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Kolar DR, Monteleone AM, Cascino G, Ertl S, Meule A, Naab S, Voderholzer U. Pathways between Child Maltreatment, Psychological Symptoms, and Life Satisfaction: A Network Analysis in Adolescent Inpatients. Res Child Adolesc Psychopathol 2024; 52:969-982. [PMID: 38289540 PMCID: PMC11108895 DOI: 10.1007/s10802-024-01172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 05/22/2024]
Abstract
Child maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, symptoms and facets of life satisfaction would be most influential in adolescent inpatients with internalizing mental disorders. N = 896 adolescent receiving inpatient psychotherapeutic treatment completed questionnaires on child maltreatment experiences, current psychopathology and subjective life satisfaction at admission and discharge (n = 765). Main diagnoses were affective (n = 322), eating (n = 447), obsessive-compulsive (n = 70) and anxiety disorders (n = 57). Network models of child maltreatment, psychopathology and life satisfaction nodes were estimated at admission and discharge and compared using network comparison tests. Potential causal shortest pathways were investigated using directed acyclic graphs.Network models were stable with no significant differences between admission and discharge. Strongest nodes of each cluster were "emotional abuse" (child maltreatment), "worthlessness", "thinking about dying" and "feeling lonely" (psychopathology) and "satisfied with life" (life satisfaction) at both admission and discharge. Emotional neglect showed direct connections to life satisfaction, indicating its relevance for therapeutic interventions. At both admission and discharge, "sexual abuse" indirectly predicted lower life satisfaction through psychological symptoms. In conclusion, child maltreatment is directly and indirectly connected to life satisfaction in adolescents with mental disorders. Emotional abuse and neglect were especially important in linking child maltreatment to life satisfaction and psychopathology.
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Affiliation(s)
- David R Kolar
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy Institute of Psychology, University of Regensburg, Sedanstr. 1, 93055, Regensburg, Germany.
| | | | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy
| | - Sebastian Ertl
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy Institute of Psychology, University of Regensburg, Sedanstr. 1, 93055, Regensburg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
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Bellato A, Perrott NJ, Marzulli L, Parlatini V, Coghill D, Cortese S. Systematic Review and Meta-Analysis: Effects of Pharmacological Treatment for Attention-Deficit/Hyperactivity Disorder on Quality of Life. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00304-6. [PMID: 38823477 DOI: 10.1016/j.jaac.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to quantify the effect of ADHD medication on QoL, and to understand if this effect differs between stimulants and non-stimulants. METHOD From the dataset of a published network meta-analysis (Cortese et al., 20181), updated on 27th February 2023 (https://med-adhd.org/), we identified randomized controlled trials (RCTs) of ADHD medications for individuals aged 6 or more with a diagnosis of ADHD based on DSM (from III to 5 editions) or ICD (9 or 10), reporting data on QoL (measured with a validated scale). The risk of bias for each RCTs was assessed using the Cochrane Risk of Bias tool 2. Multi-level meta-analytic models were conducted with R 4.3.1. RESULTS We included 17 RCTs (5,388 participants in total; 56% randomized to active medication) in the meta-analyses. We found that amphetamines (Hedge's g = 0.51, 95% CI = 0.08, 0.94), methylphenidate (0.38; 0.23, 0.54), and atomoxetine (0.30; 0.19, 0.40) were significantly more efficacious than placebo in improving QoL in people with ADHD, with moderate effect size. For atomoxetine, these effects were not moderated by the length of intervention, nor differed between children/adolescents and adults. DISCUSSION In addition to being efficacious in reducing ADHD core symptoms' severity, both stimulant and non-stimulant medications are efficacious in improving QoL in people with ADHD, albeit with lower effect sizes. Future research should explore whether and to what degree combining pharmacological and non-pharmacological interventions is likely to further improve QoL in people with ADHD. STUDY PREREGISTRATION INFORMATION Effects of pharmacological treatment for ADHD on quality of life: a systematic review and meta-analysis; https://osf.io/; qvgps.
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Affiliation(s)
- Alessio Bellato
- University of Southampton, Southampton, United Kingdom, and the University of Nottingham Malaysia, Semenyih, Malaysia.
| | - Nadia J Perrott
- Ms. Perrott is with the University of Southampton, Southampton, United Kingdom
| | | | - Valeria Parlatini
- University of Southampton, Southampton, United Kingdom, King's College London, London, United Kingdom, and Solent NHS Trust, Southampton, United Kingdom
| | - David Coghill
- University of Melbourne, Melbourne, Australia, and Murdoch Children's Research Institute, Melbourne, Australia
| | - Samuele Cortese
- University of Southampton, Southampton, United Kingdom, Università degli Studi di Bari "Aldo Moro", Bari, Italy, Solent NHS Trust, Southampton, United Kingdom, and New York University Child Study Center, New York
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3
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Arildskov TW, Thomsen PH, Sonuga-Barke EJS, Lambek R, Østergaard SD, Virring A. Is Attention-Deficit/Hyperactivity Disorder (ADHD) a Dimension or a Category? What Does the Relationship Between ADHD Traits and Psychosocial Quality of Life Tell Us? J Atten Disord 2024; 28:1035-1044. [PMID: 38281108 DOI: 10.1177/10870547231222228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
OBJECTIVE The question of whether attention-deficit/hyperactivity disorder (ADHD) is a discrete category or a continuous dimension remains clinically relevant. We report the first examination of this question from the viewpoint of the relationship between ADHD traits and psychosocial quality of life (QoL), and whether the level of QoL declines markedly around a certain high ADHD trait range suggestive of a categorical boundary. METHODS Parents/caregivers of 1,967 schoolchildren aged 6 to 11 from the general population completed the Pediatric Quality of Life Inventory and the ADHD-Rating Scale IV. Piecewise linear and non-linear regression analyses were performed. RESULTS No evidence for a non-linear association or an abrupt change in the rate of decrease in QoL was observed in the high end of the ADHD traits continuum. Instead, the relationship was consistent with linearity. CONCLUSION Psychosocial QoL gradually declines in a linear manner as ADHD trait levels increase providing further support for a dimensional model.
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Affiliation(s)
- Trine Wigh Arildskov
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
| | - Per Hove Thomsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
| | - Edmund J S Sonuga-Barke
- Department of Clinical Medicine, Aarhus University, Denmark
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Rikke Lambek
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Søren D Østergaard
- Department of Clinical Medicine, Aarhus University, Denmark
- Department of Affective Disorders, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Anne Virring
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
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Massoodi A, Moudi S, Malekiamiri M, Ahangar HG. Comparison of self-esteem and quality of life in 8-12-year-old children with ADHD with and without learning disorders. BMC Psychol 2024; 12:218. [PMID: 38643160 PMCID: PMC11031957 DOI: 10.1186/s40359-024-01732-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders in school-aged children. Learning disorder (LD) is also one of the most important psychiatric disorders in children, which can often be associated with ADHD. In this study, we sought to compare self-esteem and quality of life in 8 to 12-year-old children with attention deficit/hyperactivity disorder with and without co-occurring learning disorders in order to emphasize the importance of attention and diagnosis in children with ADHD. METHOD Among the 8- to 12-year-old outpatients referred to the child and adolescent psychiatry clinic of Omid Babol Clinic, 120 children aged 8 to 12 years with attention deficit/hyperactivity disorder whose disease was diagnosed by a child and adolescent psychiatry subspecialist. Among the tools used to collect information was the Colorado Learning Difficulties Questionnaire by Wilcott et al. (CLDQ), five-scale self-esteem test of Pepe et al. (1989) for children and quality-of-life questionnaire for 8-12-year-old children (PedsQL). RESULTS This study investigated self-esteem and quality of life in children with ADHD (n = 120, 51.7% boys). Children with ADHD and learning disabilities reported significantly lower self-esteem and quality of life compared to those with ADHD alone. CONCLUSION Considering the relatively high probability of co-occurrence of ADHD and learning disorders, if one of them is diagnosed in a child, it is possible to look for other disorders in the child in order to avoid the more severe negative effects that this co-occurrence can have on the child by diagnosing it as soon as possible.
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Affiliation(s)
- Armon Massoodi
- Assistant Professor of child and adolescent Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR, Iran.
| | - Sussan Moudi
- Associate Professor of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Maryam Malekiamiri
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia Ahangar
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
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Krol L, Hagmayer Y, von Steinbuechel N, Cunitz K, Buchheim A, Koerte IK, Zeldovich M. Reference Values for the German Version of the Quality of Life after Brain Injury in Children and Adolescents (QOLIBRI-KID/ADO) from a General Population Sample. J Pers Med 2024; 14:336. [PMID: 38672963 PMCID: PMC11051333 DOI: 10.3390/jpm14040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Assessment of health-related quality of life (HRQoL) after pediatric traumatic brain injury (TBI) has been limited in children and adolescents due to a lack of disease-specific instruments. To fill this gap, the Quality of Life after Traumatic Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire was developed for the German-speaking population. Reference values from a comparable general population are essential for comprehending the impact of TBI on health and well-being. This study examines the validity of the German QOLIBRI-KID/ADO in a general pediatric population in Germany and provides reference values for use in clinical practice. Overall, 1997 children and adolescents aged 8-17 years from the general population and 300 from the TBI population participated in this study. The questionnaire was tested for reliability and validity. A measurement invariance (MI) approach was used to assess the comparability of the HRQoL construct between both samples. Reference values were determined by percentile-based stratification according to factors that significantly influenced HRQoL in regression analyses. The QOLIBRI-KID/ADO demonstrated strong psychometric properties. The HRQoL construct was measured largely equivalently in both samples, and reference values could be provided. The QOLIBRI-KID/ADO was considered reliable and valid for assessing HRQoL in a general German-speaking pediatric population, allowing for clinically meaningful comparisons between general and TBI populations.
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Affiliation(s)
- Leonie Krol
- Department of Psychology, Clinical Psychology, Experimental Psychopathology, and Psychotherapy, University of Marburg, 35037 Marburg, Germany
| | - York Hagmayer
- Georg-Elias-Müller Institute for Psychology, Georg-August-University, 37073 Goettingen, Germany;
| | - Nicole von Steinbuechel
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
| | - Katrin Cunitz
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, 37075 Goettingen, Germany
| | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
| | - Inga K. Koerte
- cBRAIN/Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, LMU University Hospital, Ludwig-Maximilian University, 80337 Munich, Germany;
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Mass General Brigham, Harvard Medical School, Boston, MA 02115, USA
| | - Marina Zeldovich
- Institute of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (N.v.S.); (K.C.); (A.B.)
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, Freudplatz 1, 1020 Vienna, Austria
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Sørensen L, Adolfsdottir S, Kvadsheim E, Eichele H, Plessen KJ, Sonuga-Barke E. Suboptimal decision making and interpersonal problems in ADHD: longitudinal evidence from a laboratory task. Sci Rep 2024; 14:6535. [PMID: 38503800 PMCID: PMC10951300 DOI: 10.1038/s41598-024-57041-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
Over half of children with Attention-Deficit/Hyperactivity Disorder (ADHD) display interpersonal and social problems. Several lines of research suggest that suboptimal decision making, the ability to adjust choices to different risk-varying options, influences poorer choices made in social interactions. We thus measured decision making and its prediction of social problems longitudinally with the Cambridge Gambling Task in children with ADHD over four years. Children with ADHD had shown suboptimal decision making driven mainly by delay aversion at baseline and we expected this to be a stabile trait which would predict greater parent-reported social problems. From the baseline assessment (n = 70), 67% participated at the follow-up assessment, 21 from the ADHD group and 26 from the typically developing group. The mean age at the follow-up was 14.5 years old. The results confirmed our expectations that suboptimal decision making was a stabile trait in children and adolescents with ADHD. Although delay aversion did not differ from controls at follow-up it still proved to be the main longitudinal predictor for greater social problems. Our findings indicate that impulsivity in social interactions may be due to a motivational deficit in youth with ADHD.
