GUILHERME VANONI POLANCZYK
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
194 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 194
- CATEGORICAL AND DIMENSIONAL ASSESSMENT OF NUCLEUS ACCUMBENS AND AMYGDALA CONNECTIVITY IN DISRUPTIVE BEHAVIOR DISORDERS AND ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD)(2017) DIAS, Taciana G. Costa; SATO, Joao R.; FAIR, Damien A.; SALUM, Giovanni A.; ROHDE, Luis A.; BRESSAN, Rodrigo A.; PAN, Pedro M.; JACKOWSKI, Andrea P.; POLANCZYK, Guilherme V.
bookPart Tratamento do transtorno de déficit de atenção/hiperatividade em adultos(2021) FARHAT, Luis C.; MATTOS, Paulo; ROHDE, Luis Augusto; POLANCZYK, Guilherme Vanoni- Obsessive-compulsive symptom dimensions in a population-based, cross-sectional sample of school-aged children(2015) ALVARENGA, Pedro G.; CESAR, Raony C.; LECKMAN, James F.; MORIYAMA, Tais S.; TORRES, Albina R.; BLOCH, Michael H.; COUGHLIN, Catherine G.; HOEXTER, Marcelo Q.; MANFRO, Gisele G.; POLANCZYK, Guilherme V.; MIGUEL, Euripedes C.; ROSARIO, Maria C. doBackground: Obsessive-compulsive disorder can be expressed as four potentially overlapping obsessive-compulsive symptom (OCS) dimensions (OCSD) (""symmetry/ordering"", ""contamination/cleaning"", ""aggressive/sexual/religious"" and ""collecting/hoarding""). In clinical samples, some dimensions are more familial and associated with increased psychiatric comorbidity and malfunctioning. However, data concerning OCS and OCSD are scarce in non-clinical samples, particularly among children. The present study aims to estimate: (1) the prevalence and sex/age distribution of OCS/OCSD in a community-based sample of schoolchildren; (2) the association between OCS and additional clinical factors; and (3) the degree of familial aggregation of OCS/OCSD. Methods: OCS and OCSD were evaluated in 9937 Brazilian school-children (6-12 years-old) and their biological relatives using the Family History Screen. Data analyses included gradient estimated equations and post-hoc tests. Results: We included data on 9937 index-children, 3305 siblings (13-18 years-old), and 16,218 parents. Biological mothers were the informants in 87.6% of the interviews. OCS were present in 14.7% of the index-children; 15.6% of their siblings; 34.6% of their mothers and 12.1% of their fathers. The prevalence of OCS and each of the OCSD gradually increased from ages 6 to 12 years. Overall, OCS in children were associated with the presence of other psychiatric symptoms, as well as behavioral/school impairment. OCS and each of the four OCSD aggregated significantly within families. Conclusions: OCS are prevalent and associated with psychiatric symptoms and clinical impairment among school-aged children. OCSD aggregate within families in a dimension-specific fashion. These findings suggest a natural continuum between OCS and OCD with regard to their dimensional character.
- How Evidence on the Developmental Nature of Attention-Deficit/Hyperactivity Disorder Can Increase the Validity and Utility of Diagnostic Criteria(2014) POLANCZYK, Guilherme V.; MOFFITT, Terrie E.
- Cathechol-O-methyltransferase Val(158)Met polymorphism is associated with disruptive behavior disorders among children and adolescents with ADHD(2012) SALATINO-OLIVEIRA, Angelica; GENRO, Julia P.; GUIMARAES, Ana P.; CHAZAN, Rodrigo; ZENI, Cristian; SCHMITZ, Marcelo; POLANCZYK, Guilherme; ROMAN, Tatiana; ROHDE, Luis A.; HUTZ, Mara H.COMT Val(158)Met polymorphism has been associated with both symptoms of attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD): that is, oppositional defiant disorder (ODD) and conduct disorder (CD) often comorbid with ADHD. The aim of this study was to test the association between COMT Val(158)Met polymorphism and the presence of DBD in children with ADHD (n = 516). Homozygous Val/Val children showed a higher prevalence of ADHD comorbid with DBD (chi (2) = 5.762; p = 0.016; OR = 1.58; CI95% = 1.07-2.35). Our findings replicate previous results and suggest a role for COMT in the etiology of DBD in children and adolescents with ADHD.
- Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis(2021) MASSUTI, Rafael; MOREIRA-MAIA, Carlos Renato; CAMPANI, Fausto; SONEGO, Marcio; AMARO, Julia; AKUTAGAVA-MARTINS, Glaucia Chiyoko; TESSARI, Luca; V, Guilherme Polanczyk; CORTESE, Samuele; ROHDE, Luis AugustoA controversy exists on whether there is an over or underuse of medications for Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted the first meta-analysis to estimate the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals. Based on a pre-registered protocol (CRD42018085233), we searched a broad set of electronic databases and grey literature. After screening 25,676 abstracts, we retained 36 studies including 104,305 subjects, from which 18 studies met our main analysis criteria. The pooled pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. We estimated that for each individual using medication without a formal ADHD diagnosis, there are three patients with a formal diagnosis who might benefit from medication but do not receive it in the US. Our results indicate both overtreatment/misuse of medication in individuals without ADHD and pharmacological undertreatment in youths with the disorder. Our findings reinforce the need for public health policies improving education on ADHD and discussions on the benefits and limitations of ADHD medications.
- Long-term outcome of children and adolescents with obsessive-compulsive disorder: a 7-9-year follow-up of a randomized clinical trial(2020) FATORI, Daniel; POLANCZYK, Guilherme V.; MORAIS, Rosa Magaly Campelo Borba de; ASBAHR, Fernando R.Pediatric obsessive-compulsive disorder (OCD) is an impairing disorder frequently associated with long-term persistence. Long-term follow-up studies that investigated psychopathological trajectories after initial treatment are scarce. The present study is a 7-9-year follow-up of a randomized clinical trial (RCT) that tested the efficacy of group cognitive-behavioral therapy (CBT) and sertraline for children with OCD (n = 40), and aimed to describe long-term outcomes of pediatric OCD and identify predictors of these outcomes. Thirty-five participants who were included in the original study were recruited for follow-up evaluations. Participants underwent a comprehensive assessment of demographic and clinical characteristics comprised of the Structured Clinical Interview for DSM Disorders (SCID) and/or Kiddie-Schedule of Affective Disorders and Schizophrenia Present-Lifetime (K-SADS-PL), and the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Thirty-three participants had a complete psychiatric assessment at follow-up (mean age 21 years, SD 3.2; 65% male). At follow-up, 13 (39.4%) participants had an OCD diagnosis, 10 (30.3%) had a diagnosis of any mental disorder (excluding OCD), and 10 (30.3%) did not have any diagnosis of mental disorder. In total, 23 participants (69.7%) had at least one mental disorder (including OCD). Among those without OCD (n = 20), 60.6% had a mental disorder. The following characteristics at follow-up were associated with OCD diagnosis: YBOCS total score (p < 0.001), global functioning (p = 0.008), and presence of any anxiety disorder (p = 0.027). Being treated with GCBT or sertraline during the original RCT did not predict OCD at follow-up. New treatment strategies should consider the role of psychopathological trajectories using a dynamic approach to combine or change interventions to enhance prognosis.
- Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013(2014) KASSEBAUM, Nicholas J.; BERTOZZI-VILLA, Amelia; COGGESHALL, Megan S.; SHACKELFORD, Katya A.; STEINER, Caitlyn; HEUTON, Kyle R.; GONZALEZ-MEDINA, Diego; BARBER, Ryan; HUYNH, Chantal; DICKER, Daniel; TEMPLIN, Tara; WOLOCK, Timothy M.; OZGOREN, Ayse Abbasoglu; ABD-ALLAH, Foad; ABERA, Semaw Ferede; ABUBAKAR, Ibrahim; ACHOKI, Tom; ADELEKAN, Ademola; ADEMI, Zanfina; ADOU, Arsene Kouablan; ADSUAR, Jose C.; AGARDH, Emilie E.; AKENA, Dickens; ALASFOOR, Deena; ALEMU, Zewdie Aderaw; ALFONSO-CRISTANCHO, Rafael; ALHABIB, Samia; ALI, Raghib; KAHBOURI, Mazin J. Al; ALLA, Francois; ALLEN, Peter J.; ALMAZROA, Mohammad A.; ALSHARIF, Ubai; ALVAREZ, Elena; ALVIS-GUZMAN, Nelson; AMANKWAA, Adansi A.; AMARE, Azmeraw T.; AMINI, Hassan; AMMAR, Walid; ANTONIO, Carl A. T.; ANWARI, Palwasha; ARNLOV, Johan; ARSENIJEVIC, Valentina S. Arsic; ARTAMAN, Ali; ASAD, Majed Masoud; ASGHAR, Rana J.; ASSADI, Reza; ATKINS, Lydia S.; BADAWI, Alaa; BALAKRISHNAN, Kalpana; BASU, Arindam; BASU, Sanjay; BEARDSLEY, Justin; BEDI, Neeraj; BEKELE, Tolesa; BELL, Michelle L.; BERNABE, Eduardo; BEYENE, Tariku J.; BHUTTA, Zulfiqar; ABDULHAK, Aref Bin; BLORE, Jed D.; BASARA, Berrak Bora; BOSE, Dipan; BREITBORDE, Nicholas; CARDENAS, Rosario; CASTANEDA-ORJUELA, Carlos A.; CASTRO, Ruben Estanislao; CATALA-LOPEZ, Ferran; CAVLIN, Alanur; CHANG, Jung-Chen; CHE, Xuan; CHRISTOPHI, Costas A.; CHUGH, Sumeet S.; CIRILLO, Massimo; COLQUHOUN, Samantha M.; COOPER, Leslie Trumbull; COOPER, Cyrus; LEITE, Iuri da Costa; DANDONA, Lalit; DANDONA, Rakhi; DAVIS, Adrian; DAYAMA, Anand; DEGENHARDT, Louisa; LEO, Diego De; POZO-CRUZ, Borja del; DERIBE, Kebede; DESSALEGN, Muluken; DEVEBER, Gabrielle A.; DHARMARATNE, Samath D.; DILMEN, Ugur; DING, Eric L.; DORRINGTON, Rob E.; DRISCOLL, Tim R.; ERMAKOV, Sergei Petrovich; ESTEGHAMATI, Alireza; FARAON, Emerito Jose A.; FARZADFAR, Farshad; FELICIO, Manuela Mendonca; FERESHTEHNEJAD, Seyed-Mohammad; LIMA, Graca Maria Ferreira de; FOROUZANFAR, Mohammad H.; FRANCA, Elisabeth B.; GAFFIKIN, Lynne; GAMBASHIDZE, Ketevan; GANKPE, Fortune Gbetoho; GARCIA, Ana C.; GELEIJNSE, Johanna M.; GIBNEY, Katherine B.; GIROUD, Maurice; GLASER, Elizabeth L.; GOGINASHVILI, Ketevan; GONA, Philimon; GONZALEZ-CASTELL, Dinorah; GOTO, Atsushi; GOUDA, Hebe N.; GUGNANI, Harish Chander; GUPTA, Rahul; GUPTA, Rajeev; HAFEZI-NEJAD, Nima; HAMADEH, Randah Ribhi; HAMMAMI, Mouhanad; HANKEY, Graeme J.; HARB, Hilda L.; HAVMOELLER, Rasmus; HAY, Simon I.; PI, Ileana B. Heredia; HOEK, Hans W.; HOSGOOD, H. Dean; HOY, Damian G.; HUSSEINI, Abdullatif; IDRISOV, Bulat T.; INNOS, Kaire; INOUE, Manami; JACOBSEN, Kathryn H.; JAHANGIR, Eiman; JEE, Sun Ha; JENSEN, Paul N.; JHA, Vivekanand; JIANG, Guohong; JONAS, Jost B.; JUEL, Knud; KABAGAMBE, Edmond Kato; KAN, Haidong; KARAM, Nadim E.; KARCH, Andre; KAREMA, Corine Kakizi; KAUL, Anil; KAWAKAMI, Norito; KAZANJAN, Konstantin; KAZI, Dhruv S.; KEMP, Andrew H.; KENGNE, Andre Pascal; KERESELIDZE, Maia; KHADER, Yousef Saleh; KHALIFA, Shams Eldin Ali Hassan; KHAN, Ejaz Ahmed; KHANG, Young-Ho; KNIBBS, Luke; KOKUBO, Yoshihiro; KOSEN, Soewarta; DEFO, Barthelemy Kuate; KULKARNI, Chanda; KULKARNI, Veena S.; KUMAR, G. Anil; KUMAR, Kaushalendra; KUMAR, Ravi B.; KWAN, Gene; LAI, Taavi; LALLOO, Ratilal; LAM, Hilton; LANSINGH, Van C.; LARSSON, Anders; LEE, Jong-Tae; LEIGH, James; LEINSALU, Mall; LEUNG, Ricky; LI, Xiaohong; LI, Yichong; LI, Yongmei; LIANG, Juan; LIANG, Xiaofeng; LIM, Stephen S.; LIN, Hsien-Ho; LIPSHULTZ, Steven E.; LIU, Shiwei; LIU, Yang; LLOYD, Belinda K.; LONDON, Stephanie J.; LOTUFO, Paulo A.; MA, Jixiang; MA, Stefan; MACHADO, Vasco Manuel Pedro; MAINOO, Nana Kwaku; MAJDAN, Marek; MAPOMA, Christopher Chabila; MARCENES, Wagner; MARZAN, Melvin