Young adults who were diagnosed as “hyperactive” in childhood continue to have more school, work, and mental-health problems than do their nonhyperactive peers, regardless of whether they were treated with stimulant drugs, according to a new study by three Canadian researchers.
Since the mid-1970’s, many hyperactive children have been treated with Ritalin, an amphetamine drug that effectively controls many of the symptoms of hyperactivity. The Canadian study is the first to evaluate the long-term psychiatric and physiological effects of the controversial drug therapy.
The study looked at three groups of young adults, according to Lily Hechtman, a child psychiatrist at the Montreal Children’s Hospital and one of the three researchers involved. Dr. Hechtman presented the findings at the annual meeting of the American Academy of Child Psychiatry, held here last week.
The first group, slightly older than the other two, had been diagnosed as hyperactive before physicians began treating the disorder with stimulant drugs. The researchers selected this group because, otherwise, there would have been no way to determine whether the children who received drug treatment had worse symptoms.
The second group, diagnosed several years later, had taken the drug for an average of three years. And the third, normal “control” group was made up of young adults, recruited by the researchers, who had attended school with hyperactive children who received no drug treatment. The researchers who conducted the interviews did not know to which group the subjects belonged.
The researchers found few differences between those hyperactive children who had the therapy and those who did not, although those who took the drug developed higher levels of self-esteem and better social skills. But both groups differed markedly from young people of the same age who had no history of hyperactivity.
“We see that stimulant treatment in childhood may not eliminate educational, work, and life difficulties, but it may result in less social ostracism with subsequent better feelings toward others and themselves,” Dr. Hechtman said.
The hyperactivity syndrome, identified in 1902, is characterized by impulsive, restless, and inattentive behavior. Diagnosed more often in boys than in girls, the disorder is believed to affect between one in five and one in 20 children, according to researchers. (See Education Week, January 26, 1982.) Its cause remains unknown.
Since physicians began using Ritalin to treat hyperactivity, many questions have arisen about its long-term effects on the disorder. The Canadian study, however, suggests that the drug’s effects do not linger into adulthood.
“The most striking finding of the study is the repetitive pattern of finding significant differences between the stimulant-treated hyperactives and their control group, but no such differences on the same items between the two hyperactive groups,” Dr. Hechtman said.
After collecting a wide range of psychiatric, demographic, and personal information on the three groups, the researchers compared the characteristics of the young adults.
No Effect on Growth
Suggesting that the fears of drug-induced physical problems may be unfounded, the researchers discovered that the three groups were not significantly different in terms of weight, height, pulse rate, or blood pressure.
But in other ways, the young adults who had histories of hyperactivity differed significantly from their normal peers.
Those who had a history of hyperactivity and who had been treated with stimulants, the researchers found, still showed signs of restlessness. They had changed residences more frequently in the last 10 years than had the normal control group and were more likely than the control group to have no (or less ambitious) future vocational plans.
The study also suggested that a history of hyperactivity has lingering effects on the educational progress of the former hyperactive children. Those who had been treated with stimulants “tended to fail more grades in school and drop out because of poor marks,” the researchers found.
But between the treated and untreated hyperactives, the researchers found, the differences in educational achievement were not significant.
Questionnaires filled out by the subjects’ high-school guidance counselors also showed that the drug-treated hyperactives were less successful at many tasks than the students in the control group. Guidance counselors reported that the hyperactive students were less likely to do an adequate job on assigned work, to work independently, or to complete tasks. They were also regarded as less able students of mathematics and language, the researchers found.
Employers reported that the former hyperactives were as punctual as the control group, performed adequately on the job, finished assigned tasks, and got along with supervisors.
But the treated hyperactive group had held more jobs than their normal counterparts and had spent more time neither working nor in school.
Although neither group of hyperactives had higher than normal rates of psychosis or other serious psychopathology, both groups had higher rates of “personality disorders"--paranoia, excessive introversion, and the like.
