@article{a98604c9ff924f4eba52ed2403fbc6d7,
title = "Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression",
abstract = "Background: The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7–10 years of age) diagnosed with attention-deficit/hyperactivity disorder (ADHD)-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2–16 years after baseline. Methods: Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified. Treatment was monitored to age 18, and naturalistic subgroups were formed based on three patterns of long-term use of stimulant medication (Consistent, Inconsistent, and Negligible). For the follow-up, hypothesis-generating analyses were performed on outcomes in early adulthood (at 25 years of age). Planned comparisons were used to estimate ADHD-LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication. Results: For ratings of symptom severity, the ADHD-LNCG comparison was statistically significant for the parent/self-report average (0.51 ± 0.04, p <.0001, d = 1.11), documenting symptom persistence, and for the parent/self-report difference (0.21 ± 0.04, p <.0001, d =.60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the ADHD group was 1.29 ± 0.55 cm shorter than the LNCG (p <.01, d =.21), and the comparisons of the naturalistic subgroups were significant: the treated group with the Consistent or Inconsistent pattern was 2.55 ± 0.73 cm shorter than the subgroup with the Negligible pattern (p <.0005, d =.42), and within the treated group, the subgroup with the Consistent pattern was 2.36 ± 1.13 cm shorter than the subgroup with the Inconsistent pattern (p <.04, d =.38). Conclusions: In the MTA follow-up into adulthood, the ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom severity.",
author = "{the MTA Cooperative Group} and Swanson, {James M.} and Arnold, {L. Eugene} and Molina, {Brooke S.G.} and Sibley, {Margaret H.} and Hechtman, {Lily T.} and Hinshaw, {Stephen P.} and Abikoff, {Howard B.} and Annamarie Stehli and Owens, {Elizabeth B.} and Mitchell, {John T.} and Quyen Nichols and Andrea Howard and Greenhill, {Laurence L.} and Betsy Hoza and Newcorn, {Jeffrey H.} and Jensen, {Peter S.} and Benedetto Vitiello and Timothy Wigal and Epstein, {Jeffery N.} and Leanne Tamm and Lakes, {Kimberly D.} and James Waxmonsky and Marc Lerner and Joy Etcovitch and Murray, {Desiree W.} and Maximilian Muenke and Acosta, {Maria T.} and Mauricio Arcos-Burgos and Pelham, {William E.} and Kraemer, {Helena C.} and Severe, {Joanne B.} and John Richters and Donald Vereen and Elliott, {Glen R.} and Wells, {Karen C.} and Conners, {C. Keith} and John March and Cantwell, {Dennis P.} and Gibbons, {Robert D.} and Sue Marcus and Kwan Hur and Thomas Hanley and Karen Stern",
note = "Funding Information: The initial RCT phase of the MTA was supported by cooperative agreement grants and contracts from NIMH and the National Institute on Drug Abuse (NIDA) to the following: University of California–Berkeley: U01 MH50461, N01MH12009, and HHSN271200800005-C; DA-8-5550; Duke University: U01 MH50477, N01MH12012, and HHSN271200800009-C; DA-8-5554; University of California– Irvine: U01MH50440,N01MH12011, and HHSN271200800006-C; DA-8-5551; Research Foundation for Mental Hygiene (New York State Psychiatric Institute, Columbia University): U01 MH50467, N01 MH12007, and HHSN271200800007-C; DA-8-5552; Long Island–Jewish Medical Center U01 MH50453; New York University: N01MH 12004, and HHSN271200800004-C; DA-8-5549; University of Pittsburgh: U01 MH50467, N01 MH 12010, and HHSN271200800008-C; DA-8-5553; DA039881; and McGill University N01MH12008, and HHSN271200800003-C; DA-8-5548. Continuation support was provided by NIDA. Funding support for J.T.M. was provided by NIDA K23 DA032577. The Multimodal Treatment Study of Children with ADHD (MTA) was a National Institute of Mental Health (NIMH) cooperative agreement randomized clinical trial, continued under an NIMH contract as a follow-up study and finally under a National Institute on Drug Abuse (NIDA) contract. Collaborators from NIMH: B.V. (Child & Adolescent Treatment and Preventive Interventions Research Branch); Joanne B. Severe (Clinical Trials Operations and Biostatistics Unit, Division of Services and Intervention Research), P.S.J. (currently at REACH Institute and Mayo Clinic); L.E.A. (currently at Ohio State University); Kimberly Hoagwood (currently at Columbia). Previous contributors from NIMH to the early phases: John Richters (currently at National Institute of Nursing Research); Donald Vereen (currently at NIDA). Principal investigators and coinvestigators from the sites are: University of California, Berkeley/San Francisco: S.P.H. (Berkeley); G.E.R. (San Francisco); Duke University: Karen C. Wells, J.N.E. (currently at Cincinnati Children's Hospital Medical Center); D.W.M. Previous Duke contributors to early phases: C. Keith Conners (former PI); John March. University of California, Irvine: J.M.S. T.W. Previous contributor from UCLA to the early phases: Dennis P. Cantwell (deceased). New York University: H.B.A. Montreal Children's Hospital/McGill University: L.H. New York State Psychiatric Institute/Columbia University/Mount Sinai Medical Center: L.L.G. (Columbia), J.H.N. (Mount Sinai School of Medicine). University of Pittsburgh: B.S.G.M; B.H. (currently at University of Vermont); W.E.P. (PI for early phases, currently at Florida International University). Follow-up phase statistical collaborators: Robert D. Gibbons (University of Illinois, Chicago); Sue Marcus (Mt. Sinai College of Medicine); Kwan Hur (University of Illinois, Chicago). Original study statistical and design consultant: H.C.K. (Stanford University). Collaborator from the Office of Special Education Programs/US Department of Education: Thomas Hanley. Collaborator from Office of Juvenile Justice and Delinquency Prevention/Department of Justice: Karen Stern. The National Institute of Mental Health (NIMH) was involved in the initial study design and treatment phase and early follow-up but not in the adult follow-up phase. National Institute on Drug Abuse negotiated contract deliverables for the final follow-up. J.M.S. acknowledges research support, advisory board membership, speaker's bureau membership, and/or consulting for Alza, Richwood, Shire, Celgene, Novartis, Celltech, Gliatech, Cephalon, Watson, CIBA, UCB, Janssen, McNeil and Lilly. L.E.A. has received research funding from Curemark, Forest, Lilly, Neuropharm, Novartis, Noven, Shire, and YoungLiving (as well as NIH and Autism Speaks) and has consulted with or been on advisory boards for Gowlings, Neuropharm, Novartis, Noven, Organon, Otsuka, Pfizer, Roche, Seaside Therapeutics, Sigma Tau, Shire, and Tris Pharma and received travel support from Noven. L.H. has received research support, served on advisory boards and has been a speaker for Eli Lilly, GlaxoSmithKline, Ortho Janssen, Purdue and Shire. The remaining authors declare that they have no competing or potential conflicts of interest in relation to this article. Publisher Copyright: {\textcopyright} 2017 Association for Child and Adolescent Mental Health.",
year = "2017",
month = jun,
doi = "10.1111/jcpp.12684",
language = "English (US)",
volume = "58",
pages = "663--678",
journal = "Journal of Child Psychology and Psychiatry and Allied Disciplines",
issn = "0021-9630",
publisher = "Wiley-Blackwell",
number = "6",
}
