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Health Day reporter
WEDNESDAY August 18, 2021 (HealthDay News) – Experiencing attention deficit hyperactivity disorder (ADHD) in childhood is heartbreaking enough, but now new research confirms what many have long suspected: These patients will often continue to experience ADHD symptoms into adulthood.
Only about one in 10 children with the disease is likely to have complete and lasting remission of their symptoms, according to new data gleaned from following hundreds of children for 16 years.
For others, ADHD symptoms will subside as they progress from children to adolescents and adults, said lead researcher Margaret Sibley, associate professor of psychiatry and behavioral sciences in the medical school. from the University of Washington, Seattle.
These new findings run counter to previous estimates that up to half of children with ADHD could fully recover from the disorder, Sibley noted.
“ADHD is kind of a growing and waning or a dynamic and fluctuating disorder, where before we always thought of it as something you have or don’t have,” Sibley said.
Previous studies on ADHD tended to not reconnect with children until some point in adulthood, Sibley said. But in this new study, researchers hit the basics with a group of 558 children aged 8 to 16 every two years.
“This was a study in a unique position to not only see if ADHD went away, but if it would go away long term, several years in a row, and also if it would come back,” Sibley said.
The new research also focused on ADHD symptoms, asking participants about specific issues such as disorganization, impulsivity, forgetfulness, and lack of motivation.
“Previous studies have not necessarily looked at whether a person still has ADHD-like tendencies, even though they technically no longer meet the criteria” for an ADHD diagnosis, Sibley said. “You may be short of a symptom, but you still look like you have ADHD.”
Sibley and his team found that up to 30% of children with ADHD would experience complete remission at some point during their transition to adulthood.
However, most of these children would later experience a recurrence of their ADHD symptoms as their remission wore off. Overall, about two-thirds of children with ADHD had fluctuating periods of remission and recurrence over time.
The new study was published online Aug. 13 in the American Journal of Psychiatry.
According to Dr. Alex Kolevzon, director of child and adolescent psychiatry at the Icahn School of Medicine at Mount Sinai in New York City, “This is an important and rigorously conducted study that supports what clinicians who work with people with ADHD have known this for decades. – the vast majority of those affected do not get past the symptoms as was previously assumed. ”
A critical caveat: the children in this study were all diagnosed with ‘combined type of ADHD’, and these results should not be applied to children with ‘inattentive type of ADHD’ or other subtypes of ADHD. disorder, warned Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park, NY
“It is important to note that this study does not tell us anything about the long-term outcomes of people with the inattentive form of ADHD – those who have impaired function due to difficulties with sustained attention but who do not. significant hyperactivity or impulsivity issues, ”Adesman said.
Sibley said it’s long been known that there is a genetic basis for ADHD.
“These genes have to do with the parts of the brain associated with the chemical dopamine, which results in how people’s brains work in terms of their executive function and the motivational areas of the brain,” Sibley explained.
Given this, it makes sense for the disorder to come and go in many patients, as part of it is due to a person’s biology, Sibley said.
But that’s only part of the story. As with other illnesses that come with intermittent flare-ups, doctors are learning that specific “triggers” can exacerbate a person’s ADHD symptoms, she noted.
“What’s interesting to start thinking about is how you can basically turn up or down the volume of those difficulties that you have a genetic tendency for, because of other things that might be happening in your environment or things like your health behaviors, ”Sibley said.
Managing ADHD symptoms can be as simple as getting good sleep, exercise and eating well, or as deep as choosing a career that’s less likely to stress you out or trigger your disorder, doctors said.
“People with presumed ADHD in remission always require constant monitoring, especially under stressful circumstances or on high demand when symptoms may be exacerbated,” Kolevzon said. “These results also highlight the need for physicians who work with adults to become comfortable with ADHD screening and treatment. ADHD persists throughout life and is a very debilitating disorder associated with significant impact on work, relationships and daily functioning that can be effectively treated with treatment.
Sibley believes this research ultimately delivers a positive message to people with ADHD, giving them a chance to proactively manage their symptoms.
“I think we are also learning about ways that people with ADHD can take control of their own lives, can make choices to put themselves in the right environment so that they can be successful, so that people with ADHD can. know what their triggers are and are able to do the things they need to do on their own to continue to function well, ”Sibley said.
More information
The US Centers for Disease Control and Prevention has more on ADHD.
SOURCES: Margaret Sibley, PhD, associate professor, psychiatry and behavioral sciences, University of Washington School of Medicine, Seattle; Alex Kolevzon, MD, director, child and adolescent psychiatry, Icahn School of Medicine in Mount Sinai, New York; Andrew Adesman, MD, chief, developmental and behavioral pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY; American Journal of Psychiatry, Aug 13, 2021, online
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