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Affiliation(s)
- L Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway.
| | - S Adolfsdottir
- Department of Biological and Medical Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
- Division of Vision Impairments, Statped - National Service for Special Needs Education, Bergen, Norway
| | - E Kvadsheim
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - H Eichele
- Regional Resource Centre for Autism, ADHD and Tourette Syndrome Western Norway, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - K J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - E Sonuga-Barke
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
- Department of Psychology, Hong Kong University, Hong Kong, China
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Kotsis K, Boukouvala M, Tzotzi A, Koullourou I, Mitropoulou A, Serdari A, Siafaka V, Hyphantis T. Health-Related Quality of Life and Behavioral Difficulties in Greek Preschool Children with Developmental Language Disorder. Healthcare (Basel) 2024; 12:470. [PMID: 38391845 PMCID: PMC10888439 DOI: 10.3390/healthcare12040470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
Developmental language disorder (DLD) has a great impact on language skills as well as on a wide range of functioning areas, such as social and school functioning. In the present study, we aim to explore the Health-Related Quality of Life (HRQoL) of preschool children with DLD, compared to children with no language difficulties, using a self and proxy report method. A total of 230 parents of preschool children with DLD and 146 parents of children without language difficulties completed the Pediatric Quality of Life Inventory (PedsQLTM) 4.0 Generic Core Module and the Strengths and Difficulties Questionnaire (SDQ). Additionally, 71 children with DLD and 55 peers without DLD completed the self-reported PedsQLTM module. The parents of kindergarten children (5-6 years old) with DLD reported that their kids experience worse social and school functioning compared to the control group. In addition, the children with DLD self-reported lower physical and social functioning. The parents of children with DLD reported that their children experience higher hyperactivity/inattention problems than the parents of the control group. Kindergarten children with DLD have a poorer HRQoL compared to their peers, as perceived by themselves and their parents. Moreover, children with DLD present with higher hyperactivity and inattention symptoms. Health professionals working with children who have DLD need to consider not only the language difficulties but also the children's wellbeing and symptoms of hyperactivity and inattention.
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Affiliation(s)
- Konstantinos Kotsis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Maria Boukouvala
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Alexandra Tzotzi
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Iouliani Koullourou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Andromachi Mitropoulou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
| | - Aspasia Serdari
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, 68 100 Alexandroupolis, Greece
| | - Vassiliki Siafaka
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, 45 500 Ioannina, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45 110 Ioannina, Greece
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O'Loughlin R, Jones R, Chen G, Mulhern B, Hiscock H, Devlin N, Dalziel K. Comparing the Psychometric Performance of Generic Paediatric Health-Related Quality of Life Instruments in Children and Adolescents with ADHD, Anxiety and/or Depression. PHARMACOECONOMICS 2024:10.1007/s40273-024-01354-2. [PMID: 38329689 DOI: 10.1007/s40273-024-01354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The aim of this study was to examine the validity, reliability and responsiveness of common generic paediatric health-related quality of life (HRQoL) instruments in children and adolescents with mental health challenges. METHODS Participants were a subset of the Australian Paediatric Multi-Instrument Comparison (P-MIC) study and comprised 1013 children aged 4-18 years with attention-deficit/hyperactivity disorder (ADHD) (n = 533), or anxiety and/or depression (n = 480). Participants completed an online survey including a range of generic paediatric HRQoL instruments (PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, CHU9D) and mental health symptom measures (SDQ, SWAN, RCADS-25). A subset of participants also completed the HUI3 and AQoL-6D. The psychometric performance of each HRQoL instrument was assessed regarding acceptability/feasibility; floor/ceiling effects; convergent validity; known-group validity; responsiveness and test-retest reliability. RESULTS The PedsQL, CHU9D, EQ-5D-Y-3L and EQ-5D-Y-5L showed similarly good performance for acceptability/feasibility, known-group validity and convergent validity. The CHU9D and PedsQL showed no floor or ceiling effects and fair-good test-retest reliability. Test-retest reliability was lower for the EQ-5D-Y-3L and EQ-5D-Y-5L. The EQ-5D-Y-3L showed the highest ceiling effects, but was the top performing instrument alongside the CHU9D on responsiveness to improvements in health status, followed by the PedsQL. The AQoL-6D and HUI3 showed good acceptability/feasibility, no floor or ceiling effects, and good convergent validity, yet poorer performance on known-group validity. Responsiveness and test-retest reliability were not able to be assessed for these two instruments. In subgroup analyses, performance was similar for all instruments for acceptability/feasibility, known-group and convergent validity, however, relative strengths and weaknesses for each instrument were noted for ceiling effects, responsiveness and test-retest reliability. In sensitivity analyses using utility scores, performance regarding known-group and convergent validity worsened slightly for the EQ-5D-Y-3L and CHU9D, though improved slightly for the HUI3 and AQoL-6D. CONCLUSIONS While each instrument showed strong performance in some areas, careful consideration of the choice of instrument is advised, as this may differ dependent on the intended use of the instrument, and the age, gender and type of mental health condition of the population in which the instrument is being used. TRIAL REGISTRATION ANZCTR-ACTRN12621000657820.
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Affiliation(s)
- Rachel O'Loughlin
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia.
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia.
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Renee Jones
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Harriet Hiscock
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nancy Devlin
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Kim Dalziel
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Zhang DW, Johnstone SJ, Sauce B, Arns M, Sun L, Jiang H. Remote neurocognitive interventions for attention-deficit/hyperactivity disorder - Opportunities and challenges. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110802. [PMID: 37257770 DOI: 10.1016/j.pnpbp.2023.110802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
Improving neurocognitive functions through remote interventions has been a promising approach to developing new treatments for attention-deficit/hyperactivity disorder (AD/HD). Remote neurocognitive interventions may address the shortcomings of the current prevailing pharmacological therapies for AD/HD, e.g., side effects and access barriers. Here we review the current options for remote neurocognitive interventions to reduce AD/HD symptoms, including cognitive training, EEG neurofeedback training, transcranial electrical stimulation, and external cranial nerve stimulation. We begin with an overview of the neurocognitive deficits in AD/HD to identify the targets for developing interventions. The role of neuroplasticity in each intervention is then highlighted due to its essential role in facilitating neuropsychological adaptations. Following this, each intervention type is discussed in terms of the critical details of the intervention protocols, the role of neuroplasticity, and the available evidence. Finally, we offer suggestions for future directions in terms of optimizing the existing intervention protocols and developing novel protocols.
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Affiliation(s)
- Da-Wei Zhang
- Department of Psychology/Center for Place-Based Education, Yangzhou University, Yangzhou, China; Department of Psychology, Monash University Malaysia, Bandar Sunway, Malaysia.
| | - Stuart J Johnstone
- School of Psychology, University of Wollongong, Wollongong, Australia; Brain & Behaviour Research Institute, University of Wollongong, Australia
| | - Bruno Sauce
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, Netherlands; NeuroCare Group, Nijmegen, Netherlands
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Han Jiang
- College of Special Education, Zhejiang Normal University, Hangzhou, China
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10
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Wanni Arachchige Dona S, Badloe N, Sciberras E, Gold L, Coghill D, Le HND. The Impact of Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) on Children's Health-Related Quality of Life: A Systematic Review and Meta-Analysis. J Atten Disord 2023; 27:598-611. [PMID: 36800919 PMCID: PMC10068409 DOI: 10.1177/10870547231155438] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
OBJECTIVE To investigate the association between children's health-related quality of life (HRQoL) and childhood attention-deficit/hyperactivity disorder (ADHD). METHOD Databases were systematically searched for peer-reviewed literature published between 2010 and 2022. Two reviewers independently screened and assessed the quality of included studies. Meta-analysis was conducted for studies that used the Pediatric Quality of Life Inventory (PedsQL). RESULTS Twenty-three studies were included, with most rated as "good" quality. Meta-analysis found "very large" effect in both parent- (Hedges' g -1.67, 95% CI [-2.57, -0.78]) and child-reported (Hedges' g -1.28, 95% CI [-2.01, -0.56]) HRQoL for children with ADHD compared to children without ADHD. No difference between parent- and child-reported HRQoL in children with and without ADHD was found. However, parent-reported HRQoL was lower than child-reported HRQoL among children with ADHD. CONCLUSION ADHD was associated with substantially poorer children's HRQoL. Among children with ADHD, parents rated their children's HRQoL lower than the children themselves.
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Affiliation(s)
- Sithara Wanni Arachchige Dona
- Deakin University, Burwood, VIC,
Australia
- Sithara Wanni Arachchige Dona, Deakin
Health Economics, School of Health and Social Development, Faculty of Health,
Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | | | - Emma Sciberras
- Deakin University, Burwood, VIC,
Australia
- Royal Children’s Hospital, Parkville,
VIC, Australia
- The University of Melbourne, Parkville,
VIC, Australia
| | - Lisa Gold
- Deakin University, Burwood, VIC,
Australia
| | - David Coghill
- Royal Children’s Hospital, Parkville,
VIC, Australia
- The University of Melbourne, Parkville,
VIC, Australia
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11
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Zhang Z, Li R, Zhou Z, Wang P, Yang B, Wang X. The effect of physical activity on quality of life and parenting stress in children with attention-deficit/hyperactivity disorder: A randomized controlled trial. Disabil Health J 2023; 16:101377. [PMID: 36202733 DOI: 10.1016/j.dhjo.2022.101377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Poorer quality of life (QoL) is commonly observed in children with Attention-deficit/Hyperactivity Disorder (ADHD). Parents of children with ADHD also perceived elevated levels of parenting stress. Previous research has documented the positive effects of physical activity (PA) on managing ADHD symptoms. It is critical to implement ADHD management with broader functioning from both children's and parents' perspectives. OBJECTIVE This study aimed to examine whether PA would exert an influence on the QoL of children with ADHD and parenting stress of their parents. METHODS Forty-three children with ADHD (6-12 years) were randomly assigned to the PA intervention and waitlist control groups. Children in the intervention group participated in a 12-week PA program. Parent-reported QoL and parenting stress were assessed before and immediately after the intervention. Analysis of covariance with a mixed factorial design of 2 (time: before vs. after intervention) × 2 (group: PA intervention vs. waitlist control) was conducted to examine changes in QoL and parenting stress over the 12 weeks. RESULTS Compared to the control group, parents of children in the intervention group reported significant reduced overall parenting stress (p = .021, η2 = 0.142) and child domain of parenting stress (p = .024, η2 = 0.138) after the intervention. No significant improvement in QoL was documented in either group. CONCLUSIONS The participation of PA intervention positively impacts parenting stress perceived by parents of children with ADHD, which provides further evidence of the family-wide benefits of the PA intervention.
