ADULT OUTCOME OF HYPERACTIVE BOYS - EDUCATIONAL-ACHIEVEMENT, OCCUPATIONAL RANK, AND PSYCHIATRIC STATUS

Objective: The paucity of data concerning the long-term natural histor y of attention-deficit hyperactivity disorder (ADHD), a common childho od psychiatric disorder, prompted a longitudinal study to investigate the adult sequelae of the childhood disorder. Design: Prospective stud y, follow-up intervals ranging from 13 to 19 years (mean, 16 years), w ith blind systematic clinical assessments. Subjects: Ninety-one white males (mean age, 26 years), representing 88% of a cohort systematicall y diagnosed as hyperactive in childhood, and 95 (95%) of comparison ca ses of similar race, gender, age, whose teachers had voiced no complai nts about their school behavior in childhood. Results: Probands had si gnificantly higher rates than comparisons of ADHD symptoms (11% vs 1%) , antisocial personality disorders (18% vs 2%), and drug abuse disorde rs (16% vs 4%). Significant comorbidity occurred between antisocial an d drug disorders. Educational and occupational achievements were signi ficantly compromised in the probands. These disadvantages were indepen dent of psychiatric status. We did not find increased rates of affecti ve or anxiety disorders in the probands. Conclusions: Childhood ADHD p redicts specific adult psychiatric disorders, namely antisocial and dr ug abuse disorders. In the adolescent outcome of this cohort, we found that these disturbances were dependent on the continuation of ADHD sy mptoms. In contrast, in adulthood, antisocial and drug disorders appea red, in part, independent of sustained ADHD. In addition, regardless o f psychiatric status, ADHD placed children at relative risk for educat ional and vocational disadvantage. The results do not support a relati onship between childhood ADHD and adult mood or anxiety disorders.