A Naturalistic 10-Year Prospective Study of Height and Weight in Children with Attention-Deficit Hyperactivity Disorder Grown Up: Sex and Treatment Effects

Clinical and Research Programs in Pediatric Psychiatry and Adult ADHD, Psychiatry Department, Massachusetts General Hospital, and Department of Psychiatry, Harvard Medical School, Boston, MA 02114, USA.
The Journal of pediatrics (Impact Factor: 3.79). 10/2010; 157(4):635-40, 640.e1. DOI: 10.1016/j.jpeds.2010.04.025
Source: PubMed


To assess the effect of attention-deficit/hyperactivity disorder (ADHD) and its treatment on growth outcomes in children followed into adulthood.
Two identically designed, longitudinal, case-control studies of males and females with and without ADHD were combined; 124 and 137 control and subjects with ADHD, respectively, provided growth information at the 10- to 11-year follow-up. We used linear growth curve models to estimate the effect of time on change in height and whether this effect differed by sex and ADHD status. We also examined the effect of stimulant treatment on growth outcomes.
We found no evidence that ADHD was associated with trajectories of height over time or differences at follow-up in any growth outcomes. Similarly, we found no evidence that stimulant treatment was associated with differences in growth. However, among subjects with ADHD, major depression was associated with significantly larger weight in females and smaller height in males.
Our results do not support an association between deficits in growth outcomes and either ADHD or psychostimulant treatment for ADHD. These findings extend the literature on this topic into young adulthood and should assist clinicians and parents in formulating treatment plans for children with ADHD.

