Skip to main content
SpringerLink
Log in

The Age of Onset of Attention-Deficit Hyperactivity Disorder

  • Chapter
  • First Online:
Age of Onset of Mental Disorders

Abstract

Whilst the contemporary concept of attention deficit/hyperactivity disorder (ADHD) is relatively recent, the typical pattern of ADHD symptoms has been described in the literature since the nineteenth century, and these early descriptions all emphasised an onset early in life. ADHD symptoms and impairments are often present during the preschool period. However making a diagnosis during this period is challenging due to the greater variability in normal behaviours during this developmental period. The ADHD construct has been refined over time, and with the introduction of the DSM and ICD classification systems, an age of onset (AOO) criterion was introduced making it a requirement that symptoms, and later on impairment, were present before the age of 7 years. This criterion was challenged as arbitrary and lacking empirical support. In DSM-5 the AOO criterion for ADHD was adjusted such that only some symptoms appearing before the age of 12 years are required to make a diagnosis. ADHD was traditionally thought of as a disorder of childhood, and perhaps adolescence. It is now clear that ADHD often persists into adulthood, either as the full disorder or partially remitted but with continuing impairment. Several recent studies have challenged the notion that ADHD always begins in childhood. Four large community studies have identified a group of adults who did not have ADHD as children but who do meet diagnostic criteria for ADHD as adults. These findings have resulted in considerable debate, and several lines of argument have been put forward to explain the findings.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agnew-Blais JC, Polanczyk GV, Danese A, Wertz J, Moffitt TE, Arseneault L. Evaluation of the persistence, remission, and emergence of attention-deficit/hyperactivity disorder in young adulthood. JAMA Psychiat. 2016;73:713–20.

    Article  Google Scholar 

  • Alonso-Magdalena P, Quesada I, Nadal A. Endocrine disruptors in the etiology of type 2 diabetes mellitus. Nat Rev Endocrinol. 2011;7:346–53.

    Article  CAS  Google Scholar 

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association; 1980.

    Google Scholar 

  • Applegate B, Lahey BB, Hart EL, Biederman J, Hynd GW, Barkley RA, et al. Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials. J Am Acad Child Adolesc Psychiatry. 1997;36(9):1211–21.

    Article  CAS  Google Scholar 

  • Asherson P, Buitelaar J, Faraone SV, Rohde LA. Adult attention-deficit hyperactivity disorder: key conceptual issues. Lancet Psychiatry. 2016;3:568–78.

    Article  Google Scholar 

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-II). 2nd ed. Washington, DC: American Psychiatric Association; 1968.

    Google Scholar 

  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM 5. 5th ed. Washington, DC: American Psychiatric Association; 2013.

    Book  Google Scholar 

  • Barkley R, Murphy KR, Fischer M. ADHD in adults: what the science says. New York: Guilford; 2008.

    Google Scholar 

  • Barkley RA. ADHD in adults: developmental course and outcome of children with ADHD, and ADHD in clinic-referred adults. In: Barkley RA, editor. Attention-deficit hyperactivity disorder, a handbook for diagnosis and treatment. 3rd ed. New York: Guilford Press; 2006.

    Google Scholar 

  • Barkley RA, Biederman J. Toward a broader definition of the age-of-onset criterion for attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1997;36:1204–10.

    Article  CAS  Google Scholar 

  • Barkley RA, Fischer M, Edelbrock CS, Smallish L. The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry. 1990;29:546–57.

    Article  CAS  Google Scholar 

  • Berwid OG, Curko Kera EA, Marks DJ, Santra A, Bender HA, Halperin JM. Sustained attention and response inhibition in young children at risk for Attention Deficit/Hyperactivity Disorder. J Child Psychol Psychiatry. 2005;46:1219–29.

    Article  Google Scholar 

  • Biederman J, Mick E, Spencer T, Surman C, Hammerness P, Doyle R, et al. An open-label trial of OROS methylphenidate in adults with late-onset ADHD. CNS Spectr. 2006;11:390–6.

