Do children outgrow ADHD? Study says symptoms fluctuate between childhood, adulthood

09 Feb 2022
Do children outgrow ADHD? Study says symptoms fluctuate between childhood, adulthood

Recent findings by the Multimodal Treatment Study of ADHD (attention deficit hyperactivity disorder; MTA) question the belief that nearly half of the children with ADHD outgrow the disorder when they reach adulthood. In majority of the cases, symptoms come and go between childhood and young adulthood.

“Although intermittent periods of remission can be expected in most cases, 90 percent of children with ADHD in MTA continued to experience residual symptoms into young adulthood,” the authors said.

In the MTA, children with ADHD went through eight assessments over follow-up ranging from 2 years (mean age 10.44 years) to 16 years (mean age 25.12 years) after baseline.

The authors then identified those with fully remitted, partially remitted, and persistent ADHD at each time point based on parent, teacher, and self-report of symptoms and impairment, treatment utilization, and substance use and mental disorders. They also identified longitudinal patterns of remission and persistence while considering context and timing.

Nearly one in three (30 percent) children with ADHD experienced full remission at some point during follow-up, but the majority (60 percent) had ADHD recurrence following the initial period of remission.

Of the children, only 9.1 percent had recovered (sustained remission) by study endpoint, and only 10.8 percent) showed stable ADHD persistence across time points. Notably, most participants (63.8 percent) had fluctuating periods of remission and recurrence over time.

“It is estimated that childhood ADHD remits by adulthood in approximately 50 percent of cases; however, this conclusion is typically based on single endpoints, failing to consider longitudinal patterns of ADHD expression,” the authors said.

Am J Psychiatry 2022;179:142-151