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Boys with ADHD are at increased risk of psychosocial, educational and functional impairment in adulthood

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Question: What is the burden of psychosocial and functional impairments in adulthood which are associated with attention deficit/hyperactivity disorder (ADHD) in youth?

Population: 260 Caucasian boys of ages 6–17 years (140 with DSM-III-R clinician-ascertained ADHD, and 120 without the condition). Those with psychosis, autism, inadequate command of the English language or an IQ of less than 80 were excluded. From this original sample, 79 (56%) of those with ADHD and 90 (75%) of those without the condition took part in a 16 year follow-up.

Setting: USA; 1988–2006.

Prognostic factors: ADHD during youth.

Outcomes: Mood and anxiety disorders (major depressive disorder, bipolar disorder, anxiety disorders, agoraphobia, social phobia, obsessive-compulsive disorder, specific phobia, panic disorder and generalised anxiety disorder); antisocial and substance dependence disorders (oppositional defiant disorder, antisocial personality disorder, substance-dependence disorders, alcohol dependence, drug dependence and smoking dependence); current global functioning and family conflict; educational and occupational achievement (parental support, educational and occupational levels, overall socioeconomic status); and cognitive assessments. Boys with ADHD had lower baseline family socioeconomic status; therefore, this was controlled for in all statistical analyses. …

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  • Sources of funding The study was partially supported by the Lilly Foundation and the Pediatric Psychopharmacology Council Fund of Massachusetts General Hospital, Boston. Some of the authors received income and research support from various commercial sponsors.


  • Competing interests PA has completed consultancy work on behalf of Kings College London for Shire, Eli-Lilly, Janssen-Cilag and Vifor. He has educational or research grants from the same companies.