Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide. Throughout an individual's lifetime, ADHD can increase the risk of other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. In most cases ADHD arises from several genetic and environmental risk factors that each have a small individual effect and act together to increase susceptibility. The multifactorial causation of ADHD is consistent with the heterogeneity of the disorder, which is shown by its extensive psychiatric co-morbidity, its multiple domains of neurocognitive impairment and the wide range of structural and functional brain anomalies associated with it. The diagnosis of ADHD is reliable and valid when evaluated with standard criteria for psychiatric disorders. Rating scales and clinical interviews facilitate diagnosis and aid screening. The expression of symptoms varies as a function of patient developmental stage and social and academic contexts. Although there are no curative treatments for ADHD, evidenced-based treatments can markedly reduce its symptoms and associated impairments. For example, medications are efficacious and normally well tolerated, and various non-pharmacological approaches are also valuable. Ongoing clinical and neurobiological research holds the promise of advancing diagnostic and therapeutic approaches to ADHD. For an illustrated summary of this Primer, visit: http://go.nature.com/J6jiwl
This is a preview of subscription content, access via your institution
Open Access articles citing this article.
Behavioral and Brain Functions Open Access 01 September 2023
Molecular Psychiatry Open Access 03 August 2023
Treatment of adult attention-deficit hyperactivity disorder (ADHD) with transcranial direct current stimulation (tDCS): study protocol for a parallel, randomized, double-blinded, sham-controlled, multicenter trial (Stim-ADHD)
European Archives of Psychiatry and Clinical Neuroscience Open Access 22 July 2023
Subscribe to this journal
Receive 1 digital issues and online access to articles
$99.00 per year
only $99.00 per issue
Rent or buy this article
Prices vary by article type
Prices may be subject to local taxes which are calculated during checkout
Barkley, R. A. & Peters, H. The earliest reference to ADHD in the medical literature? Melchior Adam Weikard's description in 1775 of “attention deficit” (Mangel der Aufmerksamkeit, Attentio Volubilis). J. Atten. Disord. 16, 623–630 (2012).
Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J. & Rohde, L. A. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am. J. Psychiatry 164, 942–948 (2007). This meta-analysis provides both a comprehensive estimate of the prevalence of ADHD in youths and the reasons for its variability worldwide.
Polanczyk, G. V., Willcutt, E. G., Salum, G. A., Kieling, C. & Rohde, L. A. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int. J. Epidemiol. 43, 434–442 (2014).
Thomas, R., Sanders, S., Doust, J., Beller, E. & Glasziou, P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135, e994–e1001 (2015).
Erskine, H. E. et al. Epidemiological modelling of attention-deficit/hyperactivity disorder and conduct disorder for the Global Burden of Disease Study 2010. J. Child Psychol. Psychiatry 54, 1263–1274 (2013).
Sciutto, M. J. & Eisenberg, M. Evaluating the evidence for and against the overdiagnosis of ADHD. J. Atten. Disord. 11, 106–113 (2007).
Faraone, S. V., Biederman, J. & Mick, E. The age dependent decline of attention-deficit/hyperactivity disorder: a meta-analysis of follow-up studies. Psychol. Med. 36, 159–165 (2006). This meta-analysis provides a clear estimate of the persistence of ADHD from childhood to adulthood and highlights that, although the majority of ADHD cases detected in childhood do not fulfil the entire diagnostic criteria in adulthood, persistence of impairing systems is common.
Biederman, J., Mick, E. & Faraone, S. V. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am. J. Psychiatry 157, 816–818 (2000).
Simon, V., Czobor, P., Balint, S., Meszaros, A. & Bitter, I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br. J. Psychiatry 194, 204–211 (2009).
Michielsen, M. et al. Prevalence of attention-deficit hyperactivity disorder in older adults in The Netherlands. Br. J. Psychiatry 201, 298–305 (2012).
Guldberg-Kjar, T. & Johansson, B. Old people reporting childhood AD/HD symptoms: retrospectively self-rated AD/HD symptoms in a population-based Swedish sample aged 65–80. Nord. J. Psychiatry 63, 375–382 (2009).
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th edn (American Psychiatric Publishing, 2013).
Polanczyk, G. et al. Implications of extending the ADHD age-of-onset criterion to age 12: results from a prospectively studied birth cohort. J. Am. Acad. Child Adolesc. Psychiatry 49, 210–216 (2010).
Matte, B. et al. ADHD in DSM-5: a field trial in a large, representative sample of 18- to 19-year-old adults. Psychol. Med. 45, 361–373 (2015).
Larsson, H., Sariaslan, A., Langstrom, N., D'Onofrio, B. & Lichtenstein, P. Family income in early childhood and subsequent attention deficit/hyperactivity disorder: a quasi-experimental study. J. Child Psychol. Psychiatry 55, 428–435 (2014).
Biederman, J. et al. Educational and occupational underattainment in adults with attention-deficit/hyperactivity disorder: a controlled study. J. Clin. Psychiatry 69, 1217–1222 (2008).
Lingineni, R. K. et al. Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey. BMC Pediatr. 12, 50 (2012).
Visser, S. N. et al. Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003–2011. J. Am. Acad. Child Adolesc. Psychiatry 53, 34–46.e2 (2014).
Zwirs, B. W. et al. Prevalence of psychiatric disorders among children of different ethnic origin. J. Abnorm. Child Psychol. 35, 556–566 (2007).
Biederman, J. et al. Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives in psychiatrically and pediatrically referred samples. Arch. Gen. Psychiatry 49, 728–738 (1992).
Biederman, J., Faraone, S. V., Keenan, K., Knee, D. & Tsuang, M. T. Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. J. Am. Acad. Child Adolesc. Psychiatry 29, 526–533 (1990).
Larsson, H., Chang, Z., D'Onofrio, B. M. & Lichtenstein, P. The heritability of clinically diagnosed attention deficit hyperactivity disorder across the lifespan. Psychol. Med. 44, 2223–2229 (2014).
Franke, B. et al. The genetics of attention deficit/hyperactivity disorder in adults, a review. Mol. Psychiatry 17, 960–987 (2012).
Faraone, S. V. et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol. Psychiatry 57, 1313–1323 (2005).
Asherson, P. & Gurling, H. Quantitative and molecular genetics of ADHD. Curr. Top. Behav. Neurosci. 9, 239–272 (2012).
Burt, S. A. Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychol. Bull. 135, 608–637 (2009).
Larsson, H., Anckarsater, H., Rastam, M., Chang, Z. & Lichtenstein, P. Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs. J. Child Psychol. Psychiatry 53, 73–80 (2012).
Chang, Z., Lichtenstein, P., Asherson, P. J. & Larsson, H. Developmental twin study of attention problems: high heritabilities throughout development. JAMA Psychiatry 70, 311–318 (2013).
Larsson, H. et al. Genetic and environmental influences on adult attention deficit hyperactivity disorder symptoms: a large Swedish population-based study of twins. Psychol. Med. 43, 197–207 (2013).
Merwood, A. et al. Genetic associations between the symptoms of attention-deficit/hyperactivity disorder and emotional lability in child and adolescent twins. J. Am. Acad. Child Adolesc. Psychiatry 53, 209–220.e4 (2014).
Surman, C. B. et al. Deficient emotional self-regulation and adult attention deficit hyperactivity disorder: a family risk analysis. Am. J. Psychiatry 168, 617–623 (2011).
