Introduction
Methods
Results
Reference | Design | Measure | Rater |
N
| Main outcomes |
---|---|---|---|---|---|
Landgraf and Abetz [41] | Case control | CHQ | Child | 56 ADHD, 278 healthy controls, 20 haemodialysis | Reliability and validity was reported as good. The QoL of the sample receiving haemodialysis treatment was poor compared to the healthy controls and patients with ADHD. The children with ADHD did not rate their QoL as different from that of healthy controls |
Landgraf et al. [42] | Case control | CHQ | Parent | The ADHD sample showed significantly lower QoL than the healthy children on the overall summary score and the psychosocial and family subscales | |
Graetz et al. [29] | Case control | CHQ | Parent | 248 ADHD, 113 inatt, 68 hyp/imp, 67 comb, 3,298 healthy controls | Compared with non-ADHD controls, all three ADHD-subtypes were rated as having lower QoL. Combined types were rated the most impaired on most subscales. Inattentive types were rated as more impaired that hyperactive-impulsive types on several scales |
Landgraf et al. [43] | Cross sectional psychometric validation | AIM | Parent | 81 ADHD | The scales exceeded standard criteria for item convergent and discriminant validity. No floor effects and minimal (2%) ceiling effects were observed. Cronbach alpha was 0.88 and 0.93 (Child and Home Scales), respectively. Statistically significant differences were observed on both home and child scales for ADHD inattentive versus ADHD combined with better ratings for inattentive children |
Sawyer et al. [75] | Case control (population sample) | CHQ | Parent | 308 ADHD, 53 MDD, 35 CD, 2,507 healthy controls | Children with ADHD had significantly worse QoL scores than children with no disorder across all domains. Differences remained after controlling for overlapping questions. Children with MDD were described as having more pain and discomfort and emotional problems than those with CD and ADHD. Children with CD and ADHD had greater behavioural problems than those with MDD |
Bastiaansen et al. [7] | Cross sectional study in clinically referred children with psychiatric disorder | PedsQL | Parent | 310 Referred children, ADHD 107 | Different child psychiatric disorders impact differently on QoL. Children with attention-deficit had a better emotional functioning score than children with anxiety disorders. Their academic performance was significantly lower than for children with anxiety disorders and other disorders. Psychiatric comorbidity did not influence overall QoL |
Klassen et al. [38] | Cross sectional | CHQ | Parent | 131 ADHD compared to norms | Children with ADHD had comparable physical health but clinically important deficits in all psychosocial QoL domains. Poorer psychosocial QoL was correlated with greater parent-reported ADHD symptoms. Children with ≥2 comorbid disorders had worse QoL than those with no comorbidity in most areas and from those with 1 comorbid disorder in 3 domains. Predictors of psychosocial health included the number of comorbid conditions and parent rated combined ADHD symptoms |
Matza et al. [45] | Baseline data from an RCT: ATX versus Placebo | CHQ | Parent | 297 ADHD | QoL scores were significantly lower than national norms and were negatively correlated with clinical measures |
Topolski et al. [82] | Cross sectional | YQOL-R | Young person | 55 ADHD, 52 mobility impairment, 107 healthy controls | The adolescents with ADHD reported significantly lower QoL scores than the healthy control group (particularly in the Self and Relationship domains) and similar scores to those from the group with mobility impairment (a group previously demonstrated to have reduced QoL) |
Bastiaansen et al. [8] | Longitudinal study in clinically referred children with psychiatric disorder | PedsQL | Parent | 126 Referred children, 48 ADHD | 38% of children showed neither symptom reduction nor QoL improvement, 33% of children showed both a clinically symptom reduction and QoL improvement. In 11% of all children, QoL improved while the level of psychopathology remained high and in 18% psychopathology improved while the level of QoL remained high |
Escobar et al. [26] | Case control | CHQ | Parent | 120 ADHD; 93 asthma; 120 healthy | Children with ADHD were rated worse than either asthmatic or healthy children for most Child Health Questionnaire domains. The greatest differences were found in behaviour, social limitations attributable to physical problems, emotional impact on parents, and family activities |
Matza et al. [46] | Cross sectional | CHQ, CHIP-CE, EQ-5D | Parent | 126 ADHD | EQ-5D scores were correlated with several domains of the CHQ-PF50 (e.g. Mental Health, Self-Esteem, Family Activities, Psychosocial Summary Score) the CHIP-CE (e.g. Satisfaction, Comfort, Academic Performance, Peer Relations) and the ADHD-RS scales |
