* Study says rates of addiction, divorce higher
* Average incomes lower, it finds
* Many others with ADHD do fine
By Frederik Joelving
CHICAGO, Oct 15 (Reuters Health) - Children with ADHD symptoms tend to fare worse as adults than do kids without problems in school, according to the longest follow-up study of the disorder to date.
They have less education and lower income, on average, and higher rates of divorce and substance abuse, according to findings released Monday in the Archives of General Psychiatry.
"A lot of them do fine, but there is a small proportion that is in a great deal of difficulty," said Rachel Klein, a professor of child and adolescent psychiatry at New York University Langone Medical Center in New York.
"They go to jail, they get hospitalized," said Klein, whose study is the longest to date to follow people with attention deficit hyperactivity disorder or ADHD.
Children with the condition are excessively restless, impulsive and easily distracted, and often have trouble in school. There is no cure, but the symptoms can be kept in check by a combination of behavioral therapy and medication.
Klein and colleagues followed 135 white men who had been rated hyperactive by their school teachers back in the 1970s and referred to Klein's hospital. According to the researcher, the children did not have aggressive or antisocial behaviors and would have been diagnosed with ADHD today.
They all came from ordinary, middle-class homes, Klein said, and had "well-meaning" parents. When the boys were 18, the researchers established a comparison group of age-matched white boys who had visited their medical center for unrelated reasons and had not had any problems at school.
Based on interviews done when the men were 41 years old, on average, Klein's team found that those who had ADHD symptoms as children left school 2.5 years earlier than the comparison group.
Only 4 percent had higher degrees versus 29 percent of their peers.
In both groups, salaries went as high as $1.5 million a year. But in the comparison group, the average salary was about $175,000, compared to $93,000 in the adults who had been diagnosed with attention issues as children.
More than one in five of the hyperactive boys was diagnosed with ADHD three decades later, versus one in 20 in the comparison group. And about a third had been in jail at some point - about three times more than those in the comparison group.
They were also more likely to be divorced, abuse drugs and be labeled with antisocial behavior disorder. However, they were not more likely to have mood or anxiety disorders.
It's not clear from the study that ADHD, per se, puts people at risk. But Klein said ADHD-linked impulsiveness may make youngsters more likely to use drugs and spiral downward into crime and other antisocial behaviors.
"When you see signs of antisocial behavior, you really have to step in," she told Reuters Health. "You have to keep treating these kids as long as they face problems."
The U.S. Centers for Disease Control and Prevention estimates that between 3 percent and 7 percent of school-age children in the United States have ADHD.
Fewer than half will have lasting problems; for the rest, the outlook is better, according to Klein.
"Most of them are married, most of them are employed. I think that is a silver lining," she said.
J. Russell Ramsay, who studies ADHD at the University of Pennsylvania's Perelman School of Medicine, said although the kids fared worse as adults than the comparison group, they still were within the normal range in many cases.
"We are not talking about awful outcomes necessarily," said Ramsay, who was not involved in the research.
Ramsay said individuals with ADHD have different outcomes depending on the severity and complexity of their disorder.
"This is sort of a reminder to pay attention to the unique needs of the child, the educational environment and the home environment."
Treatment options include both stimulant medications such as Ritalin or Adderall, and behavioral coping strategies that can help address a child's specific difficulties.
SOURCE:Archives of General Psychiatry, online October 15, 2012.
Copyright 2012 Thomson Reuters. Click for Restrictions.
Also on HuffPost, from blogger Dr. Claire McCarthy:
Anything prescribed to somebody else
It can be really tempting, especially when you know (or someone tells you) that the medication did just the trick with that somebody else. But you can't know for sure that your child has the exact same thing -- or that the dose is right, or that it isn't going to interact with something else they are taking, or cause trouble in some other way. This is a bad corner to cut. Call your doctor instead.
Aspirin (unless your doctor prescribes it)
Giving aspirin to kids in certain situations can cause a scary and possibly deadly condition called Reye's Syndrome. Sure, it's rare and lots of us got aspirin as kids (I can still remember the chalky orange taste). But why take the chance? Use acetaminophen or ibuprofen instead.
Old liquid antibiotics
I see this all the time. There's some leftover from last month's ear infection, Junior is pulling his ear, why not? Well, here's why not. First of all, a doctor really needs to diagnose an infection, and starting an antibiotic before we have a chance to do that can really complicate things sometimes. Second, the stuff is only good for a couple of weeks after it's mixed up at the pharmacy.
This is the stuff that makes kids vomit. We used to tell everyone to keep a bottle of it handy in case their kid ate something they shouldn't (like grownup medications or poisons). Turns out that it's not such a great idea for various reasons (like some of the stuff kids get into can do more damage if it's vomited, and if what they took makes kids really sleepy, the vomit could go into their lungs) so we changed our minds and told everyone to throw the stuff out. Keep all medications and poisons out of reach, and if your kid gets into something, call <a href="http://www.poison.org/prepared/ipecac.asp" target="_hplink">Poison Control</a> at 1-800-222-1222 (works anywhere in the US).
While the stuff is probably good for a little while after the date on the bottle, it's hard to know when it's not good, so better safe than sorry. Get in the habit of going through your medicine cabinet on a regular basis and throwing out expired things -- it's such a drag to reach for the fever medicine in the middle of the night, only to find it's expired.
Cold medicines for kids under 6
They can have <a href="http://articles.cnn.com/2007-10-19/health/coldmed.fda_1_cold-medicines-liquid-medicines-pediatric-cough?_s=PM:HEALTH" target="_hplink">dangerous side effects</a>. They don't really work, anyway.