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Affiliation(s)
- Zhenzhen Zhang
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Ru Li
- Faculty of Physical Education, Shenzhen University, Shenzhen, China.
| | - Ziwei Zhou
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Peng Wang
- Cardiac Rehabilitation Center, Fuwai Hospital, CAMS&PUMC, Beijing, China
| | - Binrang Yang
- Children's Healthcare & Mental Health Center, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiaodong Wang
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
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12
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Timmermann D, Krenz U, Schmidt S, Lendt M, Salewski C, Brockmann K, von Steinbüchel N. Health-Related Quality of Life after Pediatric Traumatic Brain Injury: A Qualitative Comparison of Perspectives of Children and Adolescents after TBI and a Comparison Group without a History of TBI. J Clin Med 2022; 11:jcm11226783. [PMID: 36431260 PMCID: PMC9697382 DOI: 10.3390/jcm11226783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The assessment of the impact of pediatric traumatic brain injury (TBI) on the health-related quality of life (HRQoL) of the children and adolescents affected can be ameliorated by a disease-specific instrument. Such an instrument does not yet exist. This qualitative study investigates how children and adolescents after TBI subjectively perceive their HRQoL and whether and how this differs from the perspective of individuals without a history of TBI. METHODS Eight problem-centered interviews were conducted with 11 children and adolescents around four years after mild TBI and with eight children and adolescents around three years after moderate to severe TBI. Nine problem-centered interviews were conducted with 25 participants without a history of TBI. The interviews were recorded and transcribed verbatim. The statements were assigned to inductively and deductively derived categories relevant to the HRQoL of children and adolescents after TBI and compared with those of individuals without a history of TBI. RESULTS The HRQoL of children and adolescents after TBI tended to display both structural and content-related differences, independently of TBI severity, on several HRQoL dimensions, in contrast to the comparison group. For example, participants after TBI reported a broader range of negative emotions (such as worry, sadness, shame, and guilt), permanent physical impairments, felt that they were treated differently from others, and perceived cognitive limitations. CONCLUSIONS The results of this qualitative study identified HRQoL dimensions that are relevant to children and adolescents after TBI and underlined the need for the development of a disease-specific instrument.
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Affiliation(s)
- Dagmar Timmermann
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
- Correspondence:
| | - Ugne Krenz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Robert-Blum-Str. 13, 17487 Greifswald, Germany
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Strümper Straße 111, 40670 Meerbusch, Germany
| | - Christel Salewski
- Department of Health Psychology, Germany’s State Distance-Learning University Hagen, Universitätsstr. 33, 58097 Hagen, Germany
| | - Knut Brockmann
- Division of Pediatric Neurology, Department of Pediatrics and Adolescent Medicine, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Nicole von Steinbüchel
- Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
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13
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Cross-Cultural Validation of Health and Quality of Life Measures for Children in Hong Kong. Occup Ther Int 2022; 2022:5672679. [PMID: 36249579 PMCID: PMC9532141 DOI: 10.1155/2022/5672679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The Pediatric Quality of Life Inventory (PedsQL™) 4.0 is a health-related quality of life (HRQOL) measure designed for clinical practice and research, health policy evaluation, and general population surveys. There is a dearth of instruments measuring quality of life in children which are available in Chinese and validated for Chinese populations. Therefore, this study attempted to establish the Hong Kong populations' norms for the Chinese version of PedsQL™ and examined the psychometric properties of the measure for this population. Methods Sixty-nine children (aged 7 to 12 years) and their parents completed the child self-report and the parent proxy report, respectively, of the PedsQL™ 4.0 Generic Module. To evaluate construct validity, a group comparison of children with special educational needs (SEN) (n = 21) and those with typical development (TD) (n = 48) was conducted. Differences based on age group and gender and parent–child agreement on the perception of the child's HRQOL were also examined. Results Children with SEN had a lower quality of life perception than those with TD in the physical, social, and schooling domains. No significant differences in emotional health were found between the two groups. The differences between the children with SEN and with TD varied based on age group and gender. The differences between the parents' and children's perceptions of the children's HRQOL were insignificant in this sample. Conclusion Norms for the Chinese version of the PedsQL™ 4.0 Generic Module for the Hong Kong population were established in the study, and both the child self-report and parent proxy report were found to be reliable and valid for this population.
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Hertz-Palmor N, Gothelf D. The importance of measuring quality of life as a treatment outcome in child and adolescent psychiatry. Eur Child Adolesc Psychiatry 2022; 31:1331-1335. [PMID: 35927527 DOI: 10.1007/s00787-022-02058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nimrod Hertz-Palmor
- The Child and Adolescent Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashmoer, 5262000, Ramat Gan, Israel
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Doron Gothelf
- The Child and Adolescent Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashmoer, 5262000, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
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15
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Quality of life in pediatric patients with obsessive-compulsive disorder during and 3 years after stepped-care treatment. Eur Child Adolesc Psychiatry 2022; 31:1377-1389. [PMID: 33881628 DOI: 10.1007/s00787-021-01775-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
The present study aimed to investigate the long-term quality of life (QoL) in a large sample of pediatric obsessive-compulsive disorder (OCD) patients. The study included 220 pediatric OCD patients from the Nordic Long-term OCD Treatment Study (NordLOTS) who were evaluated at seven time points before, during, and after stepped-care treatment over a 3-year follow-up period. Data from three symptom severity trajectory classes formed the basis of the QoL evaluation: acute (n = 127, N = 147), slow (n = 46, N = 63), and limited responders (n = 47, N = 59). Patients' QoL was assessed using parent and child ratings of the revised Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). QoL was analyzed by trajectory class using a random mixed effects model. The association between pre-treatment factors and long-term QoL was investigated across classes in a multivariate model. Three years after treatment, the acute responder class had reached QoL levels from a general population, whereas the limited responder class had not. The slow responder class reached norm levels for the child-rated QoL only. Higher levels of co-occurring externalizing symptoms before treatment were associated with lower parent-rated QoL during follow-up, while adolescence and higher levels of co-occurring internalizing symptoms were associated with lower child-rated QoL during follow-up. For some patients, residual OCD symptoms in the years after treatment, even at levels below assumed clinical significance, are associated with compromised QoL. Co-occurring symptoms could be part of the explanation. Assessing QoL after OCD treatment, beyond the clinician-rated symptom severity, could detect patients in need of further treatment and/or assessment. Trial registry: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.
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16
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Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Internalizing and externalizing mental health problems affect in-school adolescent’s health-related quality of life in eastern Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0272651. [PMID: 35925999 PMCID: PMC9352091 DOI: 10.1371/journal.pone.0272651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Aims This study aimed to examine the association between mental health problems and health-related quality of life (HrQoL) among in-school adolescents 13–19 years in the Harari region, eastern Ethiopia. Materials and methods A cross-sectional study was conducted on 3227 in-school adolescents aged 13 to 19 using multistage sampling. The KIDSCREEN-10 questionnaire assessed health-related quality of life (HrQoL), while a self-administered version of the strength and difficulty questionnaire (SDQ) examined mental health issues. Data were double entered, validated, and cleaned using EpiData version 3.1 and analyzed using STATA 14.1. An ordinal logistic regression model investigated the link between the outcome variable and the predictors. The results were reported using an odds ratio with a 95% confidence interval (CI), and a p-value of less than 0.05 was considered statistically significant. Results A quarter of the adolescents (23%) reported poor health-related quality of life; adolescents with internalizing and externalizing mental health problems had the lowest health-related quality of life. After controlling for potential confounders, adolescents with abnormal (AOR = 0.48, 95% CI: 0.39, 0.59) and borderline (AOR = 0.59, 95% CI: 0.45, 0.78) levels of internalizing problems had a 52% and 41% lower probability of having high HrQoL than those with normal levels. Furthermore, individuals with abnormal (AOR = 0.59, 95% CI: 0.45, 0.77) and borderline (AOR = 0.64, 95% CI: 0.45, 0.92) levels of externalizing difficulties had a 41% and 36% lower chance of having a high health-related quality of life. Conclusions Nearly a quarter of in-school adolescents had poor health-related quality of life. High scores for internalizing and externalizing mental health problems significantly impacted the adolescents’ health-related quality of life. This emphasizes the need to address mental health issues in the school setting to improve adolescents’ overall quality of life.
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Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- * E-mail:
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, School of Health Sciences, Madda Walabu University, Robe, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Negussie Deyessa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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17
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Evers K, Maljaars J, Schepens H, Vanaken GJ, Noens I. Conceptualization of quality of life in autistic individuals. Dev Med Child Neurol 2022; 64:950-956. [PMID: 35323990 DOI: 10.1111/dmcn.15205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/14/2022]
Abstract
The present study examines to what extent two core characteristics of the quality of life (QoL) construct were incorporated in the field of autism: (1) its subjective nature; and (2) its multidimensionality. Therefore, we reviewed 174 articles examining QoL in individuals with autism. The review showed parents reporting a lower QoL compared with autistic individuals themselves, especially on internal domains. This may suggest different expectations about what a good QoL may entail. Such an underestimation of QoL by others is commonly observed in individuals with disabilities (the so-called 'disability paradox'). For the multidimensionality of the QoL construct, our findings suggest that the narrower (and more unidimensional) construct of health-related QoL is often measured instead of QoL. Additionally, a substantial proportion of items did not measure QoL, but they evaluated characteristics that may or may not have an impact on QoL. Researchers and clinicians should be aware that QoL domains are selected and operationalized differently by different instruments. QoL may benefit from an exclusive focus on subjective aspects, which can be measured alongside more normative, objective characteristics of individuals or their environment.
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Affiliation(s)
- Kris Evers
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, UPC-KU Leuven, Leuven, Belgium
| | - Jarymke Maljaars
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, UPC-KU Leuven, Leuven, Belgium
| | - Hadewych Schepens
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium
| | - Gert-Jan Vanaken
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, UPC-KU Leuven, Leuven, Belgium.,Department of Philosophy, Centre for Ethics, University of Antwerp, Antwerp, Belgium
| | - Ilse Noens
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
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18
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Caron V, Jeanneret N, Giroux M, Guerrero L, Ouimet M, Forgeot d’Arc B, Soulières I, Courcy I. Sociocultural context and autistics' quality of life: A comparison between Québec and France. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:900-913. [PMID: 34325546 PMCID: PMC9008549 DOI: 10.1177/13623613211035229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT What is already known about the topic? Quality of life refers to how people perceive aspects of their life such as physical health, material security, and interpersonal relationships. Studies have reported lower quality of life among autistic individuals than in the general population.What does this article contribute? This article contributes to a better understanding of quality of life and its measures from the point of view of autistic adults. By comparing two groups of French-speaking autistic adults from two different places (France and Québec-Canada), this research shows that the perception of quality of life and its determining factors differ for autistic adults living in each country. The Québec group reported a superior quality of life, and some quality of life predictors were different in each group. The social experience of autism-related stigmatization, however, was a powerful predictor of quality of life for all.Implications for practice, research, and policy To promote a higher quality of life for autistic people, it is important to consider the sociocultural context and implement awareness programs and public campaigns aimed at identifying and countering stigmatization processes.
