Looking Down the Road for Kids with ADHD

Children with ADHD at higher risk for mental health disorders and suicide as adults

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) What happens to kids who have ADHD when they grow up? Does the disorder go away? Or do they continue to struggle as adults? Or is it a bit of both?

A recent study found it does tend to be a bit of both but, in general, children with ADHD are at higher risk for various mental health issues.

Nearly a third of children with ADHD in the study continued to have ADHD as adults.

In addition, children with ADHD were at a higher risk for suicide as adults. They were also nearly five times more likely to have another mental health disorder, compared to individuals born in the same town during the same time period who did not have ADHD.

"Seek help for mental health issues."

The study, led by William J. Barbaresi, MD, of Boston Children’s Hospital at Harvard Medical School, aimed to see how children with attention deficit hyperactivity disorder (ADHD) did as adults.

The researchers conducted the study in two parts. First, they followed up with 5,718 adults who had been born in Rochester, Minnesota, between January 1, 1976 and December 31, 1982, and remained living there until they were at least 5 years old.

A total of 367 participants in the study had been classified with ADHD when they were children, based on their school and/or medical records. The average age of diagnosis was 10 years old.

The researchers tracked each adult to either their date of death, the date they enrolled in the second part of the study, their last date known alive or their last medical visit in Rochester before 2009.

Seven of the individuals with ADHD (1.9 percent) had died, and 10 of them (2.7 percent) were incarcerated. Among the 4,946 participants without childhood ADHD, 37 had died (0.7 percent) but information for incarceration was not provided for that population in the study.

When the researchers looked at causes of death, a higher percentage of those with ADHD had committed suicide than those without ADHD. Three of the individuals with ADHD (0.82 percent) had committed suicide, compared to 5 in the group without ADHD (0.10 percent).

For the second part of the study, the researchers conducted more in-depth follow-up with a subset of the individuals who had ADHD who agreed to participate. They and 335 control participants who did not have ADHD were all given psychiatric interviews to assess their mental health.

At this follow-up, the average age of those who had ADHD as children was age 27, and the average age among the control group was 28.

Among those who had ADHD as children, nearly a third (29 percent) met the criteria for adult ADHD. Those who had ADHD as children were also more likely to have at least one other psychiatric disorder.

While 35 percent of the control group individuals (without ADHD) met the criteria for another psychiatric disorder, 57 percent of those who had childhood ADHD met the criteria for another psychiatric disorder as adults.

The most common mental health problem found among those who had ADHD as children was alcohol dependence, which 26 percent had.

In addition, 17 percent of those who had ADHD as children now met the criteria in adulthood for antisocial personality disorder, and 16 percent met the criteria for other substance dependence or abuse.

Among those who had ADHD in childhood, 15 percent had a current or past history of hypomania, a type of mania found in individuals with bipolar disorder. In addition, 14 percent had generalized anxiety disorder, and 13 percent had depression.

The researchers concluded that "childhood ADHD is a chronic health problem, with significant risk for" continuation of ADHD into adulthood, other illnesses and a slightly higher risk of death.

Glen Elliott, MD, PhD, the chief psychiatrist and medical director at Children's Health Council and a dailyRx expert, said not much is new in the study except that the number of suicides is higher than past studies have suggested.

"The take-home lesson is clear:  ADHD is a real and chronic disorder that can profoundly affect lives not only during childhood but also into adulthood," Dr. Elliott said. "We need more, and more effective, treatments, especially with the many individuals who have ADHD along with one or more other serious psychiatric disorders.”

The study was published March 4 in the journal Pediatrics. The research was funded primarily by three Public Health Service grants, following a pilot portion of the project funded by McNeil Consumer and Specialty Pharmaceuticals. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
March 2, 2013
Last Updated:
March 4, 2013