I nvestigators from Harvard, Mayo Clinic, and Baylor College of Medicine sought to examine the long-term outcomes for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) in childhood. For the study, the investigators reviewed medical and school records on a cohort of adults who had been born in Rochester, Minnesota between 1976 and 1982 and who granted permission for the review of their records. Individuals in the cohort were classified as having a diagnosis of childhood ADHD

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... r no ADHD based on predefined criteria. Vital statistic data including overall mortality, cause-specific mortality, and rates of incarceration were collected on study participants. Standardized mortality ratios (SMR) were compared in those with and without a childhood diagnosis of ADHD. In addition, all of those members of the cohort with a childhood diagnosis of ADHD and a random sample of those without ADHD were invited to participate in a prospective assessment consisting of a standardized neuropsychiatric interview to identify the presence of current psychiatric conditions, including persistent symptoms of ADHD. Rates of psychiatric conditions in participants with and without childhood ADHD were compared. A total of 5,718 individuals granted permission for the record review. Of these, 367 were identified with childhood ADHD; 1.9% of individuals with ADHD were deceased and 2.7% were incarcerated. The SMRs for individuals with childhood ADHD compared to adult controls for all causes of death was 1.88 (95% CI, 0.83-4.26; P = .13) and for death by accident was 1.70 (95% CI, 0.49-5.97; P = .41); neither reached statistical significance. However, the SMR for suicide was 4.83 (95% CI, 1.14-20.46; P = .032) in ADHD cases. In the prospective assessments, 232 individuals with ADHD and 335 controls were enrolled; 29.3% of those with childhood ADHD met criteria for symptoms of ADHD as adults. Participants with childhood ADHD were significantly more likely than controls to have 1 or more comorbid psychiatric conditions (56.9% vs 34.9%; P < .01). The most common comorbid conditions were alcohol dependence and abuse, antisocial personality disorder, other substance abuse, and anxiety disorders. Participants with ADHD that persisted into adulthood were significantly more likely to have 1 or more comorbid psychiatric conditions than in those in whom ADHD did not persist (80.9% vs 47.0%; P < .001). The authors conclude that childhood ADHD is a chronic health problem with significant long-term morbidity and mortality.