This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Educational Achievement, Occupational Rank, and Psychiatric Status

Salvatore Mannuzza, PhD; Rachel G. Klein, PhD; Abrah Bessler; Patricia Malloy; Maria LaPadula, MA

Arch Gen Psychiatry. 1993;50(7):565-576.

Abstract
Objective
The paucity of data concerning the longterm natural history of attention-deficit hyperactivity disorder (ADHD), a common childhood psychiatric disorder, prompted a longitudinal study to investigate the adult sequelae of the childhood disorder.

Design
Prospective study, follow-up intervals ranging from 13 to 19 years (mean, 16 years), with blind systematic clinical assessments.

Subjects
Ninety-one white males (mean age, 26 years), representing 88% of a cohort systematically diagnosed as hyperactive in childhood, and 95 (95%) of comparison cases of similar race, gender, age, whose teachers had voiced no complaints about their school behavior in childhood.

Results
Probands had significantly higher rates than comparisons of ADHD symptoms (11% vs 1%), antisocial personality disorders (18% vs 2%), and drug abuse disor- ders (16% vs 4%). Significant comorbidity occurred between antisocial and drug disorders. Educational and occupational achievements were significantly compromised in the probands. These disadvantages were independent of psychiatric status. We did not find increased rates of affective or anxiety disorders in the probands.

Conclusions
Childhood ADHD predicts specific adult psychiatric disorders, namely antisocial and drug abuse disorders. In the adolescent outcome of this cohort, we found that these disturbances were dependent on the continuation of ADHD symptoms. In contrast, in adulthood, antisocial and drug disorders appeared, in part, independent of sustained ADHD. In addition, regardless of psychiatric status, ADHD placed children at relative risk for educational and vocational disadvantage. The results do not support a relationship between childhood ADHD and adult mood or anxiety disorders.

Author Affiliations
From the Children's Behavior Disorders Clinic, Hillside Division, Research Department, Long Island Jewish Medical Center, New Hyde Park, NY (Drs Mannuzza and Klein and Mss Bessler, Malloy, and LaPadula), the Department of Clinical Psychology, New York State Psychiatric Institute, New York (Drs Mannuzza and Klein and Ms Bessler), and the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY (Drs Mannuzza and Klein).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Intensity of ADHD Symptoms and Subjective Feelings of Competence in School Age Children
Hanc and Brzezinska
School Psychology International 2009;30:491-506.
ABSTRACT  

The Impact of Childhood ADHD on Dropping Out of High School in Urban Adolescents/ Young Adults
Trampush et al.
J Atten Disord 2009;13:127-136.
ABSTRACT  

Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment: A Cross-Sectional Study of 414 Clinically Diagnosed Adult ADHD Patients
Halmoy et al.
J Atten Disord 2009;13:175-187.
ABSTRACT  

Inattentive Symptoms of ADHD Are Related to Evening Orientation
Caci et al.
J Atten Disord 2009;13:36-41.
ABSTRACT  

Independence and interplay between maternal and child risk factors for preschool problem behaviors?
Hughes and Ensor
International Journal of Behavioral Development 2009;33:312-322.
ABSTRACT  

Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study
Biederman et al.
Pediatrics 2009;124:71-78.
ABSTRACT | FULL TEXT  

Variability of Attention Processes in ADHD: Observations From the Classroom
Rapport et al.
J Atten Disord 2009;12:563-573.
ABSTRACT  

Vigilance and Sustained Attention in Children and Adults With ADHD
Tucha et al.
J Atten Disord 2009;12:410-421.
ABSTRACT  

Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis
Simon et al.
Br. J. Psychiatry 2009;194:204-211.
ABSTRACT | FULL TEXT  

Untreated ADHD in Adults: Are There Sex Differences in Symptoms, Comorbidity, and Impairment?
Rasmussen and Levander
J Atten Disord 2009;12:353-360.
ABSTRACT  

The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative
de Graaf et al.
Occup. Environ. Med. 2008;65:835-842.
ABSTRACT | FULL TEXT  

Effect of Prior Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder on Subsequent Risk for Cigarette Smoking and Alcohol and Drug Use Disorders in Adolescents
Wilens et al.
Arch Pediatr Adolesc Med 2008;162:916-921.
ABSTRACT | FULL TEXT  

