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Long-term course of ADHD symptoms from childhood to early adulthood in a community sample

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Abstract

Comparatively little information is available from population-based studies on subgroup trajectories of attention-deficit/hyperactivity disorder (ADHD) core symptoms of inattention and hyperactivity-impulsivity (particularly as defined by DSM-IV and ICD-10). Recent report of a subgroup with high and increasing inattention symptoms across development requires replication. To identify the different trajectory subgroups for inattention, hyperactivity-impulsivity and total symptoms of ADHD in children and adolescents aged 7–19 years. Eleven birth cohorts from 2,593 families with children and adolescents who had parent ratings for the outcome measures of inattention, hyperactivity-impulsivity or total symptoms were considered. Data were analysed using an accelerated longitudinal design and growth mixture modelling was applied to detect subgroups. For all three outcome measures, three trajectories with low (78.3–83.3 %), moderate (13.4–18.8 %) and high (2.8–3.2 %) symptom levels were detected. Course within these subgroups was largely comparable across outcome domains. In general, a decrease in symptoms with age was observed in all severity subgroups, although the developmental course was stable for the high subgroups of inattention and total symptoms. About 3 % of children in a community-based sample follow a course with a high level of ADHD symptoms. In this high trajectory group, hyperactivity-impulsivity symptoms decrease with age from 7 to 19 years, whilst inattention and total symptoms are stable. There was no evidence for an increase in symptoms across childhood/adolescence in any of the severity groups.

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Acknowledgments

The authors thank the Robert Koch Institute for their ongoing support and co-operation. We kindly thank Deirdre Elmhirst (Elmhirst Medical Writing Services) and Christina Dose (University Hospital of Cologne) for carefully reading the manuscript. The BELLA study has been financially supported by various grants: Baseline, 1-year follow-up and 2-year follow-up of the BELLA study were financed by the Stifterverband für die Deutsche Wissenschaft. The 6-year follow-up was funded by the German Federal Ministry of Health (BMG).

Conflict of interest

None of the authors has a conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany

    Manfred Döpfner

  2. School of Child and Adolescent Psychotherapy, University of Cologne, Cologne, Germany

    Manfred Döpfner, Christopher Hautmann & Anja Görtz-Dorten

  3. Christoph-Dornier-Institute of Clinical Psychology in Childhood and Adolescence, University of Cologne, Cologne, Germany

    Manfred Döpfner & Anja Görtz-Dorten

  4. Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Fionna Klasen & Ulrike Ravens-Sieberer

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  1. Manfred Döpfner
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  5. Ulrike Ravens-Sieberer
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The BELLA study group

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Correspondence to Christopher Hautmann.

Additional information

M. Döpfner and C. Hautmann contributed equally to this paper.

Members of the BELLA study group are: Ulrike Ravens-Sieberer and Fionna Klasen, Hamburg (Principal Investigators); Claus Barkmann, Hamburg; Monika Bullinger, Hamburg; Manfred Döpfner, Köln; Beate Herpertz-Dahlmann, Aachen; Heike Hölling, Berlin; Franz Resch, Heidelberg; Aribert Rothenberger, Göttingen; Sylvia Schneider, Bochum; Michael Schulte-Markwort, Hamburg; Robert Schlack, Berlin; Frank Verhulst, Rotterdam; Hans-Ulrich Wittchen, Dresden.

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Döpfner, M., Hautmann, C., Görtz-Dorten, A. et al. Long-term course of ADHD symptoms from childhood to early adulthood in a community sample. Eur Child Adolesc Psychiatry 24, 665–673 (2015). https://doi.org/10.1007/s00787-014-0634-8

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  • DOI: https://doi.org/10.1007/s00787-014-0634-8

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