Abstract
Background

Although it is known that childhood ADHD often persists into adulthood, the childhood predictors of this persistence have not been widely studied.

Methods

Childhood history of DSM-IV ADHD and adult ADHD were assessed in ten countries in the WHO World Mental Health (WMH) Surveys. Logistic regression analysis was used to study associations of retrospectively reported childhood risk factors with adult persistence among the 629 adult respondents with childhood ADHD. The risk factors included age, gender, childhood ADHD symptom profiles and severity and treatment, comorbid child-adolescent DSM-IV disorders, childhood family adversities, and child-adolescent exposure to traumatic events.

Results

An average of 50% of children with ADHD (range: 32.8-84.1% across countries) continued to meet DSM-IV criteria for ADHD as adults. Persistence was strongly related to childhood ADHD symptom profile (highest persistence associated with the attentional plus impulsive-hyperactive type, OR = 12.4, compared to the lowest associated with the impulsive-hyperactive type), symptom severity (OR = 2.0), comorbid major depressive disorder (OR = 2.2), high comorbidity (three or more child-adolescent disorders in addition to ADHD; OR = 1.7), paternal (but not maternal) anxiety-mood disorder (OR = 2.4), and parental antisocial personality disorder (OR = 2.2). A multivariate risk profile of these variables significantly predicts persistence of ADHD into adulthood (Area Under the ROC Curve = .76).

Conclusions

A substantial proportion of children with ADHD continue to meet full criteria for ADHD as adults. A multivariate risk index classifies made up of variables that can be assessed in adolescence predicts persistence with good accuracy. Biological Psychiatry, 65(1), 46-54.

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