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: 3.74). 10/2010; 157(4):635-40, 640.e1. DOI: 10.1016/j.jpeds.2010.04.025
Source: PubMed

ABSTRACT 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
1 Follower
  • 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 · 7.83 Impact Factor
  • Advances in Pediatrics 01/2011; 58(1):153-79. DOI:10.1016/j.yapd.2011.03.002
  • [Show abstract] [Hide abstract]
    ABSTRACT: Haptoglobin (Hp) and ceruloplasmin (CP) are 2 plasma antioxidants playing a role in preventing iron-induced oxidative damage. This study presents data related to Hp phenotypes and ceruloplasmin ferroxidase activity in relation to iron store markers in patients with β-thalassemia major. Blood specimens were collected from 196 subjects (124 β-thalassemia major patients and 72 healthy controls). Serum levels of iron, total iron binding capacity (TIBC), ferritin, high sensitivity C-reactive protein (hs-CRP), ceruloplasmin, and ferroxidase activity were determined using conventional methods. Haptoglobin phenotypes were determined by polyacrylamide gel electrophoresis. As expected, the mean levels of iron store markers, except TIBC, were significantly higher in patients than in controls. Ceruloplasmin concentrations (mg/dl) and its ferroxidase activity (U/l) were significantly higher in patients than in controls (57.9±18.8 vs 46.9±14.2 and 159.9±47.8 vs 95.3±20.9; p<0.001, for CP and Hp, respectively). As for Hp phenotypes, no significant differences were observed between iron store markers and ferroxidase activity among the control group. In the patients group however, significantly higher concentrations of ceruloplasmin and its ferroxidase activity were observed among patients with Hp2-2 phenotype as compared to patients with the other phenotypes. Additionally, correlations according to Hp phenotypes revealed strong association between ceruloplasmin ferroxidase activity and serum ferritin in patients with Hp 2-2 phenotype and not in the others (r=0.331, p<0.05). Thalassemia patients with Hp 2-2 phenotype are under greater iron-driven oxidative stress than patients with other phenotypes.
    Clinica chimica acta; international journal of clinical chemistry 02/2011; 412(11-12):975-9. DOI:10.1016/j.cca.2011.02.003 · 2.76 Impact Factor
Show more