Grant: Operating Grant

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric conditions affecting 5-10% of children and 4.4% of adults with a poor long term outcome. In adolescence and adulthood, people with ADHD continue to suffer from disabling symptoms of the disorder. Compared to people who do not have ADHD, they fail at school and drop out more often, have more employment problems, have more sexually transmitted diseases and unwanted pregnancies, more frequent and severe traffic violations and car accidents, more arrests, convictions and incarcerations, and suffer from more other co-occurring psychiatric disorders. Such poor long term outcome is not due to lack of effective treatments, since research has reliably shown that medications are effective in relieving symptoms of ADHD and a combination of medications and psychosocial treatments produces improvements in various areas of functioning, including academic, social, and emotional. However, once treatment is completed, and the patients are sent out to the community for follow up, the treatment gains gradually diminish and are completely lost after two years of follow up. Community follow up has been documented to be poor by a number of studies. Our guiding hypothesis is that the poor long term outcome in ADHD is, at least in part, due to the inadequacy of community follow up in maintaining treatment gains. We aim to show that after 3 months of tailored medication and psychosocial treatment, 2 years of a medication monitoring and tailored case management follow up will be superior to standard community follow up in maintaining treatment gains. Hopefully, such a finding will inform practice guidelines and thus improve long term outcome.