The main aim of this study was to examine the age-dependent persistence of ADHD in boys transitioning from adolescence into early adulthood attending to different definitions of persistence. We conducted a 10-year follow-up study (mean follow-up time=11 years) of 110 boys with ADHD and 105 non-ADHD controls. Both groups were 6-17 years of age at ascertainment. ADHD was considered persistent at follow-up if subjects met full or subthreshold (more than half of the symptoms required for a full diagnosis) DSM-IV diagnostic criteria, failed to attain functional remission (GAF score ≤60), or were receiving treatment for ADHD. While 65% of children with ADHD no longer met full DSM-IV criteria for ADHD at the 10-year follow-up, 78% of subjects met at least one of our definitions of persistence. Persistence as described above was associated with more psychiatric comorbidity, more familiality with mood disorders, and higher levels of educational and interpersonal impairments than controls. This 10-year longitudinal follow-up study shows that the majority of ADHD boys experience persistent symptoms and functional impairments into early adulthood. Persistence of ADHD is associated with greater psychiatric comorbidity, familiality and functional impairments.

The prevalence of overweight and obesity is higher among children with developmental disabilities than in the general population. Community-based studies with larger sample sizes are required to confirm this finding. The results also highlight the need to develop health care strategies for the prevention, early identification and management of excess weight gain for this group.

Objective-The main aim of this study was to examine the association between ADHDassociated genes and the course of ADHD.Methods-Subjects were derived from identically designed case-control family studies of boys and girls with ADHD and a genetic linkage study of families with children with ADHD. Caucasian probands and family members with ADHD and with available genetic data were included in this analysis (N=563). The course of ADHD was compared in subjects with and without putative risk alleles (DRD4 7-repeat allele, DAT1 10-repeat allele, and 5HTTLPR long © 2009 Elsevier Ireland Ltd. All rights reserved.Address correspondence to Joseph Biederman, MD, Clinical and Research Program in Pediatric, Psychopharmacology, Yawkey Center, Suite 6A, Massachusetts General Hospital, Boston, MA 02114. jbiederman@partners.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript allele). The persistence of ADHD (full or subthreshold diagnosis in the last month) was plotted using Kaplan-Meier survival functions and tested with Cox proportional hazard models.Results-Survival analyses revealed that by 25 years of age 76% of subjects with a DRD4 7-repeat allele were estimated to have persistent ADHD compared to 66% of subjects without the risk allele (hazard ratio=1.66, z=2.05, p=0.04). In contrast, there were no significant associations between the course of ADHD and the DAT1 10-repeat allele (p=0.94) and 5HTTLPR long allele (p=0.65).Conclusions-Our findings suggest that the DRD4 7-repeat allele is associated with a more persistent course of ADHD.

Despite an extant literature documenting that adults with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for significant difficulties in the workplace, there is little documentation of the underlying factors associated with these impairments. The main aim of this study was to examine specific deficiencies associated with ADHD on workplace performance in a simulated workplace laboratory relative to controls. Participants were 56 non-medicated young adults with DSM-IV ADHD and 63 age and sex matched controls without ADHD. Participants spent 10 hours in a workplace simulation laboratory. Areas assessed included: 1) simulated tasks documented in a government report (SCANS) often required in workplace settings (taxing vigilance; planning; cooperation; attention to detail), 2)observer ratings, and 3)self-reports. Robust findings were found in the statistically significant differences on self-report of ADHD symptoms found between participants with ADHD and controls during all workplace tasks and periods of the workday. Task performance was found to be deficient in a small number of areas and there were few statistically significant differences identified by observer ratings. Symptoms reported by participants with ADHD in the simulation including internal restlessness, intolerance of boredom and difficulty maintaining vigilance were significant and could adversely impact workplace performance over the long-term.