Heterotypic trajectories of dimensional psychopathology across the lifespan: the case of youth‐onset attention deficit/hyperactivity disorder

Manfro, Arthur Gus; Santoro, Marcos; Polanczyk, Guilherme; Gadelha, Ary; Pan, Pedro Mário; Bressan, Rodrigo Affonseca; Brietzke, Elisa; Talarico, Fernanda; Belangero, Síntia Iole; Rohde, Luís Augusto; Salum, Giovanni Abrahão

doi:10.1111/jcpp.12987

Cited by 20 publications

(24 citation statements)

References 46 publications

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“…These individuals would not meet current diagnostic criteria for ADHD if their age-at-onset was known and the discovery of this group challenges the conceptualization of ADHD as a neurodevelopmental disorder. Three studies investigating "late-onset" ADHD have not observed associations with ADHD PRS, although these have been limited in power due to sample size [44,47,48]. Thus, while childhood and persistent ADHD appear to be genetically similar, this may not be the case for "late-onset" ADHD.…”

Section: Adhd: What Happens Over Timementioning

confidence: 99%

The importance of a developmental perspective in Psychiatry: what do recent genetic-epidemiological findings show?

Thapar

Riglin

2020

Mol Psychiatry

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There is growing appreciation that a developmental perspective is helpful in Psychiatry. However, clinical practice and research, especially in an era of very large sample sizes, often ignore the developmental context. In this perspective piece, we discuss why a developmental view is important in Psychiatry and how recent genetic-epidemiological findings further highlight this. DSM-5 childhood neurodevelopmental disorders such as ADHD, typically onset in early childhood but can persist into adult life; the same ADHD genetic loading appears to contribute across the life course. However, recent longitudinal studies have observed that ADHD symptoms may emerge later during adolescence and adult life in some individuals although the etiology of this late-onset group is unclear. The epidemiology and genetics of depression do not appear to be the same in childhood, adolescence, and adult life. Recent genetic findings further highlight this. Autistic type problems and irritability also appear to show developmental variation in their genetic etiology. These findings raise the question of whether social communication and irritability have the same meaning at different ages. Schizophrenia typically onsets after adolescence. However, it is commonly preceded by childhood antecedents that do not resemble schizophrenia itself but do appear to index schizophrenia genetic liability. We conclude that there is a need for clinicians and scientists to adopt a developmental perspective in clinical practice and research by considering age-at-onset and changes over time as well as different developmental periods when interpreting clinical symptoms.

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Section: Adhd: What Happens Over Timementioning

confidence: 99%

The importance of a developmental perspective in Psychiatry: what do recent genetic-epidemiological findings show?

Thapar

Riglin

2020

Mol Psychiatry

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“…The Brazilian High‐Risk Cohort is a school‐based community cohort of 2,511 children (1,554 high‐risk and 957 randomly selected (Salum et al., )) who received psychiatric evaluations at baseline and after three‐year follow‐up with the DAWBA administered to parents. Restricting to participants who were less than age 12 at baseline and older than age 12 at follow‐up, this study identified community comparisons ( n = 806) who had no more than two ADHD symptoms at baseline or follow‐up (and no other psychiatric disorder at baseline), childhood‐limited ADHD ( n = 64) who met ADHD diagnostic criteria at baseline and had no more than two ADHD symptoms at follow‐up, persistent ADHD ( n = 26) who met ADHD criteria both in childhood and at follow‐up, and youth‐onset ADHD ( n = 28) who had no more than two ADHD symptoms at baseline and met ADHD criteria at follow‐up (Manfro et al., ). The mean age at baseline for these groups ranged from 9.8–10.1 years and at follow‐up from 13.1–13.6 years.…”

