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Objective: To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of... more Objective: To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of conduct disorder (CD) in childhood (mean ¼ 8 years), have elevated risk-taking, accidents, and medical illnesses in adulthood (mean ¼ 41 years); whether development of CD influences risk-taking during adulthood; and whether exposure to psychostimulants in childhood predicts cardiovascular disease. We hypothesized positive relationships between childhood ADHD and risky driving (in the past 5 years), risky sex (in the past year), and between risk-taking and medical conditions in adulthood; and that development of CD/antisocial personality (APD) would account for the link between ADHD and risk-taking. We report causes of death. Method: Prospective 33-year follow-up of 135 boys of white ethnicity with ADHD in childhood and without CD (probands), and 136 matched male comparison subjects without ADHD (comparison subjects; mean ¼ 41 years), blindly interviewed by clinicians. Results: In adulthood, probands had relatively more risky driving, sexually transmitted disease, head injury, and emergency department admissions (p o .05-.01). Groups did not differ on other medical outcomes. Lifetime risk-taking was associated with negative health outcomes (p ¼ .01-.001). Development of CD/APD accounted for the relationship between ADHD and risk-taking. Probands without CD/APD did not differ from comparison subjects in lifetime risky behaviors. Psychostimulant treatment did not predict cardiac illness (p ¼ .55). Probands had more deaths not related to specific medical conditions (p ¼ .01). Conclusions: Overall, among children with ADHD, it is those who develop CD/APD who have elevated risky behaviors as adults. Over their lifetime, those who did not develop CD/APD did not differ from comparison subjects in risktaking behaviors. Findings also provide support for long-term safety of early psychostimulant treatment. J. Am. Acad. Child Adolesc. Psychiatry; 2013;52(2):153-162.
Journal of Attention Disorders, 2011
Objective-To investigate the relationship between ADHD symptoms and impairment among adults diagn... more Objective-To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood, ages 6-12.
Archives of General Psychiatry, 2012
Context: Prospective studies of childhood attentiondeficit/hyperactivity disorder (ADHD) have not... more Context: Prospective studies of childhood attentiondeficit/hyperactivity disorder (ADHD) have not extended beyond early adulthood.
Objective: To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of... more Objective: To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of conduct disorder (CD) in childhood (mean ¼ 8 years), have elevated risk-taking, accidents, and medical illnesses in adulthood (mean ¼ 41 years); whether development of CD influences risk-taking during adulthood; and whether exposure to psychostimulants in childhood predicts cardiovascular disease. We hypothesized positive relationships between childhood ADHD and risky driving (in the past 5 years), risky sex (in the past year), and between risk-taking and medical conditions in adulthood; and that development of CD/antisocial personality (APD) would account for the link between ADHD and risk-taking. We report causes of death. Method: Prospective 33-year follow-up of 135 boys of white ethnicity with ADHD in childhood and without CD (probands), and 136 matched male comparison subjects without ADHD (comparison subjects; mean ¼ 41 years), blindly interviewed by clinicians. Results: In adulthood, probands had relatively more risky driving, sexually transmitted disease, head injury, and emergency department admissions (p o .05-.01). Groups did not differ on other medical outcomes. Lifetime risk-taking was associated with negative health outcomes (p ¼ .01-.001). Development of CD/APD accounted for the relationship between ADHD and risk-taking. Probands without CD/APD did not differ from comparison subjects in lifetime risky behaviors. Psychostimulant treatment did not predict cardiac illness (p ¼ .55). Probands had more deaths not related to specific medical conditions (p ¼ .01). Conclusions: Overall, among children with ADHD, it is those who develop CD/APD who have elevated risky behaviors as adults. Over their lifetime, those who did not develop CD/APD did not differ from comparison subjects in risktaking behaviors. Findings also provide support for long-term safety of early psychostimulant treatment. J. Am. Acad. Child Adolesc. Psychiatry; 2013;52(2):153-162.
Journal of Attention Disorders, 2011
Objective-To investigate the relationship between ADHD symptoms and impairment among adults diagn... more Objective-To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood, ages 6-12.
Archives of General Psychiatry, 2012
Context: Prospective studies of childhood attentiondeficit/hyperactivity disorder (ADHD) have not... more Context: Prospective studies of childhood attentiondeficit/hyperactivity disorder (ADHD) have not extended beyond early adulthood.