ORIGINAL REPORT

Association of ADHD Symptoms Severity with Higher Paternal

and Lower Maternal Age of A Clinical Sample of Children
Ahmad Ghanizadeh

Department of Psychiatry, Research Center for Psychiatry and Behavioral Sciences,

School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Received: 15 Jun. 2012 ; Received in revised form: 15 Aug. 2012 ; Accepted: 26 Feb. 2013

Abstract- This study examines the association of father’s and mother’s age with the severity of inattention
and hyperactivity/impulsivity. Participants are 470 children with attention deficit hyperactivity disorder
(ADHD) diagnosed according to DSM-IV diagnostic criteria. Moreover, parents reported the severity of
ADHD symptoms through completing ADHD checklist. Mother’s and father’s age was associated with the
score of hyperactivity/impulsivity. Lower father’s age and advanced maternal age are associated with higher
severity of hyperactivity/impulsivity in children and adolescents with ADHD. None of mothers’ and fathers’
age is associated with ADHD inattentiveness severity in children. Maternal and paternal education levels are
not associated with ADHD severity. Older mothers and younger fathers have ADHD children with higher
hyperactivity/impulsivity severity. It should be investigated whether the father’s and mother’s age are risk
factors for ADHD.
© 2014 Tehran University of Medical Sciences. All rights reserved.
Acta Medica Iranica, 2014; 52(1): 49-51.

Keywords: Attention deficit disorder with hyperactivity; Parents, Father; Mother, Age Distribution; Child,
Educational status

Introduction risk of adverse 'externalizing' behaviours” in seven year

old children (6). While advanced paternal age is
Attention deficit hyperactivity disorder (ADHD) is a associated with poorer neuro-cognitive function in
very common psychiatric disorder in clinical samples. infancy and childhood, advance maternal age is
The rate of its symptoms in the community is up to associated with a better neuro-cognitive function in
10.1% (1). ADHD has two main categories of symptoms infancy and childhood (7). However, others reported that
including inattentiveness and hyperactivity/impulsivity. this negative impact of paternal age on neurocognition
This disorder is associated with impairment in the social, may be related to maternal educational level.
academic, adaptive, and occupational aspect of life. Controlling for the maternal educational level offset the
ADHD is a familial disorder. However, its etiology is association of advanced paternal age and neuro-
not clearly known (2, 3). Environmental and some other cognitive function of children (8).
risk factors such as maternal self-perceived distress are The association of paternal age and ADHD is rarely
involved (2, 3). The symptoms of ADHD are found in studied. There is a report that the age distribution of
early childhood at the ages less than seven year. fathers of children with ADHD is not different from the
Therefore, birth risk factors are widely researched. community sample (9). However, we could not find
Recently, there has been an increasing interest to the more studies about this matter. In addition, no study was
possible association of parental age with the neuro- found investigated the possible association of maternal
developmental disorder of autism. Higher maternal and age distribution and ADHD.
paternal age are reported for children with autism (4). This study examines whether parental age is in
Moreover, parental age is a risk factor for autism in the association with the severity of inattentiveness and
community sample of children (5). hyperactivity/impulsivity in children and adolescents
Advanced paternal age significantly increases the with ADHD.

Corresponding Author: Ahmad Ghanizadeh

Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Hafez Hospital, Shiraz, Iran.
Tel/Fax: +98 711 6279319, E-mail: [email protected]
Parental age and ADHD

The clinical sample of ADHD is usually co-morbid children, father’s educational level, mother’s educational
with other psychiatric disorders. About 59% of them level, the co-morbidity of oppositional behavior
have oppositional defiant disorder (10). Separation symptoms, and separation anxiety symptoms were
anxiety disorder is also commonly reported in the considered as covariate factors. P value less than 0.05
clinical samples of children with ADHD (10). Male was set as statistical significance.
gender, lowe maternal and paternal educational level are
a risk factor for ADHD (11). Therefore, gender, paternal Results
and maternal educational level, the co-occurrence of
oppositional behaviors and anxiety symptoms are 470 children and adolescents with ADHD are
considered as covariate factors. included in this study. 358 (76.2%) of them were boys.
Their age range was 5 to 17 years old. The mean of age
Materials and Methods and its standard deviation was 9.0 and 2.3 years,
respectively.
The participants of this study are a clinical sample of The distribution of paternal and maternal age of
470 children and adolescents with ADHD. They are children with ADHD and general population are
referrals to a Child and Adolescents Psychiatry Clinic displayed in Table 1. The age range of father’s in the
affiliated with Shiraz University of Medical Sciences. ADHD groups was from 25 to 59 years. Their mean
This is a data re-analysis of an ongoing study about years of age was 39.6(SD=5.6). The age range of
ADHD (12). mothers of children with ADHD was from 25 to 52.
The children and at least one of their parents were Their mean years of age was 33.3(SD=5.0).
interviewed face to face. Psychiatric diagnosis was made Linear regression analysis showed that father’s age
according to the diagnostic criteria of Diagnostic and and the age of children with ADHD are negatively in
Statistical Manual of Mental Disorders-Text Revised association with hyperactivity/impulsivity score (Table
(DSM-IV) (13). 1). It also showed that mother’s age, oppositional
behavior score, and separation anxiety score are
Statistical analysis significantly associated with hyperactivity/impulsivity
SPSS for windows was used for statistical analysis. score.
Two separate linear regression analyses tests, backward Second linear regression analysis showed that none
method, were used to examine whether the father’s and of father’s and mother’s age was significantly associated
mother’s age is associated with the severity of with inattentiveness score in children and adolescents
inattentiveness and hyperactivity/impulsivity scores in with ADHD (Table 2).
children with ADHD. The variables of gender of

