Does level of attention deficit-hyperactivity disorder symptoms predicts poor transition into adulthood?

  • Stéphanie BaggioEmail author
  • Joseph Studer
  • Ana Fructuoso
  • Véronique S. Grazioli
  • Patrick Heller
  • Hans Wolff
  • Gerhard Gmel
  • Nader Perroud
Original Article



Transition into adulthood is a risky period for young people with attention deficit-hyperactivity disorder (ADHD), but empirical studies on this topic are scarce. This study investigated the association between the level of ADHD symptoms and transition into adulthood.


Data were collected in the Cohort Study of Substance Use and Risk Factors among a representative sample of young Swiss men (n = 4681) over three waves. Measures included the level of ADHD symptoms and emerging adulthood assessed with the Inventory of the Dimensions of Emerging Adulthood and indicators of successful transition into adulthood.


The level of ADHD symptoms was associated with a lower success in the transition into adulthood. Young people with high level of ADHD symptoms had a reduced increase in indicators of successful transition over time. Inattention symptoms were more strongly associated with emerging adulthood measures in comparison with hyperactive symptoms.


The level of ADHD symptoms may delay the transition into adulthood, especially inattentive symptoms. Providing tailored interventions to emerging adults with ADHD symptoms may decrease the substantial impairments adults with ADHD experience in life.


Functional impairment Health care IDEA Mental health 



The C-SURF study was granted by the Swiss National Science Foundation (Project No. 148493).

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

All authors declare that they have no conflict of interest.


