Long-term outcomes in ADHD
Despite the short-term effectiveness of current treatments for ADHD, particularly stimulant treatments, the limitations of these treatments for long-term outcomes are increasingly recognized. Among these limitations are failures to achieve long-term gains in academic achievement (e.g., elevated high school dropout rates) and limited vocational opportunities and success (e.g., frequent job changes, greater unemployment). The persistence of deficits in executive functions, motivational deficits, and impairments in self-regulation are increasingly acknowledged. Risk-taking behaviors associated with the adolescent period are associated with adverse health effects and high accident rates. Combined, these features put ADHD adolescents at risk for various other comorbidities (e.g., substance use/abuse), as well as for ill effects on health (e.g., high rates of nicotine addiction). Significantly impairing symptoms are now estimated to affect approximately 70 to 80% of adolescents with ADHD1 and 50% or more of adults with a history of ADHD2. Predictors of outcomes are multifactorial and complex. Specific outcomes have differing predictors and are themselves age-and possibly gender-specific.
