Attention-deficit hyperactivity disorder natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2], Haleigh Williams, B.S.
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Overview
If left untreated, patients with ADHD may experience negative social consequences, such as isolation from and difficulty communicating with friends and loved ones. Patients are unlikely to experience any physical problems as a direct result of ADHD.[1]
Natural History
- The symptoms of ADHD usually develop in the first decade of life, and can appear as early as between the ages of 3 and 6. The symptoms of ADHD often continue through adolescence and adulthood.[2] The average age of onset of ADHD is 7 years.[3]
- Military recruits who do not require medications to finish high school or to hold a job may have similar military performance as recruits without ADHD.[4]
Negative consequences
- If left untreated, ADHD may cause negative social consequences, such as isolation from and difficulty communicating with friends and loved ones. ADHD patients are unlikely to experience any physical problems as a direct result of ADHD.[1]
- Without treatment, the patient will likely continue exhibiting symptoms of hyperactivity, impulsivity, and inattention, which can bear negative academic, professional, and social consequences. Adolescents with untreated ADHD have a higher incidence of drug abuse and law-breaking than healthy children.[1]
- There are significant adverse socioeconomic outcomes from ADHD.[5][6][7] Young adults with ADHD have more financial dependence on family members and public assistance. They may earn $543,000-$616,000 less over their lifetimes[7]. Teenage males are more likely to have automobile accidents.[8]
- Employees with ADHD may experience less meaningfulness at work[9].
- Mortality may be increased.[10]f>
Positive consequences
Employees with ADHD may have improved idea generation at work, but this is offset by less feeling of meaningfulness at work[9].
Complications
- Complications that can develop as a result of ADHD are poor grades for schoolchildren or poor progress reports/possible termination for working adults.[1]
- Complications that can develop as a result of the treatment of ADHD are elevated heart rate, anorexia, agitation, vomiting, cardiac arrhythmias, lethargy, insomnia, and irritability.[11][12][13][14] Additionally, the SNRI Atomoxetine is associated with suicidal ideation in children and adolescents.[15][16]
Prognosis
- The prognosis of ADHD is poor with treatment. Without treatment, ADHD often results in negative social and academic/professional consequences. Approximately 70% of patients who are diagnosed with ADHD as children continue to experience severe symptoms throughout adolescence and sometimes into adulthood.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Briars, L., & Todd, T. (2016). A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. The Journal of Pediatric Pharmacology and Therapeutics : JPPT, 21(3), 192–206. http://doi.org/10.5863/1551-6776-21.3.192
- ↑ National Institute of Mental Health (NIH). (2016). "Attention Deficit Hyperactivity Disorder."
- ↑ Kessler RC, Chiu WT, Demler O, Walters EE. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62(6):617-27.
- ↑ Wingo AP, Ghaemi SN (2007). "A systematic review of rates and diagnostic validity of comorbid adult attention-deficit/hyperactivity disorder and bipolar disorder". J Clin Psychiatry. 68 (11): 1776–84. PMID 18052572.
- ↑ Biederman J, Faraone SV (2006). "The effects of attention-deficit/hyperactivity disorder on employment and household income". MedGenMed. 8 (3): 12. PMID 17406154.
- ↑ Mannuzza S, Klein RG, Bessler A, Malloy P, Hynes ME (1997). "Educational and occupational outcome of hyperactive boys grown up". J Am Acad Child Adolesc Psychiatry. 36 (9): 1222–7. PMID 9291723.
- ↑ 7.0 7.1 Altszuler AR, Page TF, Gnagy EM, Coxe S, Arrieta A, Molina BS; et al. (2016). "Financial Dependence of Young Adults with Childhood ADHD". J Abnorm Child Psychol. 44 (6): 1217–29. doi:10.1007/s10802-015-0093-9. PMC 4887412. PMID 26542688.
- ↑ Redelmeier DA, Chan WK, Lu H, 2010 Road Trauma in Teenage Male Youth with Childhood Disruptive Behavior Disorders: A Population Based Analysis. PLoS Med 7(11): e1000369. doi:10.1371/journal.pmed.1000369
- ↑ 9.0 9.1 Steele, Logan M.; Pindek, Shani; Margalit, Ofra (2021). "The Advantage of Disadvantage: Is ADHD Associated with Idea Generation at Work?". Creativity Research Journal: 1–9. doi:10.1080/10400419.2021.1916368. ISSN 1040-0419.
- ↑ Dalsgaard, Søren; Øtergaard, Søren Dinesen; Leckman, James F; Mortensen, Preben Bo; Pedersen, Marianne Giørtz. "Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study". The Lancet. doi:10.1016/S0140-6736(14)61684-6.
- ↑ Vitiello B, Elliott GR, Swanson JM, Arnold LE, Hechtman L, Abikoff H; et al. (2012). "Blood pressure and heart rate over 10 years in the multimodal treatment study of children with ADHD". Am J Psychiatry. 169 (2): 167–77. doi:10.1176/appi.ajp.2011.10111705. PMC 4132884. PMID 21890793.
- ↑ "DrugBank: Methylphenidate".
- ↑ "DrugBank: Guanfacine".
- ↑ "DrugBank: Clonidine".
- ↑ Garnock-Jones KP, Keating GM (2009). "Atomoxetine: a review of its use in attention-deficit hyperactivity disorder in children and adolescents". Paediatr Drugs. 11 (3): 203–26. doi:10.2165/00148581-200911030-00005. PMID 19445548.
- ↑ Michelson D, Adler L, Spencer T, Reimherr FW, West SA, Allen AJ, Kelsey D, Wernicke J, Dietrich A, Milton D (2003). "Atomoxetine in adults with ADHD: two randomized, placebo-controlled studies". Biol. Psychiatry. 53 (2): 112–20. PMID 12547466.