Christiansen, H. et al. Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder. J. Neural Transm. 115, 163–175 (2008).
Kuntsi, J. et al. The separation of ADHD inattention and hyperactivity–impulsivity symptoms: pathways from genetic effects to cognitive impairments and symptoms. J. Abnorm. Child Psychol. 42, 127–136 (2014).
Rommelse, N. N., Franke, B., Geurts, H. M., Hartman, C. A. & Buitelaar, J. K. Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur. Child Adolesc. Psychiatry 19, 281–295 (2010).
Cole, J., Ball, H. A., Martin, N. C., Scourfield, J. & McGuffin, P. Genetic overlap between measures of hyperactivity/inattention and mood in children and adolescents. J. Am. Acad. Child Adolesc. Psychiatry 48, 1094–1101 (2009).
Doyle, A. E. & Faraone, S. V. Familial links between ADHD, conduct disorder and bipolar disorder. Curr. Psychiatry Rep. 4, 146–152 (2002).
Cross-Disorder Group of the Psychiatric Genomics Consortium. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet 381, 1371–1379 (2013).
Martin, J., Hamshere, M. L., Stergiakouli, E., O'Donovan, M. C. & Thapar, A. Genetic risk for attention-deficit/hyperactivity disorder contributes to neurodevelopmental traits in the general population. Biol. Psychiatry 76, 664–671 (2014).
Hamshere, M. L. et al. High loading of polygenic risk for ADHD in children with comorbid aggression. Am. J. Psychiatry 170, 909–916 (2013).
Hamshere, M. L. et al. Shared polygenic contribution between childhood attention-deficit hyperactivity disorder and adult schizophrenia. Br. J. Psychiatry 203, 107–111 (2013).
Elia, J. et al. Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes. Mol. Psychiatry 15, 637–646 (2010).
Williams, N. M. et al. Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder: a genome-wide analysis. Lancet 376, 1401–1408 (2010).
Williams, N. M. et al. Genome-wide analysis of copy number variants in attention deficit/hyperactivity disorder confirms the role of rare variants and implicates duplications at 15q13.3. Am. J. Psychiatry 169, 195–204 (2012).
Elia, J. et al. Genome-wide copy number variation study associates metabotropic glutamate receptor gene networks with attention deficit hyperactivity disorder. Nat. Genet. 44, 78–84 (2011).
Lesch, K. P. et al. Genome-wide copy number variation analysis in attention-deficit/hyperactivity disorder: association with neuropeptide Y gene dosage in an extended pedigree. Mol. Psychiatry 16, 491–503 (2011).
Neale, B. M. et al. Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 49, 884–897 (2010).
Gizer, I. R., Ficks, C. & Waldman, I. D. Candidate gene studies of ADHD: a meta-analytic review. Hum. Genet. 126, 51–90 (2009).
Franke, B. et al. Multicenter analysis of the SLC6A3/DAT1 VNTR haplotype in persistent ADHD suggests differential involvement of the gene in childhood and persistent ADHD. Neuropsychopharmacology 35, 656–664 (2010).
Bralten, J. et al. Candidate genetic pathways for attention-deficit/hyperactivity disorder (ADHD) show association to hyperactive/impulsive symptoms in children with ADHD. J. Am. Acad. Child Adolesc. Psychiatry 52, 1204–1212.e1 (2013).
Poelmans, G., Pauls, D. L., Buitelaar, J. K. & Franke, B. Integrated genome-wide association study findings: identification of a neurodevelopmental network for attention deficit hyperactivity disorder. Am. J. Psychiatry 168, 365–377 (2011).
Skoglund, C., Chen, Q., D'Onofrio, B. M., Lichtenstein, P. & Larsson, H. Familial confounding of the association between maternal smoking during pregnancy and ADHD in offspring. J. Child Psychol. Psychiatry 55, 61–68 (2014).
Milberger, S., Biederman, J., Faraone, S. V., Chen, L. & Jones, J. Is maternal smoking during pregnancy a risk factor for attention deficit hyperactivity disorder in children? Am. J. Psychiatry 153, 1138–1142 (1996).
Harold, G. T. et al. Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. J. Child Psychol. Psychiatry 54, 1038–1046 (2013).
Stevens, S. E. et al. Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence. J. Abnorm. Child Psychol. 36, 385–398 (2008).
Banerjee, T. D., Middleton, F. & Faraone, S. V. Environmental risk factors for attention-deficit hyperactivity disorder. Acta Pediatr. 96, 1269–1274 (2007).
Scassellati, C., Bonvicini, C., Faraone, S. V. & Gennarelli, M. Biomarkers and attention-deficit/hyperactivity disorder: a systematic review and meta-analyses. J. Am. Acad. Child Adolesc. Psychiatry 51, 1003–1019.e20 (2012).
Dasbanerjee, T. et al. A comparison of molecular alterations in environmental and genetic rat models of ADHD: a pilot study. Am. J. Med. Genet. B Neuropsychiatr. Genet. 147B, 1554–1563 (2008).
Zhu, J. et al. Prenatal nicotine exposure mouse model showing hyperactivity, reduced cingulate cortex volume, reduced dopamine turnover, and responsiveness to oral methylphenidate treatment. J. Neurosci. 32, 9410–9418 (2012).
Sagvolden, T., Russell, V. A., Aase, H., Johansen, E. B. & Farshbaf, M. Rodent models of attention-deficit/hyperactivity disorder. Biol. Psychiatry 57, 1239–1247 (2005).
van der Meer, D. et al. The serotonin transporter gene polymorphism 5-HTTLPR moderates the effects of stress on attention-deficit/hyperactivity disorder. J. Child Psychol. Psychiatry 55, 1363–1371 (2014).
Mill, J. & Petronis, A. Pre- and peri-natal environmental risks for attention-deficit hyperactivity disorder (ADHD): the potential role of epigenetic processes in mediating susceptibility. J. Child Psychol. Psychiatry 49, 1020–1030 (2008).
Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V. & Pennington, B. F. Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol. Psychiatry 57, 1336–1346 (2005).
Sergeant, J. A. Modeling attention-deficit/hyperactivity disorder: a critical appraisal of the cognitive-energetic model. Biol. Psychiatry 57, 1248–1255 (2005).
Sonuga-Barke, E. J. & Fairchild, G. Neuroeconomics of attention-deficit/hyperactivity disorder: differential influences of medial, dorsal, and ventral prefrontal brain networks on suboptimal decision making? Biol. Psychiatry 72, 126–133 (2012).
Luman, M., Tripp, G. & Scheres, A. Identifying the neurobiology of altered reinforcement sensitivity in ADHD: a review and research agenda. Neurosci. Biobehav. Rev. 34, 744–754 (2010).
Scheres, A., Lee, A. & Sumiya, M. Temporal reward discounting and ADHD: task and symptom specific effects. J. Neural Transm. 115, 221–226 (2008).
Toplak, M. E. & Tannock, R. Time perception: modality and duration effects in attention-deficit/hyperactivity disorder (ADHD). J. Abnorm. Child Psychol. 33, 639–654 (2005).
Tomblin, J. B. & Mueller, K. L. How can the comorbidity with ADHD aid understanding of language and speech disorders? Top. Lang. Disord. 32, 198–206 (2012).
Kuntsi, J. & Klein, C. Intraindividual variability in ADHD and its implications for research of causal links. Curr. Top. Behav. Neurosci. 9, 67–91 (2012).
