Prospective Follow-up Studies of ADHD: Helping Establish a Valid Diagnosis in Adults

Abstract

o m t w p c p e m b T he Journal of the American Academy of Child and Adolescent Psychiatry has long been recognized and valued as a leading publication in the field. As such, many of the articles published in it have focused on attention-deficit/ hyperactivity disorder (ADHD), a condition that affects 5% to 10% of the school-aged population, and is the most common child psychiatric disorder. The Journal has also played a role in publishing many of the controlled prospective follow-up studies of children with ADHD into adolescence and adulthood. As this editorial will outline, these studies helped establish the fact that ADHD often persists into adolescence and adulthood, and thus laid the groundwork for the validity of the ADHD diagnosis in adulthood, which is now generally accepted. The National Comorbidity Survey, which involved close to 10,000 individuals, documented a 4.4% adult prevalence of ADHD. However, several decades ago, “hyperactivity” was thought to be a condition exclusive of childhood, one that children outgrew as they entered adolescence. This belief was largely fueled by the fact that hyperactivity tended to decrease with age and so was less evident over time. However, early controlled prospective follow-up studies clearly documented that symptoms of the syndrome and associated social, academic, and emotional impairment continued into adolescence. An article published in the Journal in 1998 further helped establish the fact that the condition continued into adolescence. Clinicians, mainly pediatricians and child psychiatrists, who had a developmental focus, and who saw the continued difficulties of their patients as they progressed into adolescence, readily accepted the evidence that ADHD persisted into adolescence. However, the suggestion that ADHD may continue into adulthood was met with consider-