    Article  Google Scholar 

  • Birch HG. Brain damage in children: the biological and social aspects. Baltimore: Williams & Wilkins; 1964.

    Google Scholar 

  • Bousquet J, Jorgensen C, Dauzat M, Cesario A, Camuzat T, Bourret R, et al. Systems medicine approaches for the definition of complex phenotypes in chronic diseases and ageing. From concept to implementation and policies. Curr Pharm Des. 2014;20:5928–44.

    Article  CAS  Google Scholar 

  • Brikell I, Kuja-Halkola R, Larsson H. Heritability of attention-deficit hyperactivity disorder in adults. Am J Med Genet B Neuropsychiatr Genet. 2015;168:406–13.

    Article  Google Scholar 

  • Castellanos FX. Is adult-onset ADHD a distinct entity? Am J Psychiatry. 2015;172:929–31.

    Article  Google Scholar 

  • Caye A, Rocha TB, Anselmi L, Murray J, Menezes AM, Barros FC, et al. Attention-deficit/hyperactivity disorder trajectories from childhood to young adulthood: evidence from a birth cohort supporting a late-onset syndrome. JAMA Psychiat. 2016;73:705–12.

    Article  Google Scholar 

  • Chandra S, Biederman J, Faraone SV. Assessing the validity of the age at onset criterion for diagnosing ADHD in DSM-5. J Atten Disord. 2016. https://doi.org/10.1177/1087054716629717. http://journals.sagepub.com/doi/abs/10.1177/1087054716629717?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed. Accessed 30/07/2018.

  • Chang Z, Lichtenstein P, Asherson PJ, Larsson H. Developmental twin study of attention problems: high heritabilities throughout development. JAMA Psychiat. 2013;70:311–8.

    Article  Google Scholar 

  • Cheung CH, Rijdijk F, McLoughlin G, Faraone SV, Asherson P, Kuntsi J. Childhood predictors of adolescent and young adult outcome in ADHD. J Psychiatr Res. 2015;62:92–100.

    Article  Google Scholar 

  • Cheung CH, Rijsdijk F, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, et al. Cognitive and neurophysiological markers of ADHD persistence and remission. Br J Psychiatry. 2016;208:548–55.

    Article  Google Scholar 

  • Coghill D, Sonuga-Barke EJ. Annual research review: categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders—implications of recent empirical study. J Child Psychol Psychiatry. 2012;53:469–89.

    Article  Google Scholar 

  • Conners CK. Attention-deficit/hyperactivity disorder: historical development and overview. J Atten Disord. 2000;3:173–91.

    Article  Google Scholar 

  • Crichton A. An inquiry into the nature and origin of mental derangement: on attention and its diseases. J Atten Disord. 2008;12:200–4; discussion 205–6.

    Article  Google Scholar 

  • Dalen L, Sonuga-Barke EJ, Hall M, Remington B. Inhibitory deficits, delay aversion and preschool AD/HD: implications for the dual pathway model. Neural Plast. 2004;11:1–11.

    Article  Google Scholar 

  • Du Rietz E, Cheung CH, McLoughlin G, Brandeis D, Banaschewski T, Asherson P, et al. Self-report of ADHD shows limited agreement with objective markers of persistence and remittance. J Psychiatr Res. 2016;82:91–9.

    Article  Google Scholar 

  • Dupaul GJ, McGoey KE, Eckert TL, Vanbrakle J. Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning. J Am Acad Child Adolesc Psychiatry. 2001;40:508–15.

    Article  CAS  Google Scholar 

  • Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers. 2015;1:15020.

    Article  Google Scholar 

  • Faraone SV, Biederman J. Can attention-deficit/hyperactivity disorder onset occur in adulthood? JAMA Psychiatry. 2016;73:655–6.

    Article  Google Scholar 

  • Faraone SV, Biederman J, Doyle A, Murray K, Petty C, Adamson JJ, et al. Neuropsychological studies of late onset and subthreshold diagnoses of adult attention-deficit/hyperactivity disorder. Biol Psychiatry. 2006a;60:1081–7.

