Does Childhood Attention-Deficit/Hyperactivity Disorder Predict Risk-Taking and Medical Illnesses in Adulthood?
Open accessAbstract
Objective To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of conduct disorder (CD) in childhood (mean = 8 years), have elevated risk-taking, accidents, and medical illnesses in adulthood (mean = 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 = 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< .05-.01). Groups did not differ on other medical outcomes. Lifetime risk-taking was associated with negative health outcomes (p = .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 = .55). Probands had more deaths not related to specific medical conditions (p = .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 risk-taking behaviors. Findings also provide support for long-term safety of early psychostimulant treatment.
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Patients with ADHD or a history of childhood ADHD, particularly from non-medical causes, have higher mortality rates than those without ADHD, as consistently documented in longitudinal studies and a recent registry study.
“patients with ADHD or a history of childhood ADHD, particularly from non-medical causes, have higher mortality rates than those without ADHD, as consistently documented in longitudinal studies 222,223 and a recent registry study 224 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [222]
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- Authors
- Ramos Olazagasti, M. A., Klein, R. G., Mannuzza, S., Belsky, E. R., Hutchison, J. A., Lashua-Shriftman, E. C., & Xavier Castellanos, F.
- Affiliations
- New York University (US)
- American University (US)
- Corresponding author
- Klein, Rachel G.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 52
- Issue
- 2
- Pages
- 153-162.e4
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3662801
- OpenAlex
- W2105323867
- Cited by
- 94
- References
- 49
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 5 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 10 · 2015: 8 · 2014: 14 · 2013: 2
- FWCI
- 8.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32mh067763-10)
- National Institute of Mental Health (MH-18579, R01MH018579, T32MH-067763)
- National Institute on Drug Abuse (DA-16979, R01DA016979)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- attention deficit hyperactivity disorder, conduct disorder, antisocial personality disorder, risk-taking, risky driving behavior, sexual risk behavior, sexually transmitted infections, traumatic brain injury, emergency department admission, cardiovascular disease, psychostimulant treatment, causes of death, boys
- MeSH terms
- Accidents, Traffic, Admitting Department, Hospital, Adult, Central Nervous System Stimulants, Antisocial Personality Disorder, Attention Deficit Disorder with Hyperactivity, Cardiovascular Diseases, Child, Follow-Up Studies, Humans, Male, New York City, Personality Development, Risk-Taking, Survival Analysis, Outcome Assessment, Health Care, Diagnostic and Statistical Manual of Mental Disorders, Unsafe Sex
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