Fair, D. A., Bathula, D., Nikolas, M. A. & Nigg, J. T. Distinct neuropsychological subgroups in typically developing youth inform heterogeneity in children with ADHD. Proc. Natl Acad. Sci. USA 109, 6769–6774 (2012).
Fliers, E. A. et al. Undertreatment of motor problems in children with ADHD. Child Adolesc. Ment. Health 15, 85–90 (2009).
Coghill, D. R., Seth, S. & Matthews, K. A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models. Psychol. Med. 44, 1989–2001 (2014).
Sonuga-Barke, E., Bitsakou, P. & Thompson, M. Beyond the dual pathway model: evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 49, 345–355 (2010).
Cortese, S. et al. Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am. J. Psychiatry 169, 1038–1055 (2012).
Plichta, M. M. & Scheres, A. Ventral–striatal responsiveness during reward anticipation in ADHD and its relation to trait impulsivity in the healthy population: a meta-analytic review of the fMRI literature. Neurosci. Biobehav. Rev. 38, 125–134 (2014).
Fassbender, C. & Schweitzer, J. B. Is there evidence for neural compensation in attention deficit hyperactivity disorder? A review of the functional neuroimaging literature. Clin. Psychol. Rev. 26, 445–465 (2006).
Rubia, K. et al. Effects of stimulants on brain function in attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Biol. Psychiatry 76, 616–628 (2014).
Hart, H., Radua, J., Nakao, T., Mataix-Cols, D. & Rubia, K. Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects. JAMA Psychiatry 70, 185–198 (2013).
Posner, J., Park, C. & Wang, Z. Connecting the dots: a review of resting connectivity MRI studies in attention-deficit/hyperactivity disorder. Neuropsychol. Rev. 24, 3–15 (2014).
Castellanos, F. X. et al. Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA 288, 1740–1748 (2002).
Durston, S. et al. Magnetic resonance imaging of boys with attention-deficit/hyperactivity disorder and their unaffected siblings. J. Am. Acad. Child Adolesc. Psychiatry 43, 332–340 (2004).
Greven, C. U. et al. Developmentally stable whole brain volume reductions and developmentally sensitive caudate and putamen volume alterations in participants with attention-deficit/hyperactivity disorder and their unaffected siblings. JAMA Psychiatry 72, 490–499 (2015).
Hoogman, M. et al. Current self-reported symptoms of attention deficit/hyperactivity disorder are associated with total brain volume in healthy adults. PLoS ONE 7, e31273 (2012).
Stoodley, C. J. & Schmahmann, J. D. Functional topography in the human cerebellum: a meta-analysis of neuroimaging studies. Neuroimage 44, 489–501 (2009).
Frodl, T. & Skokauskas, N. Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatr. Scand. 125, 114–126 (2012).
van Ewijk, H., Heslenfeld, D. J., Zwiers, M. P., Buitelaar, J. K. & Oosterlaan, J. Diffusion tensor imaging in attention deficit/hyperactivity disorder: a systematic review and meta-analysis. Neurosci. Biobehav. Rev. 36, 1093–1106 (2012).
Shaw, P. et al. Mapping the development of the basal ganglia in children with attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 53, 780–789.e11 (2014).
Shaw, P. et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc. Natl Acad. Sci. USA 104, 19649–19654 (2007).
Shaw, P. et al. Development of cortical surface area and gyrification in attention-deficit/hyperactivity disorder. Biol. Psychiatry 72, 191–197 (2012).
Dreisbach, G. et al. Dopamine and cognitive control: the influence of spontaneous eyeblink rate and dopamine gene polymorphisms on perseveration and distractibility. Behav. Neurosci. 119, 483–490 (2005).
Makris, N. et al. Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder. Cereb. Cortex 17, 1364–1375 (2007).
Clerkin, S. M. et al. Thalamo–cortical activation and connectivity during response preparation in adults with persistent and remitted ADHD. Am. J. Psychiatry 170, 1011–1019 (2013).
Mattfeld, A. T. et al. Brain differences between persistent and remitted attention deficit hyperactivity disorder. Brain 137, 2423–2428 (2014).
Francx, W. et al. White matter microstructure and developmental improvement of hyperactive/impulsive symptoms in attention-deficit/hyperactivity disorder. J. Child Psychol. Psychiatry http://dx.doi.org/10.1111/jcpp.12379 (2015).
Shaw, P. et al. Trajectories of cerebral cortical development in childhood and adolescence and adult attention-deficit/hyperactivity disorder. Biol. Psychiatry 74, 599–606 (2013). This paper provides an excellent example of the type of longitudinal neuroimaging we can expect in the future. Participants were evaluated for persistence or remission of ADHD symptoms in adulthood. Cortical thinning, especially in the prefrontal cortex, was associated with persistence of ADHD symptoms into adulthood. As such, this paper shows the power of longitudinal research in ADHD to identify the correlates of persistence, which may provide predictive biomarkers for disease outcome.
Almeida, L. G. et al. Reduced right frontal cortical thickness in children, adolescents and adults with ADHD and its correlation to clinical variables: a cross-sectional study. J. Psychiatr. Res. 44, 1214–1223 (2010).
Almeida Montes, L. G. et al. Brain cortical thickness in ADHD: age, sex, and clinical correlations. J. Atten. Disord. 17, 641–654 (2013).
Faraone, S. V. & Biederman, J. Neurobiology of attention-deficit hyperactivity disorder. Biol. Psychiatry 44, 951–958 (1998).
Makris, N., Biederman, J., Monuteaux, M. C. & Seidman, L. J. Towards conceptualizing a neural systems-based anatomy of attention-deficit/hyperactivity disorder. Dev. Neurosci. 31, 36–49 (2009).
Sonuga-Barke, E. J. Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol. Psychiatry 57, 1231–1238 (2005).
Castellanos, F. X. & Tannock, R. Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nat. Rev. Neurosci. 3, 617–628 (2002).
Kuntsi, J. et al. Separation of cognitive impairments in attention-deficit/hyperactivity disorder into 2 familial factors. Arch. Gen. Psychiatry 67, 1159–1167 (2010).
Biederman, J. et al. Deficient emotional self-regulation and pediatric attention deficit hyperactivity disorder: a family risk analysis. Psychol. Med. 42, 639–646 (2012).
Epstein, J. N. & Weiss, M. D. Assessing treatment outcomes in attention-deficit/hyperactivity disorder: a narrative review. Prim. Care Companion CNS Disord. 14, PCC.11r01336 (2012).
Seixas, M., Weiss, M. & Muller, U. Systematic review of national and international guidelines on attention-deficit hyperactivity disorder. J. Psychopharmacol. 26, 753–765 (2012).
Miller, T. W., Nigg, J. T. & Miller, R. L. Attention deficit hyperactivity disorder in African American children: what can be concluded from the past ten years? Clin. Psychol. Rev. 29, 77–86 (2009).
Klimkeit, E. et al. Children should be seen and heard: self-report of feelings and behaviors in primary-school-age children with ADHD. J. Atten. Disord. 10, 181–191 (2006).
Biederman, J., Keenan, K. & Faraone, S. V. Parent based diagnosis of attention deficit disorder predicts a diagnosis based on teacher report. J. Am. Acad. Child Adolesc. Psychiatry 29, 698–701 (1990).
