Department of Psychiatry,University Medical Center Groningen,Groningen,The Netherlands.
VU University Amsterdam,Amsterdam,The Netherlands.
Psychol Med. 2019 Jan;49(2):217-223. doi: 10.1017/S0033291718000545. Epub 2018 Mar 13.
Methodological and ethical constraints have hampered studies into long-term lasting outcomes of stimulant treatment in individuals with attention-deficit/hyperactivity disorder (ADHD). Lasting effects may be beneficial (i.e. improved functioning even when treatment is temporarily ceased) or detrimental (i.e. worse functioning while off medication), but both hypotheses currently lack empirical support. Here we investigate whether stimulant treatment history predicts long-term development of ADHD symptoms, social-emotional functioning or cognition, measured after medication wash-out.
ADHD symptoms, social-emotional functioning and cognitive test performance were measured twice, 6 years apart, in two ADHD groups (stimulant-treated versus not stimulant-treated between baseline and follow-up). Groups were closely matched on baseline clinical and demographic variables (n = 148, 58% male, age = 11.1). A matched healthy control group was included for reference.
All but two outcome measures (emotional problems and prosocial behaviour) improved between baseline and follow-up. Improvement over time in the stimulant-treated group did not differ from improvement in the not stimulant-treated group on any outcome measure.
Stimulant treatment is not associated with the long-term developmental course of ADHD symptoms, social-emotional functioning, motor control, timing or verbal working memory. Adolescence is characterised by clinical improvement regardless of stimulant treatment during that time. These findings are an important source to inform the scientific and public debate.
方法学和伦理方面的限制阻碍了对注意力缺陷/多动障碍（ADHD）患者兴奋剂治疗长期结局的研究。长期影响可能是有益的（即治疗停止后仍能改善功能），也可能是有害的（即停药后功能更差），但这两种假设目前都缺乏经验支持。在这里，我们研究了兴奋剂治疗史是否可以预测 ADHD 症状、社会情感功能或认知的长期发展，这些都是在停药后进行测量的。
在 ADHD 两组（基线和随访之间有或没有兴奋剂治疗）中，两次测量 ADHD 症状、社会情感功能和认知测试表现，时间间隔为 6 年。两组在基线临床和人口统计学变量上匹配（n = 148，58%为男性，年龄 = 11.1）。还纳入了一个匹配的健康对照组作为参考。
除了两个结局测量（情绪问题和亲社会行为）之外，所有其他结局测量在基线和随访之间都有所改善。在兴奋剂治疗组中，随着时间的推移，任何结局测量上的改善都与未接受兴奋剂治疗组没有差异。
兴奋剂治疗与 ADHD 症状、社会情感功能、运动控制、时间知觉或言语工作记忆的长期发展过程无关。青春期的特点是无论在此期间是否接受兴奋剂治疗，临床症状都会改善。这些发现是为科学和公众辩论提供重要信息的来源。
