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Cited by 166Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentDevelopmental and Educational Neuropsychology

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Late-Onset ADHD Reconsidered With Comprehensive Repeated Assessments Between Ages 10 and 25

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Sibley, Margaret H., Rohde, Luis A., Swanson, James M., Hechtman, Lily T., Molina, Brooke S.G., Mitchell, John T., Arnold, L. Eugene, Caye, Arthur, Kennedy, Traci M., Roy, Arunima, Stehli, Annamarie, for the Multimodal Treatment Study of Children with ADHD (MTA) Cooperative Group·2018·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2017.17030298PMC PMC5814300
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Abstract

OBJECTIVE: Adolescents and young adults without childhood attention deficit hyperactivity disorder (ADHD) often present to clinics seeking stimulant medication for late-onset ADHD symptoms. Recent birth-cohort studies support the notion of late-onset ADHD, but these investigations are limited by relying on screening instruments to assess ADHD, not considering alternative causes of symptoms, or failing to obtain complete psychiatric histories. The authors address these limitations by examining psychiatric assessments administered longitudinally to the local normative comparison group of the Multimodal Treatment Study of ADHD. METHOD: Individuals without childhood ADHD (N=239) were administered eight assessments from comparison baseline (mean age=9.89 years) to young adulthood (mean age=24.40 years). Diagnostic procedures utilized parent, teacher, and self-reports of ADHD symptoms, impairment, substance use, and other mental disorders, with consideration of symptom context and timing. RESULTS: Approximately 95% of individuals who initially screened positive on symptom checklists were excluded from late-onset ADHD diagnosis. Among individuals with impairing late-onset ADHD symptoms, the most common reason for diagnostic exclusion was symptoms or impairment occurring exclusively in the context of heavy substance use. Most late-onset cases displayed onset in adolescence and an adolescence-limited presentation. There was no evidence for adult-onset ADHD independent of a complex psychiatric history. CONCLUSIONS: Individuals seeking treatment for late-onset ADHD may be valid cases; however, more commonly, symptoms represent nonimpairing cognitive fluctuations, a comorbid disorder, or the cognitive effects of substance use. False positive late-onset ADHD cases are common without careful assessment. Clinicians should carefully assess impairment, psychiatric history, and substance use before treating potential late-onset cases.

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Research works printed but not linked: 4

  1. Swanson JM, 1992, School-Based Assessments and Interventions for ADD Students
  2. Conners CK, 1999, Conner’s Adult ADHD Rating Scales: CAARS
  3. Bird HR, 1993, Int J Meth Psy Res, 3, 167
  4. Murphy K, 2000, ADHD Rep, 8, 1

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Metadata

Authors
Sibley, M. H., Rohde, L. A., Swanson, J. M., Hechtman, L. T., Molina, B. S. G., Mitchell, J. T., Arnold, L. E., Caye, A., Kennedy, T. M., Roy, A., Stehli, A., & for the Multimodal Treatment Study of Children with ADHD (MTA) Cooperative Group
Affiliations
  • Universidade Federal do Rio Grande do Sul (BR)
  • From the Department of Psychiatry and Behavioral Health, Florida International University, Miami; the Department of Psychiatry, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; the Child Development Center, School of Medicine, University of California, Irvine; the Division of Child Psychiatry, McGill University, Montreal Children’s Hospital, Montreal, Quebec, Canada; the Departments of Psychiatry, Psychology, and Pediatrics, University of Pittsburgh...
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2018-02-01
Volume
175
Issue
2
Pages
140-149
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2017.17030298
PMC
PMC5814300
OpenAlex
W2765395469
Cited by
165
References
36
Citations by year
2026: 16 · 2025: 18 · 2024: 8 · 2023: 22 · 2022: 21 · 2021: 18 · 2020: 21 · 2019: 14 · 2018: 26
FWCI
13.93
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (n01mh12011-0-0-1, n01mh012009-007, n01mh12008-0-0-1, n01mh12010-0-0-1, n01mh12004-0-0-0, n01mh12007-0-0-0, n01mh012012-001)
  • National Institute of Mental Health (N01 MH012007, U01MH050467, N01 MH012009, N01 MH012011, U01MH050440, N01 MH012012, U01MH050453, N01 MH012010, U01MH050461, N01 MH012004, N01 MH012008)
  • National Institute on Drug Abuse (HHSN271200800003C, K23DA032577, HHSN271200800006C, N01 DA085550, N01 DA085552, HHSN271200800008C, N01 DA085549, HHSN271200800005C, N01 DA085548, HHSN271200800007C, HHSN271200800009C, R01DA039881, N01 DA085553, N01 DA085554, HHSN271200800004C)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
late-onset ADHD, adult-onset ADHD, adolescents and young adults, stimulant medication, diagnostic exclusion, substance use, comorbidities, psychiatric history, longitudinal assessment, ADHD screening, cognitive fluctuations
MeSH terms
Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Female, Humans, Male, Comorbidity, Case-Control Studies, Age of Onset, Substance-Related Disorders, Young Adult

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