Biederman, J., Faraone, S. V., Monuteaux, M. & Grossbard, J. How informative are parent reports of ADHD symptoms for assessing outcome in clinical trials of long-acting treatments? A pooled analysis of parents' and teachers' reports. Pediatrics 113, 1667–1671 (2004).
Sayal, K. & Goodman, R. Do parental reports of child hyperkinetic disorder symptoms at school predict teacher ratings? Eur. Child Adolesc. Psychiatry 18, 336–344 (2009). This large-scale epidemiological study of 5–16 years olds in the United Kingdom provides empirical evidence that parental reports about ADHD symptoms at school have limited use in predicting teacher ratings, thereby highlighting the importance of obtaining information directly from teachers for the diagnosis of ADHD in childhood.
McKeown, R. E. et al. The impact of case definition on attention-deficit/hyperactivity disorder prevalence estimates in community-based samples of school-aged children. J. Am. Acad. Child Adolesc. Psychiatry 54, 53–61 (2015). This large-scale US-based study demonstrates how case definition and inclusion of changes in DSM-5 criteria for ADHD (for example, age of onset, symptoms causing impairment in at least two settings and reduction in the number of symptoms required for individuals ≥17 years of age) alter the prevalence estimates of ADHD in a community-based sample of school-aged children.
Valo, S. & Tannock, R. Diagnostic instability of DSM-IV ADHD subtypes: effects of informant source, instrumentation, and methods for combining symptom reports. J. Clin. Child Adolesc. Psychol. 39, 749–760 (2010).
Feldman, H. M. & Reiff, M. I. Clinical practice. Attention deficit-hyperactivity disorder in children and adolescents. N. Engl. J. Med. 370, 838–846 (2014).
Becker, A., Rothenberger, A. & Sohn, A. Six years ahead: a longitudinal analysis regarding course and predictive value of the Strengths and Difficulties Questionnaire (SDQ) in children and adolescents. Eur. Child Adolesc. Psychiatry 24, 715–725 (2015).
Halperin, J. M., Berwid, O. G. & O'Neill, S. Healthy body, healthy mind? The effectiveness of physical activity to treat ADHD in children. Child Adolesc. Psychiatr. Clin. N. Am. 23, 899–936 (2014).
Plueck, J. et al. Effectiveness of a teacher-based indicated prevention program for preschool children with externalizing problem behavior. Prev. Sci. 16, 233–241 (2015).
Biederman, J. et al. Gender effects of attention deficit hyperactivity disorder in adults, revisited. Biol. Psychiatry 55, 692–700 (2004).
Faraone, S. V. et al. Attention deficit hyperactivity disorder in adults: an overview. Biol. Psychiatry 48, 9–20 (2000).
Kooij, S. J. et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 10, 67 (2010). This article was the first European consensus about ADHD in adults. It provides an excellent review of the neurobiology, diagnosis and treatment of adults with ADHD.
The Express Scripts Lab. Turning attention to ADHD. An Express Scripts Report. U. S. Medication Trends for Attention Deficit Hyperactivity Disorder. The Lab Express Scripts[online], (2014).
Barkley, R. A., Murphy, K. R. & Fischer, M. ADHD in Adults: What the Science Says (Guildford, 2007).
Epstein, J. N. & Kollins, S. H. Psychometric properties of an adult ADHD diagnostic interview. J. Atten. Disord. 9, 504–514 (2006).
Adler, L. A. et al. Validity of pilot adult ADHD Self-Report Scale (ASRS) to rate adult ADHD symptoms. Ann. Clin. Psychiatry 18, 145–148 (2006).
Antshel, K. M. et al. Is adult attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? Psychol. Med. 39, 1325–1335 (2009).
Barkley, R. A. Deficient emotional self-regulation: a core component of attention-deficit/hyperactivity disorder. J. ADHD Related Disord. 1, 5–37 (2010).
Biederman, J. et al. Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD. Acta Psychiatr. Scand. 116, 129–136 (2007).
Sonuga-Barke, E. J. & Taylor, E. in Rutter's Child & Adolescent Psychiatry (eds Thapar, A. et al.) 738–756 (Wiley Blackwell, 2015).
Nigg, J. T., Tannock, R. & Rohde, L. A. What is to be the fate of ADHD subtypes? An introduction to the special section on research on the ADHD subtypes and implications for the DSM-V. J. Clin. Child Adolesc. Psychol. 39, 723–725 (2010).
Staller, J. & Faraone, S. V. Attention-deficit hyperactivity disorder in girls: epidemiology and management. CNS Drugs 20, 107–123 (2006).
Pingault, J. B. et al. Childhood trajectories of inattention and hyperactivity and prediction of educational attainment in early adulthood: a 16-year longitudinal population-based study. Am. J. Psychiatry 168, 1164–1170 (2011).
Biederman, J., Newcorn, J. & Sprich, S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am. J. Psychiatry 148, 564–577 (1991).
Cortese, S., Faraone, S. V., Konofal, E. & Lecendreux, M. Sleep in children with attention-deficit/hyperactivity disorder: meta-analysis of subjective and objective studies. J. Am. Acad. Child Adolesc. Psychiatry 48, 894–908 (2009).
Antshel, K. M., Zhang-James, Y. & Faraone, S. V. The comorbidity of ADHD and autism spectrum disorder. Expert Rev. Neurother. 13, 1117–1128 (2013).
Wilens, T. E. et al. Does ADHD predict substance-use disorders? A 10-year follow-up study of young adults with ADHD. J. Am. Acad. Child Adolesc. Psychiatry 50, 543–553 (2011).
Bernardi, S. et al. The lifetime impact of attention deficit hyperactivity disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Psychol. Med. 42, 875–887 (2012).
Nigg, J. T., Willcutt, E. G., Doyle, A. E. & Sonuga-Barke, E. J. Causal heterogeneity in ADHD: do we need neuropsychological subtypes? Biol. Psychiatry 57, 1224–1230 (2005).
Sjowall, D., Roth, L., Lindqvist, S. & Thorell, L. B. Multiple deficits in ADHD: executive dysfunction, delay aversion, reaction time variability, and emotional deficits. J. Child Psychol. Psychiatry 54, 619–627 (2013).
Cortese, S. et al. Cognitive training for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. J. Am. Acad. Child Adolesc. Psychiatry 54, 164–174 (2015).
Nussey, C., Pistrang, N. & Murphy, T. How does psychoeducation help? A review of the effects of providing information about Tourette syndrome and attention-deficit/hyperactivity disorder. Child Care Health Dev. 39, 617–627 (2013).
Fiks, A. G., Mayne, S., Debartolo, E., Power, T. J. & Guevara, J. P. Parental preferences and goals regarding ADHD treatment. Pediatrics 132, 692–702 (2013).
Atkinson, M. & Hollis, C. NICE guideline: attention deficit hyperactivity disorder. Arch. Dis. Child Educ. Pract. Ed. 95, 24–27 (2010).
Faraone, S. V. & Glatt, S. J. A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes. J. Clin. Psychiatry 71, 754–763 (2010). This study is among the most comprehensive meta-analytic efforts in reviewing the efficacy of stimulants and non-stimulants in adults with ADHD.
Faraone, S. V. & Buitelaar, J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur. Child Adolesc. Psychiatry 19, 353–364 (2010).
Wolraich, M. et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 128, 1007–1022 (2011).
