Early adolescent outcome of attention-deficit hyperactivity disorder in a Chinese population: 5-year follow-up study.

OBJECTIVE To examine early adolescent outcome of attention-deficit hyperactivity disorder in local Chinese children. DESIGN Cohort study. SETTING A university teaching hospital in Hong Kong. PARTICIPANTS A cohort of Chinese children with attention-deficit hyperactivity disorder diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (4th edition) who attended a day hospital between January 1998 and December 2003. MAIN OUTCOME MEASURES Data on psychopathology, academic attainment, delinquency, substance use, and other psychosocial functioning collected from multiple informants and official records. Performances of subjects were compared with a group of community controls. RESULTS A total of 150 children with attention-deficit hyperactivity disorder were reassessed 6 years after initial intake assessment (mean age, 14 years; follow-up rate, 86%). Compared with the controls, their externalising and internalising disturbances were 4 and 1.5 times more common, respectively. Adolescents with attention-deficit hyperactivity disorder were more likely to smoke cigarettes and use illicit drugs. Their academic attainment was below age norms with more than one fourth repeating grades; 7% of them had been arrested by the police compared with none of the controls. They faced more difficulties in the family environment and social problem-solving. There were discrepancies between parent and patient reports about their attention-deficit hyperactivity disorder symptoms, and officially recorded youth reports of delinquency. CONCLUSION Local Chinese children with attention-deficit hyperactivity disorder are at significant risk of multiple forms of adolescent maladjustment. Their outcome profile is similar to that reported in the West.