Matza et al. [47] | Cross sectional | Standard gamble utility interviews | Parent | 43 ADHD | Comparisons between the various health states found the expected differences between untreated mild, moderate, and severe ADHD health states suggesting that parent standard gamble interviews are a feasible and useful method for obtaining utility in ADHD |
Newcorn et al. [52] | Baseline data from an RCT: ATX versus Placebo | CHQ | Parent | 293 ADHD 39% with ODD | Youths with ADHD and without comorbid ODD had reduced QoL compared to controls. QoL was lower in those with comorbid ODD |
Pongwilairat et al. [59] | Case control | PedsQL | Child, parent | 46 ADHD, 94 healthy children | Both the children with ADHD and their parents reported a significantly lower psychosocial QoL scores than controls and their parents. Children with ADHD also reported themselves to have a significantly low physical QoL score, despite being adjudged to be physically healthy |
Rentz et al. [64] | Baseline data from an RCT | CHQ | Parent | 921 ADHD | Internal consistency (Chronbach’s alpha) at baseline was 0.88 for the Psychosocial Summary Score, ranging from 0.53 to 0.91 for the subscale scores. Construct validity was supported. Scales were responsive to change |
Secnik et al. [76] | Cross sectional | EQ-5D, standard gamble utility interviews | Parent | 83 ADHD | Parents’ raw SG scores of their child’s current health state were significantly correlated with inattentive, hyperactive, and overall ADHD symptoms and the EQ-5D visual analogue scale |
Hampel and Desman [33] | Cross sectional | Kid-KINDL-R | Child | 48 ADHD compared to norms | All domains of quality of life were impaired among children and adolescents with ADHD compared to normative data |
Klassen et al. [39] | Cross sectional | CHQ | Child, parent | 58 ADHD | Compared with population norms, across most domains, children with ADHD reported comparable health. Children rated their QOL significantly better than their parents in four areas (behaviour, self-esteem, mental health and family cohesion), and significantly poorer for one (Physical Function). Correlations between children and parents were relatively low. Discrepancies between parent-child ratings were related to the presence of a comorbid oppositional/defiant disorder, a psychosocial stressor and increased ADHD symptoms |
Ralston et al. [61] | Cross sectional | CHIP-CE | Parent | 1,478 ADHD, medication naive | Significant impairments on all CHIP-CE domains; (satisfaction, comfort, resilience, risk avoidance and achievement |
Riley et al. [65] | Cross sectional | CHIP-CE | Parent | 1,477 ADHD, medication naive | Internal consistency reliability was good-to-excellent (Chronbach’s alpha >0.70) for all CHIP-CE domains and subdomains, with almost no ceiling and floor effects. Factor analysis was broadly supportive of the original structure with minor adjustments. CHIP-CE scales were moderate-to-highly correlated with measures of ADHD and family factors |
Riley et al. [68] | Cross sectional | CHIP-CE | Parent | 1,478 ADHD, medication naive | Factors significantly associated with a poorer QoL included; ADHD symptoms, conduct problems, peer relationship problems, having asthma, multiple other somatic symptoms, co-ordination problems, family factors (having a parent with a health or mental health problem possibly caused by the child’s illness, child not living with both parents and maternal smoking during pregnancy) |
Varni and Burwinkle [83] | Validation from cross sectional population sample | PedsQL | Child/young person, parent | 72 ADHD, 66 cancer, 57 cerebral palsy, 3,256 healthy controls | Good reliability for the total scale score (Chronbach’s alpha = 0.92 child self-report, 0.92 parent proxy-report). Distinguished between healthy children and children with ADHD. Children with ADHD self-reported severely impaired psychosocial functioning, comparable to children with newly diagnosed cancer and children with cerebral palsy |
Hakkaart-van Roijen et al. [32] | Case control | CHQ | Parent | 70 ADHD, 35 children with non-ADHD behaviour problems, 60 healthy controls | No significant differences between the groups on the physical summary score. ADHD patients scored significantly lower on the psychosocial summary score compared to children in the two other samples |
Prasad et al. [60] | Baseline data from a clinical trial ATX versus standard clinical treatment | CHIP-CE | Parent | 201 ADHD, 104 ATX, 97 standard clinical treatment | QoL was compromised at baseline on a summary score and satisfaction, resilience, risk avoidance and achievement domain scores |
Yang et al. [97] | Baseline data from a naturalistic treatment study: MPH versus no medication | CHQ | Parent | 119 MPH treated school-age children with ADHD, 129 healthy controls | The QoL of methylphenidate-treated children with ADHD was rated worse than that of the healthy children on the CHQ Psychosocial Summary Score and all of the CHQ psychosocial subscales |
