This study followed 558 children who had been diagnosed with combined-type ADHD as part of a large treatment trial. Researchers checked in with them eight times over 16 years, from about age 10 into young adulthood (around age 25). The team looked at whether each person's symptoms went away and stayed away, kept going, or came and went.
Most did not fit a simple story of either outgrowing ADHD or having it for life. The largest group had symptoms that rose and fell over time (63.8%, or 356 of the 558). Just under a third reached full remission at least once (31.4%, or 175 people), but most of them saw their symptoms return later (59.4% of those who remitted). Only a small group had lasting recovery that held to the end of the study (9.1%, or 51 people). Another small group met the criteria at every check-in (10.8%).
The authors say this challenges the common idea that about half of children with ADHD outgrow it by adulthood. Because the study only observed people, it cannot say what caused symptoms to change.
The authors suggest that, for patients like these, providers should expect symptoms to come back in most who improve and should keep screening for them over time.
Source: Margaret H. Sibley, L. Eugene Arnold, James M. Swanson, et al.. Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD. American Journal of Psychiatry (2021). doi:10.1176/appi.ajp.2021.21010032