    Article  Google Scholar 

  • Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med. 2006b;36:159–65.

    Article  Google Scholar 

  • Faraone SV, Biederman J, Spencer T, Mick E, Murray K, Petty C, et al. Diagnosing adult attention deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid? Am J Psychiatry. 2006c;163:1720–9; quiz 1859.

    Article  Google Scholar 

  • Faraone SV, Kunwar A, Adamson J, Biederman J. Personality traits among ADHD adults: implications of late-onset and subthreshold diagnoses. Psychol Med. 2009;39:685–93.

    Article  CAS  Google Scholar 

  • Faraone SV, Wilens TE, Petty C, Antshel K, Spencer T, Biederman J. Substance use among ADHD adults: implications of late onset and subthreshold diagnoses. Am J Addict. 2007;16(Suppl 1):24–32; quiz 33–4.

    Article  Google Scholar 

  • Fayyad J, De Graaf R, Kessler R, Alonso J, Angermeyer M, Demyttenaere K, et al. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190:402–9.

    Article  CAS  Google Scholar 

  • Hinshaw SP. Preadolescent girls with attention-deficit/hyperactivity disorder: I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices. J Consult Clin Psychol. 2002;70:1086–98.

    Article  Google Scholar 

  • Hoza B, Gerdes AC, Hinshaw SP, Arnold LE, Pelham WE Jr, Molina BS, et al. Self-perceptions of competence in children with ADHD and comparison children. J Consult Clin Psychol. 2004;72:382–91.

    Article  Google Scholar 

  • Kadesjo C, Kadesjo B, Hagglof B, Gillberg C. ADHD in Swedish 3- to 7-year-old children. J Am Acad Child Adolesc Psychiatry. 2001;40:1021–8.

    Article  CAS  Google Scholar 

  • Kessler JW. History of minimal brain dysfunctions. In: Rie HE, Rie ED, editors. Handbook of minimal brain dysfunctions: a critical view. New York: Wiley; 1980.

    Google Scholar 

  • Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602.

    Article  Google Scholar 

  • Kieling C, Kieling RR, Rohde LA, Frick PJ, Moffitt T, Nigg JT, et al. The age at onset of attention deficit hyperactivity disorder. Am J Psychiatry. 2010;167:14–6.

    Article  Google Scholar 

  • Kramer F, Pollnow H. Uber eine hyperkinetische Erkrankung im Kindesalter. Aus der Psychiatrischen und Nerven-Klinik der Charite´ in Berlin (Direktor: Geh. Med.-Rat Prof. Dr. Bonhoeffer). Mschr Psychiat Neurol. 1932;82:21–40.

    Article  Google Scholar 

  • Kuntsi J, Pinto R, Price TS, Van Der Meere JJ, Frazier-Wood AC, Asherson P. The separation of ADHD inattention and hyperactivity-impulsivity symptoms: pathways from genetic effects to cognitive impairments and symptoms. J Abnorm Child Psychol. 2014;42:127–36.

    Article  Google Scholar 

  • Lahey BB, Pelham WE, Loney J, Kipp H, Ehrhardt A, Lee SS, et al. Three-year predictive validity of DSM-IV attention deficit hyperactivity disorder in children diagnosed at 4-6 years of age. Am J Psychiatry. 2004;161:2014–20.

    Article  Google Scholar 

  • Lahey BB, Pelham WE, Loney J, Lee SS, Willcutt E. Instability of the DSM-IV Subtypes of ADHD from preschool through elementary school. Arch Gen Psychiatry. 2005;62:896–902.

    Article  Google Scholar 

  • Lange KW, Reichl S, Lange KM, Tucha L, Tucha O. The history of attention deficit hyperactivity disorder. Atten Defic Hyperact Disord. 2010;2:241–55.

    Article  Google Scholar 

  • Larsson JO, Larsson H, Lichtenstein P. Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study. J Am Acad Child Adolesc Psychiatry. 2004;43:1267–75.

