Attention-Deficit/Hyperactivity Disorder Trajectories From Childhood to Young Adulthood

Caye, Arthur; Rocha, Thiago Botter-Maio; Anselmi, Luciana; Murray, Joseph A.; Menezes, Ana Maria Baptista; Barros, Fernando C.; Gonçalves, Helen; Wehrmeister, Fernando César; Jensen, Christina Mohr; Steinhausen, Hans-Christoph; Swanson, James M.; Kieling, Christian; Rohde, Luís Augusto

doi:10.1001/jamapsychiatry.2016.0383

Cited by 283 publications

(289 citation statements)

References 22 publications

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“…In this UK longitudinal population‐based cohort, using updated SDQ cut‐points and excluding those with high scores at one time point during childhood, we find lower rates of genuine late‐onset ADHD (0.4%) than other population‐based studies (Moffitt et al., 2015, 2.7%; Agnew‐Blais et al., 2016, 5%; Caye et al., 2016, 7.9%). Indeed, in our sample, 75% (56 of 75 with full data) of those with apparent late‐onset ADHD symptoms were due to potential misclassification once we had taken into account subthreshold or elevated SDQ ADHD scores at least one point in childhood.…”

Section: Discussionmentioning

confidence: 95%

“…(2015) found that their 3% prevalence of adult ADHD at age 38 years was 90% comprised of those without a history of childhood ADHD; Caye et al. (2016) found that 84.6% of their 18/19 year olds with ADHD did not have a history of childhood ADHD, and Agnew‐Blais et al. (2016) found that 67.5% of their 18 year olds with ADHD had not met criteria for ADHD at any assessment in childhood.…”

Section: Discussionmentioning

confidence: 99%

“…(2016) not finding elevated rates of depression and anxiety in their late‐onset ADHD group compared to the persistent group, but Caye et al. (2016) finding elevated rates of mood disorders and anxiety in their young adult ADHD group. Moffitt et al.…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, elevated rates of substance dependence were not found in the young adult ADHD group of Caye et al. (2016). Our investigation was conducted in a younger age group than some of the previous studies and before the peak age of onset for mood disorders (Kessler et al., 2007) (but not conduct disorder) so the age difference might be one contributory factor.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, adult ADHD status was not associated with the male preponderance, neuropsychological deficits or child ADHD genetic liability (as indexed by ADHD polygenic risk scores) typical of childhood onset ADHD, leading the authors to conclude that adult ADHD may not be a continuation of the childhood neurodevelopmental disorder and may have a different aetiology. Second, a Brazilian birth cohort study (Caye et al., 2016) found 85% of their young adult ADHD group, as ascertained at age 18–19 years without requiring the ‘age at onset’ criterion, had not met criteria in childhood (age 11 years). This young adult group had a female preponderance and a range of adverse outcomes including criminality, suicide attempts and comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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Investigating late‐onset ADHD: a population cohort investigation

Cooper

Hammerton

Collishaw

et al. 2018

Child Psychology Psychiatry

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BackgroundAdult ADHD has been assumed to be a continuation of childhood‐onset ADHD. However, recent studies have identified individuals with ADHD in adulthood who have not had ADHD in childhood. Whether or not these individuals have a ‘typical’ neurodevelopmental profile is not clear.MethodsWe tested two explanations for the emergence of apparent late‐onset ADHD symptomatology using the ALSPAC epidemiological cohort, by grouping individuals according to their scores on the Strengths and Difficulties Questionnaire (SDQ) hyperactivity subscale at ages 12 and 17 years. First, we tested whether some of those with apparent late‐onset ADHD symptoms had been potentially misclassified on the basis of earlier SDQ hyperactivity scores (ages 7, 8 and 9 years) or of subthreshold symptoms at age 12 years. Second, we investigated the possibility that those with ‘genuine’ late‐onset ADHD symptoms had a delayed manifestation of the same liability that underlies childhood‐onset symptoms, by investigating whether they had a similar profile of neurodevelopmental impairments (in the domains of autistic symptomatology, language, reading, spelling, executive functioning and IQ) as those with typical childhood‐onset ADHD.Results N = 56/75 (75%) of those with apparent late‐onset ADHD had had high ADHD scores at least one point in childhood, suggesting that they may have been misclassified on the basis of their score at age 12 years. The remaining 19 individuals (25%) with genuine late‐onset ADHD symptoms did not show a profile of neurodevelopmental impairment typically seen in ADHD, instead showing similar levels of autistic symptoms, language skills, executive functioning ability and IQ to those without ADHD symptoms. The only exceptions were that this group showed reading and spelling problems at age 9 years.ConclusionsOur work suggests that this small number of individuals with genuine late‐onset symptoms may not be most appropriately considered as having a typical neurodevelopmental disorder.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigating late‐onset ADHD: a population cohort investigation

Cooper

Hammerton

Collishaw

et al. 2018

Child Psychology Psychiatry

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Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents

