Attention Deficit Hyperactivity Disorder (ADHD) is a syndrome of inattention, hyperactivity, impulsiveness and other deficits of executive functions. It's now well known that ADHD often continues into adulthood (1, 2). ADHD is a chronic disorder which leads to a negative impact on functioning throughout the life cycle (3). Children with ADHD are at significant risk of multiple forms of adolescent maladjustment. Approximately up to 60% of childhood cases continue symptomatic into adulthood. In the remaining 40 percent symptoms may remit in early adulthood (4). The manifestation of ADHD changes over the course of life. In some cases the hyperactivity may disappear but decreased attention span and impulse control problems persist (5).
Approximately 1 in 25 adults have ADHD, 90% of whom may be currently untreated, with a potentially negative impact on the lives of patients and their families (6). Significant legal, academic, social, and occupational problems have been observed in adults with ADHD (7).
Follow up studies suggest that up to 33% of ADHD teens versus 1% to 9% of controls drop out high school. Children with ADHD are at risk of negative academic outcomes. ADHD and similar problems entail a risk of underachievement at school. The results indicate that students with ADHD underachieve in the school situation in relation to their optimal cognitive capacity (3).
Adolescents with ADHD complete less education by 2-3 years and demonstrate lower occupational performance at the age of 25 years. Adults with ADHD may struggle with frequent job changes, frequent partner changes, higher rates of divorce, increased motor vehicle accidents, poor money management and higher rates of unwed pregnancy (8). Although their educational performance is lower than people without ADHD, their early employment histories don't differ from those people with similar education (5). Adolescents with ADHD were more likely to smoke cigarettes and use illicit drugs. Their academic attainment was below age norms with more than one fourth repeating grades (9).
Studies show that effective treatment significantly improves quality of life (3). Severity of childhood ADHD and treatment significantly predict the persistence of ADHD into adulthood (5). As previously shown by some research for children and adolescents, stimulant medications alone did not eliminate the academic achievement deficit of ADHD undergraduates. ADHD patients who were treated with stimulants were significantly less likely to subsequently develop depressive and anxiety disorders and disruptive behavior and less likely to repeat a grade compared with participants with ADHD who were not treated. Adolescents with ADHD were also significantly more likely to be absent during the academic year, and they were over eight times more likely than adolescents without ADHD to drop out of high school. These findings demonstrate that children with ADHD continue to experience severe academic impairment into high school (10).
References:
1. Barkley RA. Major life activity and health outcomes associated with attention-deficit / hyperactivity disorder. J. Clin Psychiatry 2002;63 12:10-15.
2. Weiss G, Hechtman L. Hyperactive Children Grown Up: ADHD in Children, Adolescents, and Adults. New York, NY: Guilford Press; 1993
3. Cheng K, Myers KM, Stubble DE. Attention deficit hyperactivity disorder Child and Adolescent Psychiatry The Essentials Lippincott Williams &Wilkins
4. Biederman J, Mick E, Faraone SV. Age dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptoms type. Am J Psychiatry 2000 157:816-818
5. Sadock BJ, Sadock VA. Textbook of Child and Adolescent Psychiatry. 2009 Lippincott Williams &Wilkins
6. Culpaper L, Mattingly G. Challenges in Identifying and Managing Attention-Deficit/Hyperactivity Disorder in Adults in the Primary Care Setting: A Review of the Literature Prim Care Companion J Clin Psychiatry 2010 v. 12(6);
7. McCann BS, Roy-Byrne P Attention-deficit/hyperactivity disorder and learning disabilities in adults. Semin Clin Neuropsychiatry. 2000 Jul;5(3):191-7.
8. Spetie L, Arnold EL. Attention deficit hyperactivity disorder in Lewis Child and Adolescent Psychiatry A Comprehensive Textbook 2007 Lippincott Williams &Wilkins
9. Lam AK, Ho TP Early adolescent outcome of attention-deficit hyperactivity disorder in a Chinese population: 5-year follow-up study. J Fam Pract. 2011 Jun;60(6):364-7.
10. Kent KM, Pelham WE Jr, Molina BS, Sibley MH, Waschbusch DA, Yu J, Gnagy EM, Biswas A, Babinski DE, Karch KM.The academic experience of male high school students with ADHD.Pediatrics. 2009 Jul;124(1):71-8.