Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type.
OBJECTIVE
Symptom decline in attention deficit hyperactivity disorder (ADHD) was examined with different definitions of remission.


METHODS
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.
Biederman
J
J
Pediatric Psychopharmacology Unit, Psychiatry Service, Massachusetts General Hospital, Boston, MA 02114, USA. biederman@helix.mgh.harvard.edu
Mick
E
E
Faraone
S V
SV
D000293:Adolescent; D000367:Age Factors; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D006948:Hyperkinesis / Q000523:psychology; D007175:Impulsive Behavior / Q000523:psychology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012720:Severity of Illness Index; D009626:Terminology as Topic