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. 2019 Apr;58(4):423-432.
doi: 10.1016/j.jaac.2018.11.014. Epub 2019 Feb 2.

Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication

Andreas Jangmo  1 , Amanda Stålhandske  2 , Zheng Chang  3 , Qi Chen  3 , Catarina Almqvist  4 , Inna Feldman  5 , Cynthia M Bulik  6 , Paul Lichtenstein  3 , Brian D'Onofrio  7 , Ralf Kuja-Halkola  3 , Henrik Larsson  8
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Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication

Andreas Jangmo et al. J Am Acad Child Adolesc Psychiatry. 2019 Apr.

Abstract

Objective: Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for poor school performance, and pharmacological treatment of ADHD may have beneficial effects on school performance. Conclusions from previous research have been limited by small sample sizes, outcome measures, and treatment follow-up. The current study analyzed school performance in students with ADHD compared to students without ADHD, and the association between pharmacological treatment of ADHD and school performance.

Method: A linkage of Swedish national registers covering 657,720 students graduating from year 9 of compulsory school provided measures of school performance, electronically recorded dispensations of ADHD medication, and potentially confounding background factors such as parental socioeconomic status. Primary measures of school performance included student eligibility to upper secondary school and grade point sum.

Results: ADHD was associated with substantially lower school performance independent of socioeconomic background factors. Treatment with ADHD medication for 3 months was positively associated with all primary outcomes, including a decreased risk of no eligibility to upper secondary school, odds ratio = 0.80, 95% confidence interval (CI) = 0.76-0.84, and a higher grade point sum (range, 0.0-320.0) of 9.35 points, 95% CI = 7.88-10.82; standardized coefficient = 0.20.

Conclusion: ADHD has a substantial negative impact on school performance, whereas pharmacological treatment for ADHD is associated with higher levels in several measures of school performance. Our findings emphasize the importance of detection and treatment of ADHD at an early stage to reduce the negative impact on school performance.

Keywords: ADHD; medication; school performance; treatment.

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Figures

FIGURE 1.
FIGURE 1.
Measurement of Medication Use, Grade Conversion, and Outcome Measures in the Swedish School System from Compulsory to Upper Secondary School Note: Medication use measured during year 7-9 (shaded circles).
FIGURE 2.
FIGURE 2.
Grade Point Sum by Length of Treatment with Attention-Deficit/Hyperactivity Disorder (ADHD) Medication Note: See Table 3 for details of the statistical model. Months in treatment (prior to graduation from compulsory school) have been rounded upwards. Left scale: Crosses represent the means. (a) Students with ADHD not treated prior to graduation. Right scale: Dots represent the adjusted grade point sum by treatment length relative to students with ADHD not treated prior to graduation. The black line represents the modelled change in grade point sum extrapolated over treatment length. (b) The adjusted grade point sum of students with ADHD not treated prior to graduation relative to those treated prior to graduation
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References

    1. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942–948. - PubMed
    1. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006;36(2):159–165. - PubMed
    1. Biederman J, Faraone S, Milberger S, et al. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry. 1996;53(5):437–446. - PubMed
    1. Loe IM, Feldman HM. Academic and educational outcomes of children with ADHD. J Pediatr Psychol 2007;32(6):643–654. - PubMed
    1. Polderman TJ, Boomsma DI, Bartels M, Verhulst FC, Huizink AC. A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatr Scand 2010;122(4):271–284. - PubMed

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