Functional adult outcomes 16 years after childhood diagnosis of Attention-Deficit/Hyperactivity Disorder:MTA results

Hechtman, Lily and Swanson, James M. and Sibley, Margaret H. and Stehli, Annamarie and Owens, Elizabeth B. and Mitchell, John T. and Arnold, L. Eugene and Molina, Brooke S. G. and Hinshaw, Stephen P. and Jensen, Peter S. and Abikoff, Howard and Perez Algorta, Guillermo Daniel and Howard, Andrea L. and Hoza, Betsy and Etcovitch, Joy and Houssais, Sylviane and Lakes, Kimberly D. and Nichols, J. Quyen (2016) Functional adult outcomes 16 years after childhood diagnosis of Attention-Deficit/Hyperactivity Disorder:MTA results. Journal of the Amercian Academy of Child and Adolescent Psychiatry, 55 (11). 945-952.e2. ISSN 0890-8567

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Abstract

Objective To compare educational, occupational, legal, emotional, substance use disorder, and sexual-behavior outcomes in young adults with persistent and desistent attention-deficit/hyperactivity disorder (ADHD) symptoms and a local normative comparison group (LNCG) in the Multimodal Treatment Study of Children with ADHD (MTA). Method Data were collected 12, 14, and 16 years post-baseline (mean age 24.7 years at 16 years post-baseline) from 476 participants with ADHD diagnosed at age 7-9, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence vs. desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD vs. LNCG and Symptom-Persistent (50%) vs. Symptom-Desistent (50%) subgroups. Functional outcomes were measured with standardized and demographic instruments. Results Three patterns of functional outcomes emerged. Post-secondary education, times fired/quit a job, current income, receiving public assistance, and risky sexual behavior showed the most common pattern: the LNCG fared best, Symptom-Persistent ADHD worst, and Symptom-Desistent ADHD between, with largest effect sizes between LNCG and Symptom-Persistent ADHD. In the second pattern, seen with emotional outcomes (emotional lability, neuroticism, anxiety disorder, mood disorder) and substance use outcomes, the LNCG and Symptom-Desistent ADHD did not differ, but both fared better than Symptom-Persistent ADHD. In the third pattern, noted with jail time (rare), alcohol use disorder (common), and number of jobs held, group differences were not significant. The ADHD group had 10 deaths compared to one in the LNCG. Conclusion Adult functioning after childhood ADHD varies by domain and is generally worse when ADHD symptoms persist. It is important to identify factors and interventions that promote better functional outcomes.

Item Type:
Journal Article
Journal or Publication Title:
Journal of the Amercian Academy of Child and Adolescent Psychiatry
Additional Information:
This is the author’s version of a work that was accepted for publication in Journal of the American Academy of Child and Adolescent Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Academy of Child and Adolescent Psychiatry, 55, 11, 2016 DOI: 10.1016/j.jaac.2016.07.774
Uncontrolled Keywords:
/dk/atira/pure/subjectarea/asjc/3200/3204
Subjects:
ID Code:
81681
Deposited By:
Deposited On:
21 Sep 2016 16:00
Refereed?:
Yes
Published?:
Published
Last Modified:
05 Apr 2020 04:11