title: The Preschool Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS) 6-year follow-up.
abstract: 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).
  
  
  METHODS
  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.
authors: Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Baltimore, MD 21287, USA. mriddle@jhmi.edu
authors: Mark A
authors: MA
authors: Riddle
authors: Kseniya
authors: K
authors: Yershova
authors: Deborah
authors: D
authors: Lazzaretto
authors: Natalya
authors: N
authors: Paykina
authors: Gayane
authors: G
authors: Yenokyan
authors: Laurence
authors: L
authors: Greenhill
authors: Howard
authors: H
authors: Abikoff
authors: Benedetto
authors: B
authors: Vitiello
authors: Tim
authors: T
authors: Wigal
authors: James T
authors: JT
authors: McCracken
authors: Scott H
authors: SH
authors: Kollins
authors: Desiree W
authors: DW
authors: Murray
authors: Sharon
authors: S
authors: Wigal
authors: Elizabeth
authors: E
authors: Kastelic
authors: James J
authors: JJ
authors: McGough
authors: Susan
authors: S
authors: dosReis
authors: Audrey
authors: A
authors: Bauzó-Rosario
authors: Annamarie
authors: A
authors: Stehli
authors: Kelly
authors: K
authors: Posner
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019955:Conduct Disorder / Q000175:diagnosis / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D015337:Multicenter Studies as Topic; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors