Five‐year outcomes of ADHD diagnosed in adulthood

Abstract

There is a dearth of long‐term follow‐up studies of adults diagnosed with ADHD. Here, the aim was to evaluate long‐term outcomes in a group of ADHD patients diagnosed in adulthood and receiving routine psychiatric health care. Adults diagnosed with any type of ADHD ( n = 52) and healthy controls ( n = 73) were assessed at baseline and at a 5‐year follow‐up, using Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), Brown ADD Scale (BADDS) and Adult ADHD Self‐Report Scale (ASRS). A multivariate regression method was used to identify factors predicting 5‐year outcomes, including baseline ratings, medication intensity, comorbidity, intelligence quotient (IQ), age, and sex. After 5 years, ADHD patients reported fewer and/or less severe symptoms compared to baseline, but remained at clinically significant symptom levels and with functional deficits. Baseline self‐reports of ADHD symptoms predicted their own 5‐year outcome and low baseline functioning level predicted improved global functioning at follow‐up. Factors previously reported to predict short‐term outcomes (i.e., medication, comorbidity, IQ, age, and sex) did not anticipate long‐term outcomes in present study.

Longitudinal Analysis of Self-Reported Symptoms, Behavioral Measures, and Event-Related Potential Components of a Cued Go/NoGo Task in Adults With Attention-Deficit/Hyperactivity Disorder and Controls

“…The subjective symptom burden, expressed by the ADHD subjects in terms of perceived inattention and hyperactivity, decreased over the 2-year study period. These results are identical to those of Nylander et al (2021), who also report a decrease in these subjective assessments, however, over five years. They reported symptom decrease in the self-report scales, as well as in the clinician assessments.…”

“…They reported symptom decrease in the self-report scales, as well as in the clinician assessments. In our cohort, the symptom decrease resulted in many participants who no longer fulfilled the DSM-5 criteria at the end of the study, which was not the case in the Nylander study (Nylander et al, 2021). In our sample, the symptom alleviation corroborates with the lower percentage of participants taking methylphenidate and antidepressants at the end of the study.…”

“…The diagnosis by DSM-5 is based on the number of observable symptoms. The overall symptom burden is mostly quantified by the number of symptoms and their frequency of occurrence in daily life (van Lieshout et al, 2019;Nylander et al, 2021).…”

“…Longitudinal studies describing symptom burden, cognition (Alperin et al, 2017;van Lieshout et al, 2019;Tallberg et al, 2021), neurophysiology (Doehnert et al, 2010(Doehnert et al, , 2013Du Rietz et al, 2016;Lau-Zhu et al, 2019), and their association focus exclusively on children. Only a single study predicts longterm outcomes in adult ADHD based on data obtained during childhood and adolescents (Nylander et al, 2021). However, this study included only symptom burden, global functioning, and demographic information (medication, comorbidity, intelligence quotient, age, and sex), without considering neurophysiological characteristics of the disorder.…”

Drivers and Barriers to Tolerable and Effective Treatment for ADHD: The Importance of Treatment Perseverance and Duration of Effect

“…In the United States, the estimated prevalence of ADHD is 4.4% among adults and 9.4% among children (CDC, 2021a, 2021b; Kessler et al, 2006). Manifestations of illness are often exhibited in early childhood and may persist through adulthood, leading to accrued health and economic burdens, with far-reaching deleterious impact on the patients’ well-being throughout their life (Doshi et al, 2012; Nylander et al, 2021; Peterson et al, 2008; Secnik et al, 2005; Spencer et al, 2006).…”