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CNS Drugs
Published in: CNS Drugs 10/2010

01-10-2010 | Review Article

The Impact of Medications on Quality of Life in Attention-Deficit Hyperactivity Disorder

A Systematic Review

Author: Dr David Coghill

Published in: CNS Drugs | Issue 10/2010

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Abstract

Quality of life (QOL) describes an individual’s subjective perception of their position in life as evidenced by their physical, psychological and social functioning. Although an established outcome measure in physical health, QOL has more recently become an increasingly important measure in mental health clinical work and research. This article reviews the evidence describing the impact of medications on QOL in attention-deficit hyperactivity disorder (ADHD). Databases were searched for research studies describing the effects of medication on QOL in ADHD: 25 relevant studies were identified. Most (n = 20) of these studies have focused on children and adolescents, and most have investigated a single molecule, atomoxetine (n=15), with relatively few studies investigating methylphenidate (n=5), amfetamines (n = 4) and manifaxine (n= 1).
These studies support a positive short-term effect of medication on QOL in ADHD for children, adolescents and adults that mirrors, to some extent, the effects of these medications on ADHD symptoms, although with smaller effect sizes. Notwithstanding measurement issues, it will continue to be important that those designing and conducting clinical trials in ADHD, including both pharmacological and non-pharmacological treatments, continue to include measures of QOL as secondary outcome measures. In particular, information about QOL effects in adults and in subjects of all ages taking methylphenidate and amfetamine treatments is urgently needed. The lack of systematic studies of the impact on QOL of psychological therapies, either on their own or in multimodal combinations with medication, is a serious omission that should be urgently addressed.
Footnotes
1
The authors reported a significant improvement in parent-rated DUX-25 total score for children taking medication; however, inspection of the reported scores suggests poorer parent-rated QOL taking medication.
 
