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. 2016 Nov;55(11):945-952.e2.
doi: 10.1016/j.jaac.2016.07.774. Epub 2016 Sep 2.

Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results

Lily Hechtman  1 , James M Swanson  2 , Margaret H Sibley  3 , Annamarie Stehli  4 , Elizabeth B Owens  5 , John T Mitchell  6 , L Eugene Arnold  7 , Brooke S G Molina  8 , Stephen P Hinshaw  9 , Peter S Jensen  10 , Howard B Abikoff  11 , Guillermo Perez Algorta  12 , Andrea L Howard  13 , Betsy Hoza  14 , Joy Etcovitch  15 , Sylviane Houssais  15 , Kimberley D Lakes  4 , J Quyen Nichols  14 ; MTA Cooperative Group
Collaborators, Affiliations

Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results

Lily Hechtman et al. J Am Acad Child Adolesc Psychiatry. 2016 Nov.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] J Am Acad Child Adolesc Psychiatry. 2017 Jul;56(7):628. doi: 10.1016/j.jaac.2017.05.006. Epub 2017 Jun 21. J Am Acad Child Adolesc Psychiatry. 2017. PMID: 28647017 No abstract available.
  • Corrigendum.
    [No authors listed] [No authors listed] J Am Acad Child Adolesc Psychiatry. 2018 Mar;57(3):225. doi: 10.1016/j.jaac.2018.01.007. J Am Acad Child Adolesc Psychiatry. 2018. PMID: 29496133 No abstract available.

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 postbaseline (mean age 24.7 years at 16 years postbaseline) from 476 participants with ADHD diagnosed at age 7 to 9 years, and 241 age- and sex-matched classmates. Probands were subgrouped on persistence versus desistence of DSM-5 symptom count. Orthogonal comparisons contrasted ADHD versus LNCG and symptom-persistent (50%) versus 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 group fared best, symptom-persistent ADHD group worst, and symptom-desistent ADHD group between, with the 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 group did not differ, but both fared better than the symptom-persistent ADHD group. 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 death 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.

Keywords: ADHD; MTA; adult outcomes; follow-up; functional outcomes.

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Figures

Figure 1
Figure 1
Educational outcomes. ADHD = attention-deficit/hyperactivity disorder; LNCG = local normative comparison group.
Figure 2
Figure 2
Emotional outcomes. Note: ADHD = attention-deficit/hyperactivity disorder; LNCG = local normative comparison group.
See this image and copyright information in PMC

Comment in

References

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