Adolescent Outcomes of Childhood Attention-Deficit/Hyperactivity Disorder in a Diverse Community Sample

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 49; no. 6; pp. 595 - 605
• Main Authors: Bussing, Regina, Mason, Dana M, Bell, Lindsay, Porter, Phillip, Garvan, Cynthia
• Format: Journal Article
• Language: English
• Published: United States Elsevier 01.06.2010
• Subjects: Achievement; Adolescent; Adolescents; Alcohol Drinking - epidemiology; Alcohol Drinking - psychology; Attention Deficit and Disruptive Behavior Disorders - diagnosis; Attention Deficit and Disruptive Behavior Disorders - epidemiology; Attention Deficit and Disruptive Behavior Disorders - psychology; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - psychology; Attention Deficit Hyperactivity Disorder; Case Studies; Case-Control Studies; Child; Comorbidity; Comparative Analysis; Diagnostic and Statistical Manual of Mental Disorders; Drinking; Educational Objectives; Female; Florida; Follow-Up Studies; Grade Repetition; Humans; Intervention; Juvenile Delinquency - psychology; Juvenile Delinquency - statistics & numerical data; Juvenile Justice; Male; Marijuana; Marijuana Abuse - diagnosis; Marijuana Abuse - epidemiology; Marijuana Abuse - psychology; Mass Screening; Odds Ratio; Outcomes of Education; Quality of Life; Quality of Life - psychology; Risk; School Districts; Social Adjustment; Student Dropouts - psychology; Student Dropouts - statistics & numerical data; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Florida
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2010.03.006

Objective: To describe adolescent outcomes of childhood attention-deficit/hyperactivity disorder (ADHD) in a diverse community sample. Method: ADHD screening of a school district sample of 1,615 students aged 5 to 11 years was followed by a case-control study 8 years later. High-risk youths meeting full (n = 94) and subthreshold (n = 75) DSM-IV ADHD criteria were matched with demographically similar low-risk peers (n = 163). Outcomes domains included symptom, functional impairment, quality of life, substance use, educational outcomes, and juvenile justice involvement. Results: In all, 44% of youths with childhood ADHD had not experienced remission. Compared with unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (odds ratio [OR] = 12.9, 95% confidence interval [CI] 5.6-30.0), anxiety/depression (OR = 10.3, 95% CI 2.7-39.3), significant functional impairment (OR = 3.4, 95% CI 1.7-6.9), reduced quality of life (OR = 2.5, 95% CI 1.3-4.7), and involvement with the juvenile justice system (OR = 3.1, 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. Conclusions: ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies. (Contains 1 figure and 2 tables.)