ADHD Can Often Persist Into Adulthood03/04/13
MONDAY, March 4 (HealthDay News) -- Children with ADHD often
grow up to be adults with ADHD, a new study suggests.
Researchers found that of the 232 young adults in the study who
had childhood attention-deficit/hyperactivity disorder, 29 percent
still had it at an average age of 27. What's more, 57 percent had
at least one other mental health issue, such as alcohol abuse,
depression or chronic anxiety.
"This shows us [ADHD] is a serious, chronic condition that's not being adequately addressed," said lead researcher Dr. William Barbaresi, who directs the Developmental Medicine Center at Boston Children's Hospital.
The findings, published online March 4 and in the April print
issue of the journal
Pediatrics, give a clearer picture of how often ADHD
symptoms persist into adulthood, Barbaresi said.
Past studies have made a wide range of estimates -- partly
because they often have focused on specific groups of kids, like
boys referred to specialty treatment programs.
But the new study included 600 young adults from Rochester,
Minn. -- about 40 percent of whom had ADHD as children. Barbaresi's
team evaluated them for symptoms of adult ADHD and other
"This is likely to be a more accurate description of what's happening in the real world," Barbaresi said.
His team found that persistent ADHD often went hand-in-hand with
other issues. Of the study participants with adult ADHD, 81 percent
had at least one additional mental health condition, compared with
47 percent of those whose ADHD symptoms had faded and 35 percent of
those who had never had ADHD.
The study was funded by the U.S National Institutes of Health,
but the original pilot work received funds from McNeil Consumer and
Specialty Pharmaceuticals, which makes the ADHD drug Concerta.
J. Russell Ramsay, co-director of the Adult ADHD Treatment and
Research Program at the University of Pennsylvania in Philadelphia,
said the findings add to evidence that "ADHD has important ripple
effects throughout and across one's life, particularly in
Depression, anxiety and substance abuse are the most common
accompanying mental health issues. "In some cases," Ramsay said,
"adults with previously unrecognized ADHD may seek treatment for
these other conditions and may make partial progress -- only to
later recognize that undiagnosed ADHD was a primary source of their
According to the U.S. Centers for Disease Control and
Prevention, between 3 percent and 7 percent of school-aged kids
nationwide have ADHD. A child with ADHD might be habitually unable
to sit still, finish homework assignments or pay attention in
As kids get older, though, the signs generally become more
subtle. Teenagers may no longer be disruptive in class, but instead
be impulsive in their decisions -- such as taking risks when
they're driving, Barbaresi said.
Likewise, an adult with ADHD may be impulsive and have trouble
staying organized, being productive at work or sticking with one
task at a time. Whatever the age, ADHD treatment involves
medication, behavioral therapy or a combination of the two.
There is, however, a good deal of controversy surrounding ADHD,
with critics charging that some children are being labeled as
having a "disease" and treated with drugs they do not need. Ritalin
and other so-called stimulant medications often are prescribed for
ADHD, and some parents balk at the idea of having their child on
such a powerful drug long-term.
"Of course, there are concerns about the accuracy of diagnosis and inappropriate treatment," Barbaresi said. But, he added, that's a concern in medicine in general.
Dr. Steve Balt, editor-in-chief of the
Carlat Psychiatry Report, which bills itself as an
alternative to journals with drug-industry funding, said the study
"emphasizes the importance of accurately diagnosing and treating
ADHD in childhood," but it has its limitations.
For one, Balt said, the researchers used a "questionnaire-based
tool," rather than a full evaluation, to measure young adults'
mental health. And the fact that most adults said to have ADHD also
had other psychiatric conditions "may, in fact, speak to the
overlap of psychiatric symptoms," he said.
Alcohol abuse and antisocial personality disorder were the two
most common psychiatric diagnoses in the group. And they "have many
features in common with ADHD," Balt said.
None of that, he said, negates the importance of recognizing and
addressing children's behavioral issues or problems with attention.
The problem, he said, is in diagnosing those kids with a single
"We should use caution in describing this constellation of behaviors as a 'disease,'" he said.
The American Academy of Pediatrics says doctors should do an
evaluation for ADHD for any child aged 4 to 18 who has behavioral
problems or is falling behind at school. But that should also
include a thorough assessment for learning disabilities, emotional
issues or physical conditions that could be causing their symptoms
-- such as sleep apnea.
Barbaresi's advice to parents: "Don't accept a cursory
evaluation and a prescription."
And will getting ADHD treatment cut a child's risk of adulthood
symptoms, or other mental health issues? No one knows for sure.
Barbaresi said, however, that other studies of this same group
have found that kids treated with stimulant medication tended to
fare better in certain regards up to age 19. They had fewer
academic problems and better reading skills, for instance.
But the effects of childhood ADHD treatment on adults' outcomes
were not analyzed in the current study, Balt said. "If treatment
worked," he said, "one would expect their rates of other disorders
to be the same as the non-ADHD [participants']."
Learn more about ADHD from the
U.S. National Institute of Mental Health.
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