The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-Year Follow-Up - Giù le Mani dai Bambini

The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-Year Follow-Up

area scientifica Giù le mani dai bambini Onlus

Mark A. Riddle, M.D et. al.

Objective

To describe the clinical course of attention-deficit/hyperactivity disorder (ADHD) symptom severity and diagnosis from ages 3 to 5 up to 9 to 12 years during a 6-year follow-up after the original Preschool ADHD Treatment Study (PATS)

Mark A. Riddle, M.D, Mark A. Riddle, Kseniya Yershova, Ph.D., Deborah Lazzaretto, M.S., Natalya Paykina, M.A., Gayane Yenokyan, Ph.D., Laurence Greenhill, M.D., Howard Abikoff, Ph.D., Benedetto Vitiello, M.D., Tim Wigal, Ph.D., James T. McCracken, M.D., Scott H. Kollins, Ph.D., Desiree W. Murray, Ph.D., Sharon Wigal, Ph.D., Elizabeth Kastelic, M.D., James J. McGough, M.D., Susan dosReis, Ph.D., Audrey Bauzó-Rosario, M.A., Annamarie Stehli, M.P.H., Kelly Posner, Ph.D.

Objective

To describe the clinical course of attention-deficit/hyperactivity disorder (ADHD) symptom severity and diagnosis from ages 3 to 5 up to 9 to 12 years during a 6-year follow-up after the original Preschool ADHD Treatment Study (PATS).

Method

A total of 207 participants (75% male) from the original PATS, assessed at baseline (mean age, 4.4 years, when all met criteria for ADHD) and 3 months later (before medication treatment), were re-evaluated in three follow-up assessment visits (year 3, mean age 7.4 years; year 4, 8.3 years; and year 6, 10.4 years). Parents and teachers rated symptom severity, and clinicians established psychiatric diagnoses. Analyses examined longitudinal changes in symptom severity and ADHD diagnosis.

Results

Parent- and teacher-rated symptom severity decreased from baseline to year 3 but remained relatively stable and in the moderate-to-severe clinical range through year 6. Girls showed generally steeper decreases in symptom T-scores. At year 6, 89% (160/180) of remaining participants met ADHD symptom and impairment diagnostic criteria. Comorbidity of oppositional defiant disorder and/or conduct disorder was associated with a 30% higher risk of having an ADHD diagnosis at year 6 in the multiple logistic model. Medication status during follow-up, on versus off, did not predict symptom severity change from year 3 to year 6 after adjustment for other variables.

Conclusions

ADHD in preschoolers is a relatively stable diagnosis over a 6-year period. The course is generally chronic, with high symptom severity and impairment, in very young children with moderate-to-severe ADHD, despite treatment with medication. Development of more effective ADHD intervention strategies is needed for this age group.

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