Attention-deficit hyperactivity disorder (ADHD) is recognised as a common, disabling condition. Little information is available regarding the long-term outcomes for individuals with ADHD in the UK.
To examine the 5-year outcome for a UK cohort of children with diagnosed, treated ADHD and identify whether maternal and social factors predict key outcomes.
One hundred and twenty-six school-aged children (mean age 9.4 years, s.d. = 1.7) diagnosed with ADHD were reassessed 5 years later during adolescence (mean age 14.5 years, s.d. = 1.7) for ADHD, conduct disorder and other antisocial behaviours.
Most adolescents (69.8%) continued to meet full criteria for ADHD, were known to specialist services and exhibited high levels of antisocial behaviour, criminal activity and substance use problems. Maternal childhood conduct disorder predicted offspring ADHD continuity; maternal childhood conduct disorder, lower child IQ and social class predicted offspring conduct disorder symptoms.
The treatment and monitoring of ADHD need to be intensified as outcomes are poor especially in offspring of mothers with childhood conduct disorder symptoms.
"As adults, these individuals tend to complete fewer years of education, and have lower ranking occupational positions (McGough et al., 2005). They are also at risk for social adjustment difficulties, psychological distress, higher rates of drug dependence and antisocial behavior, poor driving records with increased risk of traffic violations and accidents (Babinski, Pelham, & Molina, 2011; Langley et al., 2010; Murphy, Barkley, & Bush, 2002). A variety of pharmacological and non-pharmacological interventions are available for the treatment of ADHD. "
[Show abstract][Hide abstract] ABSTRACT: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by pervasive and developmentally inappropriate levels of inattention, impulsivity, and hyperactivity. There is no conclusive cause of ADHD although a number of etiologic theories have been advanced. Research across neuroanatomical, neurochemical, and genetic disciplines collectively support a physiological basis for ADHD and, within the past decade, the number of neuroimaging studies concerning ADHD has increased exponentially. The current selective review summarizes research findings concerning ADHD using functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and diffusion tensor imaging (DTI). Although these technologies and studies offer promise in helping to better understand the physiologic underpinnings of ADHD, they are not without methodological problems, including inadequate sensitivity and specificity for psychiatric disorders. Consequently, neuroimaging technology, in its current state of development, should not be used to inform clinical practice.
"In all subtypes, the maladaptive behaviour is present before the age of seven, is evident in two or more settings, is inconsistent with the child's developmental level and has a negative impact on social and academic domains. Research shows that ADHD symptoms persist into adolescence and adulthood (Fayyad et al., 2007; Langley et al., 2010; Ramtekkar, Reiersen, Todorov, & Todd, 2010; Taylor, Fauset, & Harpin, 2010) increasing the risk of low quality of life, impairment in academic and occupational functioning, other psychiatric problems and antisocial behaviour (Cumyn, French, & Hechtman, 2009; Danckaerts et al., 2010; Langley et al., 2010). Epidemiological data suggest that ADHD remains underdiagnosed (Bussing, Zima, Gary, & Garvan, 2003; Sayal, Goodman, & Ford, 2006a), although an increase in recognition over the last decade has been reported in the United Kingdom (Sayal, Ford, & Goodman, 2010). "
[Show abstract][Hide abstract] ABSTRACT: Background
This study investigates the ability of primary school teachers to recognise Attention Deficit/Hyperactivity Disorder (ADHD), and the impact of subtype and child gender on recognition and proposed management. Method
Primary school teachers read one of four types of vignette describing the behaviour of a 9-year-old child: either a boy or a girl with inattentive or combined subtype of ADHD. Teachers were asked about their conceptualisation of the child's difficulties and their thoughts about need for specialist referral and other interventions. ResultsOf 496 teachers, 99% identified the presence of a problem. Subtype (combined) of ADHD influenced teachers’ recognition of ADHD and agreement that medication might be helpful. Only 13% of teachers thought that medication might be helpful. Conclusions
Results suggest a need for better teacher awareness about inattentive subtype of ADHD.
Child and Adolescent Mental Health 02/2013; 18(1). DOI:10.1111/j.1475-3588.2012.00653.x · 1.44 Impact Factor
"PIDEMIOLOGICAL STUDIES HAVE consistently identifi ed a phenotypic association between adolescent problem behaviors and adult alcohol use. In particular, conduct disorder (CD) and adolescent attention-defi cit/ hyperactivity disorder (ADHD) are often correlated with later alcohol use disorders, especially alcohol dependence (AD) (Arias et al., 2008; Friedrichs et al., 2010; Knop et al., 2009; Langley et al., 2010; Weiss et al., 1985; Whalen et al., 2002; White et al., 2001). Each of these disorders is characterized to some extent by externalizing behavior, raising the possibility that a general liability to such behavior contributes to the association among phenotypes. "
[Show abstract][Hide abstract] ABSTRACT: Adolescent problem behaviors such as conduct disorder and attention-deficit/hyperactivity disorder (ADHD) are often associated with alcohol problems in adulthood, particularly alcohol dependence. This association is partly a result of shared genetic liability. However, it is unclear whether ADHD, or an ADHD subtype, shares genetic influences with alcohol dependence beyond those also shared by conduct disorder.
We evaluated phenotypic associations between adolescent conduct disorder and ADHD phenotypes with adult alcohol dependence in a population-based sample of adult male twins (N = 1,774). We then assessed genetic and environmental relationships among phenotypes using structural equation modeling.
Individually, conduct disorder and each ADHD factor were associated with adult alcohol dependence. Results from twin modeling indicate that a genetic factor common to conduct disorder and ADHD also loads strongly onto alcohol dependence. Even after controlling for genetic factors shared with conduct disorder and other ADHD factors, the hyperactivity component of ADHD shared significant residual genetic influences with alcohol dependence.
Most of the genetically mediated association between adolescent ADHD and adult alcohol dependence is shared with conduct disorder, reflecting a generalized risk to externalizing behaviors. The significant residual genetic covariance between the ADHD factor hyperactivity/impulsivity and alcohol dependence implies that impulsive behaviors less destructive/harmful than those manifested by conduct disorder can be indicative of genetic risk for adult alcohol dependence. However, the ADHD factors inattention and forgetfulness are not uniquely predictive of genetic/environmental risk for alcohol dependence.
Journal of studies on alcohol and drugs 03/2012; 73(2):185-94. DOI:10.15288/jsad.2012.73.185 · 2.76 Impact Factor
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