Literature
1.
Danckaerts M, Sonuga-Barke EJ, Banaschewski T, et al. The quality of life of children with attention deficit/ hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2010; 19(2): 83–105PubMedCrossRef
2.
Coghill D, Danckaerts M, Sonuga-Barke E, et al. Practitioner review: quality of life in child mental health-conceptual challenges and practical choices. J Child Psychol Psychiatry 2009; 50(5): 544–61PubMedCrossRef
3.
World Health Organisation. World Health Organisation constitution. Gineva: World Health Organisation, 1947
4.
Leidy NK, Rich M, Geneste B. Recommendations for evaluating the validity of life claims for labeling and promotion. Value Health 1999; 2(2): 113–27PubMedCrossRef
5.
WHOQOL. World Health Organisation quality of life assessment (WHOQOL): position paper from the World Health Organisation. Soc Sci Med 1995; 41: 1403–9CrossRef
6.
Eiser C, Morse R. Quality-of-life measures in chronic diseases of childhood. Health Technol Assess 2001; 5(4): 1–157PubMed
7.
Bastiaansen D, Koot HM, Ferdinand RF, et al. Quality of life in children with psychiatric disorders: self-, parent, and clinician report. J Am Acad Child Adolesc Psychiatry 2004; 43(2): 221–30PubMedCrossRef
8.
Moss MS, Hoffman CJ, Mossey J, et al. Changes over 4 years in health, quality of life, mental health, and valuation of life. J Aging Health 2007; 19(6): 1025–44PubMedCrossRef
9.
Rudnick A. The impact of coping on the relation between symptoms and quality of life in schizophrenia. Psychiatry 2001; 64(4): 304–8PubMedCrossRef
10.
Wilson JM, Marcotte AC. Psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder. J Am Acad Child Adolesc Psychiatry 1996; 35(5): 579–87PubMedCrossRef
11.
August GJ, Braswell L, Thuras P. Diagnostic stability of ADHD in a community sample of school-aged children screened for disruptive behavior. J Abnorm Child Psychol 1998; 26(5): 345–56PubMedCrossRef
12.
Erhardt D, Hinshaw SP. Initial sociometric impressions of attention-deficit hyperactivity disorder and comparison boys: predictions from social behaviors and from non-behavioral variables. J Consult Clin Psychol 1994; 62(4): 833–42PubMedCrossRef
13.
Bagwell CL, Molina BS, Pelham Jr WE, et al. Attention-deficit hyperactivity disorder and problems in peer relations: predictions from childhood to adolescence. J Am Acad Child Adolesc Psychiatry 2001; 40(11): 1285–92PubMedCrossRef
14.
Satterfield J, Swanson J, Schell A, et al. Prediction of antisocial behavior in attention-deficit hyperactivity disorder boys from aggression/defiance scores. J Am Acad Child Adolesc Psychiatry 1994; 33(2): 185–90PubMedCrossRef
15.
Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006; 36(2): 159–65PubMedCrossRef
16.
Biederman J, Wilens TE, Mick E, et al. Does attention-deficit hyperactivity disorder impact the developmental course of drug and alcohol abuse and dependence? Biol Psychiatry 1998; 44(4): 269–73PubMedCrossRef
17.
Barkley RA, Fischer M, Smallish L, et al. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry 2006; 45(2): 192–202PubMedCrossRef
18.
Satterfield JH, Schell A. A prospective study of hyperactive boys with conduct problems and normal boys: adolescent and adult criminality. J Am Acad Child Adolesc Psychiatry 1997; 36(12): 1726–35PubMedCrossRef
19.
Biederman J, Monuteaux MC, Mick E, et al. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychol Med 2006; 36(2): 167–79PubMedCrossRef
20.
Biederman J, Faraone SV, Lapey K. Comorbidity of diagnosis in attention-deficit hyperactivity disorder. Child Adoles Psychiatr Clin North Am 1992; 1: 335–60
21.
Spitzer RL, Kroenke K, Linzer M, et al. Health-related quality of life in primary care patients with mental disorders: results from the PRIME-MD 1000 Study. JAMA 1995; 274(19): 1511–7PubMedCrossRef
22.
Dolan P. The measurement of health-related quality of life for use in resource allocation decisions in health care. In: Culyer AJ, Newhouse JP, editors. Handbook of health economics. North-Holland: Elsevier, 2000: 1723–60CrossRef
23.
FDA. Draft guidance for industry on patient-reported outcome measures: use in medical product development to support labeling claims. Rockville (MD): Food and Drug Administration, 2006
24.
25.
Sawyer MG, Whaites L, Rey JM, et al. Health-related quality of life of children and adolescents with mental disorders. J Am Acad Child Adolesc Psychiatry 2002; 41(5): 530–7PubMedCrossRef
26.