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Affiliation(s)
| | - Nuria Jeanneret
- Centre de recherche et de partage des savoirs InterActions, Centre intégré de santé et des services sociaux (CIUSSS) du Nord-de-l’Île-de-Montréal, Canada
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19
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Lai JS, Kallen MA, Blackwell CK, Wakschlag LS, Cella D. Psychometric Considerations in Developing PROMIS® Measures for Early Childhood. J Pediatr Psychol 2022; 47:510-522. [PMID: 35552436 PMCID: PMC9113367 DOI: 10.1093/jpepsy/jsac025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The early expression of lifespan health and disease states can often be detected in early childhood. Currently, the Patient-Reported Outcome Measurement Information System (PROMIS®) includes over 300 measures of health for individuals ages 5 years and older. We extended PROMIS to early childhood by creating developmentally appropriate, lifespan coherent parent-report measures for 1-5-year-olds. This paper describes the psychometric approaches used for these efforts. METHODS 2 waves of data from parents of children ages 1-5 were collected via 2 internet panel companies. Wave 1 data (n = 1,400) were used to evaluate item pool unidimensionality, model fit, and initial item parameters. Combined data from wave 1 and wave 2 (reference sample; n = 1,057) were used to estimate final item parameters. Using item response theory methods, we developed and tested 12 item pools: Global Health, Physical Activity, Sleep Disturbance, Sleep-related Impairment, Anger/Irritability, Anxiety, Depressive Symptoms, Positive Affect, Self-Regulation, Engagement, Family Relationships, and Peer Relationships. RESULTS Wave 1 analyses supported the unidimensionality of Physical Activity, Positive Affect, Anger/Irritability, Anxiety, Depressive Symptoms, and Global Health. Family Relationships and Peer Relationships were combined to form "Social Relationships"; Sleep Disturbance and Sleep-related Impairment were combined to form "Sleep Problems." Self-Regulation was divided into "Flexibility" and "Frustration Tolerance"; Engagement was divided into "Curiosity" and "Persistence." Short forms were developed for item banks with more than 10 items; and. CONCLUSIONS Using rigorous mixed-methods, we successfully extended PROMIS to early childhood (1-5-year-olds). Measures are now publicly available in English and Spanish (www.healthmeasures.net).
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Affiliation(s)
- Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine and Institute for Innovations in Developmental Sciences (DevSci), USA
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20
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O'Loughlin R, Hiscock H, Pan T, Devlin N, Dalziel K. The relationship between physical and mental health multimorbidity and children's health-related quality of life. Qual Life Res 2022; 31:2119-2131. [PMID: 35094215 PMCID: PMC9188523 DOI: 10.1007/s11136-022-03095-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 12/04/2022]
Abstract
Purpose To examine the relationships between physical health problems, and borderline or clinical levels of mental health symptoms and children’s health-related quality of life (HRQoL). Methods Data were from the Longitudinal Study of Australian Children (2004–2018). Parents reported on their child’s HRQoL (PedsQL), physical health problems and mental health symptoms (Strengths and Difficulties Questionnaire, SDQ). A pooled cross-sectional analysis using linear regressions examined the relationships between physical health and clinical/borderline mental health symptoms, individually and when multi-morbid, and children’s HRQoL, and whether these relationships vary by a range of child, family and social factors. Results The sample comprised 47,567 observations of children aged 4–17 years. Borderline and clinical levels of mental health symptoms were associated with significantly lower HRQoL, equal to more than two-times (10.5 points) and more than three-times (16.8 points) the clinically meaningful difference, respectively. This was a larger difference than that associated with physical health problems (4.4 points). We found a significant interaction effect between physical health problems and clinical mental health symptoms which was associated with even poorer HRQoL after accounting for the individual relationships of both problems. Mental health problems were associated with poorer HRQoL for older versus younger children; and the interaction effect was significant for boys but not girls. Conclusion Findings highlight the importance of identifying and addressing mental health symptoms in children of all ages, even if these problems do not meet formal clinical criteria. Particular attention should be paid to the mental health and HRQoL of children with physical–mental multimorbidity, who are at risk of disproportionately poorer HRQoL. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03095-1. Ongoing physical and mental health problems are common in children and adolescents and, often, children can experience both problems together. Mental and physical health problems can have wide impacts for the child, including their health-related quality of life (HRQoL), which is a measure of the way the child’s health impacts their emotional, social and physical functioning during their day-to-day life. Our study shows that children with high levels of mental health symptoms have much poorer HRQoL than their peers, and we provide new evidence that even milder mental health symptoms are associated with poorer HRQoL than in children with physical health problems. When children have both physical and mental health problems, they are at even greater risk of poorer HRQoL than would be expected. Based on our findings, we recommend that clinicians should monitor and address mental health symptoms in children as young as 4–7 years old, even if these symptoms are milder, and particular attention should be given to children with physical and mental health problems, who are at greater risk of poor HRQoL.
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Affiliation(s)
- Rachel O'Loughlin
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Harriet Hiscock
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Health Services, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Tianxin Pan
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Health Services, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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21
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Korfmacher AK, Hirsch O, Chavanon ML, Albrecht B, Christiansen H. Self-management training vs. neurofeedback interventions for attention deficit hyperactivity disorder: Results of a randomized controlled treatment study. Front Psychiatry 2022; 13:969351. [PMID: 36061275 PMCID: PMC9433654 DOI: 10.3389/fpsyt.2022.969351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Neurofeedback (NF) and self-management training (SMT) may be viable treatment options for patients with attention deficit hyperactivity disorder (ADHD) if they alleviate core symptoms, enhance the patients' self-concept and improve their quality of life (QoL). Aim of the current study is evaluating both interventions accordingly and to test whether specific improvements in core symptoms lead to more general improvements in self-concept and QoL. METHODS In a psychotherapeutic outpatient clinic in Germany, a total of N = 139 children with ADHD were screened for eligibility, of which 111 fulfilled inclusion criteria and participated in the study in accordance with the CONSORT 2010 statement. These were randomly assigned to NF vs. SMT interventions. Changes from pre- to post-intervention in core ADHD symptoms relying on parent and teacher reports (CONNERS 3) and objective tests (Qb-Test) as well as self-concept (interview with the children) and QoL assessments (using the KINDL-R self-report) were compared between patients receiving NF or SMT. RESULTS Significant improvements in ADHD symptoms were achieved similarly in both treatment groups, whilst QoL and self-concept improved after SMT only. CONCLUSION This treatment study provides further evidence that SMT and NF may reduce core symptoms, but SMT may also improve patients' self-concept and QoL and may thus in its current form be the favorable treatment option in naturalistic settings. However, several limitations of the current study implicate that further research is required before definitive conclusions and recommendations for clinical practice can be given. CLINICAL TRIAL REGISTRATION [www.clinicaltrials.gov], identifier [NCT01879644].
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Affiliation(s)
- Ann-Kathrin Korfmacher
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, Siegen, Germany
| | - Mira-Lynn Chavanon
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Björn Albrecht
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps-University Marburg, Marburg, Germany
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Ottosson S, Schachinger Lorentzon U, Kadesjö B, Gillberg C, Miniscalco C. Neurodevelopmental problems and quality of life in 6-year-olds with a history of developmental language disorder. Acta Paediatr 2022; 111:115-122. [PMID: 34516681 DOI: 10.1111/apa.16104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 08/18/2021] [Accepted: 09/10/2021] [Indexed: 12/01/2022]
Abstract
AIM To explore family-reported neurodevelopmental functioning and quality of life in 6-year-olds who had screened positive for developmental language disorder at age 2.5 years. METHODS Parents of 85 6-year-old children completed questionnaires about child neurodevelopmental difficulties and quality of life. The children were interviewed regarding quality of life, and their language was assessed by speech and language pathologists. Test results at 6 years identified three subgroups: children with developmental language disorder (n = 68) or speech sound disorder (n = 6) and children with no current language disorder (n = 11). RESULTS Out of the 68 children with developmental language disorder, 33 (48%) had significant parent-rated problems with language, executive functions 17 (25%), perception 15 (22%) and/or motor skills 15 (22%). Four (67%) of the children with speech sound disorder had significant problems with language. Significant problems were reported with language in five (45%) and with perception in four (36%) children with no current language disorder. The parents reported no impaired quality of life, whereas the children themselves reported impairment mainly with school functioning. CONCLUSIONS Overlap between language difficulties and other neurodevelopmental problems was higher in 6-year-olds who had screened positive for developmental language disorder about 3 years earlier, than in the general population. The parent and child reports of quality of life were not consistent.
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Affiliation(s)
- Simon Ottosson
- Department of Pediatrics Angered Hospital Gothenburg Angered Sweden
| | - Ulrika Schachinger Lorentzon
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatric Speech and Language Pathology Queen Silvia Children’s Hospital Gothenburg Gothenburg Sweden
| | - Björn Kadesjö
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Child Neuropsychiatry Queen Silvia Children’s Hospital Gothenburg Gothenburg Sweden
| | - Carmela Miniscalco
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatric Speech and Language Pathology Queen Silvia Children’s Hospital Gothenburg Gothenburg Sweden
- Department of Child Neuropsychiatry Queen Silvia Children’s Hospital Gothenburg Gothenburg Sweden
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Searching for What Really Matters: A Thematic Analysis of Quality of Life among Preschool Children on the Autism Spectrum. J Autism Dev Disord 2021; 52:2098-2111. [PMID: 34060000 DOI: 10.1007/s10803-021-05097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Quality of life (QoL) is an essential measure when assessing health interventions. Most early interventions for preschool children on the spectrum evaluate the effects on autism symptoms. However, researchers increasingly believe that good interventions should also improve the QoL of these children. Domains of QoL among preschool children on the autism spectrum have not previously been researched. We interviewed adults on the spectrum to explore early childhood experiences that made their lives satisfying. Our data revealed four major themes: interests, environmental regularity, sensory differences and social interactions. This study provides the first insights on aspects of life important to pre-schoolers on the spectrum. Findings will contribute to developing items for a measure of QoL among this population.
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Chezan LC, Liu J, Cholewicki JM, Drasgow E, Ding R, Warman A. A Psychometric Evaluation of the Quality of Life for Children with Autism Spectrum Disorder Scale. J Autism Dev Disord 2021; 52:1536-1552. [PMID: 33961179 DOI: 10.1007/s10803-021-05048-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 11/26/2022]
Abstract
Our purpose in this study was to validate the Quality of Life for Children with Autism Spectrum Disorder scale. We first conducted an exploratory factor analysis to examine the factor structure. Results suggested that a three-factor model (Interpersonal Relationships, Self-Determination, and Emotional Well-Being) should be retained. Next, we conducted a confirmatory factor analysis to compare a higher-order factor model and additional models. Results showed acceptable model fit for the higher-order factor model. The scale had excellent reliability (α = .90) for the overall scale and for the three subscales (Interpersonal Relationships, α = .87; Self-Determination, α = .81; and Emotional Well-Being, α = .66). The 16-item scale showed convergent and divergent validity. Implications for future research and practice are discussed.
