The first large, population-based study to follow children with attention-deficit hyperactivity disorder (ADHD) into adulthood shows that ADHD often doesn't "go away," and that children with ADHD are more likely to have other psychiatric disorders as adults. Although numbers were small, they also appear more likely to commit suicide and are often incarcerated as adults.
"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, published in the April 2013 issue of Pediatrics and online March 4. "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.
ADHD is the most common neuro-developmental disorder of childhood, affecting about 7 percent of all children and three times as many boys as girls. Most prior follow-up studies of ADHD have been small and focused on the severe end of the spectrum—like boys referred to pediatric psychiatric treatment facilities—rather than a cross-section of the ADHD population.
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.
"We suffer from the misconception that ADHD is just an annoying childhood disorder that's overtreated," says Barbaresi. "This couldn't be further from the truth. We need to have a chronic disease approach to ADHD as we do for diabetes. The system of care has to be designed for the long haul."
Barbaresi thinks the study findings may actually underestimate the bad outcomes of childhood ADHD. The study population in Rochester, Minn., was relatively heterogeneous and largely middle class, and the children tended to have good education and good access to health care. "One can argue that this is potentially a best-case scenario," Barbaresi says. "Outcomes could be worse in socioeconomically challenged populations."
He 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.
"Data indicate that the stimulant medications used to treat ADHD in children are also effective in adults, although adults tend not to be treated and may not be aware they have ADHD," Barbaresi says.
The study was supported by Public Health Service research grants #s MH076111, HD29745 and AG034676. Pilot work for a portion of the project was funded by an investigator-initiated grant from McNeil Consumer and Specialty Pharmaceuticals.
About Boston Children's Hospital
Boston Children's Hospital is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including nine members of the National Academy of Sciences, 11 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Boston Children's research community. Founded as a 20-bed hospital for children, Boston Children's today is a 395-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Boston Children's also is a teaching affiliate of Harvard Medical School. For more information about research and clinical innovation at Boston Children's, visit: http://vectorblog.org/.
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit www.mayoclinic.com and www.mayoclinic.org/news.
Meghan Weber | EurekAlert!
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy