TY - JOUR
T1 - Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study
AU - Moffitt, Terrie E.
AU - Houts, Renate
AU - Asherson, Philip
AU - Belsky, Daniel W.
AU - Corcoran, David L.
AU - Hammerle, Maggie
AU - Harrington, Honalee
AU - Hogan, Sean
AU - Meier, Madeline
AU - Polanczyk, Guilherme V.
AU - Poulton, Richie
AU - Ramrakha, Sandhya
AU - Sugden, Karen
AU - Williams, Benjamin
AU - Rohde, Luis Augusto
AU - Caspi, Avshalom
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Objective: Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder,noprospective longitudinal study has described the childhoods of the adult ADHD population. The authors report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method: Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, genome-wide association study-derived polygenic risk, and life impairment indicatorswere assessed.Data sources were participants, parents, teachers, informants, neuropsychological test results, andadministrative records.AdultADHD diagnoses used DSM-5 criteria, apart from onset age and crosssetting corroboration, which were study outcome measures. Results: As expected, childhood ADHD had a prevalence of 6% (predominantly male) and was associated with childhood comorbid disorders, neurocognitive deficits, polygenic risk, and residual adult life impairment. Also as expected, adult ADHD had a prevalence of 3% (gender balanced) and was associated with adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood ADHD and adult ADHD groups comprised virtually nonoverlapping sets; 90% of adult ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult ADHDgroup did notshowtested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD. Conclusions: The findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder?s place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD.
AB - Objective: Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder,noprospective longitudinal study has described the childhoods of the adult ADHD population. The authors report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method: Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, genome-wide association study-derived polygenic risk, and life impairment indicatorswere assessed.Data sources were participants, parents, teachers, informants, neuropsychological test results, andadministrative records.AdultADHD diagnoses used DSM-5 criteria, apart from onset age and crosssetting corroboration, which were study outcome measures. Results: As expected, childhood ADHD had a prevalence of 6% (predominantly male) and was associated with childhood comorbid disorders, neurocognitive deficits, polygenic risk, and residual adult life impairment. Also as expected, adult ADHD had a prevalence of 3% (gender balanced) and was associated with adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood ADHD and adult ADHD groups comprised virtually nonoverlapping sets; 90% of adult ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult ADHDgroup did notshowtested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD. Conclusions: The findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder?s place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD.
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U2 - 10.1176/appi.ajp.2015.14101266
DO - 10.1176/appi.ajp.2015.14101266
M3 - Article
C2 - 25998281
AN - SCOPUS:84939572238
SN - 0002-953X
VL - 172
SP - 967
EP - 977
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 10
ER -