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Study: Kids With ADHD More Likely To Have Adult Disorders

BOSTON — One of the most recent large-scale studies on attention-deficit hyperactivity disorder (ADHD) has some disturbing conclusions.

The study in the journal Pediatrics (see press release) found that children diagnosed with ADHD are more likely than other children to have other psychiatric disorders as adults.

Dr. William Barbaresi, of Boston Children’s Hospital and one of the study’s lead investigators, joined WBUR on Monday evening to discuss the findings.

WBUR’s Deborah Becker: You surveyed about 5,700 children over a very lengthy period of time, and what did you find primarily that stuck out to you?

Dr. William Barbaresi: One of the most concerning aspects of the study is that having followed the largest representative group of children with ADHD ever examined in terms of their outcome in adulthood, that many of the conditions that we thought were associated with ADHD in fact are and in large numbers.

So for example, 30 percent of children with ADHD continue to have the same condition in adulthood and among them, 80 percent have at least one associated additional mental health problem. Among the children who no longer have ADHD, nearly 50 percent also have at least one other significant mental health problem. So in sum, what it suggests is that it’s really time to re-conceptualize ADHD for what it is: a chronic medical condition that begins in childhood and for most individuals continues to have some impact into adulthood.

What were some of the other mental health issues that were observed in those who were diagnosed with ADHD as children?

The most common ones are alcohol and other drug abuse and addiction, depression, anxiety and anti-social personality disorder. Those were the top four.

If you were to look at ADHD as a chronic medical condition, what would make it different from the way we are treating it right now?

First of all, our tendency has still been to trivialize this condition and really to think of it as primarily an annoying childhood behavior problem, and in fact what we need to be doing is to start organizing systems of care that are based on an understanding of the premise of ADHD. That includes insurance coverage, which unfortunately really severely limits our ability to do comprehensive initial assessments to identify the very conditions that we know are associated with the highest risk for an adverse outcome.

But typically, it’s my understanding that, even now if a child gets ADHD — and many folks say now children are over-diagnosed with ADHD — they’re given medication. Is that enough?

First of all I would have to disagree with the issue of over-diagnosis. There are certainly children who may be inappropriately diagnosed either by making a diagnosis or, probably more often, by not making a diagnosis when it exists. It’s a question of limited access to quality assessments to make accurate diagnoses.

But once they get the diagnosis, would there be a difference in treatment then or would it still be medication and maybe some therapy?

There are very effective treatments that include medications, such as stimulant medications, but the treatment for many children does not continue long enough. It’s quite typical, for example, for children to be treated when they’re younger and then as they get older and move into adolescence, to drift away from careful follow-up and treatment and that’s the very point in their life when they begin to be at greatest risk for some of the most concerning outcomes.

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  • http://www.facebook.com/commento.accounto Commento Accounto

    This does not surprise me.
    For decades we have been all about seratonin.
    It is obviously DOPAMINE.
    Adderall did not just help me focus. It completely shreds depression.
    How are all these scientists missing this obvious thing?
    I even refer to adderall as a “happy pill”. When you can THINK and when you are living your life relying on your prefrontal cortex instead of your amygdala……you would be amazed at how different you see life and life treats you.
    Imagine that.
    All I can say to this article is “No duh”

  • Lawrence

    Just another study, probably funded by the drug companies into scaring parents into diagnosing kids who are perfectly normal into taking needless and dangerous drugs.

  • Lawrence

    Oh, yes, I was right. I just saw the fine print. It doesn’t take a rocket scientist to conclude that the drug companies are always behind studies that boost their sales.

    Pilot work for a portion of the project was funded by an
    investigator-initiated grant from McNeil Consumer and Specialty
    Pharmaceuticals.

    • http://pulse.yahoo.com/_LLH7SFRBBDZ54YLFVP6POB6XAI ANNA

      Do you have ADHD, Lawrence? Somehow I doubt it. As an older adult, I am finally putting all the pieces together and realizing the manifestations of this condition. It is scattered throughout my extended family and quite easy to spot. For you to chalk this up to big pharma scaring us to increase sales is just ridiculous. It is real and it affects your whole way of seeing and interacting with the world. I wish these drugs were around earlier to give my hyperactive uncle, brother and cousin a break from themselves. They could not stop, look or listen and were in a perpetual state of hyper-excitability. It was exhausting. And then there’s the other face of it, the daydreamer, the unfocused, ‘in another world’ person that was me. No, Lawrence, you are not right. You have an axe to grind with big pharma. They may be guilty with their over treatment of other conditions, but not this one. It’s real and it truly impedes your ability to learn, form relationships and navigate through life. You have no idea.

      • Lawrence

        Anna,

        You are confusing USE of these drugs with ABUSE.

        There are countless psychiatrists who have lost their license and are facing criminal charges due to over prescribing these and other dangerous drugs to children. The Florida Medicaid system is bankrupt due to the constant prescription to ALL kids in foster care, some taking 5 or 6 different drugs at one time.

        ABC news with Diane Sawyer even devoted an entire segment to these greedy and unscrupulous practices.

        You and others like you maybe helped with these drugs, but the drug companies fund these dubious studies in order to substantiate the wide spread abuse of these drugs to whoever they can convince “needs” them.

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