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Affiliation(s)
- Laura C Chezan
- Old Dominion University, 4501 Hampton Blvd., Child Study Center 122, Norfolk, VA, 23529, USA.
| | - Jin Liu
- University of South Carolina, 820 Main Street, Columbia, SC, 29208, USA
| | | | - Erik Drasgow
- University of South Carolina, 820 Main Street, Columbia, SC, 29208, USA
| | - Ruyi Ding
- Tsinghua Shenzhen International Graduate School, University Town of Shenzhen, Nanshan District, Shenzhen, 518055, People's Republic of China
| | - Adam Warman
- The Faison Center, 1701 Byrd Avenue, Richmond, VA, 23230, USA
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25
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Kwiatkowska K, Milczarek O, Debicka M, Baliga Z, Maryniak A, Kwiatkowski S. The health-related quality of life in children with arachnoid cysts. Clinical predictors and parent-child perspectives. J Neurosurg Sci 2021; 66:200-207. [PMID: 33870667 DOI: 10.23736/s0390-5616.21.05245-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In clinical practice, arachnoid cysts are usually detected by coincidence and are frequently considered as clinically mute. Even though an AC does not usually result in serious symptoms, the diagnosis itself can have a significant impact on the patients and their families, especially in terms of psychological functioning and quality of life. METHODS Participants were 22 pairs of children diagnosed with AC and their parents. We analysed patients' medical records and assessed them using the Stanford Binet Intelligence Scale ed. 5th. Additionally, both children and parents filled in the Polish version of the PedsQL™ 4.0 generic core module. RESULTS The HRQOL is not related to objective predictors such as radiological predictors and SB 5 results. However, there is a correlation between the HRQOL, and symptoms given in the interview. Secondly, parents assess the HRQOL of their children worse compared to the children's own ratings. Lastly, children with AC assess the HRQOL in a way that is similar to the assessment done by healthy children in the original study describing PedsQL™, whereas parents assess children's HRQOL in a way rather similar to the assessment done by parents of patients. CONCLUSIONS The results show the impact of the disease's image and understanding on the HRQOL. Basing on our results we conclude the important role of psychological support for patients with AC. We furthermore conclude that parents of children with AC assess the HRQOL of children worse compared to the children's own ratings.
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Affiliation(s)
- Karolina Kwiatkowska
- Jagiellonian University Medical College, Clinic of Children's Neurosurgery, Kraków, Poland -
| | - Olga Milczarek
- Jagiellonian University Medical College, Clinic of Children's Neurosurgery, Kraków, Poland
| | - Magdalena Debicka
- Clinic of Neurosurgery and Neurotraumatology, The University Hospital in Kraków, Poland
| | | | | | - Stanisław Kwiatkowski
- Jagiellonian University Medical College, Clinic of Children's Neurosurgery, Kraków, Poland
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26
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Krenz U, Timmermann D, Gorbunova A, Lendt M, Schmidt S, von Steinbuechel N. Health-related quality of life after pediatric traumatic brain injury: A qualitative comparison between children's and parents' perspectives. PLoS One 2021; 16:e0246514. [PMID: 33566806 PMCID: PMC7875394 DOI: 10.1371/journal.pone.0246514] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 01/20/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Pediatric traumatic brain injury (TBI) may cause a wide range of symptoms, which can negatively affect the quality of life of patients and their entire families. No internationally and simultaneously developed disease-specific instrument exists for assessing pediatric health-related quality of life (HRQoL) after TBI. The aim of the current project is to provide original material from small group interviews with individuals after TBI concerning what they state is relevant for their HRQoL. This material is required for a further study to generate items for age-adapted questionnaires assessing the TBI-specific HRQoL of children and adolescents (C&A): the QOLIBRI-Kiddy/Kid/Ado and proxy versions (Quality of Life after Brain Injury-Kiddy/Kids/Adolescents/Proxy) for individuals aged 6-17 and their parents. METHODS The semi-structured interviews were conducted with separate small groups of C&A (n = 19), divided into three age groups (5-7y, 8-12y, 13-17y), after mild, moderate, and severe TBI, and with groups of the corresponding parents (n = 26). All interviews lasted for about 60 minutes, were recorded and transcribed verbatim. The statements were investigated by qualitative analyses and sorted into categories relevant to the HRQoL of C&A after TBI. Only descriptive group comparisons but no pairwise comparisons between children and corresponding parents were performed. RESULTS The analyses led to 32 subcategories, which were assigned to six main theoretically based HRQoL categories. Many agreements exist between the C&A's and parents' perspectives within the main categories, however their focus on HRQoL differs, especially concerning age-related contents. Parents of the youngest participant group already focus on topics such as autonomy, whereas this only becomes relevant for C&A from the age of eight years on. Interestingly, even 5-year-old children were able to discuss their HRQoL, which indicates the importance of a self-report instrument. CONCLUSIONS Results obtained from this qualitative study identify the content of the HRQoL dimensions important for C&A after TBI and their parents. Both, differences and similarities in the children's and the parents' views were investigated, to get a first insight in valid dimensions for the prospective questionnaires to be developed. In a future study, items for the questionnaires will be deducted from the small group interview material and psychometrically tested in C&A after TBI from Germany. This study will address whether all statements were assigned to the suitable dimensions and whether differences between C&A and parents persist.
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Affiliation(s)
- Ugne Krenz
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Dagmar Timmermann
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Anastasia Gorbunova
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
| | - Michael Lendt
- Neuropediatrics, St. Mauritius Therapeutic Clinic, Meerbusch, Germany
| | - Silke Schmidt
- Department Health and Prevention, University of Greifswald, Greifswald, Germany
| | - Nicole von Steinbuechel
- Department of Medical Psychology and Medical Sociology, Georg-August University, Göttingen, Germany
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Celebre A, Stewart SL, Theall L, Lapshina N. An Examination of Correlates of Quality of Life in Children and Youth With Mental Health Issues. Front Psychiatry 2021; 12:709516. [PMID: 34539463 PMCID: PMC8440870 DOI: 10.3389/fpsyt.2021.709516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Quality of life (QoL) is significantly lower in children with mental health issues compared to those who are typically developing or have physical health problems. However, little research has examined factors associated with QoL in this particularly vulnerable population. To address this limitation, 347 clinically referred children and adolescents were assessed using the interRAI Child and Youth Mental Health (ChYMH) Assessment and Self-reported Quality of Life- Child and Youth Mental Health (QoL-ChYMH). Hierarchical multiple linear regression analyses were conducted to examine QoL at the domain-specific level. Children and adolescents who experienced heightened anhedonia and depressive symptoms reported lower social QoL (e.g., family, friends and activities; p = 0.024, 0.046, respectively). Additionally, children and youth who experienced heightened depressive symptoms reported lower QoL at the individual level (e.g., autonomy, health; p = 0.000), and level of basic needs (e.g., food, safety; p = 0.013). In contrast, no mental state indicators were associated with QoL related to services (e.g., school, treatment). Due to the paucity of research examining predictors of QoL in children and youth with mental health challenges, this study contributes to the field in assisting service providers with care planning and further providing implications for practice.
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Affiliation(s)
- Angela Celebre
- Faculty of Education, Western University, London, ON, Canada
| | | | - Laura Theall
- Child and Parent Resource Institute, London, ON, Canada
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28
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Coghill DR, Werner-Kiechle T, Farahbakhshian S, Bliss C, Robertson B, Huss M. Functional impairment outcomes in clinical trials of different ADHD medications: post hoc responder analyses and baseline subgroup analyses. Eur Child Adolesc Psychiatry 2021; 30:809-821. [PMID: 32691164 PMCID: PMC8060241 DOI: 10.1007/s00787-020-01586-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/24/2020] [Indexed: 11/16/2022]
Abstract
Several recent phase 3 clinical trials of attention-deficit/hyperactivity disorder (ADHD) medications have used the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P). Here, we assess WFIRS-P response in individual patients in two pivotal trials of lisdexamfetamine dimesylate (LDX) and guanfacine extended release (GXR). We also analysed pooled WFIRS-P data from seven phase 3 studies of ADHD medications to shed light on factors associated with baseline functional impairment. The proportion of patients with a change in WFIRS-P score that exceeded the minimal important difference (MID) criteria for response was greater for LDX than placebo in the Family, Learning and School, and Risky Activities domains, and was greater for GXR than placebo in the Social Activities, Learning and School, and Family domains. Responders had significantly worse baseline scores in all WFIRS-P domains (all p < 0.001) than non-responders. In the pooled analyses, baseline WFIRS-P scores in all domains were significantly worse in participants with oppositional defiant disorder (ODD) than in those without ODD. Having combined type or hyperactive-impulsive type ADHD, being enrolled into a study in Europe, being male and being younger also had modest negative effects on baseline WFIRS-P scores. The present analysis of WFIRS-P response shows that previously reported group-level improvements in WFIRS-P functional impairment score translated into clinically relevant improvements in many individual participants. Functional impairment is a diverse and subjective construct that is influenced by multiple factors. Optimal management of individuals with ADHD should involve monitoring improvements in functioning and quality of life, as well as symptomatic improvement.
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Affiliation(s)
- David R. Coghill
- grid.1008.90000 0001 2179 088XDepartments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, VIC 3010 Australia ,grid.1058.c0000 0000 9442 535XMurdoch Children’s Research Institute, Parkville, VIC Australia
| | | | | | - Caleb Bliss
- grid.419849.90000 0004 0447 7762Shire, a Takeda company, Lexington, MA USA
| | - Brigitte Robertson
- grid.419849.90000 0004 0447 7762Shire, a Takeda company, Lexington, MA USA
| | - Michael Huss
- grid.5802.f0000 0001 1941 7111Child and Adolescent Psychiatry, Johannes Gutenberg-University Mainz, Mainz, Germany
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29
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Towards standardization of economic evaluation research in the youth psychosocial care sector: A broad consultation in the Netherlands. GLOBAL & REGIONAL HEALTH TECHNOLOGY ASSESSMENT 2020; 7:117-123. [PMID: 36627969 PMCID: PMC9677588 DOI: 10.33393/grhta.2020.2143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/28/2020] [Indexed: 01/13/2023] Open
Abstract
Introduction Stakeholders are increasingly interested in the societal impact of psychosocial interventions in the youth sector, in terms of costs and quality of life, as well as in outcomes research. The aim of this broad consultation was to reach consensus regarding the steps to be undertaken to set a research agenda for the Netherlands Organisation for Health Research and Development (ZonMw) programme. Methods The broad consultation consisted of an eight-step procedure, including the conceptualization of a consultation document consisting of a scoping review of (mainly) international opinion/methodological literature and an inventory of existing Dutch guidelines and manuals for economic evaluation, a written consultation procedure among a broad range of stakeholders, and a consultation meeting with these stakeholders. Results In total 21 documents were included in the scoping review. A total of 24 stakeholders participated in the written consultation procedure and 14 stakeholders during the consultation meeting. The methodological issues and challenges, which were ranked in the top 5 by the stakeholders, are (i) outcome measurement, (ii) outcome identification, (iii) cost valuation, (iv) outcome valuation, and (v) time horizon/analytical approach. The existing guidelines and manuals provided guidance for some, but not all, issues and challenges. Discussion and Conclusion This broad consultation has contributed to a research agenda for the ZonMw programme, which will in the long run lead to the standardization of economic evaluations in this sector in the Netherlands and methodological improvement of economic evaluations in the Dutch youth sector.
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30
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Ride J, Huang L, Mulraney M, Hiscock H, Coghill D, Sawyer M, Sciberras E, Dalziel K. Is 'minimally adequate treatment' really adequate? investigating the effect of mental health treatment on quality of life for children with mental health problems. J Affect Disord 2020; 276:327-334. [PMID: 32871663 DOI: 10.1016/j.jad.2020.07.086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/29/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Minimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes. METHODS This paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8-15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding. RESULTS Compared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms. LIMITATIONS The observational data provide insight into real-world practice but require statistical methods to account for selection into treatment. CONCLUSIONS While clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice.