Varni JW, Burwinkle TM. The PedsQL as a patient-reported outcome in children and adolescents with attention-deficit/ hyperactivity disorder: a population-based study. Health Qual Life Outcomes 2006; 4: 26 [online]. Available from URL: http://​www.​hqlo.​com [Accessed 2010 Jul 26]PubMedCrossRef
27.
Berkson J. Limitations of the application of the fourfold table analysis to hospital data. Biometrics 1946; 2: 47–53PubMedCrossRef
28.
Pongwilairat K, Louthrenoo O, Charnsil C, et al. Quality of life of children with attention-deficit/hyperactivity disorder. J Med Assoc Thailand 2005; 88(8): 1062–6
29.
Klassen AF, Miller A, Fine S. Agreement between parent and child report of quality of life in children with attention-deficit/hyperactivity disorder. Child Care Health Dev 2006; 32(4): 406CrossRef
30.
31.
Flapper BCT, Schoemaker MM. Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD. Dev Med Child Neurol 2008 Apr; 50(4): 294–9PubMedCrossRef
32.
Landgraf JM, Abetz LN. Functional status and well-being of children representing 3 cultural groups: initial self reports using the CHQ-CF 87. Psych Health 1997; 12(6): 839–54CrossRef
33.
Topolski TD, Edwards TC, Patrick DL, et al. Quality of life of adolescent males with attention-deficit hyperactivity disorder. J Atten Disord 2004; 7(3): 163–73PubMedCrossRef
34.
Hampel P, Desman C. Coping and quality of life among children and adolescents with attention deficit/hyperactivity disorder. Prax Kinderpsychol Kinderpsychiatr 2006; 55(6): 425–43PubMed
35.
Escobar R, Soutullo CA, Hervas A, et al. Worse quality of life for children with newly diagnosed attention-deficit/ hyperactivity disorder, compared with asthmatic and healthy children [published erratum appears in Pediatrics 2005 Nov; 116 (5): 1266]. Pediatrics 2005; 116(3): e364–9PubMedCrossRef
36.
Landgraf JM, Abetz LN, Ware JE. The CHQ users manual. Boston (MA): Health Act, 1999
37.
Graetz BW, Sawyer MG, Hazell PL, et al. Validity of DSM-IVADHD subtypes in a nationally representative sample of Australian children and adolescents. J Am Acad Child Adolesc Psychiatry 2001; 40(12): 1410–7PubMedCrossRef
38.
Landgraf JM, Rich M, Rappaport L. Measuring quality of life in children with attention-deficit/hyperactivity disorder and their families: development and evaluation of a new tool. Arch Pediatr Adolesc Med 2002; 156(4): 384–91PubMed
39.
Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics 2004; 114(5): e541–7PubMedCrossRef
40.
Matza LS, Rentz AM, Secnik K, et al. The link between health-related quality of life and clinical symptoms among children with attention-deficit hyperactivity disorder. J Dev Behav Pediatr 2004; 25(3): 166–74PubMedCrossRef
41.
Matza LS, Secnik K, Mannix S, et al. Parent-proxy EQ-5D ratings of children with attention-deficit hyperactivity disorder in the US and the UK. Pharmacoeconomics 2005; 23(8): 777–90PubMedCrossRef
42.
Matza LS, Secnik K, Rentz AM, et al. Assessment of health state utilities for attention-deficit/hyperactivity disorder in children using parent proxy report. Qual Life Res 2005; 14(3): 735–47PubMed
43.
Newcorn JH, Spencer TJ, Biederman J, et al. Atomoxetine treatment in children and adolescents with attention-deficit/ hyperactivity disorder and comorbid oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 2005; 44(3): 240–8PubMedCrossRef
44.
Rentz AM, Matza LS, Secnik K, et al. Psychometric validation of the child health questionnaire (CHQ) in a sample of children and adolescents with attention-deficit/hyperactivity disorder. Qual Life Res 2005; 14(3): 719–34PubMedCrossRef
45.
Yang P, Hsu HY, Chiou SS, et al. Health-related quality of life in methylphenidate-treated children with attention-deficit-hyperactivity disorder: results from a Taiwanese sample. Aust N Z J Psychiatry 2007; 41(12): 998–1004PubMedCrossRef
46.
Hakkaart-van Roijen L, Zwirs BWC, Bouwmans C, et al. Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 2007 Aug; 16(5): 316–26CrossRef
47.
Bastiaansen D, Koot HM, Ferdinand RF. Psychopathology in children: improvement of quality of life without psychiatric symptom reduction? Eur Child Adolesc Psychiatry 2005; 14(7): 364–70PubMedCrossRef
48.
Secnik K, Matza LS, Cottrell S, et al. Health state utilities for childhood attention-deficit/hyperactivity disorder based on parent preferences in the United Kingdom. Med Decis Making 2005; 25(1): 56–70PubMedCrossRef
49.
Preuss U, Ralston SJ, Baldursson G, et al. Study design, baseline patient characteristics and intervention in a cross-cultural framework: results from the ADORE study. Eur Child Adolesc Psychiatry 2006; 15 Suppl. 1: i4–14PubMedCrossRef
