Age-dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptom type

Objective: Symptom decline in attention deficit hyperactivity disorder (ADH D) was examined with different definitions of remission. Method: Symptoms in 128 boys were measured five times over 4 years. The pre valences of syndromatic (less than full syndrome), symptomatic (less than s ubthreshold diagnosis), and functional (full recovery) remission were estim ated as a function of age with multivariate logistic regression. Results: Age was significantly associated with decline in total ADHD sympto ms and symptoms of hyperactivity, impulsivity, and inattention. Symptoms of inattention remitted for fewer subjects than did symptoms of hyperactivity or impulsivity. The proportion of subjects experiencing remission varied c onsiderably with the definition used (highest for syndromatic remission, lo west for functional remission). Conclusions: These results indicate that differences in reported remission rates reflect the definition used rather than the disorder's course. They p rovide systematic support for the clinical observation that hyperactivity a nd impulsivity symptoms tend to decline at a higher rate than inattention s ymptoms.