ADHD severity impacts child's health-related quality of life

The greater the severity of a child's Attention Deficit Hyperactivity Disorder (ADHD) symptoms, the more negative impacts on the child's health-related quality of life from the perspective of the child and the parent, a new study by a Baylor University psychologist has found.

Researchers compared children with ADHD in different types of treatment settings and found that children with ADHD being treated by a general pediatrician have better overall health-related quality of life and family functioning than children with ADHD being treated in a psychiatric clinic.

The study appears on-line in the Journal of Attention Disorders and is the first study to demonstrate greater negative impact on quality of life and family function in children with ADHD treated at a psychiatric clinic compared to those treated at a general pediatric clinic.

"These findings have potential implications for the health care needs of children with ADHD," said study author Dr. Christine Limbers, assistant professor of psychology and neuroscience at Baylor. ""The finding that overall agreement between children and parent ratings of the child's quality of life was low underscores the importance of evaluating both children's and parents' perspectives regarding quality of life in routine assessment in clinical practice and clinical trials for children with ADHD since their different perspectives potentially provide unique information."

The researchers surveyed nearly 200 families and evaluated health-related quality of life and family functioning, such as physical, emotional, social and family relationships, from both the perspective of children with physician-diagnosed ADHD and their parents.

Researchers then compared those results to a sample of healthy children and to children with ADHD being seen in a psychiatric clinic.

The study found children with ADHD being treated at a general pediatric clinic reported fewer problems with quality of life compared to a sample of children with ADHD being treated in a psychiatric clinic. The study also showed that while children with ADHD treated by a general pediatrician have better overall health-related quality of life than children being seen in a psychiatric clinic, they still experience significant impairments in health-related quality of life compared to healthy children, particularly in psychosocial functioning, which encompasses a wide range of behaviors related to social and emotional well being.

The researchers said that parental worry and family relationships, such as lack of communication between family members and conflicts between family members, and daily family activities, such as family activities taking more time and effort and difficulty finding time to finish household tasks, are key areas to address in a family intervention.

"The data suggest that from the perspective of parents, child social functioning may have the strongest association with impaired family functioning. Consequently, it does not seem sufficient for interventions to only address social functioning with the child," Limbers said. "Teaching parents strategies for coping with their child's social impairments is also critical"