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

被引：200

作者：

Swanson, James M. ^{[1
]}

Arnold, L. Eugene ^{[2
]}

Molina, Brooke S. G. ^{[3
,4
]}

Sibley, Margaret H. ^{[5
]}

Hechtman, Lily T. ^{[6
]}

Hinshaw, Stephen P. ^{[7
]}

Abikoff, Howard B. ^{[8
]}

Stehli, Annamarie ^{[1
]}

Owens, Elizabeth B. ^{[9
]}

Mitchell, John T. ^{[10
]}

Nichols, Quyen ^{[11
]}

Howard, Andrea ^{[12
]}

Greenhill, Laurence L. ^{[13
]}

Hoza, Betsy ^{[11
]}

Newcorn, Jeffrey H. ^{[14
]}

Jensen, Peter S. ^{[15
]}

Vitiello, Benedetto ^{[16
]}

Wigal, Timothy ^{[17
]}

Epstein, Jeffery N. ^{[18
]}

Tamm, Leanne ^{[18
]}

Lakes, Kimberly D. ^{[1
]}

Waxmonsky, James ^{[19
]}

Lerner, Marc ^{[1
]}

Etcovitch, Joy ^{[20
]}

Murray, Desiree W. ^{[21
]}

Muenke, Maximilian ^{[22
]}

Acosta, Maria T. ^{[22
]}

Arcos-Burgos, Mauricio ^{[23
]}

Pelham, William E. ^{[24
]}

Kraemer, Helena C. ^{[25
]}

机构：

[1] Univ Calif Irvine, Sch Med, Dept Pediat, Irvine, CA 92717 USA

[2] Ohio State Univ, Dept Psychiat, Nisonger Ctr, Columbus, OH 43210 USA

[3] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA

[4] Univ Pittsburgh, Sch Med, Dept Psychol, Pittsburgh, PA USA

[5] Florida Int Univ, Dept Psychiat, Miami, FL 33199 USA

[6] McGill Univ, Montreal Childrens Hosp, Div Child Psychiat, Montreal, PQ, Canada

[7] Univ Calif Berkeley, Dept Psychol, 3210 Tolman Hall, Berkeley, CA 94720 USA

[8] NYU, Langone Med Ctr, Ctr Child Study, New York, NY USA

[9] Univ Calif Berkeley, Inst Human Dev, Berkeley, CA 94720 USA

[10] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA

[11] Univ Vermont, Dept Psychol Sci, Burlington, VT USA

[12] Carleton Univ, Dept Psychol, Ottawa, ON, Canada

[13] Columbia Univ, Dept Psychiat, New York, NY USA

[14] Mt Sinai Sch Med, Dept Psychiat, New York, NY USA

[15] Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA

[16] NIMH, Bethesda, MD 20892 USA

[17] Avida Inc, Newport Beach, CA USA

[18] Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Cincinnati, OH 45229 USA

[19] Penn State Univ, Coll Med, Hershey, PA USA

[20] Montreal Childrens Hosp, Montreal, PQ, Canada

[21] Univ N Carolina, Frank Porter Graham Child Dev Inst, Chapel Hill, NC USA

[22] NHGRI, Bethesda, MD 20892 USA

[23] Univ Rosario, Inst Translat Med, Bogota, Colombia

[24] Florida Int Univ, Dept Psychol, Miami, FL 33199 USA

[25] Stanford Univ, Dept Psychiat, Stanford, CA 94305 USA

来源：

JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY | 2017年 / 58卷 / 06期

关键词：

Attention-deficit; hyperactivity disorder; follow-up studies; growth; longitudinal studies; treatment trials; medication effects; DEFICIT HYPERACTIVITY DISORDER; LATER SUBSTANCE-ABUSE; STIMULANT TREATMENT; ADHD; CHILDREN; MEDICATION; GROWTH; CHILDHOOD; METHYLPHENIDATE; THERAPY;

D O I：

10.1111/jcpp.12684

中图分类号：

B844 [发展心理学（人类心理学）];

学科分类号：

040202 ;

摘要：

BackgroundThe Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7-10years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2-16years after baseline. MethodsPrimary (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 25years of age). Planned comparisons were used to estimate ADHD-LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication. ResultsFor ratings of symptom severity, the ADHD-LNCG comparison was statistically significant for the parent/self-report average (0.510.04, p<.0001, d=1.11), documenting symptom persistence, and for the parent/self-report difference (0.210.04, p<.0001, d=.60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the ADHD group was 1.29 +/- 0.55cm shorter than the LNCG (p<.01, d=.21), and the comparisons of the naturalistic subgroups were significant: the treated group with the Consistent or Inconsistent pattern was 2.55 +/- 0.73cm shorter than the subgroup with the Negligible pattern (p<.0005, d=.42), and within the treated group, the subgroup with the Consistent pattern was 2.36 +/- 1.13cm shorter than the subgroup with the Inconsistent pattern (p<.04, d=.38). ConclusionsIn the MTA follow-up into adulthood, the ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity. Read the Commentary on this article at doi:

引用

页码：663 / 678

页数：16

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