[ad_1]
August 16, 2021
2 minutes to read
Source / Disclosures
Disclosures: Sibley says she was a consultant for Takeda Pharmaceuticals, received book royalties from Guilford Press, and received research support from NIH and the Institute of Education Sciences. Please see the study for relevant financial information from all other authors.
The assumption that half of childhood ADHD cases regress in adulthood may be inaccurate, as symptoms fluctuate in adulthood in most cases, according to results of a multimodal treatment study published in American Journal of Psychiatry.
“Substantial scientific work has examined the persistence of ADHD – the extent to which children with ADHD continue to meet the DSM criteria for the disorder into adolescence and adulthood,” Margaret H. Sibley, PhD, of the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, and colleagues have written. “However, less research has looked at remission (loss of symptoms and impairment), recurrence and recovery (sustained remission overtime). Most longitudinal studies of ADHD simply define remission as “not meeting DSM criteria”, with few attempts to identify or define distinct subtypes and patterns of remission.
Describing the common trajectories of ADHD remission, recurrence and recovery, the researchers say, is essential to inform treatment decisions by the provider, patient, and family. Previous research has shown an estimated transfer rate of ADHD in children of 50% to adulthood; however, researchers have often drawn this conclusion on the basis of unique parameters, which do not take into account longitudinal patterns of ADHD expression.
In the present study, Sibley and colleagues sought to examine how frequently and significantly children with ADHD experienced recovery, as well as different patterns of remission, in adulthood. They analyzed data from 558 children with ADHD who participated in the Multimodal ADHD Treatment Study, in which they were assessed eight times over follow-ups ranging from 2 years (mean age, 10.44 years) at 16 (average age, 25.12). ) after the baseline. They identified participants who had fully remitting, partly remitting and persistent ADHD at all times based on parents, teachers, and self-reports of ADHD symptoms and impairment, treatment use, drug use. substances and mental disorders. In addition, researchers identified longitudinal models of remission and persistence that took context and timing into account.
The results showed that about 30% of the participants regressed completely at some point during follow-up; however, 60% had a recurrence of ADHD after the initial remission period. A total of 9.1% of the sample had sustained remission according to the endpoint of the study and 10.8% had stable persistence of ADHD through the time points of the study. A total of 63.8% of participants had fluctuating periods of remission and recurrence over time.
“In view of these findings, assessing factors that may influence fluctuations in symptoms (eg, adaptation to environment, physical health) should be central to the assessment and treatment of ADHD while throughout life, ”wrote Sibley and colleagues. “Future research should investigate the malleable biological and environmental factors that trigger fluctuations in symptoms and could serve as targets for new categories of environmental or health interventions (eg, changes in factors that can catalyze and maintain symptomatic periods). Based on these results, clinicians can communicate to families that most adolescents and young adults with ADHD ([approximately] 90%) experience at least intermittent relief from their ADHD symptoms over time, which may be modulated by personal or life circumstances. “
Source link
