Adult ADHD
Visual Abstract
Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD
ADHD remission patterns in young adults
Margaret H. Sibley, Ph.D., L. Eugene Arnold, M.D., James M. Swanson, Ph.D., Lily T. Hechtman, M.D., Traci M. Kennedy, Ph.D., Elizabeth Owens, Ph.D., Brooke S.G. Molina, Ph.D., Peter S. Jensen, M.D., Stephen P. Hinshaw, Ph.D., Arunima Roy, Ph.D., Andrea Chronis-Tuscano, Ph.D., Jeffrey H. Newcorn, M.D., Luis A. Rohde, M.D., Ph.D., for the MTA Cooperative Group
April 22, 2023
study source
The American Journal of Psychiatry
Aug 2021
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What they studied
Researchers wanted to see how ADHD symptoms change as we get older. They followed a group of children with ADHD over 16 years.
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What they found
Researchers found that ADHD symptoms typically get better over time. However, most will experience fluctuations in their symptoms with periods of recurrence.
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What this means
ADHD recovery is not all or nothing for most people. If you have ADHD, it's entirely normal to have your symptoms come back from time to time.
Variable Patterns of Remission From ADHD in the
Multimodal Treatment Study of ADHD
Objective
There has been a wide range of estimates on the percentage of childhood ADHD cases that get better by adulthood. Typically, these have been around 50% or lower.
These estimates are usually based on a single measurement. Researchers have typically measured ADHD rates once in adulthood and at least once in childhood to perform the comparison.
This approach provides a useful snapshot. However, it doesn’t tell us how ADHD symptoms change over time.
Study Quote
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 ex...
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Methods
Researchers in the study measured ADHD rates eight times over 16 years to see how ADHD symptoms change over time in a group of 558 children with ADHD.
They sought to measure what percent of children get better and what percent get worse, particularly as they reach adulthood.
Study Quote
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 remit...
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Results
During the 16 years of follow-up, researchers found that around 30% of participants experienced full remission at some point. This means that just under a third of kids at some point during the study got “all better” from ADHD.
However, 60% of the participants who experienced full remission also experienced recurrence at some point. Even if someone was fortunate enough to fully recover from ADHD during their young adulthood, chances are their ADHD symptoms came back at a later point.
Researchers studied a group of 558 children with ADHD over 16 years. They found that 30% will experience full remission at some point. However, 60% of these individuals will experience recurrence as well.
Only 9% of participants in the study got better and stayed better afterward, suggesting that full and permanent recovery from ADHD is rare in young adulthood.
On the flip side, it was also rare for someone to consistently have ADHD throughout the study. Only 11% experienced stable, persistent ADHD.
Most of the participants in the study experienced fluctuating ADHD symptoms as they got older. They had periods of their life when their ADHD symptoms were better and other periods when symptoms were worse.
Researchers found that most individuals with ADHD will experience fluctuating symptoms throughout adolescence and young adulthood.
As you can see in the chart below, most individuals typically "got better," as shown by the red line, which tracks the number of persistent ADHD cases. However, most ended up with "fluctuating status," as shown by the blue line, which means that they still had ADHD symptoms come back from time to time, even as adults.
Most with ADHD will experience some periods of improvement over time. However, recurrence is common.
Study Quote
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 stu...
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Conclusions
This study shows that most children with ADHD will experience improvement over time. However, ADHD symptoms tend to come back from time to time. Individuals may also experience some level of impairment from their symptoms, even if the severity doesn't meet the full criteria of ADHD.
Study Quote
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 child...
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