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Preschool hyperactivity specifically elevates long-term mental health risks more strongly in males than females: a prospective longitudinal study through to young adulthood

Smith, Elizabeth; Meyer, Brenda J.; Koerting, Johanna; Laver-Bradbury, Cathy; Lee, Louise; Jefferson, Harriet; Sayal, Kapil; Treglown, Luke; Thompson, Margaret; Sonuga-Barke, Edmund J.S.


Elizabeth Smith

Brenda J. Meyer

Johanna Koerting

Cathy Laver-Bradbury

Louise Lee

Harriet Jefferson

Professor of Child and Adolescent Psychiatry

Luke Treglown

Margaret Thompson

Edmund J.S. Sonuga-Barke


Evidence of continuities between preschool hyperactivity and adult mental health problems highlight the potential value of targeting early identification and intervention strategies. However, specific risk factors are currently unclear. This large-scale prospective longitudinal study aimed to identify which hyperactive preschoolers are at greatest long-term risk of poor mental health. One hundred and seventy children (89 females) rated as hyperactive by their parents and 88 non-hyperactive controls (48 females) were identified from a community sample of 4,215 3 year-olds. Baseline data relating to behavioral/emotional problems and background characteristics were collected. Follow-up mental health and functional impairment outcomes were collected between 14 and 25 years of age. At age 3 years, males and females in the hyperactive group had similarly raised levels of hyperactivity and other behavior problems. In adolescence/young adulthood, these individuals showed elevated symptoms of ADHD, conduct disorder, mood disorder, anxiety and autism, as well as functional impairment. Preschool hyperactivity was strongly predictive of poor adolescent/adult outcomes for males across domains with effects being specifically driven by hyperactivity. For females, the effects of preschool hyperactivity were smaller and dropped to non-significant levels when other preschool problems were taken into account. Environmental risk factors also differed between the sexes, although these may also have been mediated by genetic risk. In conclusion, these results demonstrate marked sex differences in preschool predictors of later adolescent/adult mental health problems. Future research should include a measure of preschool inattention as well hyperactivity. The findings highlight the potential value of tailored approaches to early identification strategies.


Smith, E., Meyer, B. J., Koerting, J., Laver-Bradbury, C., Lee, L., Jefferson, H., …Sonuga-Barke, E. J. (2017). Preschool hyperactivity specifically elevates long-term mental health risks more strongly in males than females: a prospective longitudinal study through to young adulthood. European Child and Adolescent Psychiatry, 26(1), 123-136.

Journal Article Type Article
Acceptance Date May 29, 2016
Online Publication Date Jun 13, 2016
Publication Date Jan 31, 2017
Deposit Date May 31, 2016
Publicly Available Date Jun 13, 2016
Journal European Child & Adolescent Psychiatry
Print ISSN 1018-8827
Electronic ISSN 1435-165X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 26
Issue 1
Pages 123-136
Keywords Preschool hyperactivity; long-term risk; mental health; longitudinal study
Public URL
Publisher URL
Additional Information The final publication is available at Springer via


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