50.
Prasad S, Harpin V, Poole L, et al. A multi-centre, randomised, open-label study of atomoxetine compared with standard current therapy in UK children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Curr Med Res Opin 2007; 23(2): 379–94PubMedCrossRef
51.
Willcutt EG, Doyle AE, Nigg JT, et al. Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 2005; 57(11): 1336–46PubMedCrossRef
52.
Adler LA, Sutton VK, Moore RJ, et al. Quality of life assessment in adult patients with attention-deficit/hyperactivity disorder treated with atomoxetine. J Clin Psychopharmacol 2006; 26(6): 648–52PubMedCrossRef
53.
Able SL, Johnston JA, Adler LA, et al. Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychol Med 2007; 37(1): 1–11CrossRef
54.
Jenkinson C, Stewart-Brown S, Petersen S, et al. Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Community Health 1999; 53(1): 46–50PubMedCrossRef
55.
Brod M, Perwien A, Adler L, et al. Conceptualization and assessment of quality of life for adults with attention-deficit/hyperactivity disorder. Prim Psychiatry 2005; 12(6): 58–64
56.
Patrick DL, Edwards TC, Topolski TD, et al. Adolescent quality of life: Part II. Initial validation of a new instrument. J Adolesc 2002; 25(3): 287–300
57.
Rentz AM, Matza LS, Secnik K, et al. Psychometric validation of the Child Health Questionnaire (CHQ) in a sample of children and adolescents with attention-deficit/ hyperactivity disorder. Qual Life Res 2005; 14(3): 719–34PubMedCrossRef
58.
Riley AW, Spiel G, Coghill D, et al. Factors related to health-related quality of life (HRQoL) among children with ADHD in Europe at entry into treatment. Eur Child Adolesc Psychiatry 2006; 15 Suppl. 1: i38–45PubMedCrossRef
59.
Shaffer D, Gould MS, Brasic J, et al. A Children’s Global Assessment Scale (CGAS). Arch Gen Psychiatry 1983; 40(11): 1228–31PubMedCrossRef
60.
Rimmer M, Campbell C, Murphy S, et al. DADHD: the impact on parent’s and children’s quality of life. American Academy of Child and Adolescent Psychiatry Annual Meeting: 2007 Oct 23–28; Boston (MA)
61.
National Institute for Mental Health. Clinical global impressions. Psychopharmacol Bull 1985; 21(4): 839–43
62.
Banaschewski T, Coghill D, Santosh P, et al. Long-acting medications for the hyperkinetic disorders: a systematic review and European treatment guideline. Eur Child Adolesc Psychiatry 2006; 15(8): 476–95PubMedCrossRef
63.
Barkley RA, McMurray MB, Edelbrock CS, et al. Side effects of methylphenidate in children with attention deficit hyperactivity disorder: a systemic, placebo-controlled evaluation. Pediatrics 1990; 86(2): 184–92PubMed
64.
Graham J, Coghill D. Adverse effects of pharmacotherapies for attention-deficit hyperactivity disorder: epidemiology, prevention and management. CNS Drugs 2008; 22(3): 213–37PubMedCrossRef
65.
Manos M, Frazier TW, Landgraf JM, et al. HRQL and medication satisfaction in children with ADHD treated with the methylphenidate transdermal system. Curr Med Res Opin 2009; 25(12): 3001–10PubMedCrossRef
66.
Bukstein OG, Arnold LE, Landgraf JM, et al. Does switching from oral extended-release methylphenidate to the methylphenidate transdermal system affect health-related quality-of-life and medication satisfaction for children with attention-deficit/hyperactivity disorder? Child Adolesc Psychiatry Ment Health 2009; 3(1): 39 [online]. Available from URL: http://​www.​capmh.​com/​content/​3/​1/​39 [Accessed 2010 Jul 29]PubMedCrossRef
67.
Sallee FR, Ambrosini PJ, Lopez FA, et al. Health-related quality of life and treatment satisfaction and preference in a community assessment study of extended-release mixed amphetamine salts for children with attention-deficit/ hyperactivity disorder. J Outcome Res 2004; (8): 27–49
68.
Wigal SB, Wigal TL, McGough JM, et al. A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR®) and atomoxetine (Strattera®) in school-aged children with attention deficit/hyperactivity disorder. J Atten Disord 2005; 9: 275–89PubMedCrossRef
69.
Perwien AR, Faries DE, Kratochvil CJ, et al. Improvement in health-related quality of life in children with ADHD: an analysis of placebo controlled studies of atomoxetine. J Dev Behav Pediatr 2004; 25(4): 264–71PubMedCrossRef
70.
Brown RT, Perwien A, Faries DE, et al. Atomoxetine in the management of children with ADHD: effects on quality of life and school functioning. Clin Pediatr (Phila) 2006; 45(9): 819–27CrossRef
71.
