Background
Methods
Study design and procedures
Late afternoon/evening items (evening subscore) |
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Problems with homework/tasks |
Difficulty sitting through dinner |
Difficulty playing quietly in the afternoon/evening |
Inattentive and distractable in the afternoon/evening |
Difficulty transitioning |
Arguing or struggling in the afternoon/evening |
Difficulty settling at bedtime |
Difficulty falling asleep |
Early morning items (morning subscore)
|
Difficulty getting out of bed |
Difficulty getting ready |
Arguing or struggling in the morning |
Sample size and statistical analysis
Results
Patient population and disposition
Demographics | |
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Boys, N (%) | 338 (80.3) |
Girls, N (%) | 83 (19.7) |
Age [years], mean (± SD) | 11.1 (2.7) |
ADHD subtype, N (%)
| |
Combined | 278 (66.0) |
predominantly inattentive | 124 (29.5) |
predominantly hyperactive-impulsive | 6 (1.4) |
ADHD, not otherwise specified | 13 (3.1) |
Most frequent psychiatric comorbidities, N (%)
| |
Conduct disorder | 83 (19.7) |
Oppositional defiant disorder | 74 (17.6) |
Enuresis | 18 (4.3) |
Emotional disorder of childhood | 11 (2.6) |
Tic disorder | 10 (2.4) |
Depression | 6 (1.4) |
Depressed mood | 5 (1.2) |
Baseline disease characteristics, mean (± SD)
| |
ADHD-RS, total score | 32.6 (10.9) |
CGI-Severity (of ADHD) | 5.0 (0.8) |
WREMB-R, total score | 18.0 (7.0) |
GIPD, total score patient-rated | 13.1 (5.8) |
GIPD, total score parent-rated | 18.6 (6.1) |
GIPD, total score physician-rated | 20.3 (5.9) |
WREMB-R evening and morning subscores
Baseline (BL) | Week 2 | Week 8 | Week 24 | ||||||||
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N | Score | N | Score | Change | N | Score | Change | N | Score | Change | |
WREMB-R
| |||||||||||
Evening subscore (8 items) | 418 | 13.7 ± 5.24 | 419 | 8.0 ± 5.57 | -5.7 ± 5.43 | 419 | 7.1 ± 5.78 | -6.6 ± 6.14 | 419 | 8.0 ± 6.16 | -5.7 ± 6.30 |
Morning subscore (3 items) | 419 | 4.3 ± 2.49 | 418 | 2.4 ± 2.23 | -1.8 ± 2.53 | 419 | 2.1 ± 2.22 | -2.2 ± 2.84 | 419 | 2.3 ± 2.37 | -1.9 ± 2.83 |
GIPD
| |||||||||||
Difficulties in the morning | |||||||||||
patient-rated | 418 | 2.5 ± 1.60 | 418 | 2.0 ± 1.40 | -0.5 ± 1.74 | 419 | 1.9 ± 1.35 | -0.6 ± 1.80 | 419 | 1.9 ± 1.40 | -0.6 ± 1.68 |
parent-rateda | 418 | 3.4 ± 1.69 | 393 | 2.5 ± 1.44 | -0.9 ± 1.77 | 404 | 2.4 ± 1.55 | -1.0 ± 1.97 | 409 | 2.5 ± 1.62 | -0.9 ± 1.97 |
physician-rated | 419 | 3.6 ± 1.58 | 419 | 2.5 ± 1.33 | -1.1 ± 1.71 | 419 | 2.3 ± 1.45 | -1.3 ± 1.84 | 419 | 2.6 ± 1.57 | -1.1 ± 1.82 |
Difficulties during school | |||||||||||
patient-rated | 417 | 2.7 ± 1.65 | 417 | 2.1 ± 1.34 | -0.6 ± 1.66 | 418 | 2.1 ± 1.52 | -0.6 ± 1.93 | 418 | 2.2 ± 1.60 | -0.5 ± 2.04 |
parent-rateda | 415 | 3.6 ± 1.58 | 389 | 2.9 ± 1.48 | -0.8 ± 1.75 | 403 | 2.8 ± 1.61 | -0.9 ± 1.96 | 408 | 3.0 ± 1.73 | -0.7 ± 2.11 |
physician-rated | 416 | 4.0 ± 1.51 | 419 | 2.9 ± 1.40 | -1.1 ± 1.77 | 419 | 2.7 ± 1.60 | -1.3 ± 2.00 | 419 | 3.0 ± 1.75 | -1.0 ± 2.12 |
Difficulties during homework | |||||||||||
patient-rated | 416 | 2.7 ± 1.67 | 417 | 2.2 ± 1.51 | -0.5 ± 1.81 | 418 | 2.1 ± 1.50 | -0.6 ± 1.91 | 418 | 2.2 ± 1.59 | -0.5 ± 1.93 |
