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The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study.

Publication ,  Journal Article
Molina, BSG; Hinshaw, SP; Swanson, JM; Arnold, LE; Vitiello, B; Jensen, PS; Epstein, JN; Hoza, B; Hechtman, L; Abikoff, HB; Elliott, GR ...
Published in: J Am Acad Child Adolesc Psychiatry
May 2009

OBJECTIVES: To determine any long-term effects, 6 and 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA; N = 436); to test whether attention-deficit/hyperactivity disorder (ADHD) symptom trajectory through 3 years predicts outcome in subsequent years; and to examine functioning level of the MTA adolescents relative to their non-ADHD peers (local normative comparison group; N = 261). METHOD: Mixed-effects regression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variables assessed by parent, teacher, and youth report. RESULTS: In nearly every analysis, the originally randomized treatment groups did not differ significantly on repeated measures or newly analyzed variables (e.g., grades earned in school, arrests, psychiatric hospitalizations, other clinically relevant outcomes). Medication use decreased by 62% after the 14-month controlled trial, but adjusting for this did not change the results. ADHD symptom trajectory in the first 3 years predicted 55% of the outcomes. The MTA participants fared worse than the local normative comparison group on 91% of the variables tested. CONCLUSIONS: Type or intensity of 14 months of treatment for ADHD in childhood (at age 7.0-9.9 years) does not predict functioning 6 to 8 years later. Rather, early ADHD symptom trajectory regardless of treatment type is prognostic. This finding implies that children with behavioral and sociodemographic advantage, with the best response to any treatment, will have the best long-term prognosis. As a group, however, despite initial symptom improvement during treatment that is largely maintained after treatment, children with combined-type ADHD exhibit significant impairment in adolescence. Innovative treatment approaches targeting specific areas of adolescent impairment are needed.

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Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

May 2009

Volume

48

Issue

5

Start / End Page

484 / 500

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Regression Analysis
  • Reference Values
  • Psychotropic Drugs
  • Psychiatric Status Rating Scales
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Diagnostic and Statistical Manual of Mental Disorders
 

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Molina, B. S. G., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello, B., Jensen, P. S., … MTA Cooperative Group, . (2009). The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry, 48(5), 484–500. https://doi.org/10.1097/CHI.0b013e31819c23d0
Molina, Brooke S. G., Stephen P. Hinshaw, James M. Swanson, L Eugene Arnold, Benedetto Vitiello, Peter S. Jensen, Jeffery N. Epstein, et al. “The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study.J Am Acad Child Adolesc Psychiatry 48, no. 5 (May 2009): 484–500. https://doi.org/10.1097/CHI.0b013e31819c23d0.
Molina BSG, Hinshaw SP, Swanson JM, Arnold LE, Vitiello B, Jensen PS, et al. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009 May;48(5):484–500.
Molina, Brooke S. G., et al. “The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study.J Am Acad Child Adolesc Psychiatry, vol. 48, no. 5, May 2009, pp. 484–500. Pubmed, doi:10.1097/CHI.0b013e31819c23d0.
Molina BSG, Hinshaw SP, Swanson JM, Arnold LE, Vitiello B, Jensen PS, Epstein JN, Hoza B, Hechtman L, Abikoff HB, Elliott GR, Greenhill LL, Newcorn JH, Wells KC, Wigal T, Gibbons RD, Hur K, Houck PR, MTA Cooperative Group. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009 May;48(5):484–500.
Journal cover image

Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

May 2009

Volume

48

Issue

5

Start / End Page

484 / 500

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Regression Analysis
  • Reference Values
  • Psychotropic Drugs
  • Psychiatric Status Rating Scales
  • Male
  • Humans
  • Follow-Up Studies
  • Female
  • Diagnostic and Statistical Manual of Mental Disorders