    Article  Google Scholar 

  • Levy F, Hay DA, McStephen M, Wood C, Waldman I. Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study. J Am Acad Child Adolesc Psychiatry. 1997;36:737–44.

    Article  CAS  Google Scholar 

  • Mannuzza S, Klein RG, Bonagura N, Malloy P, Giampino TL, Addalli KA. Hyperactive boys almost grown up. V. Replication of psychiatric status. Arch Gen Psychiatry. 1991;48:77–83.

    Article  CAS  Google Scholar 

  • Marks DJ, Berwid OG, Santra A, Kera EC, Cyrulnik SE, Halperin JM. Neuropsychological correlates of ADHD symptoms in preschoolers. Neuropsychology. 2005;19:446–55.

    Article  Google Scholar 

  • Moffitt TE, Houts R, Asherson P, Belsky DW, Corcoran DL, Hammerle M, et al. Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. Am J Psychiatry. 2015;172:967–77.

    Article  Google Scholar 

  • NICE. Attention deficit hyperactivity disorder diagnosis and management of ADHD in children, young people and adults. London: National Institute for Health and Clinical Excellence; 2008.

    Google Scholar 

  • Polanczyk G, Caspi A, Houts R, Kollins SH, Rohde LA, Moffitt TE. 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. 2010;49:210–6.

    PubMed  Google Scholar 

  • Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164:942–8.

    Article  Google Scholar 

  • Posner K, Melvin GA, Murray DW, Gugga SS, Fisher P, Skrobala A, et al. Clinical presentation of attention-deficit/hyperactivity disorder in preschool children: the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). J Child Adolesc Psychopharmacol. 2007;17:547–62.

    Article  Google Scholar 

  • Price TS, Simonoff E, Asherson P, Curran S, Kuntsi J, Waldman I, et al. Continuity and change in preschool ADHD symptoms: longitudinal genetic analysis with contrast effects. Behav Genet. 2005;35:121–32.

    Article  Google Scholar 

  • Rapin I. Brain damage in children. In: Brennemann J, editor. Practice of paediatrics. Hagerstown: Prior; 1964.

    Google Scholar 

  • Reinhardt MC, Benetti L, Victor MM, Grevet EH, Belmonte-de-Abreu P, Faraone SV, et al. Is age-at-onset criterion relevant for the response to methylphenidate in attention-deficit/hyperactivity disorder? J Clin Psychiatry. 2007;68:1109–16.

    Article  CAS  Google Scholar 

  • Riglin L, Collishaw S, Thapar AK, Dalsgaard S, Langley K, Smith GD, et al. Association of genetic risk variants with attention-deficit/hyperactivity disorder trajectories in the general population. JAMA Psychiat. 2016;73:1285–92.

    Article  Google Scholar 

  • Sibley MH, Pelham WE, Molina BS, Gnagy EM, Waxmonsky JG, Waschbusch DA, et al. When diagnosing ADHD in young adults emphasize informant reports, DSM Items, and impairment. J Consult Clin Psychol. 2012;80(6):1052–61.

    Article  Google Scholar 

  • Simon V, Czobor P, Balint S, Meszaros A, Bitter I. Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis. Br J Psychiatry. 2009;194:204–11.

    Article  Google Scholar 

  • Smidts DP, Oosterlaan J. How common are symptoms of ADHD in typically developing preschoolers? A study on prevalence rates and prenatal/demographic risk factors. Cortex. 2007;43:710–7.

    Article  Google Scholar 

  • Smith KG, Corkum P. Systematic review of measures used to diagnose attention-deficit/hyperactivity disorder in research on preschool children. Top Early Childhood Spec Educ. 2007;27:164–73.

    Article  Google Scholar 

  • Sonuga-Barke EJ, Dalen L, Remington B. Do executive deficits and delay aversion make independent contributions to preschool attention-deficit/hyperactivity disorder symptoms? J Am Acad Child Adolesc Psychiatry. 2003;42:1335–42.

