The following broad trends emerged: (1) without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2) treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels.
Full Answer
What is the long-term prognosis for ADHD?
ADHD and Long-Term Outcomes. Of the 78% who continued to have ADHD symptoms, 35 percent continued to meet full DSM-IV criteria for ADHD, 22 percent had subsyndromal ADHD, 15 percent had impaired functioning, and 6 percent were in remission and still being treated (Biederman et al. 2010).
Which type of therapy has the most enduring effects for ADHD?
behavioral therapy In a study of treatment approaches for attention-deficit/hyperactivity (ADHD), which type of intervention was found to have the most enduring effects three years after it was administered? The therapy is very intensive; requiring 40 or more hours of intervention every week
What are the occupational outcomes of young adults with ADHD?
The study by Kuriyan et al. (2013) also found these occupational outcomes for young adults with ADHD between the ages of 23 and 32: 1 They are 11 times more likely to be unemployed and not in school. 2 They are 4 times more likely to be in unskilled vs. 3 61% more likely to have ever been fired, compared to 43% of the comparison group.
What percentage of people with ADHD go into remission?
Of the 78% who continued to have ADHD symptoms, 35 percent continued to meet full DSM-IV criteria for ADHD, 22 percent had subsyndromal ADHD, 15 percent had impaired functioning, and 6 percent were in remission and still being treated (Biederman et al. 2010).
What are the long-term outcomes that exist with ADHD?
The outcomes that were studied (with ADHD symptoms deliberately excluded as an outcome) most often included drug use/addictive behavior, academic, and antisocial behavior. This was followed by social function, self-esteem, occupation, driving, services use, and obesity outcomes.
What is the most effective treatment for ADHD?
Stimulants are the best-known and most widely used ADHD medications. Between 70-80% of children with ADHD have fewer ADHD symptoms when taking these fast-acting medications. Nonstimulants were approved for the treatment of ADHD in 2003.
What is the best treatment for a child with ADHD?
Standard treatments for ADHD in children include medications, behavior therapy, counseling and education services. These treatments can relieve many of the symptoms of ADHD , but they don't cure it....ADHD behavior therapyBehavior therapy. ... Social skills training. ... Parenting skills training. ... Psychotherapy. ... Family therapy.
What are treatment goals for ADHD?
The primary goal of an ADHD management plan is to control the core symptoms of inattention and hyperactivity/impulsivity. A multimodal management plan that incorporates a variety of strategies may work best for many patients with ADHD.
What is the most effective ADHD medication for adults?
In terms of non-stimulant medications, ADHD specialists recommend using atomoxetine as a first-choice medication for children and adults, followed by guanfacine or clonidine for children, and bupropion or nortriptyline for adults.
Which of the following was shown to be the most effective combination treatment for attention deficit hyperactivity?
In summary, stimulant medications are most effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.
What is the most common intervention for students with ADHD?
Peer tutoring is one of the most effective school-based intervention strategies to assist ADHD children and even children without this disorder with their academic progress.
How do you set long term goals for ADHD?
How to Set GoalsWrite out the goal.Write out the purpose of the goal – understanding the “why” is especially important to increase motivation in individuals with ADHD.Write out one action step – what's one small task you can do today that would bring you closer to your goal?
What is ADHD in childhood?
In childhood, attention deficit/hyperactivity disorder ( ADHD) is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more) of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal) has on ADHD long-term outcomes.
When were ADHD studies published?
Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories.
What is an Additional File 2?
Additional file 2 Treatment types reported in the included studies. This list includes all the treatments mentioned in any study. Often a treatment may have been listed in the Methods of a study but no details were provided about dose or duration or age of treatment or frequency of treatment or separate connection to a specific outcome result, for example. It was possible to group treatment types by large category (pharmacological, non-pharmacological, or MMT) and pool the reported outcomes in these categories.
Is ADHD a psychiatric disorder?