Barrientos; MASON-JONES, Amanda J.; MEHNDIRATTA, Man Mohan; MEJIA-RODRIGUEZ, Fabiola; MEMISH, Ziad A.; MENDOZA, Walter; MILLER, Ted R.; MILLS, Edward J.; MOKDAD, Ali H.; MOLA, Glen Liddell; MONASTA, Lorenzo; MONIS, Jonathan de la Cruz; HERNANDEZ, Julio Cesar Montanez; MOORE, Ami R.; MORADI-LAKEH, Maziar; MORI, Rintaro; MUELLER, Ulrich O.; MUKAIGAWARA, Mitsuru; NAHEED, Aliya; NAIDOO, Kovin S.; NAND, Devina; NANGIA, Vinay; NASH, Denis; NEJJARI, Chakib; NELSON, Robert G.; NEUPANE, Sudan Prasad; NEWTON, Charles R.; NG, Marie; NIEUWENHUIJSEN, Mark J.; NISAR, Muhammad Imran; NOLTE, Sandra; NORHEIM, Ole F.; NYAKARAHUKA, Luke; OH, In-Hwan; OHKUBO, Takayoshi; OLUSANYA, Bolajoko O.; OMER, Saad B.; OPIO, John Nelson; ORISAKWE, Orish Ebere; PANDIAN, Jeyaraj D.; PAPACHRISTOU, Christina; PARK, Jae-Hyun; CAICEDO, Angel J. Paternina; PATTEN, Scott B.; PAUL, Vinod K.; PAVLIN, Boris Igor; PEARCE, Neil; PEREIRA, David M.; PESUDOVS, Konrad; PETZOLD, Max; POENARU, Dan; POLANCZYK, Guilherme V.; POLINDER, Suzanne; POPE, Dan; POURMALEK, Farshad; QATO, Dima; QUISTBERG, D. Alex; RAFAY, Anwar; RAHIMI, Kazem; RAHIMI-MOVAGHAR, Vafa; RAHMAN, Sajjad ur; RAJU, Murugesan; RANA, Saleem M.; REFAAT, Amany; RONFANI, Luca; ROY, Nobhojit; PIMIENTA, Tania Georgina Sanchez; SAHRAIAN, Mohammad Ali; SALOMON, Joshua A.; SAMPSON, Uchechukwu; SANTOS, Itamar S.; SAWHNEY, Monika; SAYINZOGA, Felix; SCHNEIDER, Ione J. C.; SCHUMACHER, Austin; SCHWEBEL, David C.; SEEDAT, Soraya; SEPANLOU, Sadaf G.; SERVAN-MORI, Edson E.; SHAKH-NAZAROVA, Marina; SHEIKHBAHAEI, Sara; SHIBUYA, Kenji; SHIN, Hwashin Hyun; SHIUE, Ivy; SIGFUSDOTTIR, Inga Dora; SILBERBERG, Donald H.; SILVA, Andrea P.; SINGH, Jasvinder A.; SKIRBEKK, Vegard; SLIWA, Karen; SOSHNIKOV, Sergey S.; SPOSATO, Luciano A.; SREERAMAREDDY, Chandrashekhar T.; STROUMPOULIS, Konstantinos; STURUA, Lela; SYKES, Bryan L.; TABB, Karen M.; TALONGWA, Roberto Tchio; TAN, Feng; TEIXEIRA, Carolina Maria; TENKORANG, Eric Yeboah; TERKAWI, Abdullah Sulieman; THORNE-LYMAN, Andrew L.; TIRSCHWELL, David L.; TOWBIN, Jeffrey A.; TRAN, Bach X.; TSILIMBARIS, Miltiadis; UCHENDU, Uche S.; UKWAJA, Kingsley N.; UNDURRAGA, Eduardo A.; UZUN, Selen Begum; VALLELY, Andrew J.; GOOL, Coen H. van; VASANKARI, Tommi J.; VAVILALA, Monica S.; VENKETASUBRAMANIAN, N.; VILLALPANDO, Salvador; VIOLANTE, Francesco S.; VLASSOV, Vasiliy Victorovich; VOS, Theo; WALLER, Stephen; WANG, Haidong; WANG, Linhong; WANG, XiaoRong; WANG, Yanping; WEICHENTHAL, Scott; WEIDERPASS, Elisabete; WEINTRAUB, Robert G.; WESTERMAN, Ronny; WILKINSON, James D.; WOLDEYOHANNES, Solomon Meseret; WONG, John Q.; WORDOFA, Muluemebet Abera; XU, Gelin; YANG, Yang C.; YANO, Yuichiro; YENTUR, Gokalp Kadri; YIP, Paul; YONEMOTO, Naohiro; YOON, Seok-Jun; YOUNIS, Mustafa Z.; YU, Chuanhua; JIN, Kim Yun; ZAKI, Maysaa El Sayed; ZHAO, Yong; ZHENG, Yingfeng; ZHOU, Maigeng; ZHU, Jun; ZOU, Xiao Nong; LOPEZ, Alan D.; NAGHAVI, Mohsen; MURRAY, Christopher J. L.; LOZANO, RafaelBackground The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100 000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. Methods We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. Findings 292 982 (95% UI 261017-327792) maternal deaths occurred in 2013, compared with 376 034 (343483-407574) in 1990. The global annual rate of change in the MMR was -0.3% (-1.1 to 0.6) from 1990 to 2003, and -2.7% (-3.9 to -1.5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0.4% (-0.2-0.6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956.8 (685.1-1262.8) in South Sudan to 2.4 (1.6-3.6) in Iceland. Interpretation Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.