    Article  Google Scholar 

  • Still GF. Some abnormal psychical conditions in children: excerpts from three lectures. J Atten Disord. 2006;10:126–36.

    Article  Google Scholar 

  • Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management, Wolraich M, Brown L, Brown RT, Dupaul G, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128:1007–22.

    Article  Google Scholar 

  • Tandon M, Si X, Luby J. Preschool onset attention-deficit/hyperactivity disorder: course and predictors of stability over 24 months. J Child Adolesc Psychopharmacol. 2011;21:321–30.

    Article  Google Scholar 

  • Todd RD, Huang H, Henderson CA. Poor utility of the age of onset criterion for DSM-IV attention deficit/hyperactivity disorder: recommendations for DSM-V and ICD-11. J Child Psychol Psychiatry. 2008;49:942–9.

    Article  Google Scholar 

  • Towbin A. Cerebral dysfunction related to perinatal organic damage: clinical—neuropathologic correlations. J Abnorm Psychol. 1978;87:617–35.

    Article  CAS  Google Scholar 

  • van de Glind G, Konstenius M, Koeter MW, van Emmerik-van Oortmerssen K, Carpentier PJ, Kaye S, et al. Variability in the prevalence of adult ADHD in treatment seeking substance use disorder patients: results from an international multi-center study exploring DSM-IV and DSM-5 criteria. Drug Alcohol Depend. 2014;134:158–66.

    Article  Google Scholar 

  • van Lieshout M, Luman M, Twisk JW, van Ewijk H, Groenman AP, Thissen AJ, et al. A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood. Eur Child Adolesc Psychiatry. 2016a;25:1007–17.

    Article  Google Scholar 

  • van Lieshout M, Luman M, Twisk JWR, Groenman AP, Thissen AJ, Faraone SV, et al. A six-year follow up study of a large European cohort of children with attention-deficit/hyperactivity disorder combined subtype: outcomes in late adolescence and young adulthood. Eur Child Adolesc Psychiatry. 2016b;25(9):1007–17.

    Article  Google Scholar 

  • Vande Voort JL, He JP, Jameson ND, Merikangas KR. Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population. J Am Acad Child Adolesc Psychiatry. 2014;53:736–44.

    Article  Google Scholar 

  • Wilens TE, Biederman J, Brown S, Monuteaux M, Prince J, Spencer TJ. Patterns of psychopathology and dysfunction in clinically referred preschoolers. J Dev Behav Pediatr. 2002;23:S31–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Paediatrics and Psychiatry, University of Melbourne, Parkville, VIC, Australia

    David Coghill

  2. Murdoch Children’s Research Institute, Melbourne, VIC, Australia

    David Coghill

  3. Royal Children’s Hospital, Melbourne, VIC, Australia

    David Coghill

  4. MRC Social Genetic and Developmental Psychiatry (SGDP), Institute of Psychiatry, London, UK

    Phillip Asherson

  5. Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA

    Stephen V. Faraone

  6. Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Luis A. Rohde

  7. Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

    Luis A. Rohde

Authors
  1. David Coghill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Phillip Asherson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen V. Faraone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luis A. Rohde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Coghill .

Editor information

Editors and Affiliations

  1. Unit of Psychiatric Epidemiology and Evaluation, IRCCS St John of God Clinical Research Center, Brescia, Italy

    Giovanni de Girolamo

  2. Orygen The National Centre of Excellence, University of Melbourne, Victoria, Australia

    Patrick D. McGorry

  3. Association for the Improvement of Mental Health Programmes, Geneva, Switzerland

    Norman Sartorius

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Coghill, D., Asherson, P., Faraone, S.V., Rohde, L.A. (2019). The Age of Onset of Attention-Deficit Hyperactivity Disorder. In: de Girolamo, G., McGorry, P., Sartorius, N. (eds) Age of Onset of Mental Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-72619-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72619-9_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72618-2

  • Online ISBN: 978-3-319-72619-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation