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Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan
Open accessAbstract
Attention-deficit/hyperactivity disorder (ADHD) is highly heritable and the most common neurodevelopmental disorder in childhood. In recent decades, it has been appreciated that in a substantial number of cases the disorder does not remit in puberty, but persists into adulthood. Both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents. However, course and symptoms of the disorder and the comorbidities may fluctuate and change over time, and even age of onset in childhood has recently been questioned. Available evidence to date is poor and largely inconsistent with regard to the predictors of persistence versus remittance. Likewise, the development of comorbid disorders cannot be foreseen early on, hampering preventive measures. These facts call for a lifespan perspective on ADHD from childhood to old age. In this selective review, we summarise current knowledge of the long-term course of ADHD, with an emphasis on clinical symptom and cognitive trajectories, treatment effects over the lifespan, and the development of comorbidities. Also, we summarise current knowledge and important unresolved issues on biological factors underlying different ADHD trajectories. We conclude that a severe lack of knowledge on lifespan aspects in ADHD still exists for nearly every aspect reviewed. We encourage large-scale research efforts to overcome those knowledge gaps through appropriately granular longitudinal studies.
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“it is unclear whether the prevalence of adult ADHD changes with age.”
From The decreasing prevalence of ADHD across the adult lifespan confirmed (2022) · cites this paper as [5]
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“compared to childhood ADHD, adult ADHD has received far less research attention”
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“adult ADHD definitions strongly varying between studies”
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“few large population-based data sets spanning the full adult lifespan available [4-7]”
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Gao, Y., Gao, J.-H., Tang, Y.-B., Chen, Y., & Wang, C. (2026) · International Symposium on Circuits and Systems · doi:10.1109/iscas66217.2026.11562909
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“The global prevalence of ADHD in community-dwelling populations ranges from 2% to 7%, with an overall mean of approximately 5% (Franke et al. 2018; Sayal et al. 2018).”
InfluentialZhu, Y., Chen, D., & Chen, W. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1726801
“ADHD affects approximately 6 to 7% of children aged 7 to 12 years, and this prevalence decreases to 5.6% in adolescents aged 12 to 18 years (Salari et al., 2023; Franke et al., 2018).”
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“ADHD is often conceptualized as a neurodevelopmental disorder with originates in early childhood and continues into adulthood (American Psychiatric Association, 2022; Franke et al., 2018).”
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Large Language Models as Simulative Agents for Neurodivergent Adult Psychometric ProfilesPreprint
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“Unfor - tunately, research indicates that children with ADHD seem to be at a greater risk of not only developing many other disorders, such as depression, anxiety, and substance abuse (Franke et al., 2018), but also of being rejected by peers and adults.”
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“When ADHD and BD co-occur, symptom burden intensifies, resulting in greater inattention, hyperactivity, and impulsivity for ADHD [4], and more unstable mood states during manic or hypomanic episodes for BD [5].”
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Self-citationPotential impact of social media and COVID-19 restrictions on adult attention-deficit rates
Shah, P. J., Adamou, M., Cape, A., Carboni, M., Hank, D., Mukherjee, R., Shah, C., & Smith, M. (2025) · BJPsych Bulletin · doi:10.1192/bjb.2025.10162
Parent and Child Measures in Zimbabwe: an Assessment of Metric Validity
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“Hyperactivity is linked to externalising behaviours while inattention is associated with internalising disorders (Franke et al., 2018).”
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Taktil massage kan ge minskade symtom hos ungdomar med ADHD
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We need greater awareness of the ADHD continuum
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Ding, M., Zhang, R., & Feng, T. (2025) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2025.111427
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Traiettorie evolutive: una lezione dall’ADHD
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BackgroundSelf-citationGenetische Grundlagen der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung
Grimm, O., Kranz, T. M., & Reif, A. (2019) · Nervenheilkunde · doi:10.1055/a-0962-1001
“Betroffene mit ADHS zeigen insbesondere höhere Komorbidität mit Autismus, Fettleibigkeit, bipolarer Störung und Depression, Angst, Drogenkonsumstörung und Schizophrenie [8, 9].”
BackgroundInfluentialSelf-citationA breakdown in institutional communication to detect and treat ADHD: case report
Vargas-Rodríguez, Á. M., & Molina, S. M. V. (2019) · Journal of Neurology & Stroke · doi:10.15406/jnsk.2019.09.00370
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“Its prevalence among adults is estimated at 2–5% worldwide [15, 16] and is higher in males than females, with a 2:1 ratio [17, 18].”
BackgroundAdvancing Neuropsychiatric Care through Genetic and Molecular Insights
Shi, E. (2023) · The Journal of Bioscience and Medicine · doi:10.4236/jbm.2023.1110018
Bröscher, N., Lindel, C., & Schadow, T. (2022) · Unerwartete Perspektiven der Schulpsychologie · doi:10.1007/978-3-658-36512-7_1
Attention Deficit Hyperactivity Disorder (ADHD)
Pokhriyal, S. (2021) · Advances in early childhood and K-12 education · doi:10.4018/978-1-7998-7630-4.ch017
The Phenotypic Expression of ADHD in Adulthood
Pallanti, S., & Salerno, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39051-8_3
Chadi, N., Green, L., & Schizer, M. A. (2020) · Springer eBooks · doi:10.1007/978-3-030-62393-7_14 · Cited by 1
Metadata
- Authors
- Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K.-P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A.
- Affiliations
- Radboud University Nijmegen (NL)
- King's College London (GB)
- Heidelberg University (DE)
- Radboud University Medical Center (NL)
- Instituto de Salud Carlos III (ES)
- SUNY Upstate Medical University (US)
- Karolinska Institutet (SE)
- Haukeland University Hospital (NO)
- Sechenov University (RU)
- Semmelweis University (HU)
- University Hospital Frankfurt (DE)
- Corresponding author
- Franke, Barbara
- ORCID
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 28
- Issue
- 10
- Pages
- 1059-1088
- ISSN
- 0924-977X (ISSN-L)
- PMC
- PMC6379245
- OpenAlex
- W2891070637
- Cited by
- 643
- References
- 285
- Citations by year
- 2026: 73 · 2025: 88 · 2024: 92 · 2023: 91 · 2022: 86 · 2021: 90 · 2020: 81 · 2019: 37 · 2018: 2
- FWCI
- 7.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, cc-by)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by-nc-nd)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
- Publication Server of Goethe University Frankfurt am Main (Goethe University Frankfurt) (submittedVersion, cc-by)
- Semmelweis University Repository (Semmelweis University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- European Community's Seventh Framework Programme (n° 602805 (AGGRESSOTYPE), 603016 (MATRICS), 278948 (TACTICS), 602450 (IMAGEMEND))
- European Community's Horizon 2020 Programme (n° 643051 (MiND) and 667302 (CoCA))
- Netherlands Organization for Scientific Research (NWO), i.e. the Vici Innovation Program (016-130-669)
- Hungarian Brain Research Program (NAP-B KTIA_NAP_13-2014-0011)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, ADHD persistence, remission, comorbidities, substance use disorders, depression, anxiety, accidents, age of onset, cognitive trajectories, treatment effects, lifespan development, neurodevelopmental disorders, biological factors
- MeSH terms
- Aging, Attention Deficit Disorder with Hyperactivity, Humans, Comorbidity
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