Childhood ADHD Has Lingering Effects in Adulthood

A large-scale study found that adults who had been diagnosed with ADHD as children were almost 5 times as likely to commit suicide as peers who were not diagnosed with ADHD.

Children diagnosed with ADHD in childhood are more likely to have an additional psychiatric disorder and dramatically more likely to commit suicide as adults than those who were not diagnosed with ADHD in childhood, according to the results of a study published in the April 2013 edition of Pediatrics. The study, among the first large-scale efforts to follow children diagnosed with ADHD into adulthood, was carried out by researchers at Boston’s Children’s Hospital and the Mayo Clinic.

The researchers followed 5718 children who were born in Rochester, Minnesota, between 1976 and 1982; who were still living in Rochester at age 5; and whose families allowed researchers to see their medical records. Of the study participants, 367 were diagnosed with ADHD as children. Nearly three-quarters of these participants received treatment, and 232 participated in the adulthood study. Researchers examined the participants' medical records, and then conducted follow-up interviews and diagnostic tests.

The researchers found that 29% of children diagnosed with ADHD retained the disorder as adults. Fifty-seven percent of adults who were diagnosed with ADHD as children had another psychiatric disorder, compared with 35% of adults in a control group who were not diagnosed with ADHD as children. Of the participants who had ADHD as children, 81% of those who still had ADHD as adults had at least 1 comorbid psychiatric disorder, compared with 47% of those who no longer had ADHD as adults.

Adult psychiatric disorders that afflicted childhood ADHD patients included alcohol abuse dependence (26%), antisocial personality disorder (17%), other types of substance dependence or abuse (16%), hypomanic episodes (15%), anxiety disorders (14%), and major depression (13%). One finding deserves particular attention: the researchers found that suicide risk was almost 5 times as high among those diagnosed with ADHD as children as it was in the control group. Furthermore, children diagnosed with ADHD were more likely to be incarcerated.

“We suffer from the misconception that ADHD is just an annoying childhood disorder that’s overtreated,” William Barbaresi, MD, of Boston’s Children’s Hospital, the study’s lead investigator, said in a press release. “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.”

Additionally, Barbaresi noted that the study’s outcomes may represent a “best-case scenario.” The study population was homogeneous and predominantly middle class, and the participants had access to health care and a good education. “Outcomes could be worse in socioeconomically challenged populations,” said Barbaresi.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.