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.