Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.
Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.
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DOI：
10.1111/jcpp.12684
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发表时间：
2017-06
期刊：
影响因子：
--
通讯作者：
MTA Cooperative Group
中科院分区：
文献类型：
--
作者：
Swanson JM;Arnold LE;Molina BSG;Sibley MH;Hechtman LT;Hinshaw SP;Abikoff HB;Stehli A;Owens EB;Mitchell JT;Nichols Q;Howard A;Greenhill LL;Hoza B;Newcorn JH;Jensen PS;Vitiello B;Wigal T;Epstein JN;Tamm L;Lakes KD;Waxmonsky J;Lerner M;Etcovitch J;Murray DW;Muenke M;Acosta MT;Arcos-Burgos M;Pelham WE;Kraemer HC;MTA Cooperative Group
多模式治疗研究（MTA）是一项为期14个月的随机临床试验，对579名被诊断为ADHD合并型的儿童（7-10岁）进行行为和药物治疗。它过渡到515例同意继续的观察性长期随访，并增加了289名同学（258名无ADHD）作为当地规范性比较组（LNCG），在基线后2至16年进行评估。主要（症状严重程度）和次要（成人身高）的成年结果进行了详细说明。治疗监测至18岁，并根据长期使用兴奋剂药物的三种模式（一致，不一致和可忽略）形成自然主义亚组。在随访中，对成年早期（25岁）的结果进行了假设生成分析。计划比较用于估计ADHD-LNCG差异，反映症状的持续性和自然主义亚组差异，反映与延长使用药物相关的获益（症状减轻）和成本（身高抑制）。对于症状严重程度的评级，ADHD-LNCG比较对于父母/自我报告的平均值具有统计学显著性（0.51 ± 0.04，p<0.0001，d=1.11），记录症状持续性，以及父母/自我报告的差异（0.21 ± 0.04，p<0.0001，d=0.60），证明了来源差异，但反映药物效果的自然主义亚组之间的比较不显著。成人身高ADHD组比LNCG组短1.29 ± 0.55cm（p<0.01，d=0.21），自然主义亚组之间的比较具有显著性：一致或不一致模式的治疗组比可忽略模式的亚组短2.55 ± 0.73 cm（p< 0.0005，d=0.42），并且在治疗组内，具有一致模式的亚组比具有不一致模式的亚组短2.35 ± 1.13 cm（p<0.04，d=0.38）。在MTA随访到成年早期时，ADHD组与LNCG的当地规范相比表现出症状持续性。在ADHD病例的自然主义亚组中，长期使用药物与成人身高的抑制有关，但与ADHD严重程度的降低无关。
The Multimodal Treatment Study (MTA) began as a 14-month randomized clinical trial of behavioral and pharmacological treatments of 579 children (7–10 years of age) diagnosed with ADHD-combined type. It transitioned into an observational long-term follow-up of 515 cases consented for continuation and 289 classmates (258 without ADHD) added as a local normative comparison group (LNCG), with assessments 2 to 16 years after baseline. Primary (symptom severity) and secondary (adult height) outcomes in adulthood were specified. Treatment was monitored to age 18, and naturalistic subgroups were formed based on three patterns of long-term use of stimulant medication (Consistent, Inconsistent, and Negligible). In the follow-up, hypothesis-generating analyses were performed on outcomes in early adulthood (at 25 years of age). Planned comparisons were used to estimate ADHD-LNCG differences reflecting persistence of symptoms and naturalistic subgroup differences reflecting benefit (symptom reduction) and cost (height suppression) associated with extended use of medication. For ratings of symptom severity, the ADHD-LNCG comparison was statistically significant for the parent/self-report average (0.51+0.04, p<0.0001, d=1.11), documenting symptom persistence, and for the parent/self-report difference (0.21+0.04, p<0.0001, d=0.60), documenting source discrepancy, but the comparisons of naturalistic subgroups reflecting medication effects were not significant. For adult height, the ADHD group was 1.29+0.55 cm shorter than the LNCG (p<0.01, d=0.21), and the comparisons of the naturalistic subgroups were significant: the treated group with the Consistent or Inconsistent pattern was 2.55+0.73 cm shorter than the subgroup with the Negligible pattern (p< 0.0005, d=0.42), and within the treated group, the subgroup with the Consistent pattern was 2.35+1.13 cm shorter than the subgroup with the Inconsistent pattern (p<0.04, d=0.38). In the MTA follow-up into early adulthood, ADHD group showed symptom persistence compared to local norms from the LNCG. Within naturalistic subgroups of ADHD cases, extended use of medication was associated with suppression of adult height but not with reduction of symptom-severity.
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影响因子：
--
作者：
Klein, Rachel G.;Mannuzza, Salvatore;Olazagasti, Maria A. Ramos;Roizen, Erica;Hutchison, Jesse A.;Lashua, Erin C.;Castellanos, F. Xavier
通讯作者：
Castellanos, F. Xavier
DOI：
10.1097/01.chi.0000199026.91699.20
发表时间：
2006-04-01
影响因子：
13.3
作者：
Charach, A;Figueroa, M;Schachar, R
通讯作者：
Schachar, R
影响因子：
4.8
作者：
Biederman J;Petty CR;Clarke A;Lomedico A;Faraone SV
通讯作者：
Faraone SV
影响因子：
6.4
作者：
Graham, J.;Banaschewski, T.;Buitelaar, J.;Coghill, D.;Danckaerts, M.;Dittmann, R. W.;Doepfner, M.;Hamilton, R.;Hollis, C.;Holtmann, M.;Hulpke-Wette, M.;Lecendreux, M.;Rosenthal, E.;Rothenberger, A.;Santosh, P.;Sergeant, J.;Simonoff, E.;Sonuga-Barke, E. J. S.;Wong, I. C. K.;Zuddas, A.;Steinhausen, H. -C.;Taylor, E.
通讯作者：
Taylor, E.
影响因子：
5.4
作者：
Hernán, MA;Hernández-Díaz, S;Robins, JM
通讯作者：
Robins, JM