  1. Abecassis M, Isquith PK, Roth RM (2017) Characteristics of ADHD in the emerging adult: an overview. Psychol Inj Law 10:197–208. CrossRefGoogle Scholar
  2. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR), 4th edn. Author, Washington, DCCrossRefGoogle Scholar
  3. Arnett JJ, Žukauskienė R, Sugimura K (2014) The new life stage of emerging adulthood at ages 18–29 years: implications for mental health. Lancet Psychiatry 1:569–576. CrossRefPubMedGoogle Scholar
  4. Babinski DE et al (2011) Late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood: an exploratory investigation. J Atten Disord 15:204–214. CrossRefPubMedGoogle Scholar
  5. Baggio S, Iglesias K, Studer J, Gmel G (2015) An 8-Item short form of the inventory of dimensions of emerging adulthood (IDEA) among young Swiss men. Eval Health Prof 38:246–254. CrossRefPubMedGoogle Scholar
  6. Brook JS, Brook DW, Zhang C, Seltzer N, Finch SJ (2013) Adolescent ADHD and adult physical and mental health, work performance, and financial stress. Pediatrics 131:5–13. CrossRefPubMedPubMedCentralGoogle Scholar
  7. Caci H, Doepfner M, Asherson P, Donfrancesco R, Faraone SV, Hervas A, Fitzgerald M (2014) Daily life impairments associated with self-reported childhood/adolescent attention-deficit/hyperactivity disorder and experiences of diagnosis and treatment: results from the European Lifetime Impairment Survey. Eur Psychiatry 29:316–323. CrossRefPubMedGoogle Scholar
  8. Caci H, Cohen D, Bonnot O, Kabuth B, Raynaud J-P, Paillé S, Vallée L (2016) Health care trajectories for children with ADHD in France: results from the QUEST survey. J Atten Disord. CrossRefPubMedGoogle Scholar
  9. Davis JP, Dumas TM, Briley DA, Sussman S (2018) A meta-analysis of the association between substance use and emerging adult development using the IDEA scale. Am J Addict 27:166–176. CrossRefPubMedGoogle Scholar
  10. De Alwis D, Lynskey MT, Reiersen AM, Agrawal A (2014) Attention-deficit/hyperactivity disorder subtypes and substance use and use disorders in NESARC. Addict Behav 39:1278–1285. CrossRefPubMedPubMedCentralGoogle Scholar
  11. Döpfner M, Hautmann C, Görtz-Dorten A, Klasen F, Ravens-Sieberer U, group Bs (2015) Long-term course of ADHD symptoms from childhood to early adulthood in a community sample. Eur Child Adolesc Psychiatry 24:665–673. CrossRefPubMedGoogle Scholar
  12. Evans SC, Fite PJ, Hendrickson ML, Rubens SL, Mages AK (2015) The role of reactive aggression in the link between hyperactive–impulsive behaviors and peer rejection in adolescents. Child Psychiatry Hum Dev 46:903–912. CrossRefPubMedGoogle Scholar
  13. Frazier TW, Youngstrom EA, Naugle RI (2007) The latent structure of attention-deficit/hyperactivity disorder in a clinic-referred sample. Neuropsychology 21:45–64. CrossRefPubMedGoogle Scholar
  14. Ginsberg Y, Beusterien KM, Amos K, Jousselin C, Asherson P (2014) The unmet needs of all adults with ADHD are not the same: a focus on Europe. Expert Rev Neurother 14:799–812. CrossRefPubMedGoogle Scholar
  15. Gmel G et al (2015) The Swiss cohort study on substance use risk factors—findings of two waves. SUCHT 61:251–262. CrossRefGoogle Scholar
  16. Kessler RC, Adler LA, Gruber MJ, Sarawate CA, Spencer T, Van Brunt DL (2007) Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) screener in a representative sample of health plan members. Int J Methods Psychiatr Res 16:52–65. CrossRefPubMedPubMedCentralGoogle Scholar
  17. Larsson H, Anckarsater H, Råstam M, Chang Z, Lichtenstein P (2012) Childhood attention-deficit hyperactivity disorder as an extreme of a continuous trait: a quantitative genetic study of 8,500 twin pairs. J Child Psychol Psychiatry 53:73–80. CrossRefPubMedGoogle Scholar
  18. Liebrenz M, Gamma A, Ivanov I, Buadze A, Eich D (2016) Adult attention-deficit/hyperactivity disorder: associations between subtype and lifetime substance use—a clinical study. F1000Res. CrossRefPubMedCentralGoogle Scholar
  19. Lisha NE, Grana R, Sun P, Rohrbach L, Spruijt-Metz D, Reifman A, Sussman S (2012) Evaluation of the psychometric properties of the Revised Inventory of the Dimensions of Emerging Adulthood (IDEA-R) in a sample of continuation high school students Eval. Health Prof. CrossRefGoogle Scholar
  20. Lotstein DS, Inkelas M, Hays RD, Halfon N, Brook R (2008) Access to care for youth with special health care needs in the transition to adulthood. J Adolesc Health 43:23–29. CrossRefPubMedGoogle Scholar