Table 1. The association of father’s and mother’s age with the severity of parent-reported hyperactivity/impulsivity in children with
ADHD.
Variable Beta Significance 95.0% Confidence Interval for Beta
Lower bound Upper bound
Father age -0.14 0.01 -0.26 -0.03
Mother age 0.12 0.02 0.01 0.27
Age -0.23 0.001 -0.79 -0.38
Oppositional behavior score 0.54 0.001 0.45 0.62
Separation anxiety score 0.16 0.001 0.07 0.25

Table 2. The association of father’s and mother’s age with the severity of parent-reported inattentiveness in children with ADHD.
Variable Beta Significance 95.0% Confidence Interval for Beta
Lower bound Upper bound
Age 0.14 0.001 0.11 0.46
Oppositional behavior score 0.28 0.001 0.17 0.33
Separation anxiety score 0.08 0.07 -0.007 0.16
Father’s and mother’s age were not associated with the severity of parent-reported inattentiveness.

50 Acta Medica Iranica, Vol. 52, No. 1 (2014)

 A. Ghanizadeh, et al.

Discussion depression and obstetric, neonatal and early childhood

outcomes. Early Hum Dev. 2010 May;86(5):305-10.
The aim of this study was to examine whether parental PubMed PMID: 20547016. Epub 2010/06/16. eng.
age is associated the severity of inattention and 4. Gardener H, Spiegelman D, Buka SL. Prenatal risk factors
hyperactivity/impulsivity in children with ADHD. for autism: comprehensive meta-analysis. Br J Psychiatry.
Current results supports that both father’s and mother’s
2009 Jul;195(1):7-14. PubMed PMID: 19567888. Epub
age are associated with the severity of
2009/07/02. eng.
hyperactivity/impulsivity. However, none of them was
in association with the inattention severity. It shows that 5. Sasanfar R, Haddad SA, Tolouei A, Ghadami M, Yu D,
the higher age of mothers and the lower age of fathers Santangelo SL. Paternal age increases the risk for autism in
are associated with higher hyperactivity/impulsivity. No an Iranian population sample. Mol Autism. 2010;1(1):2.
previous published study was found investigated this PubMed PMID: 20678245. Pubmed Central PMCID:
association to be compared with us. 2907564. Epub 2010/08/04. eng.
If future studies confirm these associations, it should 6. Saha S, Barnett AG, Buka SL, McGrath JJ. Maternal age
investigate whether the father’s and mother’s age are and paternal age are associated with distinct childhood
risk factors for ADHD. behavioural outcomes in a general population birth cohort.
This is a cross-sectional study. Therefore, a cause Schizophr Res. 2009 Dec;115(2-3):130-5. PubMed PMID:
and effect relationship cannot be investigated. 19781913. Epub 2009/09/29. eng.
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children and adolescents. Therefore, the generalization SL, et al. Advanced paternal age is associated with
of the results to community samples or other clinics is impaired neurocognitive outcomes during infancy and
not guaranteed. There are many risk factors for the childhood. PLoS Med. 2009 Mar 10;6(3):e40. PubMed
neuro-developmental disorder should be considered such PMID: 19278291. Pubmed Central PMCID: 2653549.
as labor characteristics, low birth weight, and Epub 2009/03/13. eng.
prematurity. This study compared parental age 8. Edwards RD, Roff J. Negative effects of paternal age on
distribution between ADHD group and general children's neurocognitive outcomes can be explained by
population. Further studies may include the parents of maternal education and number of siblings. PLoS One.
children without ADHD as a control group. 2010;5(9):e12157. PubMed PMID: 20856853. Pubmed
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sample of children with ADHD. The diagnoses were 9. Gabis L, Raz R, Kesner-Baruch Y. Paternal age in autism
made using DSM-IV diagnostic criteria. In addition, spectrum disorders and ADHD. Pediatr Neurol. 2010
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