Objective This study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD.
Design and setting In this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure.
Patients 117 children with ADHD and 149 control children were included in the analyses.
Main outcome measures Maternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years.
Results Mothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01).
Conclusions Maternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.
- attention-deficit/hyperactivity disorder
- maternal adhd
- quality of life
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Contributors DE conceptualised and designed the study, drafted the initial manuscript, and approved the final manuscript as submitted. KF contributed to conceptualising and designing the study, reviewed and revised the manuscript, and approved the final manuscript as submitted. AG conducted statistical analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. ES conceptualised and designed the study, contributed to statistical analyses, provided critical input and approved the final manuscript as submitted.
Funding The Children’s Attention Project is funded by an Australian National Health and Medical Research Council (NHMRC) project grant 100852. ES’ position is funded by an NHMRC Early Career Fellowship in Population Health 1037159 (2012–2015) and an NHMRC Career Development Fellowship 1110688 (2016-2019). DE is funded by a Clinician Scientist Fellowship from the Murdoch Children’s Research Institute. MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program.
Competing interests None declared.
Ethics approval Study approval was granted by the Human Research Ethics Committee of the Royal Children’s Hospital, Melbourne (#31056).
Provenance and peer review Not commissioned; externally peer reviewed.