Faraone, S. V., Biederman, J., Spencer, T. J. & Aleardi, M. Comparing the efficacy of medications for ADHD using meta-analysis. MedGenMed. 8, 4 (2006).
Fredriksen, M., Halmoy, A., Faraone, S. V. & Haavik, J. Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: a review of controlled and naturalistic studies. Eur. Neuropsychopharmacol. 23, 508–527 (2013).
Shaw, M. et al. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Med. 10, 99 (2012).
Langberg, J. M. & Becker, S. P. Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder? Clin. Child Fam. Psychol. Rev. 15, 215–233 (2012).
van de Loo-Neus, G. H., Rommelse, N. & Buitelaar, J. K. To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended? Eur. Neuropsychopharmacol. 21, 584–599 (2011).
MTA Cooperative Group. National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder. Pediatrics 113, 754–761 (2004).
Rostain, A., Jensen, P. S., Connor, D. F., Miesle, L. M. & Faraone, S. V. Toward quality care in ADHD: defining the goals of treatment. J. Atten Disord. 19, 99–117 (2015).
Ermer, J. et al. Lisdexamfetamine dimesylate: linear dose-proportionality, low intersubject and intrasubject variability, and safety in an open-label single-dose pharmacokinetic study in healthy adult volunteers. J. Clin. Pharmacol. 50, 1001–1010 (2010).
Bendz, L. M. & Scates, A. C. Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder. Ann. Pharmacother. 44, 185–191 (2009).
Cortese, S. et al. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J. Child Psychol. Psychiatry 54, 227–246 (2013).
Maldonado, R. Comparison of the pharmacokinetics and clinical efficacy of new extended-release formulations of methylphenidate. Expert Opin. Drug Metab. Toxicol. 9, 1001–1014 (2013).
Kimko, H. et al. Population pharmacodynamic modeling of various extended-release formulations of methylphenidate in children with attention deficit hyperactivity disorder via meta-analysis. J. Pharmacokinet. Pharmacodyn. 39, 161–176 (2012).
Wilens, T. E. ADHD: Prevalence, diagnosis, and issues of comorbidity. CNS Spectr. 12 (Suppl. 6), 1–5 (2007).
Faraone, S. V., Biederman, J., Morley, C. P. & Spencer, T. J. Effect of stimulants on height and weight: a review of the literature. J. Am. Acad. Child Adolesc. Psychiatry 47, 994–1009 (2008).
Dalsgaard, S., Kvist, A. P., Leckman, J. F., Nielsen, H. S. & Simonsen, M. Cardiovascular safety of stimulants in children with attention-deficit/hyperactivity disorder: a nationwide prospective cohort study. J. Child Adolesc. Psychopharmacol. 24, 302–310 (2014).
Cooper, W. O. et al. ADHD drugs and serious cardiovascular events in children and young adults. N. Engl. J. Med. 365, 1896–1904 (2011). This article is among the more-informative studies documenting the cardiac safety of stimulants.
Mazza, M. et al. Drugs for attention deficit-hyperactivity disorder do not increase the mid-term risk of sudden death in children: a meta-analysis of observational studies. Int. J. Cardiol. 168, 4320–4321 (2013).
American Academy of Pediatrics/American Heart Association. American Academy of Pediatrics/American Heart Association clarification of statement on cardiovascular evaluation and monitoring of children and adolescents with heart disease receiving medications for ADHD: May 16, 2008. J. Dev. Behav. Pediatr. 29, 335 (2008).
Warren, A. E. et al. Cardiac risk assessment before the use of stimulant medications in children and youth: a joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry. Can. J. Cardiol. 25, 625–630 (2009).
Tanaka, Y., Rohde, L. A., Jin, L., Feldman, P. D. & Upadhyaya, H. P. A meta-analysis of the consistency of atomoxetine treatment effects in pediatric patients with attention-deficit/hyperactivity disorder from 15 clinical trials across four geographic regions. J. Child Adolesc. Psychopharmacol. 23, 262–270 (2013).
Jain, R., Segal, S., Kollins, S. H. & Khayrallah, M. Clonidine extended-release tablets for pediatric patients with attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 50, 171–179 (2011).
Biederman, J. et al. Long-term, open-label extension study of guanfacine extended release in children and adolescents with ADHD. CNS Spectr. 13, 1047–1055 (2008).
Faraone, S. V., McBurnett, K., Sallee, F. R., Steeber, J. & Lopez, F. A. Guanfacine extended release: a novel treatment for attention-deficit/hyperactivity disorder in children and adolescents. Clin. Ther. 35, 1778–1793 (2013).
Treuer, T. et al. A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability. J. Child Adolesc. Psychopharmacol. 23, 179–193 (2013).
Maneeton, N., Maneeton, B., Intaprasert, S. & Woottiluk, P. A systematic review of randomized controlled trials of bupropion versus methylphenidate in the treatment of attention-deficit/hyperactivity disorder. Neuropsychiatr. Dis. Treat. 10, 1439–1449 (2014).
Wilens, T. E., Spencer, T., Biederman, J., Wozniak, J. & Connor, D. Combined pharmacotherapy: an emerging trend in pediatric psychopharmacology. J. Am. Acad. Child Adolesc. Psychiatry 34, 110–112 (1995).
Schoenfelder, E. N., Faraone, S. V. & Kollins, S. H. Stimulant treatment of ADHD and cigarette smoking: a meta-analysis. Pediatrics 133, 1070–1080 (2014).
Biederman, J. et al. Stimulant therapy and risk for subsequent substance use disorders in male adults with ADHD: a naturalistic controlled 10-year follow-up study. Am. J. Psychiatry 165, 597–603 (2008). This study is among the largest longitudinal studies documenting the absence of increased risk of substance use disorders associated with stimulants in ADHD.
Faraone, S. V. & Wilens, T. Does stimulant treatment lead to substance use disorders? J. Clin. Psychiatry 64, 9–13 (2003).
Groenman, A. P. et al. Stimulant treatment for ADHD reduces risk for developing substance use disorder. Br. J. Psychiatry 203, 112–119 (2013).
Chang, Z. et al. Stimulant ADHD medication and risk for substance abuse. J. Child Psychol. Psychiatry 55, 878–885 (2014).
Wilens, T. et al. Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. J. Am. Acad. Child Adolesc. Psychiatry 47, 21–31 (2008).
Bangs, M. E. et al. Efficacy and safety of atomoxetine in adolescents with attention-deficit/hyperactivity disorder and major depression. J. Child Adolesc. Psychopharmacol. 17, 407–420 (2007).
Kratochvil, C. J. et al. Atomoxetine alone or combined with fluoxetine for treating ADHD with comorbid depressive or anxiety symptoms. J. Am. Acad. Child Adolesc. Psychiatry 44, 915–924 (2005). This study is among the first to document the use of atomoxetine in the management of children with ADHD and co-morbid anxiety.
Rizzo, R., Gulisano, M., Cali, P. V. & Curatolo, P. Tourette syndrome and comorbid ADHD: current pharmacological treatment options. Eur. J. Paediatr. Neurol. 17, 421–428 (2013).
Maneeton, N., Maneeton, B., Srisurapanont, M. & Martin, S. D. Bupropion for adults with attention-deficit hyperactivity disorder: meta-analysis of randomized, placebo-controlled trials. Psychiatry Clin. Neurosci. 65, 611–617 (2011).
