European Child & Adolescent Psychiatry

, Volume 25, Issue 11, pp 1151–1159 | Cite as

Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta-analysis

  • Arthur Caye
  • Alex V. Spadini
  • Rafael G. Karam
  • Eugenio H. Grevet
  • Diego L Rovaris
  • Claiton H. D. Bau
  • Luis A. Rohde
  • Christian KielingEmail author


Attention-deficit/hyperactivity disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder that continues into adulthood in up to half of diagnosed cases. In light of current evidence, factors associated with the course of the disorder remain unknown. We performed a systematic review of the literature searching for risk markers from childhood that predicted the persistence of ADHD into adulthood. We reviewed 26,168 abstracts and selected 72 for full-text review. We identified data from 16 studies, comprising 6 population-based retrospective samples and 10 clinical follow-ups. We performed meta-analyses of factors evaluated by at least three studies. Severity of ADHD (OR 2.33, 95 % CI = 1.6–3.39, p < 0.001), treatment for ADHD (OR 2.09, 95 % CI = 1.04–4.18, p = 0.037), comorbid conduct disorder (OR 1.85, 95 % CI = 1.06–3.24, p = 0.030), and comorbid major depressive disorder (OR 1.8, 95 % CI = 1.1–2.95, p = 0.019) emerged as predictors already presented in childhood for ADHD persistence into adulthood. Further, we suggest that cohort studies should be designed to clarify such an important question for research and clinical practice.


ADHD Adolescence Risk factors Persistence Course Prognosis 


Compliance with ethical standards

Conflict of interest

Dr. Grevet was on the speakers’ bureau of Shire and Novartis. He received travel awards for taking part in a meeting sponsored by Shire and the World Congress on ADHD in 2015. Dr. Rohde was on the speakers’ bureau/advisory board and/or acted as consultant for Eli-Lilly, Janssen-Cilag, Novartis and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. He also received travel awards for taking part in the 2014 APA meeting and 2015 WFADHD meeting from Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire. Dr. Kieling receives authorship royalties from publishers Artmed and Manole.

Funding source

This work was supported by research grants from the Brazilian public funding agencies, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul (FAPERGS), and Hospital de Clínicas de Porto Alegre (HCPA).

Supplementary material

787_2016_831_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 23 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Arthur Caye
    • 1
  • Alex V. Spadini
    • 1
  • Rafael G. Karam
    • 1
  • Eugenio H. Grevet
    • 1
  • Diego L Rovaris
    • 3
  • Claiton H. D. Bau
    • 3
  • Luis A. Rohde
    • 1
    • 2
  • Christian Kieling
    • 1
    Email author
  1. 1.Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do Sul. Rua Ramiro BarcelosPorto AlegreBrazil
  2. 2.National Institute of Developmental Psychiatry for Children and AdolescentsPorto AlegreBrazil
  3. 3.Department of Genetics, Instituto de BiociênciasUniversidade Federal do Rio Grande do SulPorto AlegreBrazil

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