Knowledge of the long-term course of childhood Attention Deficit Hyperactivity Disorder (ADHD) is limited by the lack of longitudinal studies that extend beyond age 25. Information about the later adult status of children with ADHD, one of the most common disorders of childhood, is important since the disorder is widely reported to persist through adulthood. Findings from this prospective 30 year longitudinal study also address the claim that bipolar disorder masquerades as ADHD.

We report on the psychiatric status of 90 males at mean age 41, diagnosed with ADHD at ages 6-12 (Mean, 8), and 102 non-ADHD males matched for age and SES in childhood, interviewed blindly by trained clinicians.

As expected, ADHD at follow-up was significantly elevated in probands (13% vs.1% in comparisons, p<.001). When the number of ADHD criteria is reduced, as recommended for ADHD in adults, rates rise to 36% and 12%, respectively (p<.001). Other disorders significantly more prevalent in probands were: antisocial personality disorder (APD) (10% vs. 0%, p<.001), drug (non-alcohol) disorders (17% vs 7%, p<.03), and nicotine dependence (29% vs 9%, p<.001)). Childhood ADHD was not associated with elevated rates of mood or anxiety disorders in adulthood.

The extended clinical course of ADHD appears diagnostically specific, consisting of ADHD, APD and drug (non-alcohol) use disorders. Findings are not consistent with expectations that ADHD persists through adulthood in the majority, or that bipolar disorder was misdiagnosed as ADHD in childhood. Findings pertaining to other functional domains also will be presented.