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

Publication ,  Journal Article
Hechtman, L; Swanson, JM; Sibley, MH; Stehli, A; Owens, EB; Mitchell, JT; Arnold, LE; Molina, BSG; Hinshaw, SP; Jensen, PS; Abikoff, HB ...
Published in: J Am Acad Child Adolesc Psychiatry
November 2016

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.

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Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

November 2016

Volume

55

Issue

11

Start / End Page

945 / 952.e2

Location

United States

Related Subject Headings

  • Young Adult
  • Substance-Related Disorders
  • Male
  • Humans
  • Female
  • Employment
  • Disease Progression
  • Developmental & Child Psychology
  • Child
  • Attention Deficit Disorder with Hyperactivity
 

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Hechtman, L., Swanson, J. M., Sibley, M. H., Stehli, A., Owens, E. B., Mitchell, J. T., … MTA Cooperative Group. (2016). Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results. J Am Acad Child Adolesc Psychiatry, 55(11), 945-952.e2. https://doi.org/10.1016/j.jaac.2016.07.774
Hechtman, Lily, James M. Swanson, Margaret H. Sibley, Annamarie Stehli, Elizabeth B. Owens, John T. Mitchell, L Eugene Arnold, et al. “Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results.J Am Acad Child Adolesc Psychiatry 55, no. 11 (November 2016): 945-952.e2. https://doi.org/10.1016/j.jaac.2016.07.774.
Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT, et al. Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results. J Am Acad Child Adolesc Psychiatry. 2016 Nov;55(11):945-952.e2.
Hechtman, Lily, et al. “Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results.J Am Acad Child Adolesc Psychiatry, vol. 55, no. 11, Nov. 2016, pp. 945-952.e2. Pubmed, doi:10.1016/j.jaac.2016.07.774.
Hechtman L, Swanson JM, Sibley MH, Stehli A, Owens EB, Mitchell JT, Arnold LE, Molina BSG, Hinshaw SP, Jensen PS, Abikoff HB, Perez Algorta G, Howard AL, Hoza B, Etcovitch J, Houssais S, Lakes KD, Nichols JQ, MTA Cooperative Group. Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results. J Am Acad Child Adolesc Psychiatry. 2016 Nov;55(11):945-952.e2.
Journal cover image

Published In

J Am Acad Child Adolesc Psychiatry

DOI

EISSN

1527-5418

Publication Date

November 2016

Volume

55

Issue

11

Start / End Page

945 / 952.e2

Location

United States

Related Subject Headings

  • Young Adult
  • Substance-Related Disorders
  • Male
  • Humans
  • Female
  • Employment
  • Disease Progression
  • Developmental & Child Psychology
  • Child
  • Attention Deficit Disorder with Hyperactivity