Young adult outcomes in the follow‐up of the multimodal treatment study of attention‐deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression
James M. Swanson,L. Eugene Arnold,Brooke S.G. Molina,Margaret H. Sibley,Lily Hechtman,Stephen P. Hinshaw,Howard Abikoff,Annamarie Stehli,Elizabeth B. Owens,John T. Mitchell,Quyen Nichols,Andrea L. Howard,Laurence L. Greenhill,Betsy Hoza,Jeffrey H. Newcorn,Peter S. Jensen,Benedetto Vitiello,Timothy Wigal,Jeffery N. Epstein,Leanne Tamm,Kimberly D. Lakes,James G. Waxmonsky,Marc Lerner,Joy Etcovitch,Desiree W. Murray,Maximilian Muenke,Maria T. Acosta,Mauricio Arcos-Burgos,William E. Pelham,Helena C. Kraemer +29 more
Reads0
Chats0
TLDR
In the MTA follow-up into adulthood, the ADHD group showed symptom persistence compared to local norms from the LNCG, and within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.Abstract:
Background
The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7–10 years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2–16 years after baseline.
Methods
Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified. Treatment was monitored to age 18, and naturalistic subgroups were formed based on three patterns of long-term use of stimulant medication (Consistent, Inconsistent, and Negligible). For the follow-up, hypothesis-generating analyses were performed on outcomes in early adulthood (at 25 years of age). Planned comparisons were used to estimate ADHD-LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication.
Results
For ratings of symptom severity, the ADHD-LNCG comparison was statistically significant for the parent/self-report average (0.51 ± 0.04, p < .0001, d = 1.11), documenting symptom persistence, and for the parent/self-report difference (0.21 ± 0.04, p < .0001, d = .60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the ADHD group was 1.29 ± 0.55 cm shorter than the LNCG (p < .01, d = .21), and the comparisons of the naturalistic subgroups were significant: the treated group with the Consistent or Inconsistent pattern was 2.55 ± 0.73 cm shorter than the subgroup with the Negligible pattern (p < .0005, d = .42), and within the treated group, the subgroup with the Consistent pattern was 2.36 ± 1.13 cm shorter than the subgroup with the Inconsistent pattern (p < .04, d = .38).
Conclusions
In the MTA follow-up into adulthood, the ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.read more
Citations
More filters
Journal Article
[Better reporting of harms in randomized trials: an extension of the CONSORT statement].
Peter C Gøtzsche,CONSORT-gruppen +1 more
Journal ArticleDOI
Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis
Jessica Van Doren,Martijn Arns,Hartmut Heinrich,Madelon A. Vollebregt,Ute Strehl,Sandra K. Loo +5 more
TL;DR: Compared to non-active control treatments, NF appears to have more durable treatment effects, for at least 6 months following treatment, and more studies are needed to properly powered comparison of follow-up effects between NF and active treatments and to further control for non-specific effects.
Journal ArticleDOI
Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases
Sudha R. Raman,Kenneth K.C. Man,Shahram Bahmanyar,Anick Bérard,Scott Bilder,Takoua Boukhris,Greta A. Bushnell,Stephen Crystal,Kari Furu,Yea Huei Kao-Yang,Øystein Karlstad,Helle Kieler,Kiyoshi Kubota,Edward Chia Cheng Lai,Jaana E. Martikainen,Géric Maura,Nicholas Moore,Dolores Montero,Hidefumi Nakamura,Anke Neumann,Virginia Pate,Anton Pottegård,Nicole L. Pratt,Elizabeth E. Roughead,Diego Macías Saint-Gerons,Til Stürmer,Chien Chou Su,Helga Zoega,Helga Zoega,Miriam C.J.M. Sturkenbroom,Esther W. Chan,David Coghill,Patrick Ip,Ian C. K. Wong,Ian C. K. Wong +34 more
TL;DR: The results show increases over time but large variations in ADHD medication use in multiple regions, particularly in adults.
Journal ArticleDOI
Treatment strategies for ADHD: an evidence-based guide to select optimal treatment
TL;DR: An evidence-based appraisal of the literature on ADHD treatment is provided, supplemented by expert opinion on plausibility, and guidance for optimizing initiation of treatment and follow-up of patients in clinical settings is provided.