Section: Prospective Studiesmentioning

confidence: 99%

“…Nearly half of the young adult ADHD group, as identified by parent report, did not meet borderline criteria for ADHD at age 7 (Riglin et al., ); and 25.3% of late‐onset individuals had low to average ADHD symptoms across all childhood assessments up through age 12 (Cooper et al., ). Additionally, in the Brazilian High‐Risk Study parent‐report was used both in childhood and adolescence and found about half of those who met full ADHD criteria in young adulthood were late‐onset (Manfro et al., ). Therefore, it seems we can safely conclude that the change in rater from parent to self does not completely account for those individuals with apparent onset of ADHD after childhood.…”

Section: Possible Explanations For Late‐onset Adhdmentioning

confidence: 99%

Annual Research Review: Does late‐onset attention‐deficit/hyperactivity disorder exist?

Asherson

Agnew-Blais

2019

Child Psychology Psychiatry

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Attention-deficit/hyperactivity disorder (ADHD) is conceptualized as an early onset childhood neurodevelopmental disorder. Prevalence in adults is around two-thirds that in childhood, yet longitudinal outcome studies of children with ADHD found a minority continue to meet full criteria in adulthood. This suggests that not all adult cases meet ADHD criteria as children, a conclusion supported by earlier studies relying on retrospective recall in adolescent and adult samples. More recently prospective follow-up of population and control samples suggest that adolescent and young adult ADHD is not always a continuation of childhood ADHD. Here, we review the literature on age of onset, to explore whether late-onset ADHD exists, and if so, examine the evidence for whether this should be considered the same or a different disorder as childhood onset ADHD. We conclude that current evidence supports the view that a significant proportion of young adults meeting criteria for ADHD would not have met full diagnostic criteria for ADHD as children. However, many in the late-onset group show some ADHD symptoms in childhood, or an externalizing disorder such as oppositional defiant disorder. Furthermore, the current studies suggest that most (but not all) cases of late-onset ADHD develop the disorder between the ages of 12-16 and can therefore be considered adolescent or early adult onset ADHD. There is a relative lack of data spanning young to older adulthood to address the question of adult-onset. Currently, there is insufficient data to clarify the extent to which early and late onset ADHD reflect a different balance of genetic and environmental risks or share the same underlying neural mechanisms. Clinicians should be aware that significantly impairing forms of ADHD can emerge beyond the age of 12 years, although perhaps rarely in the context of a complete absence of precursors. The current evidence on treatment responses is limited.

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“…Manfro et al. contribute to a fascinating (and growing) literature on youth‐onset ADHD, that is, the observation that a subtype of ADHD starts in adolescence (Manfro et al., ). By exploring general psychopathology scores in childhood and adolescence, Manfro et al.…”

Section: The P Factor As An Essential Covariate In Studies Of Specifimentioning

confidence: 99%

Editorial: The psychopathology p factor: will it revolutionise the science and practice of child and adolescent psychiatry?

Ronald

2019

Child Psychology Psychiatry

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The psychopathology p factor has emerged from a series of strong empirical studies, largely in the adult psychiatry literature. Here, some of the recent findings relating to the p factor in children and adolescents are considered and the implications for child and adolescent psychiatry are discussed. Is it essential to covary for ‘p’ when we study specific domains of psychopathology? Do neurodevelopmental conditions make up part of the psychopathology p factor? How do we treat the ‘p factor’ in clinics? This editorial considers some of the contributions from this issue of Journal of Child Psychology and Psychiatry together with the wider literature that speak to these issues.

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Heterotypic trajectories of dimensional psychopathology across the lifespan: the case of youth‐onset attention deficit/hyperactivity disorder

Cited by 20 publications

References 46 publications

The importance of a developmental perspective in Psychiatry: what do recent genetic-epidemiological findings show?

The importance of a developmental perspective in Psychiatry: what do recent genetic-epidemiological findings show?

Annual Research Review: Does late‐onset attention‐deficit/hyperactivity disorder exist?

Editorial: The psychopathology p factor: will it revolutionise the science and practice of child and adolescent psychiatry?

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