Does ADHD in Adulthood Ever Get Better

Author: Boston Children's Hospital
Published: 2013/03/06 - Updated: 2025/02/20
Publication Details: Peer-Reviewed, Findings
Topic: ADHD and ADD - Publications List

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: Study of children with ADHD in adulthood reveals ADHD often persists and ADHD kids more likely to have other psychiatric disorders as adults.

Why it matters: This report presents findings from a comprehensive, peer-reviewed study published in the journal Pediatrics, which tracked children diagnosed with attention-deficit hyperactivity disorder (ADHD) into adulthood. The study reveals that approximately 29% of these individuals continue to experience ADHD symptoms as adults, and 57% develop at least one additional psychiatric disorder, such as substance abuse or depression. These insights underscore the necessity for sustained treatment strategies and support systems for individuals with ADHD, offering valuable information for healthcare providers, caregivers, and adults managing ADHD - Disabled World (DW).

Introduction

The first large, population-based study to follow children with attention-deficit hyperactivity disorder (ADHD) into adulthood shows that ADHD often doesn't "go away," and that children with ADHD are more likely to have other psychiatric disorders as adults. Although numbers were small, they also appear more likely to commit suicide and are often incarcerated as adults.

Main Item

ADHD is defined as a problem with inattentiveness, over-activity, impulsivity, or a combination. For these problems to be diagnosed as ADHD, they must be out of the normal range for a child's age and development. Depression, lack of sleep, learning disabilities, tic disorders, and behavior problems may be confused with, or appear with, ADHD. Every child suspected of having ADHD should be carefully examined by a doctor to rule out possible other conditions or reasons for the behavior.

"Only 37.5 percent of the children we contacted as adults were free of these really worrisome outcomes," says William Barbaresi, MD, of Boston Children's Hospital, lead investigator on the study, published in the April 2013 issue of Pediatrics and online March 4. "That's a sobering statistic that speaks to the need to greatly improve the long-term treatment of children with ADHD and provide a mechanism for treating them as adults."

"This was a unique population based study of a large group of individuals with ADHD followed from childhood to adulthood," added Slavica Katusic, MD, lead Mayo Clinic investigator of the study.

ADHD is the most common neuro-developmental disorder of childhood, affecting about 7 percent of all children and three times as many boys as girls. Most prior follow-up studies of ADHD have been small and focused on the severe end of the spectrum like boys referred to pediatric psychiatric treatment facilities rather than a cross-section of the ADHD population.

The long-running study, begun when Barbaresi was at the Mayo Clinic and continued in collaboration with Mayo researchers, led by Katusic, followed all children in Rochester, Minn. who were born from 1976 through 1982, were still in Rochester at age 5 and whose families allowed access to their medical records. That amounted to 5,718 children, including 367 who were diagnosed with ADHD; of this group; 232 participated in the follow-up study. About three-quarters had received ADHD treatment as children.

At Follow-up, Researchers Found

• 29 percent of the children with ADHD still had ADHD as adults (ascertained through structured neuropsychiatric interviews).
• 57 percent of children with ADHD had at least one other psychiatric disorder as adults, as compared with 35 percent of controls. The most common were substance abuse/dependence, antisocial personality disorder, hypomanic episodes, generalized anxiety and major depression.
• Of the children who still had ADHD as adults, 81 percent had at least one other psychiatric disorder, as compared with 47 percent of those who no longer had ADHD and 35 percent of controls.
• 7 of the 367 children with ADHD (1.9 percent) had died at the time of study recruitment, 3 of them from suicide. Of the 4,946 children without ADHD whose outcomes could be ascertained, only 37 children had died, 5 by suicide.
• 10 children with ADHD (2.7 percent) were incarcerated at the time of recruitment for the study.

"We suffer from the misconception that ADHD is just an annoying childhood disorder that's over-treated," says Barbaresi. "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."

Barbaresi thinks the study findings may actually underestimate the bad outcomes of childhood ADHD. The study population in Rochester, Minn., was relatively heterogeneous and largely middle class, and the children tended to have good education and good access to health care.

"One can argue that this is potentially a best-case scenario," Barbaresi says. "Outcomes could be worse in socioeconomically challenged populations."

He advises parents of children with ADHD to ensure that their children are in high-quality treatment - and remain in treatment as they enter adolescence. Children should also be assessed for learning disabilities and monitored for conditions associated with ADHD, including substance use, depression and anxiety.

"Data indicate that the stimulant medications used to treat ADHD in children are also effective in adults, although adults tend not to be treated and may not be aware they have ADHD," Barbaresi says.

The study was supported by Public Health Service research grants #s MH076111, HD29745 and AG034676. Pilot work for a portion of the project was funded by an investigator-initiated grant from McNeil Consumer and Specialty Pharmaceuticals.

Insights, Analysis, and Developments

While this report highlights the long-term challenges faced by individuals with ADHD, it also raises important questions about how society supports neurodivergent adults. The high rates of co-occurring mental health conditions suggest that early intervention and ongoing care are critical, yet too many adults slip through the cracks. This underscores the need for better awareness, more accessible treatment options, and a shift in how ADHD is perceived - not just as a childhood disorder, but as a lifelong condition that requires understanding and support

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by Boston Children's Hospital and published on 2013/03/06, this content may have been edited for style, clarity, or brevity. For further details or clarifications, Boston Children's Hospital can be contacted at childrenshospital.org NOTE: Disabled World does not provide any warranties or endorsements related to this article.