Diagnostic stability of attention deficit hyperactivity disorder during healthcare transition

Background and Aims

The belief that ADHD remitted in adulthood and the absence of specific criteria for its diagnosis in adults have led to discrepancies in estimating its persistence, hindering proper treatment. The objective of this study was to evaluate the persistence of diagnosis and subtypes of ADHD in patients transitioning to adulthood in a specialized setting using DSM-5 criteria.

Material and Methods

Retrospective data were collected from 59 patients diagnosed with ADHD at the Hospital Universitario Infanta Leonor, Madrid, with symptom onset between 2 and 12 years of age. Subgroups were formed based on diagnosis and initial subtype stability, and descriptive and statistical analysis was performed using SPSS software.

Results

The persistence rate was 93.2 %. Persistence was significantly associated with the need for specific follow-up at present, but not with gender, current age, or treatment. High percentages of comorbidity were found in both the persistent and remission groups. The initial inattentive subtype showed greater stability, with a preservation rate of 95.83 %. The combined subtype decreased more over time, with a preservation rate of 71.4 %. The diagnostic consistency for each subtype was high, although overall diagnostic concordance decreased slightly with age.

Conclusions

ADHD stability using appropriate criteria is higher than previously described. Comprehensive follow-up is necessary regardless of the current diagnostic status, especially in the period of transition from adolescence to adulthood.