Long-term prognosis in attention-deficit/hyperactivity disorder

This article reviews controlled, prospective follow-up studies of children with attention-deficit disorder (ADHD) into young adulthood and adulthood. In their late teens, those with ADHD as children, compared with non-ADHD comparisions, show relative deficits in academic and social. functioning. In addition, about two-fifths of these children continue to experience ADHD symptoms, and a significant minority demonstrate pervasive antisocial behaviors, including drug abuse. Many of these same difficulties persist into adulthood. Compared with the comparisons, former ADHD probands complete less formal schooling, hold lower ranking occupational positions, and continue to exhibit poor social skills, antisocial personality, and symptoms of the childhood syndrome. On the other hand, as adults, nearly all former cases are gainfully employed, some in higher level positions, and a full two-thirds show no evidence of any mental disorder. Although relative deficits are seen in early to middle adolescence, young adulthood, and adulthood, childhood ADHD does not preclude achieving one's educational and vocational goals, and the majority of these children do not experience emotional or behavioral problems by their mid-twenties.