Psychiatric Status of Hyperactives as Adults: A Controlled Prospective 15-Year Follow-up of 63 Hyperactive Children

doi:10.1016/S0002-7138(09)60450-7

Journal of the American Academy of Child Psychiatry

Volume 24, Issue 2, March 1985, Pages 211-220

https://doi.org/10.1016/S0002-7138(09)60450-7 Get rights and content

Sixty-three hyperactive adults aged 21–33 and 41 matched normal controls were evaluated for their psychiatric status by means of (a) psychiatric interviews and histories using the DSM-II diagnosis; (b) psychiatric interviews carried out “blind” as to which group the subject belonged, using the SADS-L diagnosis; and (c) by means of self-rating scales. Each subject was assigned a number on the Global Assessment Scale of the SADS which measures general overall functioning. Results indicated that about half of the probands continued to have mild to severely disabling continuing symptoms of the syndrome. A significant percentage (23%) of the hyperactive adults had an Antisocial Personality Disorder on both the modified SADS-L and the DSM-I diagnostic criteria. Schizophrenia and alcoholism or alcohol abuse was not found more commonly in the hyperactive group. There was evidence that the hyperactives had more overall psychopathology and functioned generally less well than did normal controls.

References (31)

M. Laufer et al.
Hyperkinetic behavior disorders in children
J. Paediatrics
(1957)
K. Minde et al.
A five-year follow-up of 91 hyperactive school children
This Journal
(1972)
J. Werry et al.
Studies on the hyperactive child; III. The effect of chlorpromazine upon behavior and learning ability
This Journal
(1966)
C. Anderson et al.
Management of the brain damaged adolescent
Amer. J. Orthopsychiat.
(1962)
H. Bakwin et al.
Clinical Management of Behaviour Disorders in Children
(1966)
A. Blouin et al.
Teenage alcohol use among hyperactive children: a 5 year follow-up study
J. Paediat. Psychol.
(1978)
H. Borland et al.
Hyperactive boys and their brothers: A 25 year follow-up study
Arch. Gen. Psychiat.
(1976)
N. Cohen et al.
Cognitive styles in adolescents previously diagnosed as hyperactive
J. Child Psychol. Psychiat.
(1972)
A. Cox et al.
Bias resulting from missing information: some epidemiological findings
Brit. J. Prevent. Soc. Med.
(1977)
R. Dykman et al.
Long term follow-up studies of hyperactive children: a 5 year follow-up study

R. Gomez et al.

Adult psychiatric diagnosis and symptoms compatible with the hyperactive child syndrome: a retrospective study

J. Clin. Psychiat.

(1981)

D. Goodwin et al.

Alcoholism and the hyperactive child syndrome

J. Nerv. Ment. Dis.

(1975)

L. Hechtman et al.

Hyperactives as young adults: self-esteem and social skills

Canad. J. Psychiat.

(1980)

L. Hechtman et al.

Hyperactives as young adults: various clinical outcomes

J. Hopkins et al.

Cognitive style in adults originally diagnosed as hyperactives

J. Child Psychol. Psychiat.

(1979)

Cited by (633)

Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats?
2024, Toxicology and Applied Pharmacology
Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.
Review: Adult Outcome as Seen Through Controlled Prospective Follow-up Studies of Children With Attention-Deficit/Hyperactivity Disorder Followed Into Adulthood
2022, Journal of the American Academy of Child and Adolescent Psychiatry
Citation Excerpt :
Most longitudinal follow-up studies have found ADHD symptom and syndrome persistence into the adult years in a substantial proportion of research participants; however, the estimates of persistence rates have varied. The Montreal Study reported that 66% of the research participants in the hyperactive group reported at least one continuing symptom of the hyperactive syndrome (restlessness, poor concentration, impulsivity, explosiveness) compared with 7% of the control group, and their continuing symptoms had greater severity than those of control participants.12 The Milwaukee Study found that by age 27, approximately 35% of the sample could be considered recovered from the disorder defined by symptoms and functioning according to self-report or parent report based on the study’s research criteria.
To describe adult outcome of people with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and its several key predictors via a review of 7 North American controlled prospective follow-up studies: Montreal, New York, Milwaukee, Pittsburgh, Massachusetts General Hospital (MGH), Berkeley, and 7-site Multimodal Treatment Study of Children With ADHD (MTA).
All studies were prospective and followed children with a diagnosis of ADHD and an age- and gender-matched control group at regular intervals from childhood (6-12 years of age) through adolescence into adulthood (20-40 years of age), evaluating symptom and syndrome persistence, functional outcomes, and predictors of these outcomes.
The rates of ADHD syndrome persistence ranged from 5.7% to 77%, likely owing to varying diagnostic criteria and the source of information (self-report vs informant report) across the studies. However, all studies observed high rates of symptomatic persistence ranging from 60% to 86%. The 7 studies were largely consistent in finding that relative to control groups, research participants with childhood-diagnosed ADHD had significant impairments in the areas of educational functioning, occupational functioning, mental health, and physical health as well as higher rates of substance misuse, antisocial behavior, and unsafe driving. The most consistently observed predictors of functional outcomes included ADHD persistence and comorbidity, especially with disruptive behavior disorders.
Childhood ADHD has high rates of symptomatic persistence, which is associated with negative functional outcomes. Characteristics that predict these negative outcomes, such as comorbid disruptive behavior disorders, may be important targets for intervention.
Development of bipolar disorder in patients with attention-deficit/hyperactivity disorder: A systematic review and meta-analysis of prospective studies
2021, Journal of Affective Disorders
Citation Excerpt :
The funnel plots revealed a fairly homogeneous distribution of studies across sample variance and estimate direction. The longitudinal relationship between ADHD and BD is a matter of controversies, since several prospective studies of hyperactive children outcomes showed conflicting findings (Arnold et al., 2020; Biederman, 1996; Fischer et al., 2002; Mannuzza et al., 1998; Tillman and Geller, 2006; Weiss et al., 1985). Our meta-analysis aimed to summarize the results of prospective studies of children or adolescents diagnosed with ADHD according to DSM-III-R or subsequent editions to estimate the proportion of patients who develop BD.
Increasing attention has been recently paid to precursors of bipolar disorder (BD). Symptoms of attention-deficit/hyperactivity disorder (ADHD) have been reported among the most common prodromes of BD. The aim of this study was to estimate the risk of BD in youths affected by ADHD based on prospective studies.
A systematic review was conducted according to the PRISMA guidelines. A meta-analysis of single proportions was performed to compute the overall occurrence of BD in ADHD individuals. Binary outcome data were used to calculate risk estimates of BD occurrence in ADHD subjects versus Healthy Controls (HC).
An overall proportion of BD occurrence of 10.01% (95%-confidence interval [CI]: 6.47%-15.19%; I² = 82.0%) was found among 1248 patients with ADHD over 10 prospective studies. A slightly higher proportion was found when excluding one study based on jack-knife sensitivity analysis (11.96%, 95%-CI: 9.15%-15.49%; I² = 54.1%) and in three offspring studies (12.87%, 95%-CI: 8.91%-18.23%). BD occurrence was not significantly associated with mean follow-up duration (p-value = 0.2118). A greater risk of BD occurrence in ADHD versus HC from six studies was found (risk ratio: 8.97, 95%-CI: 4.26-18.87, p-value < 0.0001).
Few prospective studies have been retrieved in our search and most were not specifically aimed at assessing BD in followed-up ADHD patients.
Greater clinical attention should be paid to ADHD as an early precursor of BD since a substantial proportion of ADHD patients is expected to be diagnosed with BD during the developmental age.
Attention-Deficit/Hyperactivity Disorder (ADHD), antisociality and delinquent behavior over the lifespan
2021, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
In that survey, about 20 % of ADHD individuals also fulfilled diagnostic criteria for ASPD. Follow-up studies with ADHD children also revealed high rates of ASPD in later life (Fischer et al., 2002; Mannuzza et al., 2004; Satterfield and Schell, 1997; Weiss et al., 1985). The prevalence rates exceed by far an expected rate of random co-occurrence of both disorders of about 0.06 %, given an estimated prevalence of adult ADHD of about 3% and a prevalence for ASPD from population-based epidemiological studies of about 2%.
Attention-Deficit/Hyperactivity Disorder (ADHD) is closely linked to the development of conduct problems during socialization in early life and to an increased risk for antisocial activities and delinquency over the lifespan. The interaction between ADHD and common comorbid disorders like substance use disorders as well as changing environmental conditions could mediate the course of antisocial and delinquent behavior with increasing age. However, this complex interaction is only partially understood so far. This review presents current knowledge about the association of ADHD with antisociality and the development of delinquent behavior. Thereby, the relationships between ADHD, conduct disorder and antisocial personality disorder in offenders are discussed, as well as the impact of comorbid psychiatric disorders and psychosocial conditions on offending behavior. Also, treatment studies in offender populations with ADHD are presented.
Although our understanding of the role of ADHD in the development of criminal behavior has substantially improved during the last two decades, more research is needed to further elucidate the mechanisms generating unfavorable outcomes and to engender adequate treatment strategies for this population at risk. Moreover, more attention is needed on children with conduct problems in order to avoid antisocial or delinquent behaviors over the lifespan.
History of Childhood/Adolescence Referral to Speciality Care or Treatment in Adult Patients with Attention-Deficit/Hyperactivity Disorder: Mutual Relations with Clinical Presentation, Psychiatric Comorbidity and Emotional Dysregulation
2023, Brain Sciences
Suicide Risk among Adolescents with ADHD: An Overview from the National Inpatient Sample Data Set
2023, Journal of Nervous and Mental Disease

View all citing articles on Scopus

View full text

ARTICLEPsychiatric Status of Hyperactives as Adults: A Controlled Prospective 15-Year Follow-up of 63 Hyperactive Children

J. Paediatrics

This Journal

This Journal

Management of the brain damaged adolescent

Amer. J. Orthopsychiat.

Clinical Management of Behaviour Disorders in Children

Teenage alcohol use among hyperactive children: a 5 year follow-up study

J. Paediat. Psychol.

Hyperactive boys and their brothers: A 25 year follow-up study

Arch. Gen. Psychiat.

Cognitive styles in adolescents previously diagnosed as hyperactive

J. Child Psychol. Psychiat.

Bias resulting from missing information: some epidemiological findings

Brit. J. Prevent. Soc. Med.

Long term follow-up studies of hyperactive children: a 5 year follow-up study

Adult psychiatric diagnosis and symptoms compatible with the hyperactive child syndrome: a retrospective study

J. Clin. Psychiat.

Alcoholism and the hyperactive child syndrome

J. Nerv. Ment. Dis.

Hyperactives as young adults: self-esteem and social skills

Canad. J. Psychiat.

Hyperactives as young adults: various clinical outcomes

Cognitive style in adults originally diagnosed as hyperactives

J. Child Psychol. Psychiat.

ARTICLE
Psychiatric Status of Hyperactives as Adults: A Controlled Prospective 15-Year Follow-up of 63 Hyperactive Children