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Swanson, James M.; Arnold, L. Eugene; Molina, Brooke S.G.; Sibley, Margaret H.; Hechtman, Lily T.; Hinshaw, Stephen P.; Abikoff, Howard B.; Stehli, Annamarie; Owens, Elizabeth B.; Mitchell, John T.; Nichols, Quyen; Howard, Andrea; Greenhill, Laurence L.; Hoza, Betsy; Newcorn, Jeffrey H.; Jensen, Peter S.; Vitiello, Benedetto; Wigal, Timothy; Epstein, Jeffery N.; Tamm, Leanne; Lakes, Kimberly D.; Waxmonsky, James; Lerner, Marc; Etcovitch, Joy; [...]

Young adult outcomes in the follow‐up of the multimodal treatment study of attention‐deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression

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  • Media type: E-Article
  • Title: Young adult outcomes in the follow‐up of the multimodal treatment study of attention‐deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression
  • Contributor: Swanson, James M.; Arnold, L. Eugene; Molina, Brooke S.G.; Sibley, Margaret H.; Hechtman, Lily T.; Hinshaw, Stephen P.; Abikoff, Howard B.; Stehli, Annamarie; Owens, Elizabeth B.; Mitchell, John T.; Nichols, Quyen; Howard, Andrea; Greenhill, Laurence L.; Hoza, Betsy; Newcorn, Jeffrey H.; Jensen, Peter S.; Vitiello, Benedetto; Wigal, Timothy; Epstein, Jeffery N.; Tamm, Leanne; Lakes, Kimberly D.; Waxmonsky, James; Lerner, Marc; Etcovitch, Joy; [...]
  • imprint: Wiley, 2017
  • Published in: Journal of Child Psychology and Psychiatry
  • Language: English
  • DOI: 10.1111/jcpp.12684
  • ISSN: 0021-9630; 1469-7610
  • Keywords: Psychiatry and Mental health ; Developmental and Educational Psychology ; Pediatrics, Perinatology and Child Health
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Background</jats:title><jats:p>The Multimodal Treatment Study (<jats:styled-content style="fixed-case">MTA</jats:styled-content>) 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 (<jats:styled-content style="fixed-case">ADHD</jats:styled-content>)‐combined type. It transitioned into an observational long‐term follow‐up of 515 cases consented for continuation and 289 classmates (258 without <jats:styled-content style="fixed-case">ADHD</jats:styled-content>) added as a local normative comparison group (<jats:styled-content style="fixed-case">LNCG</jats:styled-content>), with assessments 2–16 years after baseline.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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 <jats:styled-content style="fixed-case">ADHD</jats:styled-content>‐<jats:styled-content style="fixed-case">LNCG</jats:styled-content> differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>For ratings of symptom severity, the <jats:styled-content style="fixed-case">ADHD</jats:styled-content>‐<jats:styled-content style="fixed-case">LNCG</jats:styled-content> comparison was statistically significant for the parent/self‐report average (0.51 ± 0.04, <jats:italic>p</jats:italic> &lt; .0001, <jats:italic>d</jats:italic> = 1.11), documenting symptom persistence, and for the parent/self‐report difference (0.21 ± 0.04, <jats:italic>p</jats:italic> &lt; .0001, <jats:italic>d</jats:italic> = .60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the <jats:styled-content style="fixed-case">ADHD</jats:styled-content> group was 1.29 ± 0.55 cm shorter than the <jats:styled-content style="fixed-case">LNCG</jats:styled-content> (<jats:italic>p</jats:italic> &lt; .01, <jats:italic>d</jats:italic> = .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 (<jats:italic>p</jats:italic> &lt; .0005, <jats:italic>d</jats:italic> = .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 (<jats:italic>p</jats:italic> &lt; .04, <jats:italic>d</jats:italic> = .38).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In the <jats:styled-content style="fixed-case">MTA</jats:styled-content> follow‐up into adulthood, <jats:styled-content style="fixed-case">the ADHD</jats:styled-content> group showed symptom persistence compared to local norms from the <jats:styled-content style="fixed-case">LNCG</jats:styled-content>. Within naturalistic subgroups of <jats:styled-content style="fixed-case">ADHD</jats:styled-content> cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.</jats:p></jats:sec>