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Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study

Published online by Cambridge University Press:  23 January 2015

R. G. Karam ,
V. Breda ,
F. A. Picon ,
D. L. Rovaris ,
M. M. Victor ,
C. A. I. Salgado ,
E. S. Vitola ,
K. L. Silva ,
P. O. Guimarães-da-Silva  and
N. R. Mota
...Show all authors
R. G. Karam
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
V. Breda
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
F. A. Picon
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
D. L. Rovaris
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Genetics, Instituto de Biociências, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
M. M. Victor
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
C. A. I. Salgado
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
E. S. Vitola
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
K. L. Silva
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
P. O. Guimarães-da-Silva
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
N. R. Mota
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Genetics, Instituto de Biociências, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
A. Caye
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
P. Belmonte-de-Abreu
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
L. A. Rohde
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
E. H. Grevet
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Psychiatry, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
C. H. D. Bau*
Affiliation:
ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Department of Genetics, Instituto de Biociências, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
*
* Address for correspondence: Dr. C. Bau, Department of Genetics, Instituto de Biociências, UFRGS, Porto Alegre 91501-970, RS, Brazil. (Email: [email protected])
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Abstract

Background

Course and predictors of persistence of attention deficit hyperactivity disorder (ADHD) in adults are still largely unknown. Neurobiological and clinical differences between child and adult ADHD raise the need for follow-up studies of patients diagnosed during adulthood. This study investigates predictors of ADHD persistence and the possibility of full remission 7 years after baseline assessment.

Method

A 7-year follow-up study of adults with ADHD (n = 344, mean age 34.1 years, 49.9% males) was conducted. Variables from different domains (social demographics, co-morbidities, temperament, medication status, ADHD measures) were explored with the aim of finding potential predictors of ADHD persistence.

Results

Retention rate was 66% (n = 227). Approximately a third of the sample (n = 70, 30.2%) did not maintain ADHD criteria and 28 (12.4%) presented full remission (<4 symptoms), independently of changes in co-morbidity or cognitive demand profiles. Baseline predictors of diagnostic persistence were higher number of inattention symptoms [odds ratio (OR) 8.05, 95% confidence interval (CI) 2.54–25.45, p < 0.001], number of hyperactivity/impulsivity symptoms (OR 1.18, 95% CI 1.04–1.34, p = 0.01), oppositional defiant disorder (OR 3.12, 95% CI 1.20–8.11, p = 0.02), and social phobia (OR 3.59, 95% CI 1.12–11.47, p = 0.03).

Conclusions

Despite the stage of brain maturation in adults suggests stability, approximately one third of the sample did not keep full DSM-IV diagnosis at follow-up, regardless if at early, middle or older adulthood. Although full remission is less common than in childhood, it should be considered as a possible outcome among adults.

Keywords

Adultsattentionco-morbiditydiagnosishyperactivitylongitudinal studypredictorsprospective
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 10 , July 2015 , pp. 2045 - 2056
Copyright
Copyright © Cambridge University Press 2015 

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