- A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial(2021) ZUCCOLO, Pedro Fonseca; XAVIER, Mariana O.; MATIJASEVICH, Alicia; POLANCZYK, Guilherme; FATORI, DanielBackgroundPregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression.MethodsWe will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4-5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8weeks).DiscussionThe potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care.Trial registrationClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.
- Evaluation of the Persistence, Remission, and Emergence of Attention-Deficit/Hyperactivity Disorder in Young Adulthood(2016) AGNEW-BLAIS, Jessica C.; POLANCZYK, Guilherme V.; DANESE, Andrea; WERTZ, Jasmin; MOFFITT, Terrie E.; ARSENEAULT, LouiseIMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is now recognized to occur in adulthood and is associated with a range of negative outcomes. However, less is known about the prospective course of ADHD into adulthood, the risk factors for its persistence, and the possibility of its emergence in young adulthood in nonclinical populations. OBJECTIVE To investigate childhood risk factors and young adult functioning of individuals with persistent, remitted, and late-onset young adult ADHD. DESIGN, SETTING, AND PARTICIPANTS The study sample was the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of 2232 twins born in England and Wales from January 1, 1994, to December 4, 1995. Evaluation of childhood ADHD (ages 5, 7, 10, and 12 years) included prenatal and perinatal factors, clinical characteristics, and aspects of the family environment. Among participants aged 18 years, ADHD symptoms and associated impairment, overall functioning, and other mental health disorders were examined. Data analysis was conducted from February 19 to September 10, 2015. MAIN OUTCOMES AND MEASURES Attention-deficit/hyperactivity disorder according to DSM-IV diagnostic criteria in childhood and DSM-5 diagnostic criteria in young adulthood. RESULTS Of 2232 participants in the E-Risk Study, 2040 were included in the present analysis. In total, 247 individuals met diagnostic criteria for childhood ADHD; of these, 54 (21.9%) also met diagnostic criteria for the disorder at age 18 years. Persistence was associated with more symptoms (odds ratio [OR], 1.11 [95% CI, 1.04-1.19]) and lower IQ (OR, 0.98 [95% CI, 0.95-1.00]). At age 18 years, individuals with persistent ADHD had more functional impairment (school/work: OR, 3.30 [95% CI, 2.18-5.00], home/with friends: OR, 6.26 [95% CI, 3.07-12.76]), generalized anxiety disorder (OR, 5.19 [95% CI, 2.01-13.38]), conduct disorder (OR, 2.03 [95% CI, 1.03-3.99]), and marijuana dependence (OR, 2.88 [95% CI, 1.07-7.71]) compared with those whose ADHD remitted. Among 166 individuals with adult ADHD, 112 (67.5%) did not meet criteria for ADHD at any assessment in childhood. Results from logistic regressions indicated that individuals with late-onset ADHD showed fewer externalizing problems (OR, 0.93 [95% CI, 0.91-0.96]) and higher IQ (OR, 1.04 [95% CI, 1.02-1.07]) in childhood compared with the persistent group. However, at age 18 years, those with late-onset ADHD demonstrated comparable ADHD symptoms and impairment as well as similarly elevated rates of mental health disorders. CONCLUSIONS AND RELEVANCE We identified heterogeneity in the DSM-5 young adult ADHD population such that this group consisted of a large, late-onset ADHD group with no childhood diagnosis, and a smaller group with persistent ADHD. The extent to which childhood-onset and late-onset adult ADHD may reflect different causes has implications for genetic studies and treatment of ADHD.