In this recent study in the UK, a group of young adults with a childhood diagnosis of Diagnostic and Statistical Manual of Mental Disorders – 4th Edition (DSM-IV) combined type ADHD showed increased rates of comorbid mental health problems predicted by current levels of ADHD symptoms. The findings from this study reinforce the need for continuing services and treatment for ADHD throughout the transitional years and into adulthood.
This study of 118 young adults (aged 14-24 years) diagnosed with DSM-IV combined ADHD in childhood followed the patients for an average of 6 years. Comorbid mental health problems, drug and alcohol use, and police contact were compared for patients with persistent ADHD, sub-threshold ADHD and gender-matched controls.
Co-occurring mental health problems assessed using the Clinical Interview Schedule-Revised (CIS-R)* measure were significantly higher in the persistent ADHD group compared with the control sample, and the persistent ADHD group compared with the sub-threshold ADHD group (both p<0.001). There were significant differences between the three groups for lifetime drug use (p<0.001) and police contact (p=0.01). Higher levels of emotional instability were shown with the persistent ADHD group versus the sub-threshold group (p<0.001); data were not available from the control group for this parameter.
Researchers showed that in these patients, the transition years between childhood and young adulthood were characterised by a high rate of comorbid symptoms and behavioural issues. Patients with persistent ADHD in adolescence appeared to experience difficulties with concentration, fatigue, anger and sleep, and even when ADHD was considered to be sub-threshold, there were problems that required continued treatment.
Read more about the UK findings of this 6-year follow-up study here
*CIS-R is a structured validated instrument used for rating psychiatric symptoms across 14 domains (e.g. anxiety, depression). The minimum score on each section is zero where the symptoms were either not present in the past week or were present only in mild degree. Symptoms are regarded as severe when the score is two or more with a maximum score on each section being four (ﬁve for the section on depressive ideas). A total score of 12 or more is regarded as a clinically signiﬁcant indicator of general mental health problems
Cadman T, Findon J, Eklund H, et al. Six-year follow-up study of combined type ADHD from childhood to young adulthood: predictors of functional impairment and comorbid symptoms. Eur Psychiatry 2016; 35: 47-54.