Perwien AR, Kratochvil CJ, Faries DE, et al. Atomoxetine treatment in children and adolescents with attention-deficit hyperactivity disorder: what are the long-term health-related quality-of-life outcomes? J Child Adolesc Psychopharmacol 2006 Dec; 16(6): 713–24PubMedCrossRef
72.
Biederman J, Spencer TJ, Newcorn JH, et al. Effect of comorbid symptoms of oppositional defiant disorder on responses to atomoxetine in children with ADHD: a meta-analysis of controlled clinical trial data. Psychopharmacology (Berl) 2007; 190(1): 31–41CrossRef
73.
Cheng JY, Chen RY, Ko JS, et al. Efficacy and safety of atomoxetine for attention-deficit/hyperactivity disorder in children and adolescents: meta-analysis and meta-regression analysis. Psychopharmacology (Berl) 2007; 194(2): 197–209CrossRef
74.
Wehmeier PM, Schacht A, Dittmann RW, et al. Global impression of perceived difficulties in children and adolescents with attention-deficit/hyperactivity disorder: reliability and validity of a new instrument assessing perceived difficulties from a patient, parent and physician perspective over the day. Child Adolesc Psychiatry Ment Health 2008; 2(1): 10 [online]. Available from URL: http://​www.​capmh.​com/​content/​2/​1/​10 [Accessed 2010 Jul 26]PubMedCrossRef
75.
Dittmann RW, Wehmeier PM, Schacht, A, et al. Atomoxetine treatment and ADHD-related difficulties as assessed by adolescent patients, their parents and physicians. Child Adolesc Psychiatry Ment Health 2009; (1): 21 [online]. Available from URL: http://​www.​capmh.​com/​content/​3/​1/​21 [Accessed 2010 Jul 26]CrossRef
76.
Escobar R, Montoya A, Polavieja P, et al. Evaluation of patients’ and parents’ quality of life in a randomized placebo-controlled atomoxetine study in attention-deficit/ hyperactivity disorder. J Child Adolesc Psychopharmacol 2009 Jun 1; 19(3): 253–63PubMedCrossRef
77.
Svanborg P, Thernlund G, Gustafsson PA, et al. Atomoxetine improves patient and family coping in attention deficit/ hyperactivity disorder: a randomized, double-blind, placebo-controlled study in Swedish children and adolescents. Eur Child Adolesc Psychiatry 2009 Dec; 18(12): 725–35PubMedCrossRef
78.
DeVeaugh-Geiss J, Conners CK, Sarkis EH, et al. GW320659 for the treatment of attention-deficit/hyperactivity disorder in children. J Am Acad Child Adolesc Psychiatry 2002; 41(8): 914–20CrossRef
79.
Goodman DW, Ginsberg L, Weisler RH, et al. An interim analysis of the Quality of Life, Effectiveness, Safety, and Tolerability (QU.E.S.T.) evaluation of mixed amphetamine salts extended release in adults with ADHD. CNS Spectr 2005; 10(12 Suppl. 20): 26–34PubMed
80.
Spencer TJ, Landgraf JM, Adler LA, et al. Attention-deficit/ hyperactivity disorder-specific quality of life with triple-bead mixed amphetamine salts (SPD465) in adults: results of a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2008; 69(11): 1766–75PubMedCrossRef
81.
Adler LA, Spencer T, Brown TE, et al. Once-daily atomoxetine for adult attention-deficit/hyperactivity disorder: a 6-month, double-blind trial. J Clin Psychopharmacol 2009 Feb; 29(1): 44–50PubMedCrossRef
82.
Adler LA, Liebowitz M, Kronenberger W, et al. Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder. Depress Anxiety 2009 Mar; 26(3): 212–21PubMedCrossRef
83.
84.
Solans M, Pane S, Estrada MD, et al. Health-related quality of life measurement in children and adolescents: a systematic review of generic and disease-specific instruments. Value Health 2008; 11(4): 742–64PubMedCrossRef
85.
Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003; 41(5): 582–92PubMed
86.
Doepfner M, Preuss M, Novik TS, et al. European ADHD Observational Study (ADORE): longitudinal results (baseline-3 months). American Academy of Child and Adolescent Psychiatry Annual Meeting; 2005 Oct 10; Toronto (ON)
87.
Landgraf JM. Monitoring quality of life in adults with ADHD: reliability and validity of a new measure. J Atten Disord 2007; 11(3): 351–62PubMedCrossRef
88.
Brod M, Johnston J, Able S, et al. Validation of the Adult Attention-deficit/hyperactivity disorder Quality-Of-Life scale (AAQoL): a disease-specific quality-of-life measure. Qual Life Res 2006; 15(1): 117–29PubMedCrossRef
Metadata
Title
The Impact of Medications on Quality of Life in Attention-Deficit Hyperactivity Disorder
A Systematic Review
Author
Dr David Coghill
Publication date
01-10-2010
Publisher
Springer International Publishing
Published in
CNS Drugs / Issue 10/2010
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI
https://doi.org/10.2165/11537450-000000000-00000

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