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Infographic: Men With Versus Men Without ADHD in Childhood

Infographic: Men With Versus Men Without ADHD in Childhood

 

Discussion

Recent studies provide clinically relevant information related to the course and treatment outcomes of ADHD in children and adolescents.

In the longest controlled prospective study of childhood ADHD, Klein and colleagues1 examined clinical and functional outcomes in adulthood. Study participants were boys aged 6 to 12 years (mean age 8.3 years) who had ADHD at the start of the study. The control group consisted of boys without ADHD; 135 men with ADHD in childhood (65.2% of original sample) and 136 men without ADHD (76.4% of original sample) participated in the follow up study. The follow up period was 33 years with a mean age of 41 years.

Study results showed that compared with men without childhood ADHD, men with childhood ADHD had higher rates of ongoing ADHD (22.2% vs 5.1%), antisocial personality disorder (16.3% vs 0%), substance use disorders (14.1% vs 5.1%), and psychiatric hospitalizations (24.4% vs 6.6%). There were no differences between these groups in prevalence of alcohol disorders, mood disorders, and anxiety disorders.

Men with childhood ADHD also had: 

• lower educational levels (mean 2.5 less years)

• lower occupational achievement

• lower socioeconomic status

• lower social functioning

• higher divorce rates

• more incarcerations

• higher mortality lower educational levels (mean 2.5 less years)

Based on these long-term outcomes, the investigators emphasize the importance of monitoring and treating children with ADHD.

For more information on ADHD, please see "Course and Treatment Outcomes of ADHD," by Karen Dineen Wagner, MD, PhD, on which this infographic is based.

References: 

1. Klein RG, Mannuzza S, Olazagasti MAR, et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry. 2012;69:1295-1303.

Comments

This is an interesting article. I would love to see the raw data and the testing instrument... I would also like to see a comparison of those treated with stimulants compared to those treated with behavioral therapy and a control group of positive ADHD diagnosis with no treatment. I think we stand to obtain more usable data this route.

Shannon @

Dear Sir / Madam
This is very interesting subject. We can see these patients with ADHD in adolescence but we do not see them later as an adult.
Most of them will end in slow , medium secure units and prison.
Those patients need follow up to minimize the risk toward others.

Mohamed @

I realize this article and comment are over a year old, however, I feel a comment demonstrating this level of ignorance warrants a belated response. I am a licensed professional counselor and my current practice consists, almost exclusively, of "risk" assessment and emergency psychiatric evaluations.

Even taking this infographic at face value, 1:4 ratio (for hospitalization) is hardly "Most of them"... and the ratio statistics for criminal convictions is lower still (4.4% or roughly 1:25 per the original study).

"Those patients..." do indeed benefit from followup in many cases, but I am not aware of any measured, or even anecdotal, difference in a generalized potential to harm others due to Adult ADHD.

With your attitude towards individuals with ADHD, it is no wonder that you "do not see them later as an adult."
Which also begs the question; Given your self declared lack of observation or study, upon what do you base your prognostic pessimism?
"Tis better to be thought a fool than to open one's mouth and remove all doubt."

James @

What? The study finding that 0% of "men without childhood ADHD" were found to have antisocial personality disorder (versus 16.3% in men WITH childhood ADHD) makes NO sense.

B @

This makes perfect sense. People with ADHD get abundant negative feedback from authority figures. Some of them eventually decide that authority figures are irrelevant, which encourages antisocial symptoms. Remember that the 16% and 0% are statistics from the sample, not from the population.

Scott @

yes true, we often find such long term sequelae in our clients.
special emphasis on substance use disorders thinking they might be prevented if early intervention for ADHD

Azza @

Very interesting graphic with lots of alarming statistics! I work in an inpatient setting and often feel the wrong patients are misdiagnosed with ADHD. The ones that really want the diagnosis probably don't have it and the ones who do frequently aren't diagnosed. When there is so much comorbidity present I find it difficult to diagnosis. It would be nice to have some sort of diagnostic test to help at least confirm a diagnosis. I know there was some computer based test that was approved, but likely this is probably pretty expensive.

Aaron @

There is another story to this. A lot of criminal convictions for ADHD are for illegal drug possession, but most of this appears to be for cannabis, cocaine, or other amphetamines, which like ritalin, are useful for ADHD medicinally.
Once you adjust for self medication and illegal drug convictions, adults with ADHD are actually no more likely to criminally offend or take drugs of ABUSE (cannabis, cocaine and amphetamines are not abused if used as medicine, even if illegal) than regular adults.

If currently illegal drugs were not illegal, and could be prescribed for those who found them effective, these ADHD statistics would be very different.

Julian @

I think the literature and clinical evidence is clear that marijuana worsens patients cognitive performance. It would be better to say that people with ADHD are prone to resort to marijuana and alcohol as an escape from the distress caused by their ADHD, so they feel better while their performance gets even worse due to the effects of marijuana and alcohol. This should not be considered "medicinal".

Scott @

Ditto. I always ask students what cannabis does for them. The students DIAGNOSED with ADHD say it helps them feel calm. They say without it they feel frustrated and angry.

Jeff @

Leaving aside the question of whether there is or not a bias related to the funding sources of this sudy, it would still be portant to pay attenyion to the conclusions as imanu aspects, they are not different tham the empirical evidence many of us find in our practices, particularly in respect to the incidence of substance abuse disorders , lower professional achievement and mariage failures I have not had a chance to read the whole article nut i would like to ask the aithors if they have any results specific to those children who have received treatment with amphetamines and also separate outcomes for those with adulthood Add/adhd vs those who don t have persistent symptoms iinto their adult lives
Andres Huberman MD. Manhasset. New York

ANDRES @

I agree, I am curious to know how stimulant treatment affects these statistics, especially if as noted below many of the possession convictions are for people attempting to self-medicate.

Mari @

My goodness there is a fair amount of sensitivity surrounding compensation via drug companies this will likely not change soon . It is clear that astute clinicians are able to see the merits of the question without being unduelly influenced by the drug companies nudges or suggestions . I will say that it does create more work for the clinician to read more and continuosly sift through data in order to come to the correct / most probable conclusions free of bias and influence .
I bid you all a good journey
P.S. Mark & Barry great points !!!
Nathaly

Nathaly @

dear Dr karen dineen wagner
Hi
I am the Master of Clinical Psychology. Interested in the relationship between sexual abuse in childhood and the appearance of ADHD research in this field do agree to work together?
best regards
Parisa Asmand
parisa.asmand@yahoo.com

parisa @

Why are you casting aspersions on Dr. Wagner's conclusions in this article? Dr. Wagner's connection with Adderall is not at issue in this article. Further, she also bases a lot of info in this article on the study by Klein, Mannuzza, Olazagasti, et al, not on her work with Adderall or Paxil.
I would prefer to judge the validity of her conclusions on the methodology of whatever part of the study she did as her original work and less on her reporting from the Klein et al. study.

Lynne @

ADHD, is a nelurodevelopmental disorder, the medications used do not permanently change the underlying brain abnormalities; rather, they make temporary biochemical changes that improve function. This is true of all psychiatric medications.
Barry Stanley

[The comment has been edited to remove to promotional material. -The Editors]

barry @

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