By Dennis Thompson
HealthDay reporter
WEDNESDAY, Aug 18, 2021 (HealthDay News) – Struggling with attention deficit / hyperactivity disorder (ADHD) as a child is heartbreaking enough, but now new research confirms what many have long suspected: These patients will often carry on as adults from ADHD symptoms are plagued.
Only about one in ten children with the disorder is likely to have complete and permanent remission of their symptoms, according to new data obtained from monitoring hundreds of children over the age of 16.
The rest will fade in and fade out ADHD symptoms as they grow from children to teenagers to adults, said lead researcher Margaret Sibley, an associate professor of psychiatry and behavioral science at the University of Washington School of Medicine in Seattle.
These new findings contradict previous estimates that up to half of ADHD children could expect a full recovery from the disorder, Sibley noted.
“ADHD is a type of weight gain and loss or dynamic, fluctuating disorder, while in the past we’ve seen it as something you either have or don’t,” Sibley said.
Previous studies of ADHD tended to reconnect with children only at one point in adulthood, Sibley said. But in this new study, researchers looked at a group of 558 children, ages 8-16, every two years.
“This was a unique study, not just to see if ADHD would go away, but if it would go away and come back over the long term, for several years in a row,” Sibley said.
The new research also focused on symptoms of ADHD, asking participants about specific problems such as disorganization, impulsiveness, forgetfulness, and lack of motivation.
“Previous studies have not necessarily examined whether someone still has ADHD-like tendencies, even if they no longer technically meet the criteria for an ADHD diagnosis,” said Sibley. “You can be short on a symptom but still look like you have ADHD.”
Sibley and her team found that up to 30% of children with ADHD would experience complete remission at some point during their transition into adulthood.
However, most of these children would experience a recurrence of their ADHD symptoms later when their remission faded. Overall, around two-thirds of children with ADHD had variable periods of remission and relapse over time.
The new study was published online August 13 in the American Journal of Psychiatry.
According to Dr. Alex Kolevzon, director of child and adolescent psychiatry at the Icahn School of Medicine at Mount Sinai, New York City, “This is an important and well-conducted study that supports what clinicians working with people with ADHD have known for decades . ” – the vast majority of those affected do not grow out of the symptoms as previously assumed. ”
One key caveat: All children in this study were diagnosed with the “combined type of ADHD” and these results should not be applied to children with the “inattentive type of ADHD” or other subtypes of the disorder, warned Dr. Andrew Adesman, Chief of Developmental and Behavioral Pediatrics at Cohen Children’s Medical Center in New Hyde Park, NY
“Importantly, this study tells us nothing about the long-term outcomes of people with the inattentive form of ADHD – those who have impaired function due to difficulty with sustained attention but have no significant problems with overactivity or impulsiveness,” said Adesman.
Sibley said it had long been known that ADHD had a genetic basis.
“These genes have to do with the parts of the brain that are linked to the chemical dopamine, which affects how people’s brains function in relation to their executive functions and the brain’s motivational areas,” Sibley explained.
Given that, it makes sense for the disorder to come and go in many patients as it is in part driven by a person’s biology, Sibley said.
But that’s just one part of the story. As with other diseases that come with intermittent flares, doctors learn that certain “triggers” can make a person’s ADHD symptoms worse, she noted.
“It is interesting to think about how you can essentially crank the volume up or down for such difficulties that you are genetically predisposed to because of other things that may be going on in your environment or your health,” said Sibley.
Treating ADHD symptoms could be as simple as getting good sleep, exercise, and eating right, or as in-depth as choosing a career that stresses you less or triggers your disorder, the doctors said.
“People with ADHD who are believed to be in remission still need consistent monitoring, especially in stressful or high-stress circumstances when symptoms can worsen,” Kolevzon said. “These results also underscore the need for doctors working with adults who are comfortable screening and treating ADHD to be treated effectively.”
Sibley believes that this research ultimately delivers a positive message for people with ADHD by giving them the ability to proactively manage their symptoms.
“I think we are also learning how people with ADHD can take control of their lives and make decisions, how to put themselves in the right environment, so that they can be successful, so that people with ADHD know what their triggers are and how are able to do things they must do themselves to function well, “Sibley said.
More information
The U.S. Centers for Disease Control and Prevention has more about ADHD.
SOURCES: Margaret Sibley, PhD, Associate Professor, Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle; Alex Kolevzon, MD, director, Child and Adolescent Psychiatry, Icahn School of Medicine at Mount Sinai, New York City; Andrew Adesman, MD, Chief, Developmental and Behavioral Pediatrics, Cohen Children’s Medical Center, New Hyde Park, NY; American Journal of Psychiatry, Aug 13, 2021, online
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