Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and causes adverse effects on social functioning. The present study aimed to widely investigate the predictors, particularly childhood intelligence quotient (IQ) and family environment factors, on adult clinical and academic outcomes in boys with ADHD.Methods: A total of 101 boys with ADHD in a Chinese Han ADHD cohort were followed up 7–10 years later. Baseline ADHD symptoms were evaluated using the parent version of the ADHD Rating Scale-IV (ADHD-RS-IV) and the Chinese version of the Conners' Parent Rating Scale-Revised (CPRS-48). The intelligence of the child was tested by the China-Wechsler Intelligence Scale for Children (C-WISC), and family function was assessed by the Family Environment Scale-Chinese Edition (FES-CV). Adult ADHD persistence was defined using DSM-IV criteria for ADHD, and academic outcome fell into two categories: higher academic level group (studying in senior middle school or above) and lower academic level group (studying in vocational secondary schools or below).Results: Stepwise multiple logistic regression analysis revealed that the father's character, impulsive–hyperactive index as measured by the CPRS-48, and intellectual–cultural index as measured by the FES-CV independently predicted clinical outcomes in adults, with an AUC of 0.770 (p < 0.001, 95% CI = 0.678–0.863). The corresponding sensitivity and specificity were 0.743 and 0.727, respectively. The father's education level, family economic level, and verbal IQ (VIQ) on the C-WISC independently predicted adult academic outcomes, with an AUC of 0.870 (p < 0.001, 95% CI = 0.796–0.944). The corresponding sensitivity and specificity were 0.813 and 0.783, respectively.Conclusion: Initial ADHD symptom severity and IQ, father's character and education level, and family atmosphere and function affect adult clinical and academic outcomes. Addressing these areas early may help to improve the prognosis of ADHD into adulthood.
Highlights
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood-onset neurodevelopmental disorders and is characterized by symptoms of hyperactivity, impulsivity, and inattention [1]
Participants were originally included when they met the following criteria: [1] had been unanimously diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alongside the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) by at least two experienced psychiatrists; a third psychiatrist appeared in cases of dissent between the first two psychiatrists; [2] boy aged 6–12 years, Han Chinese; [3] fullscale intelligence quotient (IQ) (FSIQ) >70; and [4] first visit to the hospital and never received drugs for ADHD
Our results showed no significant differences in age at diagnosis, ADHD subtype, only child or not, mother’s character, child’s character, parental educational level, family economic level, maternal health during pregnancy, birth and delivery status, family history, and treatment or not between the symptomatic persistence group and the symptomatic relief group
Summary
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood-onset neurodevelopmental disorders and is characterized by symptoms of hyperactivity, impulsivity, and inattention [1] It affects 3∼7% of school-age children [2], especially boys [3]. Children with ADHD are susceptible to cognitive impairments, lower self-esteem, sexual and social problems, and psychiatric comorbidities [4,5,6]. It has profound impacts on the education, career, and social functions in the adulthood of persistent patients [7]. The present study aimed to widely investigate the predictors, childhood intelligence quotient (IQ) and family environment factors, on adult clinical and academic outcomes in boys with ADHD
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