  21. Moscoso A, Jovanovic N, Rojnic M (2015) Transition from adolescent to adult mental health services in Europe from the provider’s perspective. Lancet Psychiatry 2:779–780. CrossRefPubMedGoogle Scholar
  22. Okumura MJ, Hersh AO, Hilton JF, Lotstein DS (2013) Change in health status and access to care in young adults with special health care needs: results from the 2007 national survey of adult transition and health. J Adolesc Health 52:413–418. CrossRefPubMedGoogle Scholar
  23. Parsons HM, Schmidt S, Harlan LC, Kent EE, Lynch CF, Smith AW, Keegan THM (2014) Young and uninsured: insurance patterns of recently diagnosed adolescent and young adult cancer survivors in the AYA HOPE study. Cancer 120:2352–2360. CrossRefPubMedPubMedCentralGoogle Scholar
  24. Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 43:434–442. CrossRefPubMedPubMedCentralGoogle Scholar
  25. Polderman TJC, Boomsma DI, Bartels M, Verhulst FC, Huizink AC (2010) A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatr Scand 122:271–284. CrossRefPubMedGoogle Scholar
  26. Ramos-Quiroga JA, Montoya A, Kutzelnigg A, Deberdt W, Sobanski E (2013) Attention deficit hyperactivity disorder in the European adult population: prevalence, disease awareness, and treatment guidelines. Curr Med Res Opin 29:1093–1104. CrossRefPubMedGoogle Scholar
  27. Reifman A, Colwell MJ, Arnett JJ (2007) Emerging adulthood: theory, assessment, and application. J Youth Dev 2:37–48CrossRefGoogle Scholar
  28. Sayal K, Prasad V, Daley D, Ford T, Coghill D (2017) ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. CrossRefPubMedGoogle Scholar
  29. Sciberras E (2014) ADHD research: the power of population-based studies. Lancet Psychiatry 1:248–249. CrossRefPubMedGoogle Scholar
  30. Seiffge-Krenke I (2013) “She’s leaving home…” Antecedents, consequences, and cultural patterns in the leaving home process. Emerg Adulthood 1:114–124. CrossRefGoogle Scholar
  31. Settersten RA (2007) The new landscape of adult life: road maps, signposts, and speed lines. Res Hum Dev 4:239–252. CrossRefGoogle Scholar
  32. Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, Arnold LE (2012) A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Med 10:99. CrossRefPubMedPubMedCentralGoogle Scholar
  33. Studer J et al (2013) Examining non-response bias in substance use research–are late respondents proxies for non-respondents? Drug Alcohol Depend 132:316–323. CrossRefPubMedGoogle Scholar
  34. Taylor N, Fauset A, Harpin V (2010) Young adults with ADHD: an analysis of their service needs on transfer to adult services. Arch Dis Child 95:513–517. CrossRefPubMedGoogle Scholar
  35. Treuer T et al (2017) Lost in transition: a review of the unmet need of patients with attention deficit/hyperactivity disorder transitioning to adulthood. Asia Pac Psychiatry. CrossRefPubMedGoogle Scholar
  36. van de Glind G et al (2013) Validity of the Adult ADHD Self-Report Scale (ASRS) as a screener for adult ADHD in treatment seeking substance use disorder patients. Drug Alcohol Depend 132:587–596. CrossRefPubMedPubMedCentralGoogle Scholar
  37. Wilens TE, Biederman J, Faraone SV, Martelon M, Westerberg D, Spencer TJ (2009) Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD. J Clin Psychiatry 70:1557–1562. CrossRefPubMedPubMedCentralGoogle Scholar
  38. Williamson D, Johnston C (2015) Gender differences in adults with attention-deficit/hyperactivity disorder: a narrative review. Clin Psychol Rev 40:15–27. CrossRefPubMedGoogle Scholar
  39. Wymbs B et al (2012) Risk of intimate partner violence among young adult males with childhood ADHD. J Atten Disord 16:373–383. CrossRefPubMedGoogle Scholar

Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  • Stéphanie Baggio
    • 1
    • 2
    Email author
  • Joseph Studer
    • 3
  • Ana Fructuoso
    • 1
  • Véronique S. Grazioli
    • 3
  • Patrick Heller
    • 1
  • Hans Wolff
    • 1
  • Gerhard Gmel
    • 3
    • 4
    • 5
    • 6
  • Nader Perroud
    • 7
  1. 1.Division of Prison HealthGeneva University Hospitals and University of GenevaGenevaSwitzerland
  2. 2.Life Course and Social Inequality Research CentreUniversity of LausanneLausanneSwitzerland
  3. 3.Alcohol Treatment CentreLausanne University Hospital CHUVLausanneSwitzerland
  4. 4.Addiction SwitzerlandLausanneSwitzerland
  5. 5.Centre for Addiction and Mental HealthTorontoCanada
  6. 6.University of the West of EnglandBristolUK
  7. 7.Division of Psychiatric Specialties, Department of Mental Health and PsychiatryUniversity Hospitals of GenevaGenevaSwitzerland

Personalised recommendations