ADHD and Long-Term Outcomes
A follow-up study of 232 children with ADHD (mean age 10.4 years) found that at around the age of 27, about one third (29.3%) fulfilled criteria for adult ADHD. The rates of persistence were similar for males and females, (29.3%) and (29.2%) respectively (Barbaresi et al. 2013).
A 10-year follow-up study of 110 boys diagnosed with ADHD when aged 6–17 found that 78% of the boys continued to have full or partial persistent ADHD symptoms as young adults. The researchers define persistence as meeting full DSM-IV criteria for ADHD and partial persistence as failing to attain functional remission or receiving treatment for ADHD. Of the 78% who continued to have ADHD symptoms, 35 percent continued to meet full DSM-IV criteria for ADHD, 22 percent had subsyndromal ADHD, 15 percent had impaired functioning, and 6 percent were in remission and still being treated (Biederman et al. 2010).
A 16-year follow-up study of 140 boys with ADHD found them to be significantly more impaired in psychosocial, educational and neuropsychological functioning when compared with those without ADHD (Biederman et al. 2012).
An 11-year follow-up study of 140 girls diagnosed with ADHD at ages 6–18 found that 62% of the girls continued to have impairing ADHD symptoms as young adults. They had significantly higher risks for antisocial disorders, major depression and anxiety disorders as adults when compared to girls without ADHD (Biederman et al. 2010).
Recent follow-up studies of children with ADHD show that ADHD persists from childhood to adolescence in 50%–80% of cases, and into adulthood in 35%–65% of cases (Owens et al. 2015).
32.2% of students with the combined type of ADHD drop out of high school, compared to 15% of teens with no psychiatric disorder (Breslau et al. 2011).
Between 2% and 8% of college students are estimated to have ADHD (DuPaul et al. 2009). The National Center for Education Statistics estimates that there were 20,642,819 students enrolled in college in 2012 (US NCES, 2014). If 2%–8% of this population is estimated to have ADHD, then between 412,856 and 1,651,425 students with ADHD enrolled in college in 2012.
A study by Kuriyan et al. (2013) found these outcomes for young adults diagnosed with ADHD:
- They are far less likely to enroll in a 4-year college.
- They are 11 times more likely to not enroll in any school vs. enrolling in a 4-year college.
- 50% attend vocational or junior colleges vs. 18% of the non-ADHD comparison group.
- 15% hold a 4-year degree compared to 48% of the control group.
- 0.06% held a graduate degree compared to 5.4% of the control group.
The study by Kuriyan et al. (2013) also found these occupational outcomes for young adults with ADHD between the ages of 23 and 32:
- They are 11 times more likely to be unemployed and not in school.
- They are 4 times more likely to be in unskilled vs. clerical occupation, and 6 times more likely to be in unskilled vs. professional occupations.
- 61% more likely to have ever been fired, compared to 43% of the comparison group.
- 33% more likely to have ever been laid off, compared to 13% of the comparison group.
- 53% more likely to have ever quit a job due to dislike, compared to 36% of the comparison group.
- They earned close to $2 per hour less in wages than the comparison group.
Barbaresi, William J. et al. (2013). Mortality, ADHD, and psychosocial adversity in adults with childhood ADHD: a prospective study. Pediatrics 131(4):637-644.
Biederman, Joseph at al. (July 2012). Adult outcome of attention-deficit/hyperactivity disorder: a controlled 16-year follow-up study. Journal of Clinical Psychiatry 73(7):941-50.
Biederman, Joseph et al. (May 2010). How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Research 177(3):299–304.
Biederman, Joseph et al. (April 2010). Adult Psychiatric Outcomes of Girls With Attention Deficit Hyperactivity Disorder: 11-Year Follow-Up in a Longitudinal Case-Control Study. American Journal of Psychiatry 167(4):409-417.
Breslau, Joshua et al. (March 2011). Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time. Journal of Psychiatric Research 45(3):295–301.
DuPaul, George J. et al. (November 2009). College Students With ADHD: Current Status and Future Directions. Journal of Attention Disorders 13(3):234–250.
Kuriyan, Aparajita B. et al. (January 2013). Young Adult Educational and Vocational Outcomes of Children Diagnosed with ADHD. Journal of Abnormal Child Psychology 41(1):27–41.
Owens, Elizabeth et al. (2015). Developmental Progression and Gender Differences among Individuals with ADHD. In R. A. Barkley (Ed.), Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 4th ed. (pp. 223-255). New York, NY: Guilford Press.
U.S. Department of Education, National Center for Education Statistics (NCES). (July 2014). Table 303.10. Total fall enrollment in degree-granting postsecondary institutions, by attendance status, sex of student, and control of institution: Selected years, 1947 through 2023. Accessed online at http://nces.ed.gov/programs/digest/d13/tables/dt13_303.10.asp.