New evidence challenges the assumption that half of children with ADHD will outgrow the disease in adulthood. Although patients may experience intermittent symptom remission, 90% of children with ADHD who were followed into young adulthood continued to have residual symptoms, according to the results of a prospective longitudinal study published in the American Journal of Psychiatry.
“It is important for people diagnosed with ADHD to understand that it is normal that there are times in your life when things are more uncontrollable and other times when things feel more under control,” said lead researcher Margaret H Sibley, PhD, associate professor of psychiatry and behavioral science at the University of Washington School of Medicine and researcher at the Seattle Children’s Research Institute.
Previous longitudinal studies of ADHD have focused on a single point in time and therefore were not designed to identify patients who experience symptom remission and later develop symptom recurrence, the study authors said.
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To better understand the course of the disease, the researchers examined longitudinal patterns of remission from ADHD in 558 children participating in the multimodal treatment study of ADHD (MTA). The children were subjected to 8 examinations over a 14-year follow-up period from 2 years after the start of the study (mean age 10.44 years) to 16 years after the start of the study (mean age 25.12 years). Participants with fully remitting, partially remitting, and persistent ADHD at any point in time were identified using parent, teacher, and self-reports of ADHD symptoms and impairments, treatment utilization, and comorbidity.
Fluctuating persistence and remission of ADHD symptoms found
About a third of children with ADHD (31.4%) experienced complete remission at some point during the follow-up period, with a range from 1.4% in the 2-year assessment to 18.5% in the 10-year assessment. Valuation; however, 60% of these patients have seen full or partial recurrence of ADHD symptoms after an initial period of complete remission. A majority of patients (63.8%) experienced variable persistence and remission from ADHD with no recovery. Recovery from ADHD, defined as sustained remission to the end of the study, was seen in 9.1% of patients.
The results suggest that “complete remission at a single point in time should not be associated with recovery from ADHD,” the authors noted. They called for continued regular screening for recurring symptoms and impairments after successful treatment for ADHD.
Results are limited by the design of the observational study and the discontinuation of follow-up at approximately 25 years of age. The sample included patients with combined ADHD; Therefore, the results may not be applicable to other ADHD subtypes or presentations. Missing data can also limit the results.
Some study authors stated links with biotech, pharmaceutical, and / or device manufacturers. For a full list of the author’s disclosures, see the original reference.
reference
Sibley MH, Arnold LE, Swanson JM et al .; MTA cooperative group. Variable remission patterns of ADHD in the multimodal treatment study of ADHD. Am J Psychiatry. Published online: August 13, 2021: appiajp202121010032. doi: 10.1176 / appi.ajp.2021.21010032
This article originally appeared on Clinical Advisor
