![]() Using a thorough stepwise procedure, we 1) validated age-appropriate full remission symptom thresholds in childhood, adolescence, and young adulthood 2) examined detailed symptom, impairment, comorbidity, and treatment utilization information to classify participants’ ADHD as fully remitted, partially remitted, or persistent at each of eight MTA follow-up assessments and 3) outlined longitudinal patterns of ADHD remission, recurrence, and recovery with attention to onset, duration, type (full or partial), and course of remission. In this study, we investigated longitudinal patterns of remission from ADHD in the Multimodal Treatment Study of ADHD (MTA) follow-up ( 3, 10, 11), which utilized multi-informant assessment to measure ADHD symptoms, impairments, treatment utilization, and comorbidities across 16 years, spanning childhood through young adulthood. If ADHD tends to wax and wane, factors modulating phenotypic expression must be identified and person-environment fit emphasized as a crucial framework for evaluation and treatment over time. If remission is typically temporary, practice guidelines should emphasize the need for continued ADHD screening or monitoring after remission and for rapid response to symptom reemergence. There is virtually no scientific information on the extent to which individuals sustain remission long-term (i.e., recover from ADHD symptoms and impairments), experience recurrence of ADHD after remission (i.e., remission was temporary), or fluctuate between full remission, partial remission, and ADHD persistence, that is, whether ADHD might be a waxing and waning disorder. Most longitudinal work on ADHD remission and persistence reports only a single-time snapshot of functioning, even though ADHD is considered a life-course disorder ( 2, 4– 6, 9, 10). However, the longitudinal course and optimal definition of full remission remains understudied. detected a subgroup of children whose ADHD appeared fully remitted in young adulthood (∼22%−23%), signifying possible recovery from ADHD. Thus, most participants who were classified as having remitted ADHD on the basis of traditional DSM guidelines still experienced impairing subthreshold ADHD symptoms or experienced “remission” only when receiving ADHD treatment (e.g., stimulant medication). On the other hand, the vast majority (77%−78%) had clinically elevated ADHD symptoms, impairment, and/or continuation of ADHD treatments. ( 7, 8) demonstrated that 65%−67% young adults (mean age, 22 years) with childhood ADHD no longer met full DSM criteria. In the most detailed past efforts to characterize the trajectory of ADHD, Biederman et al. Understanding common trajectories of ADHD remission, recurrence, and recovery is critical to informing provider, patient, and family treatment decisions. Most longitudinal ADHD studies simply define remission as “failing to meet DSM criteria,” with few attempts to identify or define distinct subtypes and patterns of remission ( 4– 6). However, less research has investigated remission (loss of symptoms and impairment), recurrence, and recovery (sustained remission over time). ![]() Substantial scientific work has examined ADHD persistence-the extent to which children with ADHD continue to meet DSM criteria for the disorder in adolescence and adulthood. Decades of research characterize attention deficit hyperactivity disorder (ADHD) as a neurobiological disorder typically first detected in childhood that persists into adulthood in approximately 50% of cases ( 1– 3). ![]()
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