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Published on: June 12, 2020
[Attention deficit/hyperactivity disorder: burden of the disease according to subtypes in recently diagnosed
R Escobar1, A Hervas, C Soutullo
1Lilly Research Laboratories, Alcobendas (Madrid). escobarrodrigo@lilly.com
Insights
Children with combined or inattentive Attention-Deficit/Hyperactivity Disorder (ADHD) experience worse quality of life (QoL) and more psychiatric comorbidities than those with the hyperactive-impulsive subtype. This highlights significant differences in illness burden among ADHD presentations.
Area of Science:
- Child and Adolescent Psychiatry
- Neurodevelopmental Disorders
- Quality of Life Research
Context:
- Attention-Deficit/Hyperactivity Disorder (ADHD) significantly impacts children's quality of life (QoL) and is linked to psychiatric comorbidities.
- Understanding the burden of illness across different ADHD subtypes is crucial for targeted interventions.
Purpose:
- To evaluate the burden of illness associated with different subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) in untreated, newly diagnosed children in Spain.
- To compare Quality of Life (QoL) and clinical characteristics across combined, inattentive, and hyperactive-impulsive ADHD subtypes.
Summary:
- A study of 124 children (aged 6-12) with newly diagnosed, untreated ADHD found that combined and inattentive subtypes reported significantly worse Quality of Life (QoL) compared to the hyperactive-impulsive subtype.
- Higher ADHD symptom severity correlated with poorer QoL, while no significant differences were observed in IQ, academic performance, or healthcare utilization across subtypes.
- The combined and inattentive ADHD subtypes exhibited greater disorder severity and more comorbid psychiatric disorders.
Impact:
- Findings underscore the differential impact of ADHD subtypes on children's well-being, informing clinical practice and support strategies.
- Highlights the need for subtype-specific assessments and interventions to improve Quality of Life (QoL) for children with ADHD.
- Provides valuable data for healthcare resource allocation and policy development concerning pediatric ADHD.
Introduction:
Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with deterioration of several dimensions of quality of life (QoL) and with the development of comorbid psychiatric disorders. The objective of the present study is to evaluate the burden of illness of ADHD subtypes in untreated newly diagnosed children in Spain.
Methods:
We recruited 124 children (80 combined, 25 inattentive and 19 hyperactive-impulsive subtype) aged 6-12 years with untreated newly diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition DSM-IV) ADHD. We collected socio-demographic, clinical (Attention-Deficit/Hyperactivity Disorder Rating Scale ADHD-RS], Conner's Parent Rating Scale-Revised: Short Form [CPRS:R-S], Clinical Global Impression-Severity [CGI-S], Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version [K-SADS-PL], intelligence Quotient [IQ]), Quality of Life (QoL), Child Health Questionnaire-Parent Form 50 CHQ-PF50), academic performance and health care resources utilization data. We investigated the correlations between ADHD symptom severity and QoL, academic performance and time from onset of symptoms to diagnosis.
Results:
QoL of children with combined-type ADHD was rated as significantly worse in patients with predominance of hyperactivity/impulsivity for most of the domains. Inattentive-type children also had worse ratings than patients with hyperactivity/impulsivity predominance in most of the domains. The ADHD Index of Conner's Parent Rating Scale-Revised: Short Form (CPRS-R:S) was significantly lower in hyperactive/impulsive patients. We found no differences across subtypes in IQ, academic performance and health care resources utilization. Higher ADHD symptom severity was associated to poor QoL.
Conclusions:
Combined and inattentive subtypes are associated with greater disorder severity, more comorbid psychiatric disorders, and worse QoL than the subtype with hyperactivity/impulsivity predominance.
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