Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type.

By Joseph Biederman, E. Mick, Stephen V. Faraone. American Journal of Psychiatry, 2000

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OBJECTIVE Symptom decline in attention deficit hyperactivity disorder (ADHD) was examined with different definitions of remission. METHOD Symptoms in 128 boys were measured five times over 4 years. The prevalences of syndromatic (less than full syndrome), symptomatic (less than subthreshold diagnosis), and functional (full recovery) remission were estimated as a function of age with multivariate logistic regression. RESULTS Age was significantly associated with decline in total ADHD symptoms and symptoms of hyperactivity, impulsivity, and inattention. Symptoms of inattention remitted for fewer subjects than did symptoms of hyperactivity or impulsivity. The proportion of subjects experiencing remission varied considerably with the definition used (highest for syndromatic remission, lowest for functional remission). CONCLUSIONS These results indicate that differences in reported remission rates reflect the definition used rather than the disorder's course. They provide systematic support for the clinical observation that hyperactivity and impulsivity symptoms tend to decline at a higher rate than inattention symptoms.

Subfields: Clinical Psychology, Epidemiology, Psychiatry and Mental health

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Citations in the corpus

European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010, background): “We therefore conclude that a definition of remission based on the number of criteria that have to be met in childhood does not seem appropriate in clinical practice with adults, especially as symptoms described by both DSM-IV and ICD-10 criteria typically apply to children and are not adjusted for d”
3-year follow-up of the NIMH MTA study. (2007, background): “Biederman et al. (2000) showed that hyperactive and impulsive symptoms tended to decrease whereas inattentive symptoms tended to persist.”
Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. (2007, background): “Biederman et al. (2000) found that the rates of ADHD in adults varied according to number of symptoms and level of impairment required for the diagnostic threshold.”
A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes. (2005, background): “…neuromodulator; overactivity; pollutants; reinforcement; reward; verbally governed behavior; soft signs; variability sis), or functional (full recovery) remission; and differences in reported remission rates reflect the definition used rather than the disorder’s course (Biederman et al. 2000).”
The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population (2005, methodology): “Several attempts have been made to estimate the general population prevalence of adult ADHD by extrapolation from childhood prevalence estimates in conjunction with adult persistence estimates (Weiss et al. 1985; Mannuzza et al. 1998; Biederman et al. 2000; Barkley et al. 2002) or by direct estimati”
The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies (2005, background): “Despite these limitations, our pooled analysis of ADHD outcome studies confirms the prior work of Barkley et al. (2002) and Biederman et al. (2000) who concluded that the apparent prognosis of ADHD depends on what definition of persistence one uses.”