In childhood, attention deficit/hyperactivity disorder (ADHD) is a psychiatric condition characterized by age-inappropriate levels of inattention, hyperactivity-impulsiveness or a combination of these problems [1,2]. The symptoms of ADHD often lead to functional impairment in multiple domains and lower quality of life. Therefore, in recent years the focus of intervention has expanded from ameliorating immediate symptoms of ADHD to improving functionality in several life domains. Moreover, although traditionally regarded as a childhood disorder, it is now clear that ADHD affects both children and adults. The worldwide prevalence of ADHD has been estimated at 5.29% [3,4] with approximately 4% prevalence in adults [5,6]. According to one meta-analysis, ADHD persists in about 65% of adults diagnosed as children if ADHD in partial remission is included [7], and in about 50% of adults originally diagnosed as children according to a separate estimate [8]. Persistence of ADHD may be related to ADHD symptom severity, number of symptoms, ADHD symptom subtype, ADHD in relatives, psychosocial adversity, psychiatric comorbidities, and/or parental psychopathology [8-15]. Many adults with ADHD are undiagnosed and untreated. Research on ADHD in adulthood is relatively sparse [16] despite being recognized in adults as early as 1968 as 'minimal brain dysfunction' [17] and in 1972 as 'hyperkinetic disorder' [18]. Thus the negative outcomes reported by most follow-up studies may be a consequence of untreated symptoms.
Does ADHD normalize?
Current treatments may reduce the negative impact that untreated ADHD has on life functioning, but does not usually 'normalize' the recipients.
Does ADHD affect short term effects?
The short-term effect of ADHD treatment on symptoms is well characterized. Beyond this, the longer-term consequences have been the focus of numerous individual studies but comprehensive synthesis of the available data has yet to be conducted, thus the present systematic review was performed, focusing on comprehensive summary of long-term outcomes of ADHD. Short-term studies have demonstrated decreases in core symptoms with pharmacotherapy, but there is less evidence for longer-term benefits . Poor adherence and persistence on therapy, comorbidities, poor follow-up and difficulty in accessing consistent medication management from the healthcare system may contribute to difficulty in measuring long-term effects of medication [19,20]. Non-pharmacological interventions such as specialized training for parents of children with ADHD and cognitive behavioral therapy (CBT) for adults also reduce symptoms, and a multimodal approach may have greater effect [16,21]. Both non-pharmacological (that is, psychological, social, and educational) and pharmacological treatments for ADHD are recommended by the National Institute for Health and Clinical Excellence (NICE) guidelines [22] with treatment selection depending on the age of the individual and ADHD severity. Recently published European adult guidelines for the treatment of ADHD indicate that both medications and non-pharmacological interventions may be effective for adults with ADHD, although more research specifically in adults is needed [23].
Why did Kayla's therapist teach her mindfulness meditation?
Kayla's therapist first taught her mindfulness meditation so she could focus on the present. Then, Kayla and her therapist talked about events in Kayla's past that led to her current problems. Now her therapist is teaching her to have self-respect and to think for herself. Kayla is probably being treated for
What chapter in the book does bipolar II show depressive symptoms?
Recall from Chapter 14 that bipolar II patients primarily show depressive symptoms with periods of elevated mood. Given what you have read about treatments for bipolar disorder in this chapter, why are bipolar II patients not treated solely with antidepressants, even though their main symptom is depression?
How are ADHD outcomes classified?
Outcomes were classified in a dichotomous manner, based on statistical significance reported in each study. Untreated ADHD outcomes were categorized as “poorer” than non-ADHD controls if a result was reported as statistically significantly worse than non-ADHD controls, and “similar” if statistical significance was not achieved. Outcomes were categorized to “improve” with treatment if a statistically significant improvement was associated with treatment compared with either pre-treatment baseline or untreated individuals with ADHD. If treatment effects did not reach statistical significance compared with pre-treatment baseline or untreated individuals with ADHD, or were significantly poorer than the pre-treatment baseline or untreated individuals with ADHD, then the outcome was summarized to have “no benefit” with treatment. Results of studies of individuals with treated ADHD compared with only non-ADHD controls were considered separately and only for sub-analyses for which the number of studies was small. This was done because results from studies utilizing two types of comparisons (untreated or pre-treatment measures and measures for non-ADHD controls) show that ADHD treatment often improves outcomes, but not always to a non-ADHD level ( Molina et al., 2009; Scheffler et al., 2009 ). Studies that utilize only non-ADHD controls to assess affects of ADHD treatment will not demonstrate improvements that are less than complete “normalization,” thus, results from these studies must be considered in light of this limitation. For studies with only non-ADHD controls, treatment was considered to “improve” outcomes if treated ADHD and non-ADHD control outcomes were not statistically significantly different, and to have “no benefit” if treated ADHD outcomes were statistically significantly worse than non-ADHD control outcomes. A further analysis was conducted examining improvement by treatment type with treatments categorized as pharmacological, non-pharmacological, or multimodal (i.e., combination of pharmacological and non-pharmacological treatment).
