Study: Long-Term Health Outcomes of Childhood ADHD are Chronic, Severe
Childhood ADHD should be considered a chronic health problem that increases the likelihood of adverse long-term health outcomes, according to a population-based birth cohort study of children with ADHD and psychiatric disorders. Further research on the impact of treatment is needed.
November 24, 2020
Childhood attention deficit hyperactivity disorder (ADHD or ADD) is a chronic health problem that significantly impacts functioning into adulthood and increases the risk for multiple adverse long-term outcomes, according to findings from a new study published in the Journal of Attention Disorders.1
The study, which included 232 adults with childhood ADHD and 335 adults without childhood ADHD from a 1976 to 1982 birth cohort, found that ADHD was associated with a greater likelihood for the following:
- ever having been fired (twice as likely)
- ever having a driver’s license revoked
- having a pregnancy out of wedlock
- ever being in a treatment program for alcohol, marijuana, or hard/street drugs, compared to non-ADHD referents
Notably, this new research did not compare outcomes for ADHD patients who received treatment and those who did not, however previous research on the same birth cohort found that ADHD medication use was linked to reduced rates of substance use disorder, fewer emergency room visits, and improved school function in childhood. Adults in the present study completed an extensive psychosocial questionnaire and researchers also reviewed data that was previously reported regarding the birth cohort’s learning abilities and psychiatric disorders.
- 69.4% of participants with childhood ADHD also had a learning disorder, compared to 12.5% of non-ADHD referents
- 59.5% of participants with childhood ADHD also had at least one psychiatric disorder, compared to 17.6% of non-ADHD referents
A latent class analysis was conducted to assess patterns of functional outcomes of the whole sample and a three-class solution was used to distinguish between “good,” “intermediate,” and “poor” functioning.
The “good” functioning class was characterized by having higher education, income, and rates of marriage. The “intermediate” group was characterized by a high likelihood of being fired, initiating sexual activity under the age of 18, and medium levels of income and education. The “poor” functioning class was characterized by high levels of trouble with the law, sexual initiation under the age of 18, treatment for alcohol, marijuana, or drug use, and no education beyond high school.
Participants with childhood ADHD comprised 24.9% of the study’s “good” functioning class, 53.5% of the “intermediate,” and 62.8% of the “poor” functioning class. Comorbid learning disorders were not associated with likelihood of being in the “poor” versus “intermediate” functioning classes, but the “poor” functioning class had a greater number of participants with a childhood psychiatric disorder, and co-occurring childhood ADHD with a childhood psychiatric disorder, compared to the “intermediate” functioning class.
Researchers concluded that childhood ADHD should be viewed as a serious condition that increases the risk for multiple negative long-term outcomes, and that those with childhood ADHD and psychiatric disorders might be at highest risk. They suggested that treatment for ADHD should consider the impact of ADHD on virtually all functional domains; previous research on the same birth cohort found that medicating children with ADHD was linked to reduced rates of substance use disorder, emergency room visits, and improved school function in childhood.
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1Harstad EB, Katusic S, Sideridis G, Weaver AL, Voigt RG, Barbaresi WJ. Children With ADHD Are at Risk for a Broad Array of Adverse Adult Outcomes That Cross Functional Domains: Results From a Population-Based Birth Cohort Study. Journal of Attention Disorders. October 2020. doi:10.1177/1087054720964578