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Affiliation(s)
- Jemimah Ride
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Australia.
| | - Li Huang
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Melissa Mulraney
- Murdoch Children's Research Institute, Australia; Department of Paediatrics, University of Melbourne, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Australia; Department of Paediatrics, University of Melbourne, Australia; Health Services Research Unit, Royal Children's Hospital, Australia
| | - David Coghill
- Department of Paediatrics, University of Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia
| | | | | | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Australia
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31
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Oakley BF, Tillmann J, Ahmad J, Crawley D, San José Cáceres A, Holt R, Charman T, Banaschewski T, Buitelaar J, Simonoff E, Murphy D, Loth E. How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:389-404. [PMID: 33023296 PMCID: PMC7874383 DOI: 10.1177/1362361320959959] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous studies have reported reduced quality of life in autism. Improving quality of life for autistic people is, therefore, a key priority for clinical research and practice. However, the relative impact of core autism traits (e.g. social-communication difficulties), as compared to associated mental health symptoms (e.g. anxiety, depression) on quality of life remains poorly understood. This is despite at least 20%–50% of autistic individuals experiencing associated anxiety and/or depression symptoms. Hence, we measured subjective quality of life in 573 six to thirty-year-olds (autism spectrum disorder N = 344), using two widely validated questionnaires. Adults self-reported on the World Health Organization Quality of Life–Brief instrument. Parents of children/adolescents completed the Child Health and Illness Profile. We assessed individual variability across both measures and modelled associations between quality of life, core autism traits, anxiety, and depression symptoms. Across both age groups and quality of life measures, autistic individuals scored lower than comparison individuals, on average, particularly for physical health in adults (d = −1.24, 95% confidence interval: [−1.56, −0.93]) and school achievement for children/adolescents (d = −1.06, 95% confidence interval: [−1.29, −0.84]). However, a notable proportion of autistic individuals (36%–71% across quality of life domains) did not have reduced quality of life. Across ages and quality of life measures, severity of associated symptoms was significantly related to reduced quality of life on several domains, after accounting for core autism traits. Most notably, depression symptoms were related to reduced physical/psychological well-being in both adults (β ⩾ −0.34) and children/adolescents (β = −0.29, 95% confidence interval: [−0.36, −0.14]). For children/adolescents, anxiety symptoms (β ⩾ −0.28) and core social-communication difficulties (β ⩾ −0.22) were also related to subjective quality of life outcomes. Overall, findings indicate that not all autistic individuals experience reduced subjective quality of life. Variability in quality of life is significantly influenced by associated symptoms, across developmental stage. This may provide a tractable target for mental health services to improve quality of life for autistic individuals over the lifespan.
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Affiliation(s)
| | | | - Jumana Ahmad
- King's College London, UK.,University of Greenwich, UK
| | | | | | | | - Tony Charman
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
| | | | - Jan Buitelaar
- Radboud University Nijmegen Medical Center, The Netherlands.,Karakter Child and Adolescent Psychiatry University Center, The Netherlands
| | - Emily Simonoff
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
| | - Declan Murphy
- King's College London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), UK
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32
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Wennberg B, Janeslätt G, Gustafsson PA, Kjellberg A. Occupational performance goals and outcomes of time-related interventions for children with ADHD. Scand J Occup Ther 2020; 28:158-170. [PMID: 32955952 DOI: 10.1080/11038128.2020.1820570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Children with attention deficit hyperactivity disorder (ADHD) have difficulties with occupational performance, related to difficulties with time-processing ability. AIMS To examine the outcome of a multimodal time-related intervention designed to support children aged 9-15 years with ADHD, to achieve their occupational performance goals and improve satisfaction with occupational performance. A further aim was to compare the children's ratings of outcome with their parents' ratings and to analyse the occupational performance goals. MATERIAL AND METHODS A pre-post design was used. Participants were 27 children, aged 9-15 years. Children and parents rated occupational performance and satisfaction at baseline and follow-up, after 24 weeks, using the Canadian Occupational Performance Measure (COPM). The intervention consisted of time-skills training and time-assistive devices (TADs). Descriptive and non-parametric statistics were used. RESULTS Significant improvements were found in reported performance and satisfaction. Children's were higher than those of their parents. Most goals were about carrying out daily routines, knowing the duration of an activity and knowing what will happen in the near future. CONCLUSION AND SIGNIFICANCE The study contributes to knowledge about suitable interventions for children with ADHD who have time-related difficulties. Occupational therapy interventions, including TADs and time-skills training, resulted in significantly improved occupational performance.
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Affiliation(s)
- Birgitta Wennberg
- Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.,Centre for Clinical Research Dalarna, Falun, Sweden
| | - Per A Gustafsson
- Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Anette Kjellberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrkoping, Sweden
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33
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Mierau JO, Kann-Weedage D, Hoekstra PJ, Spiegelaar L, Jansen DEMC, Vermeulen KM, Reijneveld SA, van den Hoofdakker BJ, Buskens E, van den Akker-van Marle ME, Dirksen CD, Groenman AP. Assessing quality of life in psychosocial and mental health disorders in children: a comprehensive overview and appraisal of generic health related quality of life measures. BMC Pediatr 2020; 20:329. [PMID: 32620157 PMCID: PMC7333319 DOI: 10.1186/s12887-020-02220-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/22/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Mental health problems often arise in childhood and adolescence and can have detrimental effects on people's quality of life (QoL). Therefore, it is of great importance for clinicians, policymakers and researchers to adequately measure QoL in children. With this review, we aim to provide an overview of existing generic measures of QoL suitable for economic evaluations in children with mental health problems. METHODS First, we undertook a meta-review of QoL instruments in which we identified all relevant instruments. Next, we performed a systematic review of the psychometric properties of the identified instruments. Lastly, the results were summarized in a decision tree. RESULTS This review provides an overview of these 22 generic instruments available to measure QoL in children with psychosocial and or mental health problems and their psychometric properties. A systematic search into the psychometric quality of these instruments found 195 suitable papers, of which 30 assessed psychometric quality in child and adolescent mental health. CONCLUSIONS We found that none of the instruments was perfect for use in economic evaluation of child and adolescent mental health care as all instruments had disadvantages, ranging from lack of psychometric research, no proxy version, not being suitable for young children, no age-specific value set for children under 18, to insufficient focus on relevant domains (e.g. social and emotional domains).
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Affiliation(s)
- Jochen O Mierau
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
- Aletta Jacobs School of Public Health, Groningen, The Netherlands
| | | | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lisan Spiegelaar
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik Buskens
- University Medical Center Groningen and Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - M Elske van den Akker-van Marle
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Carmen D Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Annabeth P Groenman
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, freepostnumber 176, 9700VB, Groningen, The Netherlands.
- Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
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Ten Hoopen LW, de Nijs PFA, Duvekot J, Greaves-Lord K, Hillegers MHJ, Brouwer WBF, Hakkaart-van Roijen L. Children with an Autism Spectrum Disorder and Their Caregivers: Capturing Health-Related and Care-Related Quality of Life. J Autism Dev Disord 2020; 50:263-277. [PMID: 31625009 PMCID: PMC6946729 DOI: 10.1007/s10803-019-04249-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study investigated health-related QoL (HRQoL) and care-related quality of life (CarerQol) in clinically referred children with an autism spectrum disorder (ASD), and their primary and secondary caregivers. The EuroQol five-dimensional (EQ-5D) and the CarerQol questionnaires were used to respectively measure health-related QoL and care-related QoL. Primary caregivers reported pain/discomfort (42%) and anxiety/depression (40%). In caring, they mostly experienced problems in the relationship with the child (84%), and in combining care with daily activities (51%). Children with ASD had a relevantly lower QoL. Despite negative effects, almost all caregivers (96%) derived fulfillment from caring for their affected children. HRQoL and CarerQol reports of primary caregivers and children were correlated, both providing useful information to ASD measurement and treatment.
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Affiliation(s)
- Leontine W Ten Hoopen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Pieter F A de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Jorieke Duvekot
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Kirstin Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Yulius Mental Health, P.O. Box 753, 3300 AT, Dordrecht, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia Children's Hospital, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Yulius Mental Health, P.O. Box 753, 3300 AT, Dordrecht, The Netherlands
| | - Werner B F Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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Coghill DR, Joseph A, Sikirica V, Kosinski M, Bliss C, Huss M. Correlations Between Clinical Trial Outcomes Based on Symptoms, Functional Impairments, and Quality of Life in Children and Adolescents With ADHD. J Atten Disord 2019; 23:1578-1591. [PMID: 28836895 PMCID: PMC6732817 DOI: 10.1177/1087054717723984] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess relationships between treatment-associated changes in measures of ADHD symptoms, functional impairments, and health-related quality of life in children and adolescents with ADHD. METHOD Pearson correlation coefficients were calculated post hoc for changes from baseline to endpoint in outcomes of one randomized, placebo- and active-controlled trial of lisdexamfetamine (osmotic-release methylphenidate reference) and one of guanfacine extended-release (atomoxetine reference). RESULTS Changes in ADHD Rating Scale IV (ADHD-RS-IV) total score generally correlated moderately with changes in Child Health and Illness Profile-Child Edition: Parent Report Form (CHIP-CE:PRF) Achievement and Risk Avoidance ( r ≈ .4), but weakly with Resilience, Satisfaction, and Comfort ( r ≈ .2); and moderately with Weiss Functional Impairment Rating Scale-Parent (WFIRS-P) total score ( r ≈ .5). CHIP-CE PRF Achievement and Risk Avoidance correlated moderately to strongly with WFIRS-P total score ( r ≈ .6). CONCLUSION The ADHD-RS-IV, CHIP-CE:PRF, and WFIRS-P capture distinct but interconnected aspects of treatment response in individuals with ADHD.
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Affiliation(s)
- David R. Coghill
- University of Melbourne, Victoria,
Australia,University of Dundee, UK,David R. Coghill, Departments of Paediatrics and
Psychiatry, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne,
Melbourne, Victoria 3010, Australia.
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Dose C, Hautmann C, Doepfner M. Functional Impairment in Children With Externalizing Behavior Disorders: Psychometric Properties of the Weiss Functional Impairment Rating Scale-Parent Report in a German Clinical Sample. J Atten Disord 2019; 23:1546-1556. [PMID: 27469396 DOI: 10.1177/1087054716661234] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the psychometric properties of a German adaptation of the Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) in a clinical sample of children (4-12 years) with externalizing behavior disorders. METHOD Data were collected within two clinical trials (N = 264). Factorial validity, reliability, and divergent validity from symptoms of ADHD and oppositional defiant disorder (ODD) were assessed. RESULTS Confirmatory factor analyses revealed that a bifactor model consistent with the theoretical assumption of a general construct of impairment (total scale) and additional specific factors (subscales) provided satisfactory data fit. Model-based reliability estimates showed that both the general construct and specific factors accounted for item variance. Internal consistencies were >.70, part-whole corrected item-scale correlations mostly >.30. Correlations between the WFIRS-P Scales and ADHD and ODD symptoms were low to moderate. CONCLUSION The results support the factorial validity, reliability, and divergent validity of the WFIRS-P.