What are the academic outcomes of ADHD?
(a) A study of individuals with ADHD with high IQ (≥120) reported that they had significantly poorer achievement scores in math but not in reading or grade retention rates compared with non-ADHD controls , matched as a group for IQ, gender, and socioeconomic status ( Antshel et al., 2009 ). Treatment status was not specified in that study. (b) A study examining outcomes of individuals with treated ADHD with high IQ (≥120) also found math achievement scores poorer than non-ADHD controls, but no significant difference in reading achievement scores or grade retention rates compared with non-ADHD controls matched as a group for IQ and age ( Antshel et al., 2008 ). (c) A third study ( Banks et al., 1995) reported that 29% of a group of medical students who were in danger of not graduating and physicians who had failed to pass the Medical Board Exam were diagnosed with ADHD (compared with 4.4% prevalence of ADHD in the general adult population in the United States; Kessler et al., 2006 ). In the same study, the individuals with ADHD scored the lowest on the Medical College Admission Test (MCAT; M subtest score: 6.024); lower than two learning disability subgroups ( M subtest score for reading learning disability group: 6.539; M subtest score for visual/spatial learning disability group: 7.167; population mean for the same year: 8.287). Treatment history of the individuals was not reported.
What does the left bar on the ADHD test mean?
Left-hand bar of each outcome group indicates proportion of achievement test and academic performance outcomes similar to non-ADHD controls (dark shade) and poorer than non-ADHD controls (light shade) for individuals with untreated AD HD. Remaining bars indicate improved results (dark shade) or no benefit (light shade) with treatment reported for each type of measure compared with untreated ADHD (either pre-treatment baseline or untreated group of individuals with ADHD). Numbers in bars indicate the number of outcomes for each bar. Pharm = pharmacological treatment; Non-pharm = non-pharmacological treatment; MMT = multimodal treatment.
How many studies are statistically adjusted for learning disorders?
Eleven studies statistically adjusted for learning disorders and 2 studies excluded individuals with learning disorders. Results from this subset of studies were consistent with the overall results for both untreated and treated ADHD outcomes ( Table 3 ).
What are the inclusion criteria for ADHD?
Inclusion criteria required that ADHD be the primary condition of study (not secondary to autism, for example). Longitudinal studies must have had prospective follow-up or retrospective measures of 2 years or more, and cross-sectional study participants were all 10 years old or older.
How is improvement with treatment related to achievement test scores?
For achievement test scores, improvement with treatment was demonstrated for 78% of the outcomes (7 of 9) when the comparison was with pre-treatment baseline and 80% of the outcomes (4 of 5) when the comparison was with untreated individuals with ADHD. For academic performance, improvement with treatment was demonstrated for 50% of the outcomes (1 of 2) when the comparison was with pre-treatment baseline and 40% of the outcomes (4 of 10) when the comparison was with untreated individuals with ADHD.
What are the outcomes of academic measures?
Specific academic measures reported in each study were categorized into one of two outcome groups: either achievement test scores or academic performance. Achievement test outcomes included results on standardized tests such as the Wide Range Achievement Test (WRAT) and American College Testing (ACT). Academic performance outcomes included such indicators of success within the school environment as grades, grade retention, high school completion, and college attendance. Grade retention and school expulsions were compared across world regions, as we anticipated that these outcomes may differ regionally.
What are the long term outcomes of ADHD?