Karen

Cho

Stone

et al. 2018

JAMA

212

123

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IMPORTANCE Modern digital platforms are easily accessible and intensely stimulating; it is unknown whether frequent use of digital media may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD).OBJECTIVE To determine whether the frequency of using digital media among 15-and 16-year-olds without significant ADHD symptoms is associated with subsequent occurrence of ADHD symptoms during a 24-month follow-up.DESIGN, SETTING, AND PARTICIPANTS Longitudinal cohort of students in 10 Los Angeles County, California, high schools recruited through convenience sampling. Baseline and 6-, 12-, 18-, and 24-month follow-up surveys were administered from September 2014 (10th grade) to December 2016 (12th grade). Of 4100 eligible students, 3051 10th-graders (74%) were surveyed at the baseline assessment.EXPOSURES Self-reported use of 14 different modern digital media activities at a high-frequency rate over the preceding week was defined as many times a day (yes/no) and was summed in a cumulative index (range, 0-14).MAIN OUTCOMES AND MEASURES Self-rated frequency of 18 ADHD symptoms (never/rare, sometimes, often, very often) in the 6 months preceding the survey. The total numbers of 9 inattentive symptoms (range, 0-9) and 9 hyperactive-impulsive symptoms (range, 0-9) that students rated as experiencing often or very often were calculated. Students who had reported experiencing often or very often 6 or more symptoms in either category were classified as being ADHD symptom-positive. RESULTS Among the 2587 adolescents (63% eligible students; 54.4% girls; mean [SD] age 15.5 years [0.5 years]) who did not have significant symptoms of ADHD at baseline, the median follow-up was 22.6 months (interquartile range [IQR], months). The mean (SD) number of baseline digital media activities used at a high-frequency rate was 3.62 (3.30); 1398 students (54.1%) indicated high frequency of checking social media (95% CI, 52.1%-56.0%), which was the most common media activity. High-frequency engagement in each additional digital media activity at baseline was associated with a significantly higher odds of having symptoms of ADHD across follow-ups (OR, 1.11; 95% CI, 1.06-1.16). This association persisted after covariate adjustment (OR, 1.10; 95% CI, 1.05-1.15). The 495 students who reported no high-frequency media use at baseline had a 4.6% mean rate of having ADHD symptoms across follow-ups vs 9.5% among the 114 who reported 7 high-frequency activities (difference; 4.9%; 95% CI, 2.5%-7.3%) and vs 10.5% among the 51 students who reported 14 high-frequency activities (difference, 5.9%; 95% CI, 2.6%-9.2%).CONCLUSIONS AND RELEVANCE Among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. Further research is needed to determine whether this association is causal.

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Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia

Levine,

Rotstein,

Kodesh

et al. 2023

JAMA Netw Open

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ImportanceEvidence that adult attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk of dementia is scarce and inconsistent, and potential sources of bias are untested.ObjectiveTo examine the association between adult ADHD and the risk of dementia.Design, Setting, and ParticipantsThis prospective national cohort study consisted of 109 218 members of a nonprofit Israeli health maintenance organization born between 1933 and 1952 who entered the cohort on January 1, 2003, without an ADHD or dementia diagnosis and were followed up to February 28, 2020. Participants were aged 51 to 70 years in 2003. Statistical analysis was conducted from December 2022 to August 2023.ExposureAdult ADHD was a time-varying covariate, classified as present from the age of the first diagnosis (using the International Classification of Diseases, Ninth Revision, and the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision); otherwise, absent.Main Outcome and MeasuresCox regression models were fitted to quantify the association between adult ADHD and the risk of incident dementia with hazard ratios (HRs) and their 95% CIs unadjusted and in the primary analysis, using inverse probability weights, adjusted for 18 sources of potential confounding. In 14 complementary analyses, subgroup and sensitivity analyses were implemented.ResultsAt the beginning of the follow-up, the sample of 109 218 participants had a mean (SD) age of 57.7 (5.5) years, 56 474 participants (51.7%) were female, and 52 744 (48.3%) were male. During follow-up, 730 participants (0.7%) received a diagnosis of adult ADHD, and 7726 (7.1%) received a diagnosis of dementia. Dementia occurred among 96 of 730 participants (13.2%) with adult ADHD and 7630 of 108 488 participants (7.0%) without adult ADHD. In the primary analysis, compared with the absence of adult ADHD, the presence of adult ADHD was statistically significantly (P &lt; .001) associated with an increased dementia risk (unadjusted HR, 3.62 [95% CI, 2.92-4.49; P &lt; .001]; adjusted HR, 2.77 [95% CI, 2.11-3.63; P &lt; .001]). Twelve of the 14 complementary analyses did not attenuate the conclusions based on the results of the primary analysis. There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.Conclusions and RelevanceIn this cohort study of individuals born between 1933 and 1952 and followed up in old age, adult ADHD was associated with an increased risk of dementia. Policy makers, caregivers, patients, and clinicians may wish to monitor reliably for ADHD in old age.

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Attention-Deficit/Hyperactivity Disorder Trajectories From Childhood to Young Adulthood

Abstract: The findings of this study do not support the assumption that adulthood ADHD is necessarily a continuation of childhood ADHD. Rather, they suggest the existence of 2 syndromes that have distinct developmental trajectories.

Cited by 283 publications

References 22 publications

Investigating late‐onset ADHD: a population cohort investigation

Investigating late‐onset ADHD: a population cohort investigation

Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents

Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia

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