Childhood Emotional and Behavioral Problems Predict Adolescent ADHD with Psychiatric Comorbidity

Rationale: As the age of onset for ADHD is usually in childhood, it is likely that hyperactivity in childhood predicts hyperactivity also in adolescence. Moreover, some emotional and behavioural symptoms in childhood – apart from ADHD symptoms – may differ in their predictive ability for ADHD as well as its more severe forms in adolescence, especially that with comorbid disorders. Since comorbid ADHD is related to impairment in many domains of functioning, it is essential to identify the psychiatric symptoms most likely to predict the most severe forms of ADHD.

Objective: We investigated whether childhood psychiatric problems predict adolescent ADHD taking into account its comorbidities, severity and impairment.

Methods: The study population was based on the non-selected Northern Finland Birth Cohort 1986 (N = 9,432). At the age of 8 years, children’s emotional and behavioural problems were assessed by teachers. In adolescence, a subpopulation (n = 457) and their parents were interviewed with the Kiddie-SADS-PL and clinical ADHD diagnoses were made.

Results: High scores on teachers’ Rutter B2 behavioural and hyperactivity subscales were associated with adolescent ADHD, and even more strongly with ADHD and comorbidity. Among those with ADHD only, behavioural problems predicted severity of ADHD, while among those also having comorbidities, it predicted impairment in overall functioning.

Conclusions: Childhood behavioural problems predicted adolescent ADHD, its comorbidities, severity and impairment. Teachers can have a key role in identifying children in need of behavioural evaluation and subsequent support due to increased risk of adolescent ADHD with comorbidity.