Growing Out of ADHD: The Relationship Between Functioning and Symptoms
Young and Gudjonsson
J Atten Disord 2008;12:162-169.
ABSTRACT  

Practice Parameter for the Assessment and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder
Focus 2008;6:401-426.
ABSTRACT | FULL TEXT  

Age of Methylphenidate Treatment Initiation in Children With ADHD and Later Substance Abuse: Prospective Follow-Up Into Adulthood
Mannuzza et al.
Am. J. Psychiatry 2008;165:604-609.
ABSTRACT | FULL TEXT  

The Expression of Adult ADHD Symptoms in Daily Life: An Application of Experience Sampling Methodology
Knouse et al.
J Atten Disord 2008;11:652-663.
ABSTRACT  

Social Appraisal of Adult ADHD: Stigma and Influences of the Beholder's Big Five Personality Traits
Canu et al.
J Atten Disord 2008;11:700-710.
ABSTRACT  

Comparison of a Norm-Based Versus Criterion-Based Approach to Measuring ADHD Symptomatology in College Students
McKee
J Atten Disord 2008;11:677-688.
ABSTRACT  

ADHD Prevalence in Adult Outpatients With Nonpsychotic Psychiatric Illnesses
Almeida Montes et al.
J Atten Disord 2007;11:150-156.
ABSTRACT  

Psychiatric Comorbidity in ADHD Symptom Subtypes in Clinic and Community Adults
Sprafkin et al.
J Atten Disord 2007;11:114-124.
ABSTRACT  

Services for adults with attention-deficit hyperactivity disorder: national survey
Edwin and McDonald
Psychiatr. Bull. 2007;31:286-288.
ABSTRACT | FULL TEXT  

Comparing ADHD in Velocardiofacial Syndrome to Idiopathic ADHD: A Preliminary Study
Antshel et al.
J Atten Disord 2007;11:64-73.
ABSTRACT  

Attention-Deficit/Hyperactivity Disorder: Diagnosis, Lifespan, Comorbidities, and Neurobiology
Spencer et al.
J Pediatr Psychol 2007;32:631-642.
ABSTRACT | FULL TEXT  

Academic and Educational Outcomes of Children With ADHD
Loe and Feldman
J Pediatr Psychol 2007;32:643-654.
ABSTRACT | FULL TEXT  

The pathophysiology, medical management and dental implications of adult attention-deficit/hyperactivity disorder
Friedlander et al.
Journal of the American Dental Association 2007;138:475-482.
ABSTRACT | FULL TEXT  

Service innovation: transitional attention-deficit hyperactivity disorder clinic
Verity and Coates
Psychiatr. Bull. 2007;31:99-100.
FULL TEXT  

ADHD and Achievement: Meta-Analysis of the Child, Adolescent, and Adult Literatures and a Concomitant Study With College Students
Frazier et al.
J Learn Disabil 2007;40:49-65.
ABSTRACT  

National Estimates and Factors Associated With Medication Treatment for Childhood Attention-Deficit/Hyperactivity Disorder
Visser et al.
Pediatrics 2007;119:S99-S106.
ABSTRACT | FULL TEXT  

Effects of Coexisting Disorders on Cognition and Behavior in Children With ADHD.
Crawford et al.
J Atten Disord 2006;10:192-199.
ABSTRACT  

ADHD in college students.
Weyandt and DuPaul
J Atten Disord 2006;10:9-19.
ABSTRACT  

Driving anger and driving behavior in adults with ADHD.
Richards et al.
J Atten Disord 2006;10:54-64.
ABSTRACT  

Prevalence and Correlates of Estimated DSM-IV Child and Adult Separation Anxiety Disorder in the National Comorbidity Survey Replication
Shear et al.
Am. J. Psychiatry 2006;163:1074-1083.
ABSTRACT | FULL TEXT  

A Nationwide Epidemiologic Modeling Study of LD: Risk, Protection, and Unintended Impact
McDermott et al.
J Learn Disabil 2006;39:230-251.
ABSTRACT  

Parental Schemata in the Management of Children With Attention Deficit-Hyperactivity Disorder
Bull and Whelan
Qual Health Res 2006;16:664-678.
ABSTRACT  

The Prevalence and Correlates of Adult ADHD in the United States: Results From the National Comorbidity Survey Replication
Kessler et al.
Am. J. Psychiatry 2006;163:716-723.
ABSTRACT | FULL TEXT  

Psychometric properties of an adult ADHD diagnostic interview.
Epstein and Kollins
J Atten Disord 2006;9:504-514.
ABSTRACT  

Anxiety and Mood Disorders in Adolescents With Childhood Attention-Deficit/Hyperactivity Disorder
Bagwell et al.
Journal of Emotional and Behavioral Disorders 2006;14:178-187.
ABSTRACT  

What Is the Prevalence of Adult ADHD? Results of a Population Screen of 966 Adults
Faraone and Biederman
J Atten Disord 2005;9:384-391.
ABSTRACT  

Prevalence and Correlates of ADHD Symptoms in the National Health Interview Survey
Cuffe et al.
J Atten Disord 2005;9:392-401.
ABSTRACT  

Psychiatric Comorbidity in Adult Attention Deficit Hyperactivity Disorder: Findings From Multiplex Families
McGough et al.
Am. J. Psychiatry 2005;162:1621-1627.
ABSTRACT | FULL TEXT  

Instability of the DSM-IV Subtypes of ADHD From Preschool Through Elementary School
Lahey et al.
Arch Gen Psychiatry 2005;62:896-902.
ABSTRACT | FULL TEXT  

Coping Skills and Parent Support Mediate the Association Between Childhood Attention-Deficit/Hyperactivity Disorder and Adolescent Cigarette Use
Molina et al.
J Pediatr Psychol 2005;30:345-357.
ABSTRACT | FULL TEXT  

Attention-Deficit/Hyperactivity Disorder Among Adolescents: A Review of the Diagnosis, Treatment, and Clinical Implications
Wolraich et al.
Pediatrics 2005;115:1734-1746.
ABSTRACT | FULL TEXT  

Temperament and Character Profiles and the Dopamine D4 Receptor Gene in ADHD
Lynn et al.
Am. J. Psychiatry 2005;162:906-913.
ABSTRACT | FULL TEXT  

Accuracy of Self-Evaluation in Adults with ADHD: Evidence from a Driving Study
Knouse et al.
J Atten Disord 2005;8:221-234.
ABSTRACT  

Adjustment, Social Skills, and Self-Esteem in College Students With Symptoms of ADHD
Shaw-Zirt et al.
J Atten Disord 2005;8:109-120.
ABSTRACT  

Training Raters to Assess Adult ADHD: Reliability of Ratings
Adler et al.
J Atten Disord 2005;8:121-126.
ABSTRACT  

ADHD and Dyscalculia: Evidence for Independent Familial Transmission
Monuteaux et al.
J Learn Disabil 2005;38:86-93.
ABSTRACT  

Introduction
Hill
Arch. Dis. Child. 2005;90:i1-i1.
FULL TEXT  

The effect of ADHD on the life of an individual, their family, and community from preschool to adult life
Harpin
Arch. Dis. Child. 2005;90:i2-i7.
ABSTRACT | FULL TEXT  

The Construct Validity of the Internal Restlessness Scale
Weyandt et al.
Assessment for Effective Intervention 2005;30:53-63.
ABSTRACT  

What happens when children with attention deficit/hyperactivity disorder grow up?
Newton-Howes
JRSM 2004;97:531-535.
FULL TEXT  

Correct Interpretation of Latent Versus Observed Abilities: Implications From Structural Equation Modeling Applied to the WISC-III and WIAT Linking Sample
Oh et al.
Journal of Special Education 2004;38:159-173.
ABSTRACT  

Diagnostic Controversies in Adult Attention Deficit Hyperactivity Disorder
McGough and Barkley
Am. J. Psychiatry 2004;161:1948-1956.
ABSTRACT | FULL TEXT  