Connor, D. F., Glatt, S. J., Lopez, I. D., Jackson, D. & Melloni, R. H. Jr. Psychopharmacology and aggression. I: a meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD. J. Am. Acad. Child Adolesc. Psychiatry 41, 253–261 (2002).
Connor, D. F. et al. Effects of guanfacine extended release on oppositional symptoms in children aged 6–12 years with attention-deficit hyperactivity disorder and oppositional symptoms: a randomized, double-blind, placebo-controlled trial. CNS Drugs 24, 755–768 (2010).
Newcorn, J. H., Spencer, T. J., Biederman, J., Milton, D. R. & Michelson, D. Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. J. Am. Acad. Child Adolesc. Psychiatry 44, 240–248 (2005).
Simonoff, E. et al. Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability. J. Child Psychol. Psychiatry 54, 527–535 (2013).
Levin, H. et al. Symptoms of attention-deficit/hyperactivity disorder following traumatic brain injury in children. J. Dev. Behav. Pediatr. 28, 108–118 (2007).
Shaywitz, B. A., Williams, D. W., Fox, B. K. & Wietecha, L. A. Reading outcomes of children and adolescents with attention-deficit/hyperactivity disorder and dyslexia following atomoxetine treatment. J. Child Adolesc. Psychopharmacol. 24, 419–425 (2014).
Biederman, J. et al. Effects of stimulant medication on neuropsychological functioning in young adults with attention-deficit/hyperactivity disorder. J. Clin. Psychiatry 69, 1150–1156 (2008).
Faraone, S. V. et al. Atomoxetine and Stroop task performance in adult attention-deficit/hyperactivity disorder. J. Child Adolesc. Psychopharmacol. 15, 664–670 (2005).
Langberg, J. M. et al. Patterns and predictors of adolescent academic achievement and performance in a sample of children with attention-deficit/hyperactivity disorder. J. Clin. Child Adolesc. Psychol. 40, 519–531 (2011).
Ghuman, J. K. & Ghuman, H. S. Pharmacologic intervention for attention-deficit hyperactivity disorder in preschoolers: is it justified? Paediatr. Drugs 15, 1–8 (2013).
Sonuga-Barke, E. J. et al. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am. J. Psychiatry 170, 275–289 (2013). This comprehensive article uses meta-analysis to document the relative efficacy of non-pharmacological interventions for ADHD. It shows that efficacy measures from poorly blinded studies markedly overestimate the efficacy of treatments.
Faraone, S. V. & Antshel, K. M. Towards an evidence-based taxonomy of nonpharmacologic treatments for ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 965–972 (2014).
Stevenson, J. et al. Research review: the role of diet in the treatment of attention-deficit/hyperactivity disorder — an appraisal of the evidence on efficacy and recommendations on the design of future studies. J. Child Psychol. Psychiatry 55, 416–427 (2014).
Nigg, J. T. & Holton, K. Restriction and elimination diets in ADHD treatment. Child Adolesc. Psychiatr. Clin. N. Am. 23, 937–953 (2014).
Pfiffner, L. J. & Haack, L. M. Behavior management for school-aged children with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 731–746 (2014).
Wells, K. C. et al. Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study. J. Abnorm. Child Psychol. 28, 543–553 (2000).
Evans, S. W., Langberg, J. M., Egan, T. & Molitor, S. J. Middle school-based and high school-based interventions for adolescents with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 699–715 (2014).
Faraone, S. V. & Antshel, K. M. ADHD: non-pharmacologic interventions. Child Adolesc. Psychiatr. Clin. N. Am. 23, xiii–xiv (2014). This issue reviews the clinical methodology and data that support efficacy for the following non-pharmacological interventions for ADHD: cognitive–behavioural therapy, family therapy, psychotherapy, social skills training, behavioural management, working memory training, neurofeedback, lifestyle interventions, traditional Chinese medicine, restriction and food colour exclusion diets and herbal and nutritional products.
Daley, D. et al. Behavioral interventions in attention-deficit/hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains. J. Am. Acad. Child Adolesc. Psychiatry 53, 835–847.e5 (2014).
Mikami, A. Y., Jia, M. & Na, J. J. Social skills training. Child Adolesc. Psychiatr. Clin. N. Am. 23, 775–788 (2014).
Abikoff, H. et al. Remediating organizational functioning in children with ADHD: immediate and long-term effects from a randomized controlled trial. J. Consult. Clin. Psychol. 81, 113–128 (2013).
DuPaul, G. J., Gormley, M. J. & Laracy, S. D. School-based interventions for elementary school students with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 687–697 (2014).
Antshel, K. M. & Olszewski, A. K. Cognitive behavioral therapy for adolescents with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 825–842 (2014).
Safren, S. A. Cognitive–behavioral approaches to ADHD treatment in adulthood. J. Clin. Psychiatry 67 (Suppl. 8), 46–50 (2006).
Knouse, L. E. & Safren, S. A. Current status of cognitive behavioral therapy for adult attention-deficit hyperactivity disorder. Psychiatr. Clin. North Am. 33, 497–509 (2010).
Seidman, L. J. Neuropsychologically informed strategic psychotherapy in teenagers and adults with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 843–852 (2014).
Robin, A. L. Family therapy for adolescents with ADHD. Child Adolesc. Psychiatr. Clin. N. Am. 23, 747–756 (2014).
Arns, M., de Ridder, S., Strehl, U., Breteler, M. & Coenen, A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin. EEG Neurosci. 40, 180–189 (2009).
Holtmann, M., Sonuga-Barke, E., Cortese, S. & Brandeis, D. Neurofeedback for ADHD: a review of current evidence. Child Adolesc. Psychiatr. Clin. N. Am. 23, 789–806 (2014).
Sonuga-Barke, E., Brandeis, D., Holtmann, M. & Cortese, S. Computer-based cognitive training for ADHD: a review of current evidence. Child Adolesc. Psychiatr. Clin. N. Am. 23, 807–824 (2014).
Klingberg, T. et al. Computerized training of working memory in children with ADHD — a randomized, controlled trial. J. Am. Acad. Child Adolesc. Psychiatry 44, 177–186 (2005).
Bogels, S. M., de Bruin, E. L. & van der Oord, S. in Cognitive Behaviour Therapy for Children and Families 3rd edn (eds Graham, P. & Reynolds, S. ) 371–384 (Cambridge Univ. Press, 2013).
Groenman, A. P. et al. Substance use disorders in adolescents with attention deficit hyperactivity disorder: a 4-year follow-up study. Addiction 108, 1503–1511 (2013).
Lichtenstein, P. et al. Medication for attention deficit-hyperactivity disorder and criminality. N. Engl. J. Med. 367, 2006–2014 (2012). This very large population study found an association of ADHD with criminal behaviour and that medications for ADHD reduce such behaviour.
Cortese, S., Faraone, S. V., Bernardi, S., Wang, S. & Blanco, C. Adult attention-deficit hyperactivity disorder and obesity: epidemiological study. Br. J. Psychiatry 203, 24–34 (2013).
Biederman, J. & Faraone, S. V. The effects of attention-deficit/hyperactivity disorder on employment and household income. MedGenMed 8, 12 (2006).
Chang, Z., Lichtenstein, P., D'Onofrio, B. M., Sjolander, A. & Larsson, H. Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study. JAMA Psychiatry 71, 319–325 (2014).
