Investigating the childhood symptom profile of community-based individuals diagnosed with attention-deficit/hyperactivity disorder as adults

Taylor, M. J., Larsson, H., Gillberg, C. , Lichtenstein, P. and Lundström, S. (2019) Investigating the childhood symptom profile of community-based individuals diagnosed with attention-deficit/hyperactivity disorder as adults. Journal of Child Psychology and Psychiatry, 60(3), pp. 259-266. (doi: 10.1111/jcpp.12988) (PMID:30338854)

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Abstract

BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) is currently defined as a disorder with onset during childhood. Although ADHD occurs in adults as well as children, recent debate has focused on whether adult ADHD represents a continuation of a child-onset disorder or if ADHD may, in at least some cases, have an adult onset. We therefore aimed to test the hypothesis of adult-onset ADHD using a sample born relatively recently (1992-1999) in order to minimize confounding by secular changes in diagnostic practices. METHODS:We identified 74 individuals with a community diagnosis of ADHD first assigned during adulthood. We also identified individuals with childhood (N = 194) and adolescent (N = 394) community diagnoses of ADHD. These groups were compared with a comparison group (N = 14,474) on their childhood ADHD and neuropsychiatric symptoms, and rate of other psychiatric diagnoses during childhood. RESULTS:Having an adulthood community diagnosis of ADHD was associated with a mean increase in childhood ADHD symptoms of approximately three times that of the comparison group. Individuals with an adult community diagnosis of ADHD also displayed more autistic traits, motor problems, learning difficulties, tics, and oppositional behavior. Forty two percent of these individuals, compared with 1% of comparison cases, had a psychiatric diagnosis other than ADHD as children. In post-hoc analyses of 21 ADHD cases showing few or no ADHD symptoms in childhood, we were unable to detect any other childhood symptomatology in only nine cases, of whom six were female. CONCLUSIONS:Our results indicate that alternative explanations for data that appear to show adult onset ADHD, such as sex biases in diagnostic practices, need rigorous testing before adult onset ADHD can be accepted as a valid clinical construct.

Item Type:Articles
Additional Information:CATSS is funded by the Swedish Research Council for Health, Working Life and Welfare, and the Swedish Research Council. We acknowledge support from the Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) framework (grant no. 340‐2013‐5867). The specific study in this manuscript was funded by a grant from the Fredrik and Ingrid Thurings Stiftelse.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gillberg, Professor Christopher
Authors: Taylor, M. J., Larsson, H., Gillberg, C., Lichtenstein, P., and Lundström, S.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
Journal Name:Journal of Child Psychology and Psychiatry
Publisher:Wiley
ISSN:0021-9630
ISSN (Online):1469-7610
Published Online:19 October 2018

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