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    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of the American Academy of Child & Adolescent Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Academy of Child & Adolescent Psychiatry, 56, 4, 2017 DOI: 10.1016/j.jaac.2017.01.016

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Psychotic symptoms in ADHD: an analysis of the MTA database

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<mark>Journal publication date</mark>04/2017
<mark>Journal</mark>Journal of the Amercian Academy of Child and Adolescent Psychiatry
Issue number4
Volume56
Number of pages8
Pages (from-to)336-343
Publication StatusPublished
Early online date4/02/17
<mark>Original language</mark>English

Abstract

Objective: To assess the prevalence of psychotic symptoms among youths (age 14-25 years) with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) combined type. Method: The participants in the Multimodal Treatment Study of Children with ADHD (MTA) and a local normative comparison group (LNCG) were systematically assessed 6, 8, 10, 12, 14, and 16 years after the original enrollment at a mean age of 8.5 years. Trained research assistants administered a psychosis screener, and positive screens were referred to study clinicians to confirm or exclude psychosis. Possible associations between screening positive and alcohol or substance use were assessed. Results: Data were available from 509 MTA participants (88% of the original MTA sample) and 276 LNCG subjects (96% of the original sample), with a mean age of 25.1 and 24.6 years, respectively, at Year 16. Twenty-six MTA subjects (5%, 95% CI: 3, 7) and 11 LNCG (4%, 95% CI: 2, 6) screened positive for at least one psychotic symptom (p=0.60). Most psychotic symptoms were transient. The prevalence of clinician-confirmed psychotic symptoms was 1.1% (95% C.I. 0.2, 2.1) in the MTA and 0.7% (0, 1.7) in the LNCG (p=0.72). Greater cannabis use was reported by those who screened (p<0.05) and were confirmed positive (p<0.01). Conclusions: There was no evidence that ADHD increased the risk for psychotic symptoms. In both the ADHD and normative comparison groups, more frequent cannabis use was associated with greater likelihood of experiencing psychotic symptoms, thus supporting the recommendation that youth should not use cannabis.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of the American Academy of Child & Adolescent Psychiatry. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of the American Academy of Child & Adolescent Psychiatry, 56, 4, 2017 DOI: 10.1016/j.jaac.2017.01.016