James, A., Lai, F. H. & Dahl, C. Attention deficit hyperactivity disorder and suicide: a review of possible associations. Acta Psychiatr. Scand. 110, 408–415 (2004).
Biederman, J. et al. Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am. J. Psychiatry 150, 1792–1798 (1993).
Barkley, R. A., Fischer, M., Smallish, L. & Fletcher, K. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J. Am. Acad. Child Adolesc. Psychiatry 45, 192–202 (2006).
Biederman, J. et al. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychol. Med. 36, 167–179 (2006).
Ramos Olazagasti, M. A. et al. Does childhood attention-deficit/hyperactivity disorder predict risk-taking and medical illnesses in adulthood? J. Am. Acad. Child Adolesc. Psychiatry 52, 153–162.e4 (2013).
Klein, R. G. et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch. Gen. Psychiatry 69, 1295–1303 (2012).
Dalsgaard, S., Ostergaard, S. D., Leckman, J. F., Mortensen, P. B. & Pedersen, M. G. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet 385, 2190–2196 (2015).
Danckaerts, M. et al. The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur. Child Adolesc. Psychiatry 19, 83–105 (2010). This review of 36 studies found that ADHD is associated with lower HRQOL across a broad range of psychosocial, achievement and self-evaluation domains. The effect of ADHD on HRQOL was similar to that of other mental health conditions and severe physical disorders. Higher numbers of ADHD symptoms and impairments predicted poorer HRQOL.
Riley, A. W. et al. Factors related to health-related quality of life (HRQoL) among children with ADHD in Europe at entry into treatment. Eur. Child Adolesc. Psychiatry 15 (Suppl. 1), I38–I45 (2006).
Agarwal, R., Goldenberg, M., Perry, R. & William Ishak, W. The quality of life of adults with attention deficit hyperactivity disorder: a systematic review. Innov. Clin. Neurosci. 9, 10–21 (2012).
Brod, M., Pohlman, B., Lasser, R. & Hodgkins, P. Comparison of the burden of illness for adults with ADHD across seven countries: a qualitative study. Health Qual. Life Outcomes 10, 47 (2012).
Caci, H. et al. Daily life impairments associated with childhood/adolescent attention-deficit/hyperactivity disorder as recalled by adults: results from the European Lifetime Impairment Survey. CNS Spectr. 20, 112–121 (2015).
Coghill, D. The impact of medications on quality of life in attention-deficit hyperactivity disorder: a systematic review. CNS Drugs 24, 843–866 (2010).
Barbaresi, W. J., Katusic, S. K., Colligan, R. C., Weaver, A. L. & Jacobsen, S. J. Modifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: does treatment with stimulant medication make a difference? Results from a population-based study. J. Dev. Behav. Pediatr. 28, 274–287 (2007).
Ljung, T., Chen, Q., Lichtenstein, P. & Larsson, H. Common etiological factors of attention-deficit/hyperactivity disorder and suicidal behavior: a population-based study in sweden. JAMA Psychiatry 71, 958–964 (2014).
Man, K. K. et al. Methylphenidate and the risk of trauma. Pediatrics 135, 40–48 (2015).
Perwien, A. R. et al. Atomoxetine treatment in children and adolescents with attention-deficit hyperactivity disorder: what are the long-term health-related quality-of-life outcomes? J. Child Adolesc. Psychopharmacol. 16, 713–724 (2006).
Hechtman, L. et al. Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. J. Am. Acad. Child Adolesc. Psychiatry 43, 812–819 (2004).
Banaschewski, T. et al. Health-related quality of life and functional outcomes from a randomized-withdrawal study of long-term lisdexamfetamine dimesylate treatment in children and adolescents with attention-deficit/hyperactivity disorder. CNS Drugs 28, 1191–1203 (2014).
Collins, P. Y. et al. Grand challenges in global mental health. Nature 475, 27–30 (2011).
Gelernter, J. Genetics of complex traits in psychiatry. Biol. Psychiatry 77, 36–42 (2015).
Sagvolden, T., Russell, V. A., Aase, H., Johansen, E. B. & Farshbaf, M. Rodent models of attention-deficit/hyperactivity disorder. Biol. Psychiatry 57, 1239–1247 (2005).
Norton, W. H. Toward developmental models of psychiatric disorders in zebrafish. Front. Neural Circuits 7, 79 (2013).
van der Voet, M., Harich, B., Franke, B. & Schenck, A. ADHD-associated dopamine transporter, latrophilin and neurofibromin share a dopamine-related locomotor signature in Drosophila. Mol. Psychiatry http://dx.doi.org/10.1038/mp.2015.55 (2015). This paper suggests that the fruitfly, Drosophila melanogaster, can clarify biological pathways from gene to disease in ADHD. As this animal model enables fast, cheap and scalable investigations of gene function at several levels from molecule to cell to behaviour, and is also amenable to drug testing, it may provide a powerful model for the evaluation of gene-to-disease pathways and new candidate pharmacological treatments for ADHD. Such high-throughput models will be needed to discover new treatments.
Brennand, K. J. et al. Modelling schizophrenia using human induced pluripotent stem cells. Nature 473, 221–225 (2011).
Thompson, P. M. et al. The ENIGMA Consortium: large-scale collaborative analyses of neuroimaging and genetic data. Brain Imaging Behav. 8, 153–182 (2014).
Kooij, J. J. et al. Internal and external validity of attention-deficit hyperactivity disorder in a population-based sample of adults. Psychol. Med. 35, 817–827 (2005).
Sanislow, C. A. et al. Developing constructs for psychopathology research: research domain criteria. J. Abnorm. Psychol. 119, 631–639 (2010).
Thome, J. et al. Biomarkers for attention-deficit/hyperactivity disorder (ADHD). A consensus report of the WFSBP task force on biological markers and the World Federation of ADHD. World J. Biol. Psychiatry 13, 379–400 (2012).
Peng, X., Lin, P., Zhang, T. & Wang, J. Extreme learning machine-based classification of ADHD using brain structural MRI data. PLoS ONE 8, e79476 (2013).
Edden, R. A., Crocetti, D., Zhu, H., Gilbert, D. L. & Mostofsky, S. H. Reduced GABA concentration in attention-deficit/hyperactivity disorder. Arch. Gen. Psychiatry 69, 750–753 (2012).
Oades, R. D., Slusarek, M., Velling, S. & Bondy, B. Serotonin platelet-transporter measures in childhood attention-deficit/hyperactivity disorder (ADHD): clinical versus experimental measures of impulsivity. World J. Biol. Psychiatry 3, 96–100 (2002).
Faraone, S. V. & Zhang-James, Y. Can sodium/hydrogen exchange inhibitors be repositioned for treating attention deficit hyperactivity disorder? An in silico approach. Am. J. Med. Genet. B Neuropsychiatr. Genet. 162B, 711–717 (2013).
Adler, L. D. & Nierenberg, A. A. Review of medication adherence in children and adults with ADHD. Postgrad. Med. 122, 184–191 (2010).
Lurie, J. D. & Morgan, T. S. Pros and cons of pragmatic clinical trials. J. Comp. Eff. Res. 2, 53–58 (2013).
Biederman, J., Petty, C. R., O'Connor, K. B., Hyder, L. L. & Faraone, S. V. Predictors of persistence in girls with attention deficit hyperactivity disorder: results from an 11-year controlled follow-up study. Acta Psychiatr. Scand. 125, 147–156 (2012).