Overall, the results of the present study show that the long-term outcomes for participants with ADHD when left untreated were poor compared with non-ADHD controls, and that treatment of ADHD improved long-term outcomes, but usually not to the point of normalization. The outcomes that were studied (with ADHD symptoms deliberately excluded as an outcome) most often included drug use/addictive behavior, academic, and antisocial behavior. This was followed by social function, self-esteem, occupation, driving, services use, and obesity outcomes. These trends may reflect what is of most immediate interest to society in a given time period. For example, obesity, the least-studied outcome, has come into interest only recently, likely due to the increasing obesity epidemic in developed countries. Increasing interest in the epidemiology of obesity, led to the report of an association between obesity and ADHD in 2002 [ 51 ]. Our data also indicate that there are specific geographical trends, with academic outcomes being of greater interest for study in the US and Canada and antisocial behaviors of greater interest in Europe. This difference of interest may be a function of only more severe cases, likely to have oppositional-defiant or conduct disorder comorbidity, being diagnosed outside Northern America. These trends have been described in more detail in a separate publication [ 35 ].
What are the effects of ADHD treatment?
Treatment resulted in beneficial effects for many of the outcomes reported (72% of outcome results). These beneficial effects were observed as either significant improvement over pretreatment baseline, in comparison to untreated ADHD participants, or stabilization of the outcomes (that is, prevention of the deterioration over time from baseline reported with untreated ADHD [ 43 – 46 ]). Driving and obesity outcomes were the most often reported to be responsive to treatment. Of course, a decrease in obesity may be due to an appetite suppressant effect of stimulants and atomoxetine. The relatively small number of studies of these two outcomes (two studies each) comparing treated with untreated ADHD and the consistently positive response to treatment support further investigation in these areas. Three other outcomes that were often reported to be responsive to treatment were self-esteem, social function, and academic outcomes. These results are supported by a relatively large number of studies (10, 12, and 21 studies, respectively) comparing participants with treated ADHD with participants with untreated ADHD. These outcomes may be more closely related to symptom relief. The outcomes reported are not independent of one another and changes in one may reflect changes in others. The wider effects of response to treatment in these two areas may warrant further investigation.
How many studies were published on ADHD in 2008?
The number of long-term outcome studies published at the peak in 2008 was 42 studies, dropping back to 28 in 2009 and 2010.
How prevalent is ADHD in the world?
The worldwide prevalence of ADHD has been estimated at 5.29% [ 3, 4] with approximately 4% prevalence in adults [ 5, 6 ].
What is ADHD in childhood?
In childhood, attention deficit/hyperactivity disorder ( ADHD) is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more) of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal) has on ADHD long-term outcomes.
What are the outcomes of ADHD?
Outcomes from 351 studies were grouped into 9 major categories: academic, antisocial behavior, driving, non-medicinal drug use/addictive behavior, obesity, occupation, services use, self-esteem, and social function outcomes. The following broad trends emerged: (1) without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2) treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels. Only English-language papers were searched and databases may have omitted relevant studies.
When were ADHD studies published?
Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories.
Why did Kayla's therapist teach her mindfulness meditation?
Kayla's therapist first taught her mindfulness meditation so she could focus on the present. Then, Kayla and her therapist talked about events in Kayla's past that led to her current problems. Now her therapist is teaching her to have self-respect and to think for herself. Kayla is probably being treated for
Is it embarrassing for Ellie if her peers discover she is taking medication?
a. it may be embarrassing for Ellie if her peers discover she is taking medication.
Which group shows the greatest benefit from a combination of therapy and medication?
Adolescents show the greatest benefit from a combination of therapy and medication.
What is the cognitive triad?
The cognitive triad, identified by Dr. Aaron Beck, is a combination of negative thoughts that are believed to be related to the symptoms of depression. Which is NOT a part of the cognitive triad?
What is Aaron's personality disorder?
Aaron has been diagnosed with antisocial personality disorder , and the main symptom he experiences is that he always feels hostile. This leads to inappropriate lashing out at others, and it has cost him relationships and jobs. Which type of medication might be helpful in reducing his hostility levels?
Why is Alexis diagnosed with OCD?
an increased risk of becoming suicidal. Alexis was diagnosed with OCD because she has to check the locks on her house and car many times before she can leave them. Her therapist asks her to lock a door then takes away the keys so Alexis cannot lock the door again.
Do antidepressants cause a child to be at risk?
The use of antidepressants with children and adolescents is associated with an increased risk of potentially dangerous outcomes. This prompted the U.S. Food and Drug Administration (FDA) to require warning labels on the packaging of these medications. What was one potentially dangerous impact?