Three-Year Predictive Validity of DSM-IV Attention Deficit Hyperactivity Disorder in Children Diagnosed at 4-6 Years of Age
Lahey et al.
Am. J. Psychiatry 2004;161:2014-2020.
ABSTRACT | FULL TEXT  

The marital and family functioning of adults with ADHD and their spouses
Eakin et al.
J Atten Disord 2004;8:1-10.
ABSTRACT  

Attention-deficit hyperactivity disorder in adults: validity unknown
Zwi and York
Adv. Psychiatr. Treat. 2004;10:248-256.
ABSTRACT | FULL TEXT  

Attention deficit hyperactivity disorder in adulthood
Toone
J. Neurol. Neurosurg. Psychiatry 2004;75:523-525.
FULL TEXT  

Persistence of Attention-Deficit/Hyperactivity Disorder into adulthood: What have we learned from the prospective follow-up studies?
Mannuzza et al.
J Atten Disord 2003;7:93-100.
ABSTRACT  

Is ADHD a Risk Factor for Psychoactive Substance Use Disorders? Finding From a Four-Year Prospective Follow-Up Study
Biederman et al.
Focus 2003;1:196-204.
ABSTRACT | FULL TEXT  

Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample
Canu and Carlson
J Atten Disord 2003;6:123-133.
ABSTRACT  

A qualitative study of Australian GPs' attitudes and practices in the diagnosis and management of attention-deficit/hyperactivity disorder (ADHD)
Shaw et al.
Fam Pract 2003;20:129-134.
ABSTRACT | FULL TEXT  

Assessment and management of attention-deficit hyperactivity disorder in adults
Weiss and Murray
CMAJ 2003;168:715-722.
ABSTRACT | FULL TEXT  

Does the Treatment of Attention-Deficit/Hyperactivity Disorder With Stimulants Contribute to Drug Use/Abuse? A 13-Year Prospective Study
Barkley et al.
Pediatrics 2003;111:97-109.
ABSTRACT | FULL TEXT  

Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature
Wilens et al.
Pediatrics 2003;111:179-185.
ABSTRACT | FULL TEXT  

Accuracy of Adult Recall of Childhood Attention Deficit Hyperactivity Disorder
Mannuzza et al.
Am. J. Psychiatry 2002;159:1882-1888.
ABSTRACT | FULL TEXT  

Conduct problems, gender and adult psychiatric outcome of children with attention-deficit hyperactivity disorder
DALSGAARD et al.
Br. J. Psychiatry 2002;181:416-421.
ABSTRACT | FULL TEXT  

A DSM-IV Axis I Comorbidity Study of Males (n = 120) With Paraphilias and Paraphilia-Related Disorders
Kafka and Hennen
Sex Abuse 2002;14:349-366.
ABSTRACT  

A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study of SLI381 (Adderall XR) in Children With Attention-Deficit/Hyperactivity Disorder
Biederman et al.
Pediatrics 2002;110:258-266.
ABSTRACT | FULL TEXT  

The Relationship Between Intelligence and Performance on the Test of Variables of Attention (TOVA)
Weyandt et al.
J Learn Disabil 2002;35:114-120.
ABSTRACT  

Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatric Clinic
Biederman et al.
Am. J. Psychiatry 2002;159:36-42.
ABSTRACT | FULL TEXT  

Driving anger and other driving-related behaviors in high and low ADHD symptom college students
Richards et al.
J Atten Disord 2002;6:25-38.
ABSTRACT  

Psychotherapy of Adults with Comorbid Attention-Deficit/Hyperactivity Disorder and Psychoactive Substance Use Disorder
Aviram et al.
J. Psychother. Pract. Res. 2001;10:179-186.
ABSTRACT | FULL TEXT  

Effect of repeated methylphenidate administration on presynaptic dopamine and behaviour in young adult rats
Sproson et al.
J Psychopharmacol 2001;15:67-75.
ABSTRACT  

A Controlled Clinical Trial of Bupropion for Attention Deficit Hyperactivity Disorder in Adults
Wilens et al.
Am. J. Psychiatry 2001;158:282-288.
ABSTRACT | FULL TEXT  

A review of the pharmacotherapy of adults with Attention-Deficit/ Hyperactivity Disorder
Wilens et al.
J Atten Disord 2001;5:189-202.
ABSTRACT  

Relationship between current quality of life and family of origin dynamics for college students with Attention- Deficit/Hyperactivity Disorder
Grenwald-Mayes
J Atten Disord 2001;5:211-222.
ABSTRACT  

Behavioral Symptoms and Psychiatric Diagnoses Among 162 Children in Nonalcoholic or Alcoholic Families
Schuckit et al.
Am. J. Psychiatry 2000;157:1881-1883.
ABSTRACT | FULL TEXT  

Central Conduction Time of Magnetic Brain Stimulation in Attention-Deficit Hyperactivity Disorder
Ucles et al.
J Child Neurol 2000;15:723-728.
ABSTRACT  

Challenges to determining adolescent medication response in an outpatient clinical setting: Comparing Adderal and methylphenidate for ADHD
Barkley et al.
J Atten Disord 2000;4:102-113.
ABSTRACT  

Use of Self-Ratings in the Assessment of Symptoms of Attention Deficit Hyperactivity Disorder in Adults
Murphy and Schachar
Am. J. Psychiatry 2000;157:1156-1159.
ABSTRACT | FULL TEXT  

Age-Dependent Decline of Symptoms of Attention Deficit Hyperactivity Disorder: Impact of Remission Definition and Symptom Type
Biederman et al.
Am. J. Psychiatry 2000;157:816-818.
ABSTRACT | FULL TEXT  

Amelioration of specific working memory deficits by methylphenidate in a case of adult attention deficit/hyperactivity disorder
Mehta et al.
J Psychopharmacol 2000;14:299-302.
ABSTRACT  

Tourette syndrome, associated conditions and the complexities of treatment
Robertson
Brain 2000;123:425-462.
ABSTRACT | FULL TEXT  

Life History Reports of Young Adults Previously Referred for Mental Health Services
Mcconaughy and Wadsworth
Journal of Emotional and Behavioral Disorders 2000;8:202-215.
ABSTRACT  

From the Editor
J Atten Disord 2000;3:173-191.
ABSTRACT  

Towards defining a meaningful anxiety phenotype for research in ADHD children
Mennin et al.
J Atten Disord 2000;3:192-199.
ABSTRACT  

A Pilot Controlled Clinical Trial of ABT-418, a Cholinergic Agonist, in the Treatment of Adults With Attention Deficit Hyperactivity Disorder
Wilens et al.
Am. J. Psychiatry 1999;156:1931-1937.
ABSTRACT | FULL TEXT  

Self-ratings of ADHD symptoms in adults I: Factor structure and normative data
Conners et al.
J Atten Disord 1999;3:141-151.
ABSTRACT  

Self-ratings of ADHD symptomas in auts II: Reliability, validity, and diagnostic sensitivity
Erhardt et al.
J Atten Disord 1999;3:153-158.
ABSTRACT  

Effects of ADHD, Conduct Disorder, and Gender on Substance Use and Abuse in Adolescence
Disney et al.
Am. J. Psychiatry 1999;156:1515-1521.
ABSTRACT | FULL TEXT  

Treatment of Attention-Deficit-Hyperactivity Disorder
Elia et al.
NEJM 1999;340:780-788.
FULL TEXT  

Attention deficit hyperactivity disorder
HILL
Arch. Dis. Child. 1998;79:381-384.
FULL TEXT  

A 55-Year-Old Man With Attention-Deficit/Hyperactivity Disorder
Biederman
JAMA 1998;280:1086-1092.
FULL TEXT  

DOPA Decarboxylase Activity in Attention Deficit Hyperactivity Disorder Adults. A [Fluorine-18]Fluorodopa Positron Emission Tomographic Study
Ernst et al.
J. Neurosci. 1998;18:5901-5907.
ABSTRACT | FULL TEXT  

Age-Related Changes in Brain Glucose Metabolism in Adults With Attention-Deficit/Hyperactivity Disorder and Control Subjects
Ernst et al.
J. Neuropsychiatry Clin. Neurosi. 1998;10:168-177.
ABSTRACT | FULL TEXT  

Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Goldman et al.
JAMA 1998;279:1100-1107.
ABSTRACT | FULL TEXT