References
More filters
2000 CDC Growth Charts for the United States: methods and development.
Robert J. Kuczmarski,Cynthia L. Ogden,Shumei S. Guo,Laurence M. Grummer-Strawn,Katherine M. Flegal,Zuguo Mei,Rong Wei,Lester R. Curtin,Alex F. Roche,Clifford L. Johnson +9 more
TL;DR: The 2000 CDC growth charts were developed with improved data and statistical procedures and now have an instrument for growth screening that better represents the racial-ethnic diversity and combination of breast- and formula-feeding in the United States.
Journal ArticleDOI
A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder
P. S. Jensen,L. E. Arnold,Je Richters,Jb Severe,D Vereen,Benedetto Vitiello,E. Schiller,Stephen P. Hinshaw,Gr Elliott,C.K. Conners,Kc Wells,John S. March,James M. Swanson,Timothy Wigal,Dennis P. Cantwell,Hb Abikoff,J Hechtman,Ll Greeenhill,Jh Newcorn,We Pelham,B Hoza,Hk Kraemer +21 more
TL;DR: In this paper, a group of 579 children with ADHD Combined Type, aged 7 to 9.9 years, were assigned to 14 months of medication management (titration followed by monthly visits); intensive behavioral treatment (parent, school, and child components, with therapist involvement gradually reduced over time); the two combined; or standard community care (treatments by community providers).
Journal ArticleDOI
A structural approach to selection bias.
TL;DR: This work argues that the causal structure underlying the bias in each example is essentially the same: conditioning on a common effect of 2 variables, one of which is either exposure or a cause of exposure and the other is either the outcome or acause of the outcome.
Journal ArticleDOI
The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies
TL;DR: The results show that estimates of ADHD's persistence rely heavily on how one defines persistence, yet, regardless of definition, the analyses show that evidence for ADHD lessens with age.
Related Papers (5)
A 14-Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder
The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study
Brooke S. G. Molina,Stephen P. Hinshaw,James M. Swanson,L. Eugene Arnold,Benedetto Vitiello,Peter S. Jensen,Jeffery N. Epstein,Betsy Hoza,Lily Hechtman,Howard Abikoff,Glen R. Elliott,Laurence L. Greenhill,Jeffrey H. Newcorn,Karen C. Wells,Timothy Wigal,Robert D. Gibbons,Kwan Hur,Patricia R. Houck +17 more
ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Mark L. Wolraich,Joseph F. Hagan,Carla C. Allan,Carla C. Allan,Eugenia Chan,Eugenia Chan,Dale Davison,Marian F. Earls,Steven W. Evans,Susan K. Flinn,Tanya E. Froehlich,Tanya E. Froehlich,Jennifer Frost,Joseph R. Holbrook,Christoph U. Lehmann,Herschel R. Lessin,Kymika Okechukwu,Karen Pierce,Karen Pierce,Jonathan D Winner,William Zurhellen,Subcommittee On Children,Hyperactive Disorder +22 more
3-Year Follow-up of the NIMH MTA Study
Peter S. Jensen,L. Eugene Arnold,James M. Swanson,Benedetto Vitiello,Howard Abikoff,Laurence L. Greenhill,Lily Hechtman,Lily Hechtman,Stephen P. Hinshaw,William E. Pelham,Karen C. Wells,C. Keith Conners,Glen R. Elliott,Jeffery N. Epstein,Betsy Hoza,John S. March,Brooke S. G. Molina,Jeffrey H. Newcorn,Jeffrey H. Newcorn,Joanne B. Severe,Timothy Wigal,Robert D. Gibbons,Kwan Hur +22 more
Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis
Samuele Cortese,Nicoletta Adamo,Cinzia Del Giovane,Christina Mohr-Jensen,Adrian J. Hayes,Sara Carucci,Lauren Z Atkinson,Luca Tessari,Tobias Banaschewski,David Coghill,David Coghill,Chris Hollis,Emily Simonoff,Alessandro Zuddas,Corrado Barbui,Marianna Purgato,Hans-Christoph Steinhausen,Farhad Shokraneh,Farhad Shokraneh,Jun Xia,Andrea Cipriani +20 more