Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder with the telltale signs of inattentiveness, impulsiveness, and over or hyper activity. It affects three to five percent of school age children directly and is more often diagnosed in males than females. The symptoms do present themselves differently between the two genders. ADHD can cause many problems if not properly diagnosed and treated during school but the problem does not go away upon graduation.
The first large, population-based study to follow children with ADHD into adulthood shows that children with ADHD are more likely to have other psychiatric disorders as adults. Depression is another common problem among those with ADHD. Although numbers were small, they also appear more likely to commit suicide and are often incarcerated as adults.
"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 4 March. "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.
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, MN 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.
The researchers found:
• 29 percent of the children with ADHD still had ADHD.
• 57 percent of children with ADHD had at least one other psychiatric disorder as adults. The most common were substance abuse/dependence, antisocial personality disorder, hypomanic episodes, generalized anxiety and major depression.
• 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 overtreated," 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."
Dr. James Wiley, with focus-md.com, compared ADHD and diabetes. He found some similarities between ADHD and Type 1 diabetes. Both diabetes and ADHD have a genetic aspect. He points out that children with a low birth weight are higher at risk for ADHD. In ADHD the brain’s neurotransmitters, like dopamine and norepinephrine, are under activated.
ADHD is a chronic condition. It can, if not treated, lead to not only depression and trouble with the law but also problems keeping a job. Difficulties in dealing with co-workers may also be an issue.
The Center for Disease Control & Prevention (CDC) lists the symptoms for children as:
• have a hard time paying attention
• daydream a lot
• not seem to listen
• be easily distracted from schoolwork or play
• forget things
• be in constant motion or unable to stay seated
• squirm or fidget
• talk too much
• not be able to play quietly
• act and speak without thinking
• have trouble taking turns
• interrupt others
Barbaresi 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. Treatment can consist of medications, behavior therapy or a combination of the two.
This article was taken in part from a press release by Boston Children’s Hospital. It is not intended to replace the medical advice of your physician. If you are experiencing any of the symptoms of ADHD, make an appointment with your physician.
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