Please visit the forum for lots more info on Adult ADHD and the media.
Done over by the BBC!
Full details of our irritation to follow, but the makers of the recent Panorama 'What Next for Craig?' [date of broadcast] have set a new low for journalistic integrity at the BBC. The programme appeared to claim that medication has 'no effect whatever' on people with ADHD and based this on a particular study.The study is known as '3-Year Follow-up of the NIMH MTA Study'. It was published in the Journal of the American Academy of Child and Adolescent Psychiatry in August 2007.
Despite Panorama's claims to the contrary, the study says that treatment with medication over a three year period was effective, as were other behavioural type treatments.
There were other aspects of the programme that were quite unfair and just plain wrong. We hope to update this page with more about this shortly. In the meantime here is a [not ready!] to the study in full (be warned: it is a biggish file, it opens in a separate window and you need adobe to read it), here is a link to the abstract and here is the transcript of the Panorama programme (opens in separate window).
Abstract of 3-Year Follow-up of the NIMH MTA Study
ABSTRACTObjective: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of
medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC)
differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt)
over those that did not (Beh+CC). This report examines 36-month outcomes, 2 years after treatment by the study ended.
Method: For primary outcome measures (attention-deficit/hyperactivity disorder [ADHD] and oppositional defiant disorder
[ODD] symptoms, social skills, reading scores, impairment, and diagnostic status), mixed-effects regression models and
orthogonal contrasts examined 36-month outcomes.
Results: At 3 years, 485 of the original 579 subjects (83.8%)
participated in the follow-up, now at ages 10 to 13 years, (mean 11.9 years). In contrast to the significant advantage of
MedMgt+Comb over Beh+CC for ADHD symptoms at 14 and 24 months, treatment groups did not differ significantly on
any measure at 36 months. The percentage of children taking medication 950% of the time changed between 14 and 36
months across the initial treatment groups: Beh significantly increased (14% to 45%), MedMed+Comb significantly
decreased (91% to 71%), and CC remained constant (60%Y62%). Regardless of their treatment use changes, all of the
groups showed symptom improvement over baseline. Notably, initial symptom severity, sex (male), comorbidity, public
assistance, and parental psychopathology (ADHD) did not moderate children’s 36-month treatment responses, but these
factors predicted worse outcomes over 36 months, regardless of original treatment assignment.
Conclusions: By 36
months, the earlier advantage of having had 14 months of the medication algorithm was no longer apparent, possibly due
to age-related decline in ADHD symptoms, changes in medication management intensity, starting or stopping medications
altogether, or other factors not yet evaluated. J. Am. Acad. Child Adolesc. Psychiatry, 2007;46(8):989Y1002. Key Words:
attention-deficit/hyperactivity disorder, clinical trial, stimulant, behavior therapy, multimodal treatment.
