Young adult mental health and functional outcomes among individuals with remitted, persistent and late-onset ADHD

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Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with mental health problems and functional impairment across many domains. However, how the longitudinal course of ADHD affects later functioning remains unclear.
Aims: To disentangle how ADHD developmental patterns are associated with young adult functioning.
Methods: The Environmental Risk (E-Risk) Longitudinal Twin Study is a population-based cohort of 2,232 twins born in England and Wales in 1994-1995. We assessed ADHD in childhood at ages 5, 7, 10, and 12 and in young adulthood at age 18. We examined three developmental patterns of ADHD from childhood to young adulthood— remitted, persistent, and late–onset ADHD— and compared these groups to one another and to non-ADHD controls on age-18 functioning. We additionally tested whether group differences were due to childhood IQ, childhood conduct disorder, or familial factors shared between twins.
Results: Compared to individuals without ADHD, those with remitted ADHD showed poorer physical health and socioeconomic outcomes in young adulthood. Individuals with persistent or late-onset ADHD showed poorer functioning across all domains including mental health, substance use, psychosocial, physical health, and socioeconomic outcomes. Overall, these associations were not explained by childhood IQ, childhood conduct disorder or shared familial factors.
Conclusions: Long-term associations of childhood ADHD with adverse physical health and socioeconomic outcomes underscore the need for early intervention. Young adult ADHD showed stronger associations with poorer mental health, substance use, and psychosocial outcomes, emphasizing the importance of identifying and treating adults with ADHD.
Original languageEnglish
Pages (from-to)526-534
JournalBritish Journal of Psychiatry
Issue number3
Early online date29 Jun 2018
Publication statusPublished - 16 Aug 2018


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