Association of childhood adversities on the persistence and remission of drug-naïve attention-deficit/hyperactivity disorder in a longitudinal community-based sample

Psychiatry Res. 2025 Dec 2;356:116867. doi: 10.1016/j.psychres.2025.116867. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the influence of Adverse Childhood Experiences (ACEs) on the natural course of attention-deficit/hyperactivity disorder (ADHD) without the effect of ADHD medication.

METHODS: 457 Finnish children partook in a clinical study where their ADHD trajectory was defined from the age of 7 to the age of 16. The participants were divided into six study groups: Control (N = 269), persistent ADHD (N = 90), Remitting ADHD (N = 40), Sub-Threshold ADHD (N = 25), Partially Remitting ADHD (N = 18), and Late-Onset ADHD (N = 15). ADHD was screened using the SWAN rating scale for ADHD symptoms, and then selected participants were interviewed using the Kiddie-SADS-PL semistructured interview. The mean ACE score was 1.03 in the Control Group, 1.29 in Persistent ADHD Group, 1.19 in Remitting Group, 1.12 in Sub-Threshold Group, 1.93 in Partially Remitting Group, and 1.0 in Late-Onset group. Using binary logistic regression analysis with psychiatric comorbidities and sex as confounders we studied the association of ACEs to these trajectories.

RESULTS: The analysis identified a statistically significant association between high ACE scores and a partially remitting ADHD trajectory (Odds Ratio = 2.07, 95 % Confidence Intervals = 1.26-3.38, p = .004).

CONCLUSION: A high ACE score showed an association with having some persistent ADHD symptoms in adolescence while not reaching the diagnostic threshold for ADHD in the partially remitting group. This is a novel finding, and further studies with larger samples would be needed to replicate and extend these preliminary findings.

PMID:41351892 | DOI:10.1016/j.psychres.2025.116867