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 journalArticle (Academic Journal)peer-review

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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 languageEnglish
JournalBritish Journal of Psychiatry
Early online date21 Sep 2021
Publication statusE-pub ahead of print - 21 Sep 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 ( ). 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.


  • ADHD
  • adult
  • age-at-onset
  • retrospective


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