Mathematical models of complex dose‐response relationships: Implications for experimental design in psychopharmacologic research

Faraone, Stephen V.; Simpson, John C.; Brown, Walter A.

doi:10.1002/sim.4780110512

Cited by 16 publications

(8 citation statements)

References 15 publications

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“…Longer follow-up studies should be conducted to answer this question. Also, because we did not manipulate treatment as an independent variable, we cannot use our study to determine treatment effectiveness (Faraone et al, 1992) nor to describe the untreated course of ADHD. For some variables the data were quite sparse and comparisons were underpowered.…”

Section: Discussionmentioning

confidence: 99%

How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

Biederman

Petty

Evans

et al. 2010

Psychiatry Research

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The main aim of this study was to examine the age-dependent persistence of ADHD in boys transitioning from adolescence into early adulthood attending to different definitions of persistence. We conducted a 10-year follow-up study (mean follow-up time=11 years) of 110 boys with ADHD and 105 non-ADHD controls. Both groups were 6-17 years of age at ascertainment. ADHD was considered persistent at follow-up if subjects met full or subthreshold (more than half of the symptoms required for a full diagnosis) DSM-IV diagnostic criteria, failed to attain functional remission (GAF score ≤60), or were receiving treatment for ADHD. While 65% of children with ADHD no longer met full DSM-IV criteria for ADHD at the 10-year follow-up, 78% of subjects met at least one of our definitions of persistence. Persistence as described above was associated with more psychiatric comorbidity, more familiality with mood disorders, and higher levels of educational and interpersonal impairments than controls. This 10-year longitudinal follow-up study shows that the majority of ADHD boys experience persistent symptoms and functional impairments into early adulthood. Persistence of ADHD is associated with greater psychiatric comorbidity, familiality and functional impairments.

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Section: Discussionmentioning

confidence: 99%

How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

Biederman

Petty

Evans

et al. 2010

Psychiatry Research

Self Cite

398

288

View full text Add to dashboard Cite

show abstract

“…17 In all studies in which treated and untreated youths with ADHD had a similar severity at baseline, examination of individual studies 14,21,22,24 -26 reveals a reduction in the risk for SUD (Table 2). In contrast, in the 1 study in which SUD was associated with earlier stimulant exposure, severity at baseline was asymmetrically represented in the treated group.…”

Section: Discussionmentioning

confidence: 99%

“…17 This paradox occurs because of 2 naturalistic correlations: 1) for many psychiatric disorders, people with more severe disorders are usually given more intense treatments (ie, higher doses or longer duration of treatment); and 2) for many disorders, increasing severity predicts worse outcome. Thus, we assessed studies for evidence of baseline severity differences between the treated and untreated ADHD groups.…”

Section: Methodsmentioning

confidence: 99%

Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature

et al. 2003

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Objective.Concerns exist that stimulant therapy of youths with attention-deficit/hyperactivity disorder (ADHD) may result in an increased risk for subsequent substance use disorders (SUD). We investigated all long-term studies in which pharmacologically treated and untreated youths with ADHD were examined for later SUD outcomes. Methods.A search of all available prospective and retrospective studies of children, adolescents, and adults with ADHD that had information relating childhood exposure to stimulant therapy and later SUD outcome in adolescence or adulthood was conducted through PubMed supplemented with data from scientific presentations. Meta-analysis was used to evaluate the relationship between stimulant therapy and subsequent SUD in youths with ADHD in general while addressing specifically differential effects on alcohol use disorders or drug use disorders and the potential effects of covariates. Results.Six studies—2 with follow-up in adolescence and 4 in young adulthood—were included and comprised 674 medicated subjects and 360 unmedicated subjects who were followed at least 4 years. The pooled estimate of the odds ratio indicated a 1.9-fold reduction in risk for SUD in youths who were treated with stimulants compared with youths who did not receive pharmacotherapy for ADHD (z = 2.1; 95% confidence interval for odds ratio [OR]: 1.1–3.6). We found similar reductions in risk for later drug and alcohol use disorders (z = 1.1). Studies that reported follow-up into adolescence showed a greater protective effect on the development of SUD (OR: 5.8) than studies that followed subjects into adulthood (OR: 1.4). Additional analyses showed that the results could not be accounted for by any single study or by publication bias. Conclusion.Our results suggest that stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.

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“…We did not manipulate treatment as an independent variable, and cannot use our study to determine treatment effectiveness (Faraone, Simpson, & Brown, 1992) nor to describe the untreated course of ADHD. A second independent reporter was not available for all participants assessed which could have led to an underestimate of ADHD persistence.…”

Section: Discussionmentioning

confidence: 99%

Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

et al. 2010

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Objective The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered persistent at follow-up if participants met full diagnostic criteria for DSM-IV ADHD or met residual criteria for DSM-IV ADHD with associated impairment (Global Age Forum [GAF] score < 60). Results By age 16 years, ADHD was persistent in 71% (95% CI = 61–79%) of girls with ADHD. Participants with persistent ADHD at follow-up had more psychiatric comorbidity, behavior problems, and functional impairment than girls with ADHD in remission. Remitted ADHD, however, continued to be associated with functional impairment relative to non-ADHD controls. Persistence at 5 years was predicted by increased behavioral impairment at baseline. Conclusion This 5-year follow-up suggests that many girls with ADHD experience persistent symptoms and/or functional impairment through late adolescence and into early adulthood.

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Mathematical models of complex dose‐response relationships: Implications for experimental design in psychopharmacologic research

Cited by 16 publications

References 15 publications

How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD

Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature

Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

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