Holmes, J. et al. The child attention-deficit hyperactivity disorder teacher telephone interview (CHATTI): reliability and validity. Br. J. Psychiatry 184, 74–78 (2004).
Ward, M. F., Wender, P. H. & Reimherr, F. W. The Wender Utah Rating Scale: an aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. Am. J. Psychiatry 150, 885–890 (1993).
The authors thank M. Mehta for help with incorporating the default mode network into Figure 4. S.V.F. is supported by the K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway, the European Commission's Seventh Framework programme (FP7/2007–2013) under grant agreement no. 602805 and National Institute of Mental Health (NIMH) grants R13MH059126 and R01MH094469. J.B. is supported by grants from the Netherlands Organization for Health Research and Development (ZonMw 60-60600-97-193), the Netherlands Organization for Scientific Research (NWO; grants 1750102007010, 433-09-242 and 056-13-015), and by the European Commission's Seventh Framework programme (FP7/2007-2013) under grant agreement no. 278948 (TACTICS), 602450 (IMAGEMEND), 602805 (AGGRESSOTYPE) and 603016 (MATRICS); and Horizon 2020 research programme (grant agreement no. 643051 (MiND) and 642996 (BRAINVIEW)). His research also receives funding from the US NIH Consortium grant no. U54 EB020403, supported by a cross-NIH alliance that funds Big Data to Knowledge Centers of Excellence. B.F. is supported by grants from NWO (grants no. 433-09-229 and 016-130-669), from the European Commission's Seventh Framework programme (grant agreement no. 278948 (TACTICS), 602450 (IMAGEMEND) and 602805 (Aggressotype)); and Horizon 2020 research programme (grant agreement no. 643051 (MiND)). Her research also receives funding from the NIH Consortium grant no. U54 EB020403, supported by a cross-NIH alliance that funds Big Data to Knowledge Centers of Excellence. J.A.R.-Q. is supported by grants from and Departament de Salut, Government of Catalonia, Spain, Instituto de Salud Carlos III-FIS (PI12/01139), Plan Nacional Sobre Drogas (PNSD2011/0080) and the European Commission's Seventh Framework programme. R.T. is supported by grants from the Canadian Institutes for Health Research (CIHR #245899) and the Institute of Education Sciences (R305A120184). L.A.R. is supported by a grant from the National Counsel of Technological and Scientific Development – CNPq (grant no. 304678/2010-4). E.J.S.S.-B. is supported by grants from the Economic Social Research Council (ES/I037970/1), Medical Research Council (MR/K022474/1), National Institute for Health Research (NIHR PGfAR – RP-PG-0108-10061), MQ Transforming Mental Health (MQ14PP_83), European Commission's Seventh Framework programme (2007–2013) under grant agreement no. 260576 and an unrestricted programme grant from Shire Pharmaceuticals.
S.V.F. has received income, travel expenses and/or research support from, and/or has been on an advisory board for, and/or participated in continuing medical education programmes sponsored by: Pfizer, Ironshore, Shire, Akili Interactive Labs, CogCubed, Alcobra, VAYA Pharma, Neurovance, Impax, NeuroLifeSciences, Otsuka, McNeil, Janssen, Novartis, Eli Lilly and the US NIH. With his institution, S.V.F. has US patent US20130217707 A1 for the use of sodium–hydrogen exchange inhibitors in the treatment of ADHD. He receives royalties for books published by Guilford Press: Straight Talk about Your Child's Mental Health; Oxford University Press: Schizophrenia: The Facts; and Elsevier: ADHD: Non-Pharmacologic Treatments. J.K.B. has been a consultant to, a member of an advisory board for, and/or speaker for: Janssen-Cilag BV, Eli Lilly, Shire, Lundbeck, Roche and Servier. He receives research support from the NIH, the European Commission's Seventh Framework programme, the Marie Curie programme and the Netherlands Organization for Scientific Research (NWO). R.T. is an advisory board member for, has served as consultant for, received travel awards from, and/or received software licenses from: the Canadian ADHD Resource Alliance (CADDRA), Shire, Purdue, the Ministry of Education of Newfoundland and Labrador, BioMed Central and Pearson-Cogmed. She receives authorship royalties from Springer and Cambridge University Press. E.J.S.S.-B. has received speaker fees, consultancy, research funding and/or conference support from: Shire, Janssen-Cilag, Neurotech solutions, Medice and the Universities of Leuven, Aarhus and Copenhagen. He has received book royalties from Oxford University Press and Jessica Kingsley, the latter related to the New Forest Parenting Programme. T.B. has served in an advisory or consultancy role for, received conference support from, received speakers' fees from, and/or been involved in clinical trials sponsored by: Hexal Pharma, Eli Lilly, Medice, Novartis, Otsuka, Oxford outcomes, PCM Scientific, Shire and Vifor Pharma. The present work is unrelated to the above grants and relationships. J.B. has received research support or honoraria from: The US Department of Defense, American Academy of Child and Adolescent Psychiatry (AACAP), Alcobra, Forest Research Institute, Ironshore, Lundbeck, Magceutics Inc., Merck, PamLab, Pfizer, Shire, SPRITES, Sunovion, Vaya Pharma/Enzymotec, Massachusetts General Hospital (MGH) Psychiatry Academy, American Professional Society of ADHD and Related Disorders (APSARD), ElMindA, McNeil and the NIH. He has a US patent application pending (Provisional number #61/233,686) through MGH corporate licensing on a method to prevent stimulant abuse. He has received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Ingenix, Prophase, Shire, Bracket Global, Sunovion and Theravance; these royalties were paid to the Department of Psychiatry at MGH. J.A.R.-Q. has been on the speakers' bureau for, acted as consultant for and/or received travel awards from: Eli Lilly, Janssen-Cilag, Novartis, Shire, Lundbeck, Ferrer and Rubió in the past 3 years. The ADHD Program chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the past 3 years: Eli Lilly, Janssen-Cilag, Shire, Rovi and Rubió. B.F. has received speaker fees from Merz. L.A.R. has been on the speakers' bureau for, on the advisory board for, received travel grants from and/or acted as a consultant for: Eli Lilly, Janssen-Cilag, Novartis and Shire in the past 3 years. He receives authorship royalties from Oxford University Press and ArtMed. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the past 3 years: Eli Lilly, Janssen-Cilag, Novartis and Shire. P.A. has been on the speakers' bureau for, on the advisory board for and/or has received unrestricted educational and research awards from: Janssen-Cilag, Novartis, Shire, Qbtech, Vifor Pharma, GW Pharmaceuticals, PCM Scientific and Eli Lilly. All fees related to these activities are paid to Kings College London.
About this article
Cite this article
Faraone, S., Asherson, P., Banaschewski, T. et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 1, 15020 (2015). https://doi.org/10.1038/nrdp.2015.20
This article is cited by
Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder
Child and Adolescent Psychiatry and Mental Health (2023)
Random capillary glucose levels throughout pregnancy, obstetric and neonatal outcomes, and long-term neurodevelopmental conditions in children: a group-based trajectory analysis
BMC Medicine (2023)
Behavioral and Brain Functions (2023)
Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder
BMC Psychiatry (2023)
ADHD genetic burden associates with older epigenetic age: mediating roles of education, behavioral and sociodemographic factors among older adults
Clinical Epigenetics (2023)