MONDAY, Dec. 10 (HealthDay News) -- If children with
attention-deficit/hyperactivity disorder, or ADHD, continue to have
the condition in adulthood, a new study suggests that they may face
an array of physical and mental health issues.
The study, which spanned more than 30 years, found that people
who had ADHD as teens and adults face a greater risk of stress,
work problems, financial troubles, physical health issues and
additional mental health issues, such as depression or antisocial
"When children who had ADHD in adolescence became adults with ADHD, they had a higher probability of depressive mood and anxiety, and they were much more likely to have antisocial personality disorder. They also had difficulty in terms of work and experienced a great deal of financial stress," said study author Judith Brook, a professor of psychiatry at New York University School of Medicine in New York City.
"The other thing we found was that marijuana had pervasive adverse effects and was associated with a number of other factors, such as impaired work performance," noted Brook.
The findings were released online Dec. 10 in advance of
publication in the January print issue of the journal
The study included 551 children. Seventy-two of those children
were diagnosed with ADHD in 1975 when they were between the ages of
14 and 16. The researchers followed up with the children as they
grew, and the final of five outcome surveys was given at an average
age of 37.
Study volunteers were asked about their overall health with
questions like: "How true or false is it that you seem to get sick
a little easier than other people?" They were also asked about
their mental health and possible stressors, with questions such as:
"How much of the time have you been very nervous?" and "Have you
been in physical fights repeatedly?" or "Because of your current
financial situation, is it true that you sometimes worry about
losing your job?"
Compared to people without ADHD in their teens and adulthood,
those with the disorder had 82 percent higher odds of having
impaired physical health. They were also more than twice as likely
to have another mental health problem and more than three times as
likely to have antisocial personality disorder, a condition in
which a person often manipulates or even violates the rights of
others. This behavior is often criminal in nature, according to the
U.S. National Institutes of Health.
Adults with ADHD were also 2.5 times more likely to have
problems at work, and more than three times as likely to have high
financial stress, the investigators found.
"Work difficulties are probably the result of impulsivity and a lack of persistence. People with ADHD get distracted," Brook explained.
As to how ADHD might affect overall physical health, she said it
wasn't clear why people with ADHD might have poorer health. But,
she theorized that this finding might also have to do with
impulsive, distractable behavior. People may not eat the foods they
should or follow-up with their doctors, she suggested.
Brook said the researchers were surprised by the magnitude of
the antisocial personality disorder finding, and they suspect it
may have something to do with a less than ideal parent-child
attachment, as well as being rejected by their peers.
So, are children with ADHD doomed to have difficult lives full
of stress and struggle?
Not necessarily, said Brook. Many children and teens with ADHD
will outgrow the disorder before they reach adulthood. And, today,
more treatments are available to help those who continue to have
ADHD than were available to the people in this study.
"With treatment, a certain number of these youngsters will develop techniques to cope, which helps a great deal. And, many will choose fields where they can excel," said Brook, who added that those affected by the disorder today may not be as stigmatized by society, either. "ADHD is more accepted today. Overall, it's just more acceptable now to have a psychological disorder than it was in 1975," said Brook.
Dr. Andrew Adesman, chief of developmental and behavioral
pediatrics at the Steven and Alexandra Cohen Children's Medical
Center of New York in New Hyde Park, said it's extremely important
to realize that the findings are based on treatments that were
available in the 1970s and 1980s, and that children diagnosed today
have many more treatment options available to them.
"I don't want to suggest that there aren't increased risks for these kids, because there are. But, what was an outcome for kids who were diagnosed in 1975 may have relatively little relevance for children diagnosed with ADHD today," Adesman said.
"We have improvements in medications, educational accommodations and even higher education that could change outcomes. We can't ignore this study, but we need to look at it in context," he added.
Adesman said it's also important to remember that this is likely
a very small percentage of the general population.
Both experts said it's important for parents to be attuned to
their children and to get them evaluated right away if they suspect
"Problem behaviors can be minimized early on for the best possible outcomes," Adesman said.
Brook said the parent-child relationship is also key, but
acknowledged that having a child with ADHD can be very hard on
parents. She suggested encouraging children to develop the
strengths they have.
"Try to pick areas where they can succeed, so they get positive reinforcement," she advised. "When they have some success, it can help offset other areas, and they'll be more likely to be accepted by their peers and less likely to feel depressed or anxious."
While the study found an association between ADHD in adulthood
and a raised risk of problems with mental and physical health, it
did not prove a cause-and-effect relationship.
Learn more about ADHD from the
Centers for Disease Control and Prevention.