Objective:

It is estimated that childhood attention deficit hyperactivity disorder (ADHD) remits by adulthood in approximately 50% of cases; however, this conclusion is typically based on single endpoints, failing to consider longitudinal patterns of ADHD expression. The authors investigated the extent to which children with ADHD experience recovery and variable patterns of remission by adulthood.

Methods:

Children with ADHD (N=558) in the Multimodal Treatment Study of ADHD (MTA) underwent eight assessments over follow-ups ranging from 2 years (mean age, 10.44 years) to 16 years (mean age, 25.12 years) after baseline. The authors identified participants with fully remitted, partially remitted, and persistent ADHD at each time point on the basis of parent, teacher, and self-reports of ADHD symptoms and impairment, treatment utilization, and substance use and mental disorders. Longitudinal patterns of remission and persistence were identified that considered context and timing.

Results:

Approximately 30% of children with ADHD experienced full remission at some point during the follow-up period; however, a majority of them (60%) experienced recurrence of ADHD after the initial period of remission. Only 9.1% of the sample demonstrated recovery (sustained remission) by study endpoint, and only 10.8% demonstrated stable ADHD persistence across study time points. Most participants with ADHD (63.8%) had fluctuating periods of remission and recurrence over time.

Conclusions:

The MTA findings challenge the notion that approximately 50% of children with ADHD outgrow the disorder by adulthood. Most cases demonstrated fluctuating symptoms between childhood and young adulthood. Although intermittent periods of remission can be expected in most cases, 90% of children with ADHD in MTA continued to experience residual symptoms into young adulthood.

中文翻译：

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多动症多模式治疗研究中多动症缓解的可变模式

客观的：

据估计，大约 50% 的儿童期注意力缺陷多动障碍 (ADHD) 会在成年后得到缓解；然而，这个结论通常基于单一终点，没有考虑 ADHD 表达的纵向模式。作者调查了 ADHD 儿童在成年后经历恢复的程度和不同的缓解模式。

方法：

ADHD 多模式治疗研究 (MTA) 中的 ADHD 儿童 (N=558) 在基线后 2 年（平均年龄 10.44 岁）至 16 年（平均年龄 25.12 岁）的随访期间接受了八项评估。作者根据家长、老师和自我报告的 ADHD 症状和损伤、治疗利用、物质使用和精神障碍，确定了每个时间点完全缓解、部分缓解和持续性 ADHD 的参与者。确定了考虑背景和时间的缓解和持续的纵向模式。

结果：

大约 30% 的 ADHD 儿童在随访期间的某个时候经历了完全缓解；然而，他们中的大多数 (60%) 在最初的缓解期后经历了多动症的复发。只有 9.1% 的样本在研究终点时表现出恢复（持续缓解），只有 10.8% 的样本在研究时间点上表现出稳定的 ADHD 持久性。大多数 ADHD 参与者 (63.8%) 的缓解期和复发期随时间波动。

结论：

MTA 的调查结果挑战了大约 50% 的 ADHD 儿童在成年后会摆脱这种疾病的观念。大多数病例在儿童期和成年早期表现出波动的症状。虽然在大多数情况下可以预期出现间歇性缓解期，但 90% 的 MTA 多动症儿童在成年早期仍会继续出现残留症状。