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Cited by 246Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentBehavioral and Psychological Studies

Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study

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Biederman, Joseph, Monuteaux, Michael C., Spencer, Thomas, Wilens, Timothy E., Faraone, Stephen V.·2009·Pediatrics
DOI 10.1542/peds.2008-3347PMC PMC2954591
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Abstract

OBJECTIVE: Little is known about the effect of stimulant treatment in youth with attention-deficit/hyperactivity disorder (ADHD) on the subsequent development of comorbid psychiatric disorders. We tested the association between stimulant treatment and the subsequent development of psychiatric comorbidity in a longitudinal sample of patients with ADHD. METHODS: We conducted a case-control, 10-year prospective follow-up study into young-adult years of youth with ADHD. At baseline, we assessed consecutively referred white male children with (n = 140) and without (n = 120) ADHD, aged 6 to 18 years. At the 10-year follow-up, 112 (80%) and 105 (88%) of the children in the ADHD and control groups, respectively, were reassessed (mean age: 22 years). We examined the association between stimulant treatment in childhood and adolescence and subsequent comorbid disorders and grade retention by using proportional hazards survival models. RESULTS: Of the 112 participants with ADHD, 82 (73%) were previously treated with stimulants. Participants with ADHD who were treated with stimulants were significantly less likely to subsequently develop depressive and anxiety disorders and disruptive behavior and less likely to repeat a grade compared with participants with ADHD who were not treated. CONCLUSIONS: We found evidence that stimulant treatment decreases the risk for subsequent comorbid psychiatric disorders and academic failure in youth with ADHD.

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  • Early and optimal treatment of ADHD has been shown to reduce the risk of developing certain psychiatric comorbidities.

    “Early and optimal treatment of ADHD has also been shown to reduce the risk of developing certain psychiatric comorbidities.29”

    From Health care resource utilization and costs associated with psychiatric comorbidities in adult patients with attention-deficit/ hyperactivity disorder (2024) · cites this paper as [29]

    The Results report that youth with ADHD who received stimulant treatment were less likely to subsequently develop major depression, conduct disorder, oppositional-defiant disorder, and multiple anxiety disorders. But the study assessed whether stimulant treatment preceded those outcomes, not whether treatment was early or optimal; the Discussion also acknowledges possible unmeasured confounding, so it does not establish that treatment caused the lower risk. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • Patients with ADHD, whether treated or not, are at increased risk for early death, suicide, and increased psychiatric comorbidity, particularly substance use disorders.

    “It is indicated in prospective studies that patients with ADHD, whether treated or not, are at increased risk for early death, suicide, and increased psychiatric comorbidity, particularly substance use disorders.71,72”

    From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [72]

    The Introduction (page unavailable) says ADHD is associated with high rates of psychiatric comorbidity, and the Results (page unavailable) compare subsequent disorders in stimulant-treated and untreated youth. The paper does not report an increased risk of early death or suicide, and substance use disorders were not among the outcomes analyzed. Its results also distinguish treated from untreated youth rather than finding the same psychiatric risk in both groups. (LLM, conf=0.88)

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  • Early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs.

    “It has been suggested that early and optimal treatment of ADHD could potentially alter the trajectory of psychiatric morbidity down the road by preventing the emergence of psychiatric comorbidities such as mood and anxiety disorders or SUDs [7,8].”

    From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [7]

    The Discussion reports that stimulant-treated boys with ADHD had a lower subsequent risk of depressive and anxiety disorders and suggests that effective treatment may alter their developmental trajectory. The paper does not assess substance use disorders as an outcome, and it does not establish that treatment was early or optimal; its naturalistic design also cannot establish prevention as a causal effect. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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  • Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life.

    “Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life.”

    From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [7]

    The Discussion reports that stimulant treatment for childhood ADHD was associated with lower subsequent risks of depressive, disruptive, and anxiety disorders, and suggests it may alter a developmental trajectory. The study does not establish that early recognition or treatment of existing comorbidities changes later psychiatric morbidity; it examined stimulant treatment for ADHD in a sample of males. (LLM, conf=0.86)

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  • In a 10-year longitudinal follow-up study of male youths with ADHD, those treated with stimulants were significantly less likely to have impaired functional outcomes than those not treated.

    “In a 10-year longitudinal follow-up study of male youths with ADHD, Biederman et al. (2009) [7] found that those who were treated with stimulants had a significantly lower risk of developing comorbid depressive and anxiety disorders as adults, and were also significantly less likely to have impaired functional outcomes, than those who were not treated.”

    From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [7]

    The Results report that stimulant-treated youths had significantly lower rates of grade retention, an educational functional outcome. The Discussion describes possible protection against some functional outcomes, but the copy does not establish a significant reduction in impaired functioning more broadly. (LLM, conf=0.82)

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Research works printed but not linked: 2

  1. [2]Faraone SV Sergeant J Gillberg C Biederman J The Worldwide Prevalence of ADHD: Is it an American Condition? World Psychiatry 2003 2 2 104 113 16946911 PMC1525089
  2. [36]Spitzer RL Williams JB Gibbon M First MB Structured Clinical Interview for DSM-III-R: Non-Patient Edition (SCID-NP, Version 1.0) Washington, DC American Psychiatric Press 1990

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Related

Authors
Biederman, J., Monuteaux, M. C., Spencer, T., Wilens, T. E., & Faraone, S. V.
Affiliations
  • Massachusetts General Hospital (US)
  • State University of New York (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2009-07-01
Volume
124
Issue
1
Pages
71-78
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2008-3347
PMC
PMC2954591
OpenAlex
W2124820904
Cited by
246
References
41
Citations by year
2026: 2 · 2025: 13 · 2024: 14 · 2023: 16 · 2022: 18 · 2021: 8 · 2020: 16 · 2019: 14 · 2018: 12 · 2017: 19 · 2016: 9 · 2015: 14 · 2014: 16 · 2013: 15 · 2012: 23
FWCI
12.12
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Drug Abuse (K24DA016264)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD036317, 5R01 HD36317)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
attention deficit hyperactivity disorder, stimulant medication, psychiatric comorbidity, depressive disorders, anxiety disorders, disruptive behavior disorders, school retention, school failure, long-term outcomes, youth
MeSH terms
Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Follow-Up Studies, Humans, Male, Comorbidity, Proportional Hazards Models, Case-Control Studies

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