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Teen ADHD May Increase Risk for Adult Problems
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By Kathleen Doheny
Reviewed by Hansa D. Bhargava, MD
''ADHD in adolescence has long-lasting effects on adjusting to the vicissitudes of life and is associated with difficulties in being a wage earner, worker, parent, and so forth," says researcher David W. Brook, MD, professor of psychiatry at New York University School of Medicine.
Brook and his colleagues looked at data that assessed teens at ages 14 and 16, and later as adults at 37. The original study began in 1975.
The analysis, published in Pediatrics, reports on the 551 men and women who completed the evaluation at several time points, ending in either 2005 or 2006.
Brook believes it may be the longest study to date that followed teens with ADHD to look at its later impact.
ADHD affects up to 7% or more of school-age children. They have trouble paying attention, often act impulsively, and can be very physically active.
Teens With ADHD: Tracking Future Risks
The researchers assessed how well the teens did as they moved through adolescence and into early adulthood. They evaluated physical and mental health, work performance, worries about finances, and other areas.
"We wanted to look at the long-term effects of ADHD in adolescence on later functioning," Brook says.
Compared to teens and young adults without ADHD, those with ADHD had:
About 40% of children with ADHD continue to have symptoms into adulthood, according to research from the group Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
Why ADHD Issues May Persist
The study didn't go into why the problems of ADHD persist. However, Brook has a speculation.
"We think it has to do with impaired difficulty in the parent-child relationship when they are teens," he says.
Parents whose kids are diagnosed with ADHD may have difficulty forming a close, mutual parent-child relationship, says Brook. He is citing previous research by Judith S. Brook, EdD, also of NYU and a researcher on the new study.
A close parent-child relationship may help protect the person from later problems, he says.
The study did not look at treatments given and if that affected adult issues. However, the findings strongly suggest that doctors should focus on early diagnosis and treatment of teen ADHD, Brook says, to reduce the fallout as adults.
Outlook for Teens With ADHD: Perspective
"It's not surprising at all," says Ruth Hughes, PhD, the CEO of CHADD. Other studies have also found a link between teen ADHD and adult functioning.
The impact of ADHD on later physical health issues has gotten less attention than other issues, she says, so it is a plus that the study looked at that.
"The authors really emphasize the importance of intervention early, and we absolutely agree," she says. Without early treatment, children can develop very unhealthy coping mechanisms.
For instance, she says, a teen with ADHD may say: "Why try? Everyone says I am a screw-up." However, if parents and teachers stress the value of trying, and value that over the outcome, the teen may take another view.
One limitation of the study, she says, is the lack of information on treatment, which may have found that early treatment makes a difference in later functioning.
While the findings may be discouraging, Hughes says there are always exceptions, especially if the parent-child relationship that Brook talks about is strong.
Teens with ADHD can go on to lead productive lives, she says. Her own son, who has ADHD, is a prime example. "One of the things we would never let him get away with was not trying," she says. If he tried at school, and got a C, that was viewed, she says, as ''fantastic."
"Today, he is 25, a junior in college and getting A's," she says. "He is majoring in parks and recreation, a perfect niche for him. He's not desk-bound. He loves to work with kids but didn't want to be a teacher. His classes are interactive. He is building on his strengths. He has learned he always has to try and he has to manage his ADHD."
SOURCES: David W. Brook, MD, professor of psychiatry, New York University School of Medicine. Brook, JS. Pediatrics, January 2013. Ruth Hughes, PhD, CEO of CHADD, Children and Adults With ADD.