Persistence and remission of ADHD during adulthood: a 7-year clinical follow-up study
Abstract
Background: Course and predictors of persistence of attention deficit hyperactivity disorder (ADHD) in adults are still largely unknown. Neurobiological and clinical differences between child and adult ADHD raise the need for follow-up studies of patients diagnosed during adulthood. This study investigates predictors of ADHD persistence and the possibility of full remission 7 years after baseline assessment. Method: A 7-year follow-up study of adults with ADHD ( n = 344, mean age 34.1 years, 49.9% males) was conducted. Variables from different domains (social demographics, co-morbidities, temperament, medication status, ADHD measures) were explored with the aim of finding potential predictors of ADHD persistence. Results: Retention rate was 66% ( n = 227). Approximately a third of the sample ( n = 70, 30.2%) did not maintain ADHD criteria and 28 (12.4%) presented full remission (<4 symptoms), independently of changes in co-morbidity or cognitive demand profiles. Baseline predictors of diagnostic persistence were higher number of inattention symptoms [odds ratio (OR) 8.05, 95% confidence interval (CI) 2.54–25.45, p < 0.001], number of hyperactivity/impulsivity symptoms (OR 1.18, 95% CI 1.04–1.34, p = 0.01), oppositional defiant disorder (OR 3.12, 95% CI 1.20–8.11, p = 0.02), and social phobia (OR 3.59, 95% CI 1.12–11.47, p = 0.03). Conclusions: Despite the stage of brain maturation in adults suggests stability, approximately one third of the sample did not keep full DSM-IV diagnosis at follow-up, regardless if at early, middle or older adulthood. Although full remission is less common than in childhood, it should be considered as a possible outcome among adults.
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Most longitudinal work on ADHD remission and persistence reports only a single-time snapshot of functioning.
“Most longitudinal work on ADHD remission and persistence reports only a single-time snapshot of functioning, even though ADHD is considered a life-course disorder.”
From Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD (2022) · cites this paper as [6]
Most ADHD longitudinal studies simply define remission as failing to meet DSM criteria, with few attempts to identify or define distinct subtypes and patterns of remission.
“Most ADHD longitudinal studies simply define remission as “failing to meet DSM criteria,” with few attempts to identify/define distinct subtypes and patterns of remission.”
From Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD (2022) · cites this paper as [6]
ADHD is considered a life-course disorder.
“even though ADHD is considered a life-course disorder.”
From Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD (2022) · cites this paper as [6]
There is virtually no scientific information on the extent to which individuals sustain remission long-term, experience recurrence of ADHD post-remission, or fluctuate between full remission, partial remission, and ADHD persistence.
“There is virtually no scientific information on the extent to which individuals sustain remission long-term (i.e., recover from ADHD symptoms and impairments), experience recurrence of ADHD post-remission (i.e., remission is temporary), or fluctuate between full remission, partial remission, and ADHD persistence (whether ADHD might be a waxing and waning disorder).”
From Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD (2022) · cites this paper as [6]
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- Authors
- Karam, R. G., Breda, V., Picon, F. A., Rovaris, D. L., Victor, M. M., Salgado, C. A. I., Vitola, E. S., Silva, K. L., Guimarães-da-Silva, P. O., Mota, N. R., Caye, A., Belmonte-de-Abreu, P., Rohde, L. A., Grevet, E. H., & Bau, C. H. D.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Hospital de Clínicas de Porto Alegre (BR)
- Corresponding author
- Bau, C. H. D.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-01-23
- Volume
- 45
- Issue
- 10
- Pages
- 2045-2056
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2130983324
- Cited by
- 113
- References
- 14
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 10 · 2023: 9 · 2022: 11 · 2021: 15 · 2020: 7 · 2019: 5 · 2018: 12 · 2017: 17 · 2016: 10 · 2015: 6
- FWCI
- 12.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universidade Federal do Rio Grande do Sul
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, ADHD persistence, inattentive symptoms, hyperactivity/impulsivity symptoms, oppositional defiant disorder, social anxiety disorder, comorbidities, temperament, ADHD medication, brain maturation
- MeSH terms
- Phobia, Social, Adolescent, Adult, Aged, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Brazil, Follow-Up Studies, Hospitals, Teaching, Humans, Interview, Psychological, Methylphenidate, Middle Aged, Regression Analysis, Remission Induction, Comorbidity, Treatment Outcome, Young Adult
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