Download full-text


Available from: Michael C Monuteaux, Oct 29, 2014
    • "Similarly, adult women diagnosed with ADHD are more likely to report depressive symptoms, to be more stressed and anxious, to have more external locus of control and lower self-esteem than women who did not meet diagnostic criteria for ADHD [46]. Interestingly, in a naturalistic 10-year prospective case-control study in males and females with and without ADHD conducted to assess the effects of ADHD and its treatment on height and weight, whilst there was no no evidence that ADHD or that stimulant treatment was associated with differences at follow-up in any growth outcomes; among subjects with ADHD, major depression was associated with significantly larger weight in females and smaller height in males [47] "
    [Show abstract] [Hide abstract]
    ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial and heterogeneous neurodevelopmental disorder characterized by a persistent pattern of age-inappropriate levels of inattention, hyperactivity, and/or impulsivity. Evidence from epidemiological studies indicate that the prevalence of ADHD in males and females may be more similar than once thought, with a ratio of approximately 2:1 in children and 1.6:1 in adults. In the present chapter it is aimed to review the neurobiological mechanisms that underlie gender differences in attention, hyperactivity and impulsivity, focusing on the differential aspects of ADHD in males. There are gender-related differences in comorbid psychiatric conditions among subjects with ADHD along the life-span, with males having higher rates of ¨externalizing¨ disorders, while females may have more frequently ¨internalizing¨ disorders. ADHD is a polygenic disorder and various evidence suggest that genetic effects may be more pronounced in boys, and boys may have a lower threshold for the expression of neurodevelopmental and conduct disorders. A growing literature reveals ADHD-related dysfunctions in multiple neuronal networks involved in higher-level cognitive and sensorimotor functions, including the visual system, as well as in the default network. However, the majority of neuroimaging studies of ADHD have used largely or exclusively male individuals. Scattered reports have suggested gender differences in patterns of neural activation consistent with hypotheses and evidences suggesting right frontal abnormalities, as well as altered cerebellar-prefrontal-striatal networks in ADHD, more prominent in males. Future research, using large enough samples should expand our understanding about gender effects in ADHD, as this will improve diagnosis, prognosis and treatment.
    Neurobiology of men's mental health, Edited by Leo Sher, Timothy R. Rice, 10/2015: chapter Neurobiological basis of attention deficit hyperactivity disorder (ADHD). Are males different?: pages 29-41; Nova Science Publishers., ISBN: 978-1-63483-217-5
  • Source
    • "However, other reports suggest that these effects on growth may attenuate over time and that final adult height is not impacted (Rapoport and Inoff- Germain, 2002). Another recent study with longer follow-up times reported no significant drug effects of growth (Biederman et al, 2010), consistent with an absence of effects in adulthood. In this study, the absence of any growth suppression may be due to the timing of treatment with respect to the periods of rapid growth. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite the widespread use of stimulant medications for the treatment of attention deficit hyperactivity disorder, few studies have addressed their long-term effects on the developing brain or susceptibility to drug use in adolescence. Here, we determined the effects of chronic methylphenidate (MPH) treatment on brain dopamine (DA) systems, developmental milestones, and later vulnerability to substance abuse in juvenile nonhuman primates. Male rhesus monkeys (approximately 30 months old) were treated daily with either a sustained release formulation of MPH or placebo (N=8 per group). Doses were titrated to achieve initial drug blood serum levels within the therapeutic range in children and adjusted throughout the study to maintain target levels. Growth, including measures of crown-rump length and weight, was assessed before and after 1 year of treatment and after 3-5 months washout. In addition, positron emission tomography scans were performed to quantify binding availability of D2/D3 receptors and dopamine transporters (DATs). Distribution volume ratios were calculated to quantify binding of [(18)F]fluoroclebopride (DA D2/D3) and [(18)F]-(+)-N-(4-fluorobenzyl)-2β-propanoyl-3β-(4-chlorophenyl)tropane (DAT). Chronic MPH did not differentially alter the course of weight gain or other measures of growth, nor did it influence DAT or D2/D3 receptor availability after 1 year of treatment. However, after washout, the D2/D3 receptor availability of MPH-treated animals did not continue to decline at the same rate as control animals. Acquisition of intravenous cocaine self-administration was examined by first substituting saline for food reinforcement and then cocaine doses (0.001-0.1 mg/kg per injection) in ascending order. Each dose was available for at least five consecutive sessions. The lowest dose of cocaine that maintained response rates significantly higher than saline-contingent rates was operationally defined as acquisition of cocaine reinforcement. There were no differences in rates of acquisition, overall response rates, or cocaine intake as a function of cocaine dose between groups. In an animal model that closely mimics human development; chronic treatment with therapeutic doses of sustained release MPH did not have a significant influence on the regulation of DATs or D2/D3 receptors, or on standard measures of growth. Furthermore, this treatment regimen and subsequent drug washout did not have an impact on vulnerability to cocaine abuse.
    Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 07/2012; 37(12):2555-65. DOI:10.1038/npp.2012.117 · 7.05 Impact Factor
  • Source
    • "It should be noted that they did not compare overweight or underweight or short stature between ADHD and nonm-ADHD children and did not exclude those who received psychostimulants. Also Biederman et al. (14) showed no relationship between ADHD and growth outcome in a sample with mean age of 22 years but they found an association between comorbidity with major depression and significant weight gain in females with ADHD. They found that among males with ADHD, major depression is associated with a significant reduction in height. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in children. According to concern regarding the growth of these children, this study was carried out to compare height and weight between 5-6-year-old boys with ADHD and those without ADHD in Ahvaz, Iran Methods: In this cross-sectional study, 32 5-6-year-old ADHD boys with the Conners’ rating scale (CRS) of ≥ 15 were compared to 32 non-ADHD same-age boys with CRS of < 15. Exclusion criteria were some special disease with negative effect on growth and psychostimulant treatment. Centers for Disease Control and Prevention (CDC) curves were used to determine the growth status. Results: Comparison between ADHD and non-ADHD boys regarding mean height (111.95 ± 6.12 vs. 110.77 ± 6.22 cm), weight (19.39 ± 3.65 vs. 19.19 ± 3.75), and body mass index (15.44 ± 1.82 vs. 15.54 ± 1.67) showed no statistically significant difference (P>0.05). Conclusion: Our study does not support an association between problems in growth outcomes and ADHD in 5-6 years old boys
    03/2011; 5(2):71-75.
Show more