Table 2.
Treatment studies of quality of life in ADHD
| 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 |
CHQ Child Health Questionnaire, CHIP-CE Child Health Illness Profile-Child Edition, DUX-25 Dutch Child AZL TNO Quality of Life, GIPD Global Impression of Perceived Difficulties, PedsQL Pediatric Quality of Life Inventory, TACQOL TNO AZL Child Quality of Life, ADHD attention deficit hyperactivity disorder, inatt inattentive type, hyp/imp hyperactive/impulsive type, comb combined type, ODD oppositional defiant disorder, DCD developmental coordination disorder, ATX atomoxetine, MPH methylphenidate, MAS XR mixed amphetamine salts extended release