Flapper et al. [28] | Case control followed by open label trial (MPH) | DUX-25, TACQOL | Child, parent | 23 ADHD + DCD, 23 healthy controls | Both child’s self- and parent proxy ratings demonstrated lower overall QoL with subscale scores demonstrating lower functioning in motor, autonomic, cognitive, and social domains |
Reference | Design | Measure | Rater |
N
| Duration | Main outcomes |
---|---|---|---|---|---|---|
Methylphenidate | ||||||
Yang et al. [97] | Naturalistic treatment (MPH vs. no medication) | CHQ | Parent | 119 MPH treated school-age children with ADHD, 129 healthy controls | NA | Improvement of ADHD core symptoms after medication treatment predicted higher psychosocial QoL |
Flapper et al. [28] | Case control followed by open label trial (MPH) | DUX-25, TACQOL | Child, parent | 23 ADHD + DCD, 23 healthy controls | 4 weeks | QoL scores improved in 18 children receiving MPH versus controls |
Mixed amphetamine salts | ||||||
Sallee et al. [71] | Open label (MAS XR) | PedsQL | Parent | 2,968 ADHD | 7 weeks | Mean PedsQL total score improved significantly from baseline to follow-up |
Wigal et al. [92] | RCT (MAS XR vs. ATX) | PedsQL | Parent | 203 ADHD; 102 MAS XR, 101 ATX | 3 weeks | Mixed amphetamine salts extended release and atomoxetine treatment both led to statistically significant improvements in QoL, but the difference between medication effects were only statistically significant for the school functioning subscale for which the improvement in the Mixed amphetamine salts extended release group was larger than that for the atomoxetine group |
Atomoxetine | ||||||
Matza et al. [45] | RCT (ATX vs. Placebo) | CHQ | Parent | 297 ADHD | 8 weeks | Improvement in clinical symptoms was associated with corresponding improvement in QoL |
Perwien et al. [57] | Post hoc analysis of three RCTs (ATX vs. placebo) | CHQ | Parent | 647 ADHD | 8 weeks × 2, 7 weeks × 1 | Children who received atomoxetine had significantly greater improvement in QoL than the placebo. There were no significant differences between once-a-day and twice-a-day dosing. Improvement in QoL was predicted by treatment with atomoxetine, lower QoL scores, no prior history of stimulant use, and absence of oppositional defiant disorder |
Newcorn et al. [52] | RCT (ATX vs. Placebo) | CHQ | Parent | 293 ADHD, 39% with ODD | 8 weeks | Youths with ADHD and comorbid ODD showed greater improvement in QoL on ATX than placebo. Treatment response was similar in youths with and without ODD, except that the comorbid group only improved at higher doses |
Brown et al. [15] | RCT (ATX vs. Placebo) | CHQ | Parent | 153 | 7 weeks | Parent reported QoL demonstrated a trend toward better response to ATX than to placebo |
Perwien et al. [58] | Open label trial; extension of RCTs (ATX) | CHQ | Parent | 912 ADHD, 312 completed long term trial and included in outcome analyses | 24 months | Significant improvements were observed on the psychosocial summary scale, and all psychosocial domains but not the physical health domains following acute treatment with atomoxetine. The improvements on the psychosocial summary scale were either maintained or slightly improved after 24 months of treatment |
Biederman et al. [13] | Post hoc meta-analysis of RCTs (ATX vs. Placebo) | CHQ | Parent | 510 ADHD | NA | ADHD subjects treated with ATX showed significant improvements from baseline compared to those on placebo on most of the CHQ measures irrespective of the comorbidity with ODD |
Cheng et al. [16] | Meta-regression analysis of RCTs (ATX vs. Placebo) | CHQ | Parent | 1828 ADHD | NA | Parent reported QoL improved with ATX treatment |
Prasad et al. [60] | Open label trial (ATX vs. standard clinical treatment) | CHIP-CE | Parent | 201 ADHD, 104 ATX, 97 standard clinical treatment | 10 weeks | QoL was compromised at baseline on a summary score, and improved during the 10-week study for both groups. Improvement in QoL was higher for patients treated with atomoxetine compared with standard clinical treatment at week 10 |
Wehmeier et al. [88] | Open label trial (ATX) | GIPD | Child, parent, physician | 262 ADHD | 24 weeks | It is questionable whether the GIPD is a true measure of QoL. Quality of life as reflected by the degree of perceived difficulties improved over time. Change in GIPD scores was greatest within the first 2 weeks. Children perceived the degree of difficulties as significantly less compared to parents and physicians. Agreement of ratings was highest between physicians and parents |
GW320659 | ||||||
DeVeaugh-Geiss et al. [20] | Open label dose titration (GW320659) | CHQ | Parent | 51 ADHD | 11 weeks | Significant improvements compared with baseline on 7 of the 12 subscales of the CHQ |