic events.
Results
An average of 50% of children with ADHD (range: 32.8%–84.1% across countries) continued
to meet DSM-IV criteria for ADHD as adults. Persistence was strongly related to childhood
ADHD symptom profile (highest persistence associated with the attentional plus impulsive-hyperactive
type, odds ratio [OR] = 12.4, compared with the lowest associated with the impulsive-hyperactive
type), symptom severity (OR = 2.0), comorbid major depressive disorder (MDD; OR =
2.2), high comorbidity (≥3 child/adolescent disorders in addition to ADHD; OR = 1.7),
paternal (but not maternal) anxiety mood disorder (OR = 2.4), and parental antisocial
personality disorder (OR = 2.2). A multivariate risk profile of these variables significantly
predicts persistence of ADHD into adulthood (area under the receiving operator characteristic
curve = .76).
Conclusions
A substantial proportion of children with ADHD continue to meet full criteria for
ADHD as adults. A multivariate risk index comprising variables that can be assessed
in adolescence predicts persistence with good accuracy.
Key Words
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Article info
Publication history
Published online: November 13, 2008
Accepted:
October 2,
2008
Received in revised form:
September 23,
2008
Received:
April 29,
2008
Identification
Copyright
© 2009 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