parent-rateda | 417 | 4.0 ± 1.65 | 390 | 3.1 ± 1.51 | -1.0 ± 1.67 | 403 | 3.0 ± 1.63 | -1.0 ± 1.97 | 408 | 3.0 ± 1.69 | -1.0 ± 2.03 |
physician-rated | 415 | 4.2 ± 1.56 | 418 | 3.0 ± 1.46 | -1.2 ± 1.72 | 419 | 2.9 ± 1.62 | -1.4 ± 1.91 | 419 | 3.0 ± 1.68 | -1.2 ± 1.99 |
Difficulties in the evening | |||||||||||
patient-rated | 418 | 2.5 ± 1.72 | 419 | 1.9 ± 1.26 | -0.6 ± 1.67 | 419 | 1.9 ± 1.32 | -0.6 ± 1.86 | 419 | 1.9 ± 1.34 | -0.6 ± 1.84 |
parent-rateda | 419 | 3.8 ± 1.60 | 394 | 2.8 ± 1.50 | -1.0 ± 1.66 | 404 | 2.6 ± 1.52 | -1.2 ± 1.79 | 409 | 2.7 ± 1.60 | -1.1 ± 1.87 |
physician-rated | 419 | 4.2 ± 1.47 | 419 | 2.8 ± 1.43 | -1.4 ± 1.56 | 419 | 2.6 ± 1.54 | -1.5 ± 1.82 | 419 | 2.9 ± 1.72 | -1.3 ± 1.85 |
GIPD scores at different times of the day, as perceived by patients, parents and physicians
Correlation of WREMB-R evening and morning subscores and the respective GIPD scores for the evening and morning items
Correlation with WREMB-R evening subscore | ||||||
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GIPD evening (patient-rated) | GIPD evening (parent-rated) | GIPD evening (physician-rated) | ||||
Week | N | Correlation | N | Correlation | N | Correlation |
0 | 416 | 0.321 [0.231–0.404] | 413 | 0.537 [0.464–0.602] | 414 | 0.695 [0.641–0.741] |
1 | 412 | 0.276 [0.184–0.363] | 401 | 0.625 [0.561–0.681] | 410 | 0.717 [0.665–0.760] |
2 | 397 | 0.337 [0.247–0.421] | 392 | 0.686 [0.630–0.735] | 399 | 0.790 [0.750–0.824] |
4 | 383 | 0.348 [0.257–0.433] | 382 | 0.672 [0.612–0.723] | 387 | 0.767 [0.722–0.805] |
6 | 365 | 0.398 [0.307–0.480] | 359 | 0.774 [0.728–0.812] | 368 | 0.790 [0.748–0.826] |
8 | 326 | 0.270 [0.166–0.368] | 324 | 0.731 [0.675–0.778] | 326 | 0.772 [0.723–0.812] |
12 | 314 | 0.177 [0.067–0.282] | 312 | 0.684 [0.619–0.738] | 317 | 0.707 [0.647–0.758] |
16 | 271 | 0.347 [0.237–0.447] | 268 | 0.683 [0.612–0.741] | 274 | 0.764 [0.709–0.809] |
24 | 259 | 0.336 [0.223–0.440] | 257 | 0.733 [0.670–0.784] | 261 | 0.767 [0.711–0.812] |
all visits pooled | 3143 | 0.351 [0.320–0.382] | 3108 | 0.708 [0.690–0.725] | 3156 | 0.790 [0.776–0.803] |
Correlation with WREMB-R morning subscore
| ||||||
GIPD morning (patient-rated)
|
GIPD morning (parent-rated)
|
GIPD morning (physician-rated)
| ||||
N
|
Correlation
|
N
|
Correlation
|
N
|
Correlation
| |
0 | 416 | 0.258 [0.166–0.346] | 413 | 0.612 [0.547–0.668] | 414 | 0.714 [0.663–0.758] |
1 | 411 | 0.442 [0.361–0.517] | 400 | 0.644 [0.582–0.698] | 409 | 0.727 [0.677–0.769] |
2 | 397 | 0.318 [0.226–0.403] | 392 | 0.699 [0.644–0.746] | 399 | 0.760 [0.714–0.798] |
4 | 383 | 0.311 [0.217–0.398] | 382 | 0.754 [0.706–0.794] | 387 | 0.742 [0.693–0.783] |
6 | 365 | 0.297 [0.200–0.388] | 359 | 0.738 [0.686–0.781] | 368 | 0.778 [0.734–0.815] |
8 | 326 | 0.331 [0.231–0.424] | 324 | 0.677 [0.612–0.731] | 326 | 0.776 [0.729–0.816] |
12 | 314 | 0.332 [0.229–0.426] | 312 | 0.734 [0.678–0.781] | 317 | 0.791 [0.746–0.829] |
16 | 271 | 0.361 [0.252–0.460] | 268 | 0.710 [0.645–0.764] | 274 | 0.779 [0.727–0.821] |
24 | 259 | 0.313 [0.198–0.418] | 257 | 0.734 [0.671–0.785] | 261 | 0.778 [0.725–0.822] |
all visits pooled | 3142 | 0.371 [0.341–0.401] | 3107 | 0.719 [0.701–0.735] | 3155 | 0.786 [0.772–0.799] |