Assessment of age-at-onset criterion for adult attention-deficit hyperactivity disorder

Lucy Riglin; Rachel Blakey; Kate Langley; Ajay Thapar; Sharifah Shameem Agha; George Davey Smith; Evangelia  Stergiakouli; Anita Thapar

doi:10.1192/bjp.2021.122

Assessment of age-at-onset criterion for adult attention-deficit hyperactivity disorder

Lucy Riglin, Rachel Blakey, Kate Langley, Ajay Thapar, Sharifah Shameem Agha, George Davey Smith, Evangelia Stergiakouli , Anita Thapar^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 ADHD criteria (N=138), using a prospective population cohort, we compared four different approaches to asking those at age 25 years when their symptoms started. Receiver Operating Characteristic curves showed variation between the approaches (χ(3)=8.99, p=0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve 0.57-0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment.

Original language	English
Journal	British Journal of Psychiatry
Early online date	21 Sept 2021
DOIs	https://doi.org/10.1192/bjp.2021.122
Publication status	E-pub ahead of print - 21 Sept 2021

Bibliographical note

Funding Information:
The UK Medical Research Council and the Wellcome Trust (grant ref.: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and L.R. and A.T. will serve as guarantors for the contents of this paper. A comprehensive list of grant funding is available on the ALSPAC website ( www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). The primary outcome measures for age 25 data used in the paper were specifically funded by the Wellcome Trust (204895/Z/16/Z). R.B., G.D.S. and E.S. work in a unit that receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_00011/1 and MC_UU_00011/3). This research was funded by the Wellcome Trust (204895/Z/16/Z). For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

Publisher Copyright:
© The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

Keywords

ADHD
adult
age-at-onset
retrospective
ALSPAC

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10.1192/bjp.2021.122

Full-text PDF (author’s accepted manuscript)
This research was funded in whole, or in part, by the Wellcome Trust [204895/Z/16/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://doi.org/10.1192/bjp.2021.122 . Please refer to any applicable terms of use of the publisher.
Accepted author manuscript, 166 KBLicence: CC BY
Supplementary information PDF
This research was funded in whole, or in part, by the Wellcome Trust [204895/Z/16/Z]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://doi.org/10.1192/bjp.2021.122 . Please refer to any applicable terms of use of the publisher.
Accepted author manuscript, 140 KBLicence: CC BY

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IEU: MRC Integrative Epidemiology Unit Quinquennial renewal
Gaunt, L. F. (Principal Investigator) & Davey Smith, G. (Principal Investigator)
1/04/18 → 31/03/23
Project: Research

Cite this

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title = "Assessment of age-at-onset criterion for adult attention-deficit hyperactivity disorder",

abstract = "To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 ADHD criteria (N=138), using a prospective population cohort, we compared four different approaches to asking those at age 25 years when their symptoms started. Receiver Operating Characteristic curves showed variation between the approaches (χ(3)=8.99, p=0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve 0.57-0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment. ",

keywords = "ADHD, adult, age-at-onset, retrospective, ALSPAC",

author = "Lucy Riglin and Rachel Blakey and Kate Langley and Ajay Thapar and Agha, {Sharifah Shameem} and {Davey Smith}, George and Evangelia Stergiakouli and Anita Thapar",

note = "Funding Information: The UK Medical Research Council and the Wellcome Trust (grant ref.: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and L.R. and A.T. will serve as guarantors for the contents of this paper. A comprehensive list of grant funding is available on the ALSPAC website ( www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). The primary outcome measures for age 25 data used in the paper were specifically funded by the Wellcome Trust (204895/Z/16/Z). R.B., G.D.S. and E.S. work in a unit that receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_00011/1 and MC_UU_00011/3). This research was funded by the Wellcome Trust (204895/Z/16/Z). For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: {\textcopyright} The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.",

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AU - Riglin, Lucy

AU - Blakey, Rachel

AU - Langley, Kate

AU - Thapar, Ajay

AU - Agha, Sharifah Shameem

AU - Davey Smith, George

AU - Stergiakouli , Evangelia

AU - Thapar, Anita

N1 - Funding Information: The UK Medical Research Council and the Wellcome Trust (grant ref.: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and L.R. and A.T. will serve as guarantors for the contents of this paper. A comprehensive list of grant funding is available on the ALSPAC website ( www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). The primary outcome measures for age 25 data used in the paper were specifically funded by the Wellcome Trust (204895/Z/16/Z). R.B., G.D.S. and E.S. work in a unit that receives funding from the University of Bristol and the UK Medical Research Council (MC_UU_00011/1 and MC_UU_00011/3). This research was funded by the Wellcome Trust (204895/Z/16/Z). For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

PY - 2021/9/21

Y1 - 2021/9/21

N2 - To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 ADHD criteria (N=138), using a prospective population cohort, we compared four different approaches to asking those at age 25 years when their symptoms started. Receiver Operating Characteristic curves showed variation between the approaches (χ(3)=8.99, p=0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve 0.57-0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment.

AB - To investigate the accuracy of the age-at-onset criterion in those who meet other DSM-5 ADHD criteria (N=138), using a prospective population cohort, we compared four different approaches to asking those at age 25 years when their symptoms started. Receiver Operating Characteristic curves showed variation between the approaches (χ(3)=8.99, p=0.03); all four showed low discrimination against symptoms that had been assessed when they were children (area under the curve 0.57-0.68). Asking adults to recall specific symptoms may be preferable to recalling at what age symptoms started. However limitations to retrospective recall add to debate on the validity of ADHD age-at-onset assessment.

KW - ADHD

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KW - age-at-onset

KW - retrospective

KW - ALSPAC

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DO - 10.1192/bjp.2021.122

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JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

ER -

Assessment of age-at-onset criterion for adult attention-deficit hyperactivity disorder

Abstract

Bibliographical note

Keywords

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Projects

IEU: MRC Integrative Epidemiology Unit Quinquennial renewal

Cite this