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Affiliation(s)
- Christina Dose
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Germany
| | - Christopher Hautmann
- School for Child and Adolescent Cognitive Behavior Therapy at the University of Cologne
| | - Manfred Doepfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Germany School for Child and Adolescent Cognitive Behavior Therapy at the University of Cologne
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Mulraney M, Giallo R, Sciberras E, Lycett K, Mensah F, Coghill D. ADHD Symptoms and Quality of Life Across a 12-Month Period in Children With ADHD: A Longitudinal Study. J Atten Disord 2019; 23:1675-1685. [PMID: 28490210 DOI: 10.1177/1087054717707046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the relationship between ADHD symptom severity and quality of life (QoL) across three time points over a 12-month period and investigate whether sleep modifies this relationship. METHOD Children aged 5 to 13 years with ADHD were recruited from 21 pediatric practices across Victoria, Australia ( N = 392). Child QoL (parent-report) and ADHD symptoms (both parent- and teacher-report) were assessed at three time points (0, 6, and 12 months), and sleep was assessed at baseline (parent-report). Data were analyzed using Pearson's correlations and autoregressive cross-lagged panel models. RESULTS Parent-reported ADHD symptoms predicted poorer QoL at each subsequent time point ( r = -.10 to -.13), and a small bidirectional relationship was observed between teacher-reported ADHD symptoms and QoL from 6 to 12 months. Sleep moderated the relationship between ADHD symptoms and QoL. CONCLUSION Clinicians need to look beyond core ADHD symptoms to other factors that may be influencing QoL in children with ADHD.
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Affiliation(s)
- Melissa Mulraney
- 1 Murdoch Childrens Research Institute, Parkville, Australia.,2 The Royal Children's Hospital, Parkville, Australia.,3 The University of Melbourne, Parkville, Australia
| | - Rebecca Giallo
- 1 Murdoch Childrens Research Institute, Parkville, Australia
| | - Emma Sciberras
- 1 Murdoch Childrens Research Institute, Parkville, Australia.,3 The University of Melbourne, Parkville, Australia.,4 Deakin University, Geelong, Australia
| | - Kate Lycett
- 1 Murdoch Childrens Research Institute, Parkville, Australia
| | - Fiona Mensah
- 1 Murdoch Childrens Research Institute, Parkville, Australia.,2 The Royal Children's Hospital, Parkville, Australia.,3 The University of Melbourne, Parkville, Australia
| | - David Coghill
- 1 Murdoch Childrens Research Institute, Parkville, Australia.,2 The Royal Children's Hospital, Parkville, Australia.,3 The University of Melbourne, Parkville, Australia
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Joseph A, Kosmas CE, Patel C, Doll H, Asherson P. Health-Related Quality of Life and Work Productivity of Adults With ADHD: A U.K. Web-Based Cross-Sectional Survey. J Atten Disord 2019; 23:1610-1623. [PMID: 30215265 PMCID: PMC6732822 DOI: 10.1177/1087054718799367] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The objective of this study was to assess health-related quality of life (HRQoL) in adult ADHD. METHOD U.K. residents aged 18 to 55 years with ADHD and no major mental health comorbidities completed an online survey of disorder history, the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L), and the Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH). ADHD Rating Scale-IV (ADHD-RS-IV) score was assessed by telephone. RESULTS In total, 233 participants completed the study (mean age 32.6 years; 65.2% women). Mean ( SD) ADHD-RS-IV total score, EQ-5D utility, and visual analog scale (VAS) scores were 43.5 (7.88), 0.74 (.21), and 69.8 (17.76), respectively. Mean ( SD) WPAI:GH scores indicated that health problems caused 45.7% (29.9) overall work impairment and 45.8% (28.9) impairment in regular daily activities. Greater work and activity impairment were both significantly independently associated with lower utility after adjusting for age, gender, and somatic comorbidities. CONCLUSION Adult ADHD impairs HRQoL, work productivity, and regular daily activities.
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Affiliation(s)
| | | | | | | | - Philip Asherson
- King’s College London, Greater London,
UK,Philip Asherson, Professor, Institute of
Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF,
UK.
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Huber M, Havas C. Restricted Speech Recognition in Noise and Quality of Life of Hearing-Impaired Children and Adolescents With Cochlear Implants - Need for Studies Addressing This Topic With Valid Pediatric Quality of Life Instruments. Front Psychol 2019; 10:2085. [PMID: 31572268 PMCID: PMC6751251 DOI: 10.3389/fpsyg.2019.02085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 08/27/2019] [Indexed: 11/27/2022] Open
Abstract
Cochlear implants (CI) support the development of oral language in hearing-impaired children. However, even with CI, speech recognition in noise (SRiN) is limited. This raised the question, whether these restrictions are related to the quality of life (QoL) of children and adolescents with CI and how SRiN and QoL are related to each other. As a result of a systematic literature research only three studies were found, indicating positive moderating effects between SRiN and QoL of young CI users. Thirty studies addressed the quality of life of children and adolescents with CI. Following the criteria of the World Health Organization (WHO) for pediatric health related quality of life HRQoL (1994) only a minority used validated child centered and age appropriate QoL instruments. Moreover, despite the consensus that usually children and adolescents are the most prominent informants of their own QoL (parent-reports complement the information of the children) only a minority of investigators used self-reports. Restricted SRiN may be a burden for the QoL of children and adolescents with CI. Up to now the CI community does not seem to have focused on a possible impairment of QoL in young CI users. Further studies addressing this topic are urgently needed, which is also relevant for parents, clinicians, therapists, teachers, and policy makers. Additionally investigators should use valid pediatric QoL instruments. Most of the young CI users are able to inform about their quality of life themselves.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Clara Havas
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
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Velõ S, Keresztény Á, Ferenczi-Dallos G, Balázs J. Long-Term Effects of Multimodal Treatment on Psychopathology and Health-Related Quality of Life of Children With Attention Deficit Hyperactivity Disorder. Front Psychol 2019; 10:2037. [PMID: 31607973 PMCID: PMC6769122 DOI: 10.3389/fpsyg.2019.02037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/20/2019] [Indexed: 11/13/2022] Open
Abstract
Aim The current study aimed to examine the association between long-term (36 months) multimodal (pharmacological and psychological) treatment and psychopathology and health-related quality of life (HRQoL) in children with attention deficit/hyperactivity disorder (ADHD) from the perspectives of both the children and parents. Methods The sample consisted of 23 children with ADHD (21 boys, 2 girls, mean age = 13.46 years, SD = 2.36) and 23 healthy control children (11 boys, 12 girls, mean age = 12.49 years, SD = 1.75). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was applied to measure psychopathology and both parent and self-rated versions of the Inventory for the Measure of the Quality of Life in Children and Adolescents were used to assess HRQoL at baseline and at the 36-month follow-up visit. The ADHD group took part in multimodal (medical and behavioral) therapy. The healthy control group did not get any intervention. Results At the baseline, the ADHD group was characterized with higher scores in nine MINI Kid scales and showed lower HRQoL than the control group according to both children and their parents. At the 36-month follow-up visit six scale scores (ADHD, social phobia, oppositional defiance and conduct disorder, major depressive episode, dysthymic disorder) showed statistically significant decreases in the ADHD group, while these scores were constant in the control group. Parent-rated HRQoL was significantly lower in the clinical group at baseline than at the end of the study, but there were no significant changes in the control group. Self-reported changes in HRQoL matched parent-reported changes. Interpretation Multimodal therapy is associated with decreased psychopathology and improved HRQoL over the long term.
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Affiliation(s)
- Szabina Velõ
- Doctoral School of Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Ágnes Keresztény
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Gyöngyvér Ferenczi-Dallos
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Vadaskert Foundation, Child Psychiatry Hospital and Outpatient Clinic, Budapest, Hungary
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Bjørknes University College, Oslo, Norway
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Adams D, Clark M, Keen D. Using self‐report to explore the relationship between anxiety and quality of life in children on the autism spectrum. Autism Res 2019; 12:1505-1515. [DOI: 10.1002/aur.2155] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/27/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
| | - Megan Clark
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
| | - Deb Keen
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
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An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework. J Autism Dev Disord 2019; 48:2148-2163. [PMID: 29423605 PMCID: PMC5948258 DOI: 10.1007/s10803-018-3482-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.
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Rissanen A, Lindberg N, Marttunen M, Sintonen H, Roine R. CAPMH health-related quality of life among adolescent psychiatric outpatients: a 12-month follow-up study among 12-14-year-old Finnish boys and girls. Child Adolesc Psychiatry Ment Health 2019; 13:17. [PMID: 30962819 PMCID: PMC6434830 DOI: 10.1186/s13034-019-0278-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/15/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Little is known about adolescents' perceptions about their health-related quality of life (HRQoL) in the course of routine adolescent psychiatric treatment. The aim of this 1-year follow-up study was to investigate HRQoL and changes in it among youths receiving adolescent psychiatric outpatient treatment. METHODS The study comprised 158 girls and 82 boys aged 12-14 years from 10 psychiatric outpatient clinics in one Finnish hospital district. Same-aged population controls (210 girls and 162 boys) were randomly collected from comprehensive schools. HRQoL was measured using the 16D instrument. The questionnaire was self-administered when the adolescents entered the polyclinics (= baseline), after a treatment period of 6 months, and after 12 months. RESULTS The mean age of respondents was 13.8 years (SD 0.63). At baseline, the mean HRQoL score of both female and male outpatients was significantly lower than that of population controls (p < 0.001). HRQoL of female patients was significantly worse than that of male patients (p < 0.001). In girls, HRQoL improved continuously during the 12-month follow-up, yet it remained worse than that of female population controls. Among boys, HRQoL was substantially better at the 6-month follow-up than at baseline, but this positive development was no longer seen at the 12-month follow-up. CONCLUSIONS From the perspective of HRQoL, girls seem to benefit more than boys from adolescent psychiatric outpatient treatment. Possible explanations for this finding are discussed.
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Affiliation(s)
- Anne Rissanen
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Lohja, Finland
| | - Nina Lindberg
- Department of Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mauri Marttunen
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Risto Roine
- Helsinki University Hospital, Administration, Research, and Development, Helsinki, Finland and Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
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Park BE, Lee JS, Kim HY, Bae JN, Kim WH, Kim HY, Rim MR, Kang SG, Choi SH. The Influence of Depression and School Life on the Quality of Life of Korean Child and Adolescent Patients with Attention-Deficit/Hyperactivity Disorder:A Comparison of the Perspectives of the Patients and Their Caregivers. Soa Chongsonyon Chongsin Uihak 2019; 30:2-8. [PMID: 32595314 PMCID: PMC7289493 DOI: 10.5765/jkacap.180027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to compare the quality of life reported by patients with attention-deficit/hyperactivity disorder (ADHD) to the patients' quality of life as reported by their caregivers. In addition, it aimed to examine how emotional problems, including depression and anxiety, and the severity of the symptoms affect the quality of life reported by the patients and their caregivers. Methods The patients' quality of life and their degree of depression and anxiety were measured using the Pediatric Quality of Life Inventory (PedsQL) 4.0 Child Self-Report, the Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale, respectively. The caregivers' perception of the patients' quality of life and severity of the ADHD symptoms were measured using the PedsQL 4.0 Parent Proxy Report and the Conners' Parent Rating Scale (CPRS), respectively. A total of 66 participants completed the survey. The independent-samples t-test, Pearson's correlation analysis, and multiple regression analysis were conducted. Results The mean score of the PedsQL 4.0 Child Self-Report was significantly higher than the mean score of the PedsQL 4.0 Parent Proxy Report. However, for school function, the PedsQL 4.0 Child Self-Report score was significantly lower than that of Parent Proxy Report. The correlation between the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores was significant only for emotional function and social function. The multiple regression analysis showed that the PedsQL 4.0 Child Self-Report and PedsQL 4.0 Parent Proxy Report scores were significantly predicted by the CDI and CPRS scores, respectively. Conclusion Our results demonstrate that there are clear differences between the quality of life reported by the patient themselves and that reported by their caregivers. In addition, the findings suggest that it is critical to treat the patients' accompanying depressive symptoms.
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Affiliation(s)
- Byeong-Eon Park
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Jeong-Seop Lee
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Hee-Yun Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Jae-Nam Bae
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Hye-Young Kim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Mi-Roo Rim
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Sang-Gu Kang
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
| | - Seo-Hyun Choi
- Department of Psychiatry, University of Inha College of Medicine, Inha Medical Center, Incheon, Korea
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Ranøyen I, Gulliksrud E, Indredavik MS, Stenseng F. Psychiatric problems and quality of life in a clinical sample of adolescents: The role of peer relations. Scand J Child Adolesc Psychiatr Psychol 2019; 6:183-192. [PMID: 33520763 PMCID: PMC7703841 DOI: 10.21307/sjcapp-2018-019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The quality of peer relations is linked to mental health in childhood and adolescence, but few studies have investigated its clinical relevance. In particular, the potential mediating role of peer functioning in the associations between different dimensions of symptoms and quality of life (QoL) has not been sufficiently examined. OBJECTIVE In a clinical sample of adolescents, we examined peer relations in light of psychiatric diagnoses, as well as QoL and symptoms of mental health problems, with particular focus on symptoms of anxiety, depression, and ADHD. We also examined the potential mediating role of peer problems in the relationship between such symptoms and QoL. METHODS The sample consisted of 603 adolescents (ages 13-18) referred to clinical assessment. Psychiatric diagnoses according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, were collected from participants' clinical charts. Symptoms of disorders, QoL, and quality of peer relations were measured by self-report questionnaires. RESULTS Adolescents diagnosed with anxiety/depressive disorder reported more peer problems and lower QoL than adolescents with attention deficit/hyperactivity disorder. These findings were supported with symptom ratings. A path model with bootstrapping was used to assess the potential mediating role of peer problems in the association between symptoms and QoL, showing that peer problems partly mediated the relationship between emotional symptoms and QoL, but not the relationship between ADHD-symptoms and QoL. CONCLUSION Improvement of peer relations may be a fruitful path for enhancing QoL among adolescents with symptoms of anxiety and depression.
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Affiliation(s)
- Ingunn Ranøyen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Eva Gulliksrud
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
| | - Marit S. Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Frode Stenseng
- Department of Education and Lifelong Learning, NTNU, Trondheim, Norway
- Queen Maud University College, Trondheim, Norway
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Balázs J, Miklósi M, Keresztény A, Hoven CW, Carli V, Wasserman C, Hadlaczky G, Apter A, Bobes J, Brunner R, Corcoran P, Cosman D, Haring C, Kahn JP, Postuvan V, Kaess M, Varnik A, Sarchiapone M, Wasserman D. Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081698. [PMID: 30096890 PMCID: PMC6121583 DOI: 10.3390/ijerph15081698] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 12/17/2022]
Abstract
Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.
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Affiliation(s)
- Judit Balázs
- Vadaskert Child and Adolescent Psychiatric Hospital, 1021 Budapest, Hungary.
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
| | - Mónika Miklósi
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
- Heim Pál National Pediatric Institute, 1131 Budapest, Hungary.
| | - Agnes Keresztény
- Institute of Psychology, Eötvös Loránd University, 1064 Budapest, Hungary.
- School of Ph.D. Studies, Semmelweis University, 1085 Budapest, Hungary.
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Camilla Wasserman
- Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA.
- Department of Health Sciences, University of Molise, 86100 Campobasso, Italy.
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Alan Apter
- Feinberg Child Study Center, Schneider Children's Medical Center, Tel Aviv University, Tel Aviv 6997801, Israel.
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo; Centro de InvestigaciónBiomédica en Red de Salud Mental, CIBERSAM, 33006 Oviedo, Spain.
| | - Romuald Brunner
- Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany.
- Department of Child and Adolescent Psychiatry, University of Regensburg, 93053 Regensburg, Germany.
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland.
| | - Doina Cosman
- Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
| | - Christian Haring
- Research Division for Mental Health, University for Medical Information Technology (UMIT), 6060 Hall in Tirol, Austria.
| | - Jean-Pierre Kahn
- Department of Psychiatry, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, 54003 Nancy, France.
| | - Vita Postuvan
- Mental Health Department, PINT, University of Primorska, 6000 Koper, Slovenia.
| | - Michael Kaess
- Section Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, University of Heidelberg, 69117 Heidelberg, Germany.
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland.
| | - Airi Varnik
- Estonian-Swedish Mental Health & Suicidology Institute, Ctr. Behav & Hlth Sci, Tallinn University, 10120 Tallinn, Estonia.
| | - Marco Sarchiapone
- Department of Health Sciences, University of Molise, 86100 Campobasso, Italy.
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, SE-171 77 Stockholm, Sweden.
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Parenting as a Mechanism of Change in Psychosocial Treatment for Youth with ADHD, Predominantly Inattentive Presentation. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:841-855. [PMID: 27628742 DOI: 10.1007/s10802-016-0199-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We investigated whether parenting and child behavior improve following psychosocial treatment for Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Presentation (ADHD-I) and whether parenting improvements mediate child outcomes. We analyzed data from a randomized clinical trial investigating the efficacy of a multicomponent psychosocial intervention (Child Life and Attention Skills, CLAS, n = 74) in comparison to Parent-Focused Treatment (PFT, n = 74) and treatment as usual (TAU, n = 51) for youth with ADHD-I (average child age = 8.6 years, range 7-11 years, 58 % boys). Child and parent/family functioning were assessed prior to treatment, immediately following treatment, and at follow-up into the subsequent school year using parent and teacher reports of inattention, organization, social skills, academic competency (teachers only), parenting daily hassles, and positive and negative parenting behaviors (parents only). Both treatment groups improved on negative parenting and home impairment, but only CLAS families also improved on positive parenting as well as academic impairment. Improvements in positive and negative parenting mediated treatment effects on child impairment independent of improvements in child inattention, implicating parenting as an important mechanism of change in psychosocial treatment for ADHD-I. Further, whereas parent-focused training produces improvements in negative parenting and impairment at home for children with ADHD-I, a multicomponent approach (incorporating child skills training and teacher consultation) more consistently produces improvements at school and in positive parenting, which may contribute to improvements in social skills into the next school year.
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Coghill DR, Banaschewski T, Soutullo C, Cottingham MG, Zuddas A. Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2017; 26:1283-1307. [PMID: 28429134 PMCID: PMC5656703 DOI: 10.1007/s00787-017-0986-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 04/03/2017] [Indexed: 10/31/2022]
Abstract
Children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD) experience functional impairment and poor health-related quality of life (HRQoL) in addition to symptoms of inattention/hyperactivity-impulsivity. To synthesize qualitatively the published evidence from randomized, double-blind, placebo-controlled trials of the effectiveness of pharmacotherapy on functional impairment or HRQoL in patients with ADHD, a systematic PubMed searching and screening strategy was designed to identify journal articles meeting pre-specified criteria. Post hoc analyses and meta-analyses were excluded. HRQoL outcomes, functional outcomes and the principal ADHD symptom-based outcome were extracted from included studies. An effect size of 0.5 versus placebo was used as a threshold for potential clinical relevance (unreported effect sizes were calculated when possible). Of 291 records screened, 35 articles describing 34 studies were included. HRQoL/functioning was usually self-rated in adults and proxy-rated in children/adolescents. Baseline data indicated substantial HRQoL deficits in children/adolescents. Placebo-adjusted effects of medication on ADHD symptoms, HRQoL and functioning, respectively, were statistically or nominally significant in 18/18, 10/12 and 7/9 studies in children/adolescents and 14/16, 9/11 and 9/10 studies in adults. Effect sizes were ≥0.5 versus placebo for symptoms, HRQoL and functioning, respectively, in 14/16, 7/9 and 4/8 studies in children/adolescents; and 6/12, 1/6 and 1/8 studies in adults. Effect sizes were typically larger for stimulants than for non-stimulants, for symptoms than for HRQoL/functioning, and for children/adolescents than for adults. The efficacy of ADHD medication extends beyond symptom control and may help reduce the related but distinct functional impairments and HRQoL deficits in patients with ADHD.
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Affiliation(s)
- David R Coghill
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, VIC, Australia.
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, VIC, Australia.
- Division of Neuroscience, University of Dundee, Dundee, UK.
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - César Soutullo
- Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, University of Navarra Clinic, Pamplona, Spain
| | | | - Alessandro Zuddas
- Child and Adolescent Psychiatry Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
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49
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Lee YC, Yang HJ, Lee WT, Teng MJ. Do parents and children agree on rating a child’s HRQOL? A systematic review and Meta-analysis of comparisons between children with attention deficit hyperactivity disorder and children with typical development using the PedsQLTM. Disabil Rehabil 2017; 41:265-275. [DOI: 10.1080/09638288.2017.1391338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Yi-Chen Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei City, Taiwan (R.O.C)
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Wan-Ting Lee
- Department of Rehabilitation, Occupational Therapy Room, Sing Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ming-Jen Teng
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
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50
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Jonsson U, Alaie I, Löfgren Wilteus A, Zander E, Marschik PB, Coghill D, Bölte S. Annual Research Review: Quality of life and childhood mental and behavioural disorders - a critical review of the research. J Child Psychol Psychiatry 2017; 58:439-469. [PMID: 27709604 DOI: 10.1111/jcpp.12645] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND An individual's subjective perception of well-being is increasingly recognized as an essential complement to clinical symptomatology and functional impairment in children's mental health. Measurement of quality of life (QoL) has the potential to give due weight to the child's perspective. SCOPE AND METHODOLOGY Our aim was to critically review the current evidence on how childhood mental disorders affect QoL. First, the major challenges in this research field are outlined. Then we present a systematic review of QoL in children and adolescents aged 0-18 years formally diagnosed with a mental and behavioural disorder, as compared to healthy or typically developing children or children with other health conditions. Finally, we discuss limitations of the current evidence base and future directions based on the results of the systematic review and other relevant literature. FINDINGS AND CONCLUSIONS The systematic review identified 41 eligible studies. All were published after the year 2000 and 21 originated in Europe. The majority examined QoL in neurodevelopmental disorders, including attention-deficit hyperactivity disorder (k = 17), autism spectrum disorder (k = 6), motor disorders (k = 5) and intellectual disability (k = 4). Despite substantial heterogeneity, studies demonstrate that self-reported global QoL is significantly reduced compared to typical/healthy controls across several disorders and QoL dimensions. Parents' ratings were on average substantially lower, casting doubt on the validity of proxy-report. Studies for large diagnostic groups such as depressive disorders, anxiety disorders, (early onset) schizophrenia and eating disorders are largely lacking. We conclude that representative, well-characterized normative and clinical samples as well as longitudinal and qualitative designs are needed to further clarify the construct of QoL, to derive measures of high ecological validity, and to examine how QoL fluctuates over time and is attributable to specific conditions or contextual factors.
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Affiliation(s)
- Ulf Jonsson
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna Löfgren Wilteus
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Eric Zander
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Peter B Marschik
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,iDN - Interdisciplinary Developmental Neuroscience, Institute of Physiology, Medical University of Graz, Graz, Austria
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Vic, Australia.,Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Sven Bölte
- Neuropsychiatry Unit, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Stockholm, Sweden.,Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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