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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.”
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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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“Educational attainment is among the phenotypes with the strongest negative genetic correlations with ADHD, as demonstrated above